Skip to main content
SpringerLink
Log in

Building Blocks for a Clinical Imaging Informatics Environment

  • Published:
Journal of Digital Imaging Aims and scope Submit manuscript

Abstract

Over the past 20 years, imaging informatics has been driven by the widespread adoption of radiology information and picture archiving and communication and speech recognition systems. These three clinical information systems are commonplace and are intuitive to most radiologists as they replicate familiar paper and film workflow. So what is next? There is a surge of innovation in imaging informatics around advanced workflow, search, electronic medical record aggregation, dashboarding, and analytics tools for quality measures (Nance et al., AJR Am J Roentgenol 200:1064–1070, 2013). The challenge lies in not having to rebuild the technological wheel for each of these new applications but instead attempt to share common components through open standards and modern development techniques. The next generation of applications will be built with moving parts that work together to satisfy advanced use cases without replicating databases and without requiring fragile, intense synchronization from clinical systems. The purpose of this paper is to identify building blocks that can position a practice to be able to quickly innovate when addressing clinical, educational, and research-related problems. This paper is the result of identifying common components in the construction of over two dozen clinical informatics projects developed at the University of Maryland Radiology Informatics Research Laboratory. The systems outlined are intended as a mere foundation rather than an exhaustive list of possible extensions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Nance Jr, JW, Meenan C, Nagy PG: The future of the radiology information system. AJR Am J Roentgenol 200(5):1064–1070, 2013. doi:10.2214/AJR.12.10326

    Article  PubMed  Google Scholar 

  2. OpenLDAP, Main Page. Available at: http://www.openldap.org/. Accessed August 23, 2010.

  3. Using ADSI, LDAP, and Network Management Functions With Active Directory. Available at: http://msdn.microsoft.com/en-us/library/ms806997.aspx. Accessed September 26, 2010.

  4. Download CAS Server | Jasig Community. Available at: http://www.jasig.org/cas/download. Accessed September 26, 2010.

  5. Liu BJ, Zhou Z, Huang HK: A HIPAA-compliant architecture for securing clinical images. J Digit Imaging 19(2):172–180, 2006. doi:10.1007/s10278-005-9248-5

    Article  PubMed Central  PubMed  Google Scholar 

  6. Gregg B, D'Agostino H, Toledo EG: Creating an IHE ATNA-based audit repository. J Digit Imaging 19(4):307–315, 2006. doi:10.1007/s10278-006-0927-7

    Article  PubMed Central  PubMed  Google Scholar 

  7. ATNA FAQ - IHE Wiki. Available at: http://wiki.ihe.net/index.php?title=ATNA_FAQ. Accessed August 23, 2010.

  8. Boyd AD, Hosner C, Hunscher DA, Athey BD, Clauw DJ, Green LA: An “Honest Broker” mechanism to maintain privacy for patient care and academic medical research. Int J Med Inform 76(5–6):407–411, 2007. doi:10.1016/j.ijmedinf.2006.09.004

    Article  PubMed  Google Scholar 

  9. Silvey SA, Schulte J, Smaltz DH, Kamal J. Honest broker protocol streamlines research access to data while safeguarding patient privacy. AMIA Annu Symp Proc. 2008:1133

  10. Boyd AD, Hunscher DA, Kramer AJ, et al. The “Honest Broker” method of integrating interdisciplinary research data. AMIA Annu Symp Proc. 2005:902.

  11. Boyd AD, Saxman PR, Hunscher DA, et al: The University of Michigan Honest Broker: a Web-based service for clinical and translational research and practice. J Am Med Inform Assoc 16(6):784–91, 2009. doi:10.1197/jamia.M2985

    Article  PubMed Central  PubMed  Google Scholar 

  12. Liu J, Erdal S, Silvey SA, et al: Toward a fully de-identified biomedical information warehouse. AMIA Annu Symp Proc. 2009:370–374, 2009

    PubMed Central  PubMed  Google Scholar 

  13. Webreach I. Mirth. Webreach, Inc Available at: http://www.mirthproject.org/. Accessed May 06, 2012.

  14. Rubin DL, Desser TS: A data warehouse for integrating radiologic and pathologic data. J Am Coll Radiol 5(3):210–217, 2008. doi:10.1016/j.jacr.2007.09.004

    Article  PubMed  Google Scholar 

  15. Voet T, Devolder P, Pynoo B, Vercruysse J, Duyck P: Design and Implementation of an Open Source Indexing Solution for a Large Set of Radiological Reports and Images. Journal of Digital Imaging. 20:11–20, 2007

    Article  PubMed Central  PubMed  Google Scholar 

  16. Wong ST, Hoo KS, Knowlton RC, et al: Design and applications of a multimodality image data warehouse framework. J Am Med Inform Assoc 9(3):239–254, 2002

    Article  PubMed Central  PubMed  Google Scholar 

  17. Zhou F, Xu Y: RepPop: a database for repetitive elements in Populus trichocarpa. BMC Genomics. 10:14, 2009. doi:10.1186/1471-2164-10-14

