Arnon Makori MD, Presenter: Medical Advisory Board, Carestream Health, Inc

Roni Zaharia, Abstract Co-Author: Consultant, RZ Software Services

Our novel solution can help many medical organizations confronted with the difficult task of securely connecting External Imaging Providers to their PACS, and improve patient care.

External Imaging Providers (EIP) in 150 sites perform 500K imaging studies for our HMO per year in addition to over 4M performed internally in 50 centers and 12 hospitals.IT Security policy doesn’t allow EIP to access our internal network.While DICOM is the used for Medical Imaging, Enterprise File Sharing (EFS) gains popularity for delivering other digital documents within and across enterprise boundaries.We’ve combined EFS and DICOM to create image-sharing solution with our EIP so that all external studies can be stored in our PACS.  

An appliance in the EIP site (EIPA) encapsulates a DICOM Storage SCP and a EFS Client Software. Modalities sends the studies performed for our HMO to the EIPA using DICOM. The EIPA publishes the studies securely using the EFS client. The EFS server is installed in our DMZ. Antivirus scanner checks every uploaded file. Another EFS client pulls the files into our network.Once inside our network, the content of every DICOM file is validated for correctness of demographic information, key elements (e.g. Accession Number, Study ID) and other DICOM tags required by our PACS. Once validated, the studies are sent to the PACS using DICOM protocol. Every EIPA sends a ‘heartbeat’ file periodically. The heartbeats are monitored and an alert is raised when not received on time. The heartbeat file contains a list of DICOM files stored on the EIPA. A reconciliation process compares the list from the EIPA with the list of files that arrived to the EFS Server.  

Our  solution combines Modern File Sharing Technology and DICOM Protocol, eliminating the need for manual import of external studies into our PACS.The solution successfully passed evaluation phase where it processed hundreds of studies per day. Major Advantages: Eliminate cumbersome VPN configuration; automatic; Scalable; Secure; EFS agnostic - other products including consumer services, Google Drive, DropBox, etc. can be utilized. Note: encryption of the DICOM files may be required when using consumer online file sharing.    

Makori, A, Zaharia, R, A Novel Solution for a Secure Image Sharing Solution Using Enterprise Online File Sharing.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045546.html