Cloud-based medical imaging system
Learn how we helped our client:
store medical images and other patient data in a centralized place
facilitate sharing of medical images among radiologists and clinicians
ensure secure and cost-effective medical image storage
relieve patients of needing to bring images to consultations
Business context
Our client is a midsized hospital network with facilities distributed across several US cities. The network has a hospital management system (HMS) with a custom electronic health record (EHR) module.
Here are the challenges our client encountered:
After diagnostic sessions, radiologists had to print images or burn them on DVDs and give them to patients. The biggest problem was that patients often lost medical images or forgot to bring them to consultations with their clinicians. Also, when patients visited doctors in another city, they usually didn’t have medical images with them.
Medical images were stored at each radiologist’s individual workstation, with no centralized access. Thus, the client’s compliance department had to maintain the security of each radiologist’s workstation within the whole hospital network instead of simply ensuring the security of the EHR module.
Within one complex diagnostic session, a patient goes through examinations on different medical equipment for a proper diagnosis. Before each examination, the radiologist needs to view images from the previous examination (such as an ultrasound). To view them, the network’s radiologists had to physically visit other radiology departments, as they couldn’t access these images directly at their workstations.
Our client needed to make medical images an integral part of patient information and establish secure access to them via the central EHR module. To provide this capability, Yalantis built a software solution for seamlessly transmitting medical images from medical equipment to the centralized EHR system.
Software product overview
We developed a multi-component software solution that ensures secure data exchange between all hospital network facilities and the cloud.
Our solution also optimizes storage costs, as the cloud EHR system doesn’t store physical medical images. It contains only links to images stored on the local servers of each radiology department.
Our solution consists of the following elements:
A new EHR system software component Including:
that coordinates the handling of medical images across all facilities within a hospital network
to ensure that medical images are protected and managed according to the overall access and data handling policies
that enables radiologists to review images during diagnostic sessions and add them to scan reports
that allow radiologists and clinicians to view DICOM images at their workstations together with other patient data in the EHR
Custom DICOM server software
Synchronized with the EHR module aggregates and pre-processes all medical images received from medical equipment and serves as the only secure medical image storage within each radiology department. We also provided the client’s IT department with detailed documentation to set up medical equipment to transfer images directly to the server of the corresponding radiology department in the hospital network.
Yalantis’ approach to development
Before embarking on the actual development process, we performed the following activities:
Overview of business challenges
We outlined key challenges to focus on such as decentralized medical image storage and difficulty of access to it.
Requirements elicitation
We elicited, analyzed, and prioritized our client’s requirements to identify core functionality and select the right technology stack.
Market research
We researched similar software solutions on the market to define their functional, customization, and integration capabilities.
Development of a deployment strategy
We thoroughly assessed the client’s current business condition to decide on a deployment strategy that would preserve the radiology department’s workflow.
Implementation options for the client
We offered the client two implementation options to choose from:
The client chose to build a custom software solution, as it could entirely cover their business requirements and easily integrate into the existing workflow.
To optimize the custom development process and reduce expenses, we relied on specialized ready-made frameworks and libraries. With their help, we avoided building certain small solution components from scratch. For instance, we used ready-made libraries for the DICOM viewer and for processing secure HL7 protocols.
Solution architecture
We built a high-level solution architecture to outline the technical realization of our solution based on the client’s business requirements. The architecture consists of the hospital infrastructure, cloud infrastructure, and a secure private network.
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Hospital infrastructure includes:
allowing clinicians to send patient data (patient ID, patient’s body orientation inside medical equipment, etc.) to medical equipment and the EHR system and view medical images
for printing medical images and burning them on DVDs for patients’ personal use
that stores medical images within a single radiology department
that clinicians can use as an alternative to their workstations to securely access patient data, including medical images
Hospital infrastructure
Cloud infrastructure consists of:
A media conversion service for transforming DICOM medical images to JPG and MP4 formats so they can be displayed on mobile devices, tablets, and laptops
An orchestrational DICOM service for identifying and retrieving medical images from the radiology department’s server
An API gateway and decision-making service for handling all data requests that defines on which device a clinician is making the request and in which format and through which protocol the clinician should receive the requested data
A conditional access service that enforces data access policies, ensuring that only authorized users get access to the patient’s health data
The central EHR system that contains patients’ records
An HL7 server to convert medical images to the secure HL7 format and securely transfer converted images to devices that can’t display DICOM images
Cloud infrastructure
Ensuring software security
To guarantee secure data exchange between hospitals and the cloud, we implemented a secure private network. It ensures that data is exchanged via secured TLS channels to prevent data compromise or interception.
To provide secure medical image storage, we ensured that:
each radiology department’s local DICOM server is the only place where medical images generated in this department are stored
the EHR system and the orchestrational DICOM service contain only links to the original images on the DICOM server
Our deployment strategy
To avoid interrupting hospital services, we deployed our software solution in three stages:
Medical equipment in this facility sends medical images to both the radiologist’s workstation and the new DICOM server.
Medical equipment in one facility sends images only to the DICOM server in that facility, and clinicians can access images only via the new EHR component.
The new solution is implemented across all facilities within the client’s hospital network.
Project results
Before
A radiologist’s workstation stored all medical images generated during diagnostic sessions.
Patients could receive medical images only as hard copies or DVDs.
Clinicians expected patients to bring copies of medical images to every consultation.
The hospital’s compliance department had to regulate the storage of images and access to them with time-consuming security measures.
After
Medical equipment transfers medical images in DICOM format directly to the server, not to the radiologist’s workstation. Now, the radiologist uses their workstation only to send, access, and view patients’ medical images.
Patients don’t have to bring medical images to consultations. Any authorized clinician across all hospital facilities can view a patient’s images along with other health data in the EHR module.
The radiologist can still print images or burn them on a DVD at the patient’s request. But now, the radiologist also always adds medical images to the scan report and sends them to the EHR system.