The first standard for transmitting medical images, ACR/NEMA 300, was built in the early ‘80s. DICOM was introduced in ‘93 and has been regularly updated since. Does accessing patient imaging in your organization feel like a history lesson?

Cloud platform technologies improve security, lower the cost of data management & enable future use cases. Has your organization looked to the cloud to help your imaging strategy yet? In this blog, Eastwall walks through some of the modern DICOM functionality available today.


Growing Clinical Data & New Capabilities in the Cloud

The medical imaging industry has grown exponentially—over the last two and a half decades, there has been a significant development in image acquisition solutions, which have boosted image quality and adoption in different clinical applications. Healthcare is projected to deliver the greatest industry-specific CAGR of 36 percent out to 2025 (Global healthcare data is forecasted to reach 2.3 zettabytes in this coming year alone) and medical imaging data represents approximately 80 – 90 percent of that growth.

While the data is growing, provider and vendor management capabilities for solutions with storage, compute, support, and system upgrades are having a difficult time keeping up. Interoperability of on-premises systems with other clinical data solutions, combined with increasing workloads within imaging departments, creates a struggle to achieve desired outcomes.  Vendor technology lock-in, IT change management, datacenter growth restrictions, project planning and purchasing delays are additional contributing factors. Bringing health data into the cloud creates various challenges such as security sign-off, privacy concerns, cloud vendor competition and staff knowledge/education & training.   

Microsoft: The Modern Solution

Microsoft’s managed platform service within Azure Health Data Services  ingests and persists DICOM objects at thousands of images per second and can combine clinical, imaging, and MedTech data in the cloud using global interoperability standards like FHIR and DICOM. The DICOM service within AHDS allows standards-based communication with any DICOMweb™ enabled systems.  The service can integrate imaging metadata with clinical data in FHIR while maintaining unified storage and cloud platform capabilities within healthcare systems. Backed by robust PHI compliance measures, it includes features such as:

  • Extended Query Tags: Additionally index DICOM studies, series, and instances on both standard and private DICOM tags by expanding list of tags that are already specified within DICOM Conformance Statement.

  • Change Feed: Access ordered, guaranteed, immutable, read-only logs of all the changes that occur in DICOM service. Client applications can read these logs at any time independently, in parallel and at their own pace.

  • DICOMcast: Via DICOMcast, DICOM service can inject DICOM metadata into a FHIR service, or FHIR server, as an imaging study resource allowing a single source of truth for both clinical data and imaging metadata.

  • Scalability: DICOM service is designed out-of-the-box to support different workload levels at a hospital, region, country and global scale without sacrificing any performance spec by using autoscaling features.

  • Role-based access: You control your data. Role-based access control (RBAC) enables you to manage how your data is stored and accessed. Providing increased security and reducing administrative workload, you determine who has access to the datasets you create, based on role definitions you create for your environment.

Bringing DICOM data together with Fast Healthcare Interoperability Resources (FHIR®) based clinical data in a well-architected cloud platform is a game changer.  A properly implemented & connected architecture is critical for organizing, storing and accessing DICOM data.  Cloud platform technologies improve security, lower the cost of data management, and enable future use cases such as machine learning and advanced analytics.  Health systems should have the right tools to bring data in, normalize in-flight, and enrich with other data sources.

Cloud-based Clinical Differentiators

The differentiator in bringing DICOM & FHIR data into the cloud is a centralized ecosystem. No other organization, tool, service or provider has a single-stop shop for all things DICOM. Consider the applications of a modern PHI data estate in the cloud:

  • Decentralized Clinical Trials (DCTs): Clinical trials are critical to new developments and life-saving breakthrough therapies. Microsoft cloud adds tools, capabilities, and security that enable trust and protection for patients. DCTs have the potential to reach more people, gather more meaningful insights and improve health equity across large geographic and socioeconomic areas

  • Correlate clinical context: Medical images usually are devoid of supplemental diagnosis, treatment or causality information. Microsoft’s platform allows for the enrichment of metadata associated with DICOM images, integrating these critical clinical data points into DICOM data. Key patient information, linked via FHIR, enhances the longitudinal patient view.

  • Programmatic anonymization of PHI data for secondary use: Remove sensitive PHI data to enable machine learning, building sensible cohorts for larger cross-facility studies and insights. Expand use-cases for data beyond patient-centric clinical use, opening up opportunities in pharmaceutical, genetic, research & development and academic areas.

  • Interoperation with third parties & clinical software: Microsoft’s platform is underpinned by the FHIR and HL7 standard, without any vendor lock-in. Ensure that your patient data estate easily operates with other software on-premise, self-hosted in the cloud & external SaaS products.

These benefits are not inclusive of the standard information technology & operational benefits of cloud - increased reporting & analytics capabilities, robust security ecosystems and standards on which other applications are built & operated. Working with a trusted partner is key. Eastwall has worked with dozens of leading organizations to prioritize data initiatives, gather requirements and build data estates that fit cloud-native use cases. Our ex-industry team brings decades of healthcare-centric knowledge into our architecture & technology design practices. We help design, build, and operate innovative cloud solutions on the Azure platform. Please contact us for a free consultation on how various Azure cloud services can help transform your business. Eastwall has a proven Data Modernization methodology and Healthcare Integration QuickStart offering that can help your business navigate the challenges of modern DICOM management.

tagList [azure, data, healthcare]

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