Overcoming remote image reading challenges

Imagine sitting on a beach reading an X-ray …

This is the line that almost every medical imaging provider has been saying to radiologists for years. Yet, even today, dimly lit reading rooms with radiologists tethered to dedicated workstations are the norm.

The reason? Aside from the fact you could barely see a picture on a monitor with the sun shining down on the screen, there are still challenges that make reading from home difficult.

Hardware, bandwidth, and security issues impact remote reading

The three primary challenges to remote reading are security, network, and hardware requirements. Traditional PACS clients require powerful workstations and graphics cards to drive the image processing and rendering. This is true for normal computed radiography (CR) as well as advanced viewing like maximum intensity projection/multi-planar reformation (MIP/MPR) and fusion.

So, facilities either have to invest in additional reading workstations for their radiologists to read from home or, more likely, the radiologists themselves purchase their own hardware to avoid driving into the hospital when on call. Maintaining these offsite systems is also a challenge.

In the past, network bandwidth has been an issue when you are dealing with the data-intensive radiology images. With the increased availability of reliable high-speed internet, this is less of an obstacle than it used to be, although it can still be an issue in rural areas.

However, even with high-speed internet, traditional PACS workstations still need to download and cache all images the radiologist wants to review, including priors. Plus, if the radiologist needs to view an unexpected imaging study, he or she will have to download it in real-time, which means sitting and waiting.

Meanwhile, ensuring the security and control of protected health information (PHI) continues to be a focus and challenge in healthcare — one where the industry has publicly struggled. Transferring patient images and information from the healthcare facility and storing them on remote/home workstations is a huge security risk.

And there are many questions.

Is the data encrypted during transfer with a VPN? Is the data deleted from the local workstations when not needed? Are updates being applied to the local workstations?

All these things can lead to data leaks that could have serious consequences.

The right universal viewer is the answer

The best way to mitigate these issues is with a zero-footprint, secure, web-based viewing platform. By allowing a user to view images within a web browser without the need for Active-X or other plug-ins, you can view images on any hardware – even mobile devices – depending on the exam and permitted regulations.

And, using server-side rendering, all the computation is done on the server. That means even advanced tasks like 3D rendering, fusion, and vessel analysis can be completed without need for graphics cards or expensive machines. Because the images are securely streamed to the device using standard, web-based secure sockets layer (SSL) encryption, images are never saved on the local device.

It works almost like Netflix for your entire medical imaging library.

By moving everything into a web environment and doing all the heavy lifting on the server side, radiologists have the freedom to view images without worrying about what hardware they have, managing the security of the image locally, or even wondering about network bandwidth. You still may not be able to read an X-ray on the beach in the sun, but you might be able to do it under a good umbrella.

I’ll be sharing much more about remote image interpretation during a special educational session at SIIM 2019. I hope to see you there.

Also, feel free to drop by our SIIM 2019 booth # 501/503!

Michael Joslin

Michael Joslin

Michael Joslin is a solution engineer for Hyland Healthcare.

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