In practice, three types of medical data need archival storage. The raw medical data can be ascertained directly from the patient. We here refer to X-ray, CT, MRI and so on. These are stored in Dicom PACS and multi-media databases. The derived medical data constitute the subsequent diagnosis and are likewise kept in multi-media RIS and HIS databases. Finally, the reconstructed medical data consist of computer generated models and will reside on a WWW server.
Storage of medical information is one of the most critical corner stones in telemedicine. All medical imaging data should be stored in Dicom 3.0 format in a picture archiving system referred to as PACS. The Digital Imaging and Communications in Medicine (DICOM) Standard has been developed to meet the needs of manufacturers and users of medical imaging equipment for interconnection of devices on standard networks. It is envisaged that the World Wide Web will be adopted as the accessibility medium and the Internet as the communication medium in the global telemedical information society, reason why there should be a WWW interface to the storage components.
The Dicom 3.0 standard includes the possibility of both expansion and updating whereas it also allows simplified development for all types of medical imaging. To find out whether two devices claiming conformance are able to exchange meaningful information Dicom should provide the answer. In the near future, this standard even will offer support for creation of files on removable media, for new data structures and extended hard copy print management.
Currently, there already are a number of software providers presenting WWW Dicom Interfaces. The procedure starts with the user running a WWW browser and specifying a URL on one of DICOM PACS Unix workstations. This URL refers to an HTML file containing a query form. Next, the user fills in the query form and submits the request via a CGI (Common Gateway Interface) program that executes on the DICOM PACS server. By means of the form field values, the program communicates with the archive via Dicom requests to determine the patients matching the search criteria. The user may now select a patient which in turn causes the studies for this patient to appear and finally choose a study retrieving thus the required images from the archive and having them displayed via the Web browser.
Detailed information about the Dicom 3.0 standard is reserved for you on a special web site. You can consult an extensive paper on the creation of the global telemedical information society edited by Euromed project manager Andrew Marsh in our section analysis . Finally, we refer those who are really addicted to telemedicine to the narcisus.esd.ece.ntua.gr/ (www/euromed.html ( Euromed ) site.