New DICOM extensions for softcopy and hardcopy display consistency.

The DICOM standard defines in detail how medical images can be communicated. However, the rules on how to interpret the parameters contained in a DICOM image which deal with the image presentation were either lacking or not well defined. As a result, the same image frequently looks different when displayed on different workstations or printed on a film from various printers. Three new DICOM extensions attempt to close this gap by defining a comprehensive model for the display of images on softcopy and hardcopy devices: Grayscale Standard Display Function, Grayscale Softcopy Presentation State and Presentation Look Up Table.

All you need to know about a PACS RFP, you learned in kindergarten.

Key to purchasing any picture archiving and communications system (PACS) is the generation of a request for proposal (RFP), which defines the system's requirements. An RFP is not difficult to create and, in fact, one can follow simple rules such as outlined in Robert Fulghum's book, All I Really Need to Know, I Learned in Kindergarten. "Take time to look" is the first rule--don't jump into new adventures. Instead, start with a mission statement and clear objectives. Define the stakeholders and assemble the team. "Share everything" is the second rule to follow. This includes information, objectives and definitions of the problem. You'll want to define your specifications. What are the component requirements? How will you integrate information systems at your facility? What about performance--how is it defined and what is expected? Warm cookies and cold milk--or common sense--is another rule, particularly around issues that may seem obvious such as training and service. Who is going to do it, and what is required? "Watch out for traffic and hold hands." This rule, as applied to PACS and an RFP, means stick together. Create a partnership with your vendors. Talk to as many vendors and other users as possible. Last, "be aware of wonder." Fulghum's Rule, as applied here, means performance will speak for itself, particularly when there is significant improvement in the service you provide to your users.

DICOM versus HL7 for modality interfacing.

Digital modalities such as CT, MRI, Ultrasound and Computerized Radiography systems, generating softcopy images to be used by a Picture Archiving and Communication System (PACS), need to identify the images properly in order to retrieve and manage them. In many cases, a technologist re-enters patient demographic and study related information at the modality, even although it is usually already present somewhere in the hospital information system (IS). In order to achieve a higher level of efficiency and uniquely identify the created image objects, it is obvious that an interface between the IS and modality to exchange this information is highly desired. There are two options for a modality vendor to implement an IS interface, either using the Health Level (HL7) or Digital Imaging Communication in Medicine (DICOM) communication standard. This paper will explain characteristics of both protocols, and demonstrate that it is preferred to use DICOM versus HL7. In addition, it will show that DICOM is supported by most modality vendors, based on the result of a poll of their Modality Worklist versus HL7 support.