    Article  PubMed Central  PubMed  Google Scholar 

  18. Wright A, Bates DW, Middleton B, et al: Creating and sharing clinical decision support content with Web 2.0: Issues and examples. J Biomed Inform 42(2):334–346, 2009

    Article  PubMed  Google Scholar 

  19. Seebregts CJ, Mamlin BW, Biondich PG, et al: The OpenMRS Implementers Network. Int J Med Inform 78(11):711–720, 2009. doi:10.1016/j.ijmedinf.2008.09.005

    Article  PubMed  Google Scholar 

  20. Meenan C, King A, Toland C, Daly M, Nagy P: Use of a Wiki as a Radiology Departmental Knowledge Management System. J Digit Imaging 23(2):142–151, 2010. doi:10.1007/s10278-009-9180-1

    Article  PubMed Central  PubMed  Google Scholar 

  21. Kohli M, Bradshaw J: What is a Wiki, and How Can it be Used in Resident Education? Journal of Digital Imaging 24(1):170–175, 2011. doi:10.1007/s10278-010-9292-7

    Article  PubMed Central  PubMed  Google Scholar 

  22. Hodis E, Prilusky J, Martz E, Silman I, Moult J, Sussman JL: Proteopedia—a scientific “wiki” bridging the rift between three-dimensional structure and function of biomacromolecules. Genome Biol 9(8):R121, 2008. doi:10.1186/gb-2008-9-8-r121

    Article  PubMed Central  PubMed  Google Scholar 

  23. Friend S, Schadt E: Something wiki this way comes. Interview by Bryn Nelson. Nature. 458(7234):13, 2009. doi:10.1038/458013a

    Google Scholar 

  24. Feltrin E, Campanaro S, Diehl AD, et al: Muscle Research and Gene Ontology: New standards for improved data integration. BMC Med Genomics. 2:6, 2009. doi:10.1186/1755-8794-2-6

    Article  PubMed Central  PubMed  Google Scholar 

  25. Demczuk L, Gottschalk T, Littleford J: Introducing information literacy into anesthesia curricula. Can J Anaesth 56(4):327–335, 2009. doi:10.1007/s12630-009-9063-4

    Article  PubMed  Google Scholar 

  26. Csosz E, Mesko B, Fesus L: Transdab wiki: the interactive transglutaminase substrate database on web 2.0 surface. Amino Acids 36(4):615–7, 2009. doi:10.1007/s00726-008-0121-y

    Article  CAS  PubMed  Google Scholar 

  27. Cobus L: Using blogs and wikis in a graduate public health course. Med Ref Serv Q 28(1):22–32, 2009. doi:10.1080/02763860802615922

    Article  PubMed  Google Scholar 

  28. Nagy P, Warnock M, Daly M, Rehm J, Ehlers K: Radtracker: a web-based open-source issue tracking tool. J Digit Imaging. 15(Suppl 1):114–119, 2002. doi:10.1007/s10278-002-5059-0

    Article  PubMed  Google Scholar 

  29. Morgan M, Branstetter B, Mates J, Chang P: Flying Blind: Using a Digital Dashboard to Navigate a Complex PACS Environment. Journal of Digital Imaging 19(1):69–75, 2006

    Article  PubMed Central  PubMed  Google Scholar 

  30. Nagy PG, Warnock MJ, Daly M, Toland C, Meenan CD, Mezrich RS: Informatics in Radiology: Automated Web-based Graphical Dashboard for Radiology Operational Business Intelligence. Radiographics 29(7):1897–906, 2009. doi:10.1148/rg.297095701

    Article  PubMed  Google Scholar 

  31. Nagy PG, Pierce B, Otto M, Safdar NM: Quality control management and communication between radiologists and technologists. J Am Coll Radiol. 5(6):759–765, 2008. doi:10.1016/j.jacr.2008.01.013

    Article  PubMed  Google Scholar 

  32. Morgan M, Branstetter B, Lionetti D, Richardson J, Chang P: The Radiology Digital Dashboard: Effects on Report Turnaround Time. Journal of Digital Imaging 21(1):50–58, 2008

    Article  PubMed Central  PubMed  Google Scholar 

  33. 2008 Critical Access Hospital National Patient Safety Goals | Joint Commission. Available at: http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/08_cah_npsgs.htm. Accessed September 10, 2009.

Download references

Acknowledgments

We acknowledge Micah Adams, MS for providing diagram support.

Author information

Authors and Affiliations

  1. Department of Radiology, Indiana University School, 550 University Blvd, Indianapolis, IN, USA

    Marc D Kohli

  2. Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Max Warnock, Mark Daly, Christopher Toland & Chris Meenan

  3. Russell H. Morgan Department of Radiology, Johns Hopkins University, Ellicott City, MD, USA

    Paul G. Nagy

Authors
  1. Marc D Kohli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Max Warnock
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mark Daly
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christopher Toland
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chris Meenan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paul G. Nagy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marc D Kohli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kohli, M.D., Warnock, M., Daly, M. et al. Building Blocks for a Clinical Imaging Informatics Environment. J Digit Imaging 27, 174–181 (2014). https://doi.org/10.1007/s10278-013-9645-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10278-013-9645-0

Keywords

Search

Navigation