Standards efforts aim to improve ability to exchange images

Current work on standards aims to facilitate the exchange of images, or better integrate diagnostic patient views with other clinical systems.

While much progress has been made on the separate fields of data exchange standards and image standards, more attention is turning to enabling the integration of images into electronic medical records, as well as their increased accessibility from other clinical systems.

Several presenters at the annual conference of the Society for Imaging Informatics in Medicine highlighted progress being made in imaging exchange this year through several organizations promoting relevant standards.

For example, work is continuing to use the Fast Healthcare Interoperability Resources (FHIR) standard and various DICOM protocols to bring both radiology data and images into patients’ electronic health records, said Brad Genereaux, medical imaging alliance manager for NVIDIA, who is active in both HL7 and DICOM.

Genereaux said both FHIR and DICOMweb enable use of the Internet to exchange clinical information and function as complementary services. Both will increasingly be used together in imaging workflows, facilitating patient encounters, from the start of the visit to the delivery of the radiologist’s report.



The result of the use of both sets of standards will enable clinicians to see thumbnail images, or have access to imaging studies, in the bodies of reports included in patients’ records.

Genereaux also said efforts are underway through JSON data exchange formats to enable the communication of artificial intelligence findings within clinicians’ workflows. He also highlighted work being done on FHIRcast, which is intended to synchronize healthcare applications in real time to show the same clinical content to a common user. For example, a radiologist often works in three disparate applications at the same time (a radiology information system, a PACS and a dictation system), and FHIRcast would help by having the three systems display the same study or patient at the same time.

Integrating the Healthcare Enterprise (IHE) also is ramping up efforts to enable image and data exchange within records systems, said Kinson Ho, a member of the radiology domain and planning committee for IHE and solution architect for Change Healthcare. IHE is addressing the challenge of pulling images from the cloud and getting them “the last mile,” to the clinician who’s requested them. It’s looking to develop a standardized “importer” that serves as the intervening technology to achieve this.

For its part, DICOM—through some of its 32 workgroups—is looking to add supplements to its overarching standard for image exchange, said Kevin O'Donnell, a member of DICOM Standards Committee. Included in its efforts are initiatives to address security concerns and ways to better manage 3D image files in PACS systems.