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31-01-2009, 12:43 AM

Flipping back the pages of history, we stumble upon many incidents which gave modern medicine its current shape and form. The invention of X-Ray by Sir William Roentgen was indeed a break-through in the medicine, which removed all misconceptions and beliefs which people used to rear. X-Ray paved a strong base for medical imaging and is the predecessor of many modern specialized scanning and diagnostic equipments viz Computed Tomography, Magnetic Image Resonance, Ultra Sound Digital Radiology, Computed Radiology etc.

Whoever has said the phrase, that ?necessity is the mother of invention? is right especially in the case of medicine. The inventions in medical imaging took new shape when an urge for compatibility and communication became need of the hour. Many medical imaging equipment vendors had created a ?product lock-in? system which prevented the systems from communicating with each other. Ultimately getting the inspiration from the strains of such attempts, a group of radiologists American College Of Radiologists (ACR) came forward with an idea to create an internationally accepted standard which would communicate medical images and related data with other similar-but-different-vendor supplied medical imaging devices. Their attempts bloomed when they got an equally powerful partner from another association of electrical manufacturers called National Electrical Manufacturers Association (NEMA). The partnership became the first step towards the establishment of an international medical imaging standard, in the year 1992, which became the heart throb of modern medicