Halamka: DICOM = A non-standard standard
John D. Halamka, MD, CIO of Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School in Boston, seems to be taking a bit of flak for a recent assertion dubbing DICOM a "non-standard standard."

“DICOM is a great standard that has unified many processes within organizations, linking radiology modalities and PACS,” Halamka wrote in his blog.

However, he added that additional work is needed.

This observation stems the Halamka’s firsthand experience, not as a CIO—but as the family member of an imaging patient.

When his wife’s mammogram at a local hospital triggered the need for additional follow-up work, the couple decided BIDMC was ideally positioned.

Transferring the imaging data from point A to point B, however, illustrated Halamka’s point.

“We asked for the images to be transmitted to BIDMC and we were told that we needed to visit the radiology department Monday-Friday 9am-5pm for a CD to be created so that Kathy could drive it 20 miles to BIDMC. The CD contained a proprietary viewer that required Windows and hence was not visible on our home computers (all Mac OSX).”

Halamka presented an ideal scenario as contrast to the status quo. With a true standard:
  • An implementation guide for DICOM would specify required vendor neutral content—a basic set of metadata that would work with any viewer. Any vendor-specific/proprietary metadata would be stored separately from the required basic content, so that extensions do not impact generic viewers.
  • DICOM would combine content and transport in a single standard to drive an open ecosystem of image sharing among healthcare providers.
  • EHRs with vendor-neutral DICOM viewers should be able to incorporate DICOM content sent via Direct into patient records.

This vision will help drive the agenda for the Healthcare IT Standards Committee from April to June, Halamka concluded in his blog, Life as a Healthcare CIO.