Images within the Electronic Health Record

Cross-Enterprise Document Sharing for Imaging (XDS-I) lays the basic framework for deploying medical images in the Electronic Health Record (EHR). During deployment efforts in many countries, a main challenge has arisen from the need to compare old images with current ones. Presently, most medical imaging applications are part of a broader system known as Picture Archiving and Communication System (PACS); they visualize and process images that they manage and archive; they need to import images for visualization which leads to a problem related to persistency management and information consistency. A solution consisting in avoiding image import is achievable with image streaming. In this paper we describe how XDS-I can be used in conjunction with Web Access to DICOM Persistent Objects (WADO) and DICOM transfer syntax for JPEG 2000 Interactive Protocol (JPIP) to enable streaming of medical images directly from EHR connected imaging sources to image processing workstations.