PubMed · 10119089
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J R Pinkert, L L Wear. 1992. Computer instructions and the control unit.. https://pubmed.ncbi.nlm.nih.gov/10119089/
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Modern Web browsers support image distribution with two shortcomings: (1) image grayscale presentation at client workstations is often sub-optimal and generally inconsistent with the presentation state on diagnostic workstations and (2) an Electronic Patient Record (EPR) application usually cannot directly access images with an integrated viewer. We have modified our EPR and our Web-based image-distribution system to allow access to images from within the EPR. In addition, at the client workstation, a grayscale transformation is performed that consists of two components: a client-display-specific component based on the characteristic display function of the class of display system, and a modality-specific transformation that is downloaded with every image. The described techniques have been implemented in our institution and currently support enterprise-wide clinical image distribution. The effectiveness of the techniques is reviewed.
Utilizing thin client software and open source server technology, a collaborative architecture was implemented allowing for sharing of Digital Imaging and Communications in Medicine (DICOM) and non-DICOM images with real-time markup. Using the Web browser as a thin client integrated with standards-based components, such as DHTML (dynamic hypertext markup language), JavaScript, and Java, collaboration was achieved through a Web server/proxy server combination utilizing Java Servlets and Java Server Pages. A typical collaborative session involved the driver, who directed the navigation of the other collaborators, the passengers, and provided collaborative markups of medical and nonmedical images. The majority of processing was performed on the server side, allowing for the client to remain thin and more accessible.
A frequently cited reason for not using commercial off-the-shelf (COTS) hardware in picture archiving and communications systems (PACS) is lack of capacity, reliability, and scalability. This report describes the evaluation the scalability of COTS hardware in a clinical PACS by migrating from an active server-passive backup server environment to an active-active cluster server arrangement.