In the past few decades advances in healthcare have emerged, as new forms of technological integration are implemented as part of the overall healthcare management system. Healthcare providers, doctors and patients require more technological integration into the system providing real time data analysis and the possibility of enhancing medical knowledge. Sharing that knowledge can lead to what many describe as "digital medicine" where stored clinical data can generate medical knowledge which can be widely distributed, incorporated into decision support systems, and lead to more effective medical practices (Bouler & Morgenstern, 2005). Digital medical image processing within the healthcare area has its origins in the 1970's when computed tomography was introduced as the first digital modality. In the decades that followed, advances in digital medical imaging technology have dramatically affected the planning and design of diagnostic interventional radiology facilities. Soon after the advent of computerized tomography scanners in the late 1980's, it became apparent that a method of storage and transmission of radiographic and other images more efficient than the traditional X-ray file room were needed (Bouler & Morgenstern, 2005).
Introduction into Healthcare
Digital imaging was introduced into the healthcare field shortly after its origin. In an effort to develop a standard means by which users of different digital medical imaging equipment, for example, computerized tomography, MRI and DSA, could interface display or other devices to these machines, the American College of Radiology (ACR) and the National Electrical Manufacturers Association (NEMA) formed a joint committee in 1983. In 1985 the standard Version 1.0 was published, and Version 2.0 was published shortly after in 1988 by both the ACR and the NEMA's efforts. The final digital imaging exchange standard created by these associations was called DIACOM, introduced in 1993. The DIACOM standard developed creating an open platform for the communication of medical images, and facilitated the exchange and processing of vendor independent medical images in digital form. Image acquisition devices, image archives, hardcopy devices and imaging workstations from different vendors can be connected into a common information infrastructure and integrated with other information systems such as the Hospital Information System or Radiology Information System (Inrajit et.al., 2003).
The DIACOM standard achieved this by creating a DIACOM image that consisted of a list of data attributes of image related information including patient identification data, device parameters, radiation dose, contrast media and image resolution and windowing. Since it's introduction within healthcare, DIACOM is also used on other image related medical fields, such as pathology, endoscopy, dentistry, ophthalmology and dermatology. At the time of it's introduction into healthcare, DIACOM also offered network services that were based on the client/server concept.
Impact on Healthcare
Digital medical imaging has several impacts on current healthcare services. Today, DIACOM is the ubiquitous standard in radiology and imaging industry for the exchange and management of images and image related information (Inrajit et.al., 2003). Currently, in addition to the most basic DIACOM service, image transmission, a number of advanced services also exist. There is a DIACOM image archive service that allows images to be searched in a Picture Archiving and Communication System (PACS) by certain patient information, such as date the images were created and modality. These pictures are downloadable from the archive. DIACOM also offers a print service that allows for access to laser cameras or printers over a network so that multiple modalities and workstations can share printers. Another advanced service is a DIACOM modality worklist service that facilitates an automatically downloadable up-to-date worklist that includes the patient demographic data from the information system to the modality.
Pros and Cons
As with any new technology, there are several pros and cons of digital medical imaging. The main advantage of image management is the convenience, because all DSA derived images are available for all specialists at any computer, manifestly facilitating the delivery of quality healthcare. Additionally, these images can be accessed at any time for reexamination or for closer examination. The speed of image transmission and image retrieval is supported by a fast network, and these images can be used for training and presentation. In times where speed of the care is a factor between life and death or the prevention of further damage, the speed, accuracy and medical knowledge available as…