As DICOM-compliant devices proliferate across a healthcare information system, their installation and monitoring becomes problematic for PACS administrators. In many cases, these devices are located outside the radiology department, and in some cases, are dispersed beyond the physical boundaries of the administrator’s institution.
Adding to the management complexity, DICOM devices often require time-consuming, multi-vendor coordination and require a complex network of inter-dependency among the technologies, according to Harshad N. Puppalwar, a solutions architect and domain specialist at CitiusTech, a Sarasota, Fla.-based healthcare technology and business-process services provider.
“The increasing emphasis on interoperability of healthcare information networks is making this very challenging,” he said during a scientific session presentation at the 2008 Society for Imaging Informatics in Medicine (SIIM) conference in Seattle. Puppalwar discussed an approach to efficiently discover, monitor and map DICOM-compliant devices on a network via the creation of a DICOM asset manager (DAM).
The solution Puppalwar proposed collects data from currently available technologies and healthcare standards to achieve its goals. For example, he said, automated device discovery can be accomplished using a combination of dynamic host configuration protocol (DHCP), domain name system (DNS), lightweight directory access protocol (LDAP), and simple network management protocol (SNMP) services.
Once a DICOM device has been discovered on a network by using these services, monitoring it can be performed by using a standard DICOM Echo command, Puppalwar said.
“In case of a failure to respond to this command, alerts can be provided to flag and indicate the nature of the malfunction,” he observed. “Additionally, alerts can be generated for systems which have stopped responding or have malfunctioned. These alerts can go a long way in providing first-line inputs for DICOM-level breakdowns.”
Once DICOM-compliant device configurations are established, a dependency map can be created to provide administrators with a visual representation of the entire DICOM network, Puppalwar said.
“The basic information for application dependency mapping exists in all configuration files, routing tables, and port allocation tables, as well as all information that the different infrastructure components supporting the application use to function at runtime,” he noted.
Puppalwar outlined five components he and his team identified as necessary for a successful DAM tool:
1. A user interface that allows an administrator to interact with devices, configure settings and view error logs;
2. A web-based application, which permits the tool to be accessed from multiple locations;
3. An SNMP monitor that acts as a real-time monitoring device;
4. A mapping engine that provides real-time information of the connected devices in a DICOM network; and
5. An SNMP server that monitors the transactions among systems in the network.
According to Puppalwar, such an approach can significantly enhance the ability of PACS administrators to better understand the operational deployment of DICOM devices on a network; control the impact application changes have on its infrastructure; and discover security-related vulnerabilities and potential threats.
“If you don’t track your assets, you cannot effectively manage them,” he noted.
He and his team believe their schema can be extended over time to provide additional functionalities such as periodic, automated reports on network status; rule-based failover configuration to circumvent failures from affecting workflow; and auditing information for regulatory compliance.
Although the tool proposed by Puppalwar addresses DICOM-compliant devices, he envisions one day broadening the scope of the application to discover, monitor and map non-imaging medical devices that can be attached to a healthcare information system, such as patient monitors and contrast injectors.