A place for open source in PACS
Open source tools have helped promote DICOM standards from early on in relation to PACS use. The tools – which can be used as fully implemented production software – can also be useful for teaching as well as ways to measure performance, said Ron Sweeney, engineer 3, Spectrum Health, Technology and Information Solutions of Grand Rapids, Mich., at the Open Source PACS Tools session today at the Society for Imaging Informatics in Medicine (formerly SCAR) annual meeting in Austin, Texas.
Of course, open source is a big deal these days. It’s a major buzz word in the tech world, and even PRI (Public Radio International) has taken the name for one of its programs. Many open source tools are in existence, but as of yet many of them are not being used in medical settings because they have not been documented for use in “PACS trenches,” said Sweeney.
One of the key uses of open source is as a “packet sniffer” that is able to monitor a network’s traffic. One of these tools is called Ethereal which has the core function of evaluating DICOM information. Ethereal was originally developed by Gerald Combs in 1997, but as is the nature of open source, it has since been modified by various others. Ethereal is able to identify erroneous data packets, protocol errors, and information can be used to evaluate and highlight “pinpoint bottlenecks” so that a network continues to run as efficiently as possible so that data transmission is not interrupted, said Sweeney.
This application, like all open source tools, can be customized to fit your particular PACS environment. Also, various filters within the system can help to zero in on the specific information you are trying to find so that you can effectively inspect the data. Ethereal also allows PACS administrators to look at “network traffic in time-sequence fashion,” said Sweeney.
Other open source tools he highlighted included Ruby on Rails and Nagios. Rails is a framework that is “full-stack” and can be used to develop database-backed applications to help developers more speedily develop applications. One example Sweeney provided was PACSTrak that is used for tracking activity related to PACS, such as changes, conformance statements, and how devices are interrelating, he said.
Nagio can help monitor the performance of PACS and identify systems problems well before an administrator is aware of them. The application does checks on certain system components at intervals determine chosen by the administrator and reports back.
Overall, the open nature of all of these apps provides that they can be adjusted situation to situation so that they can be greatly beneficial to any facility, Sweeney said.

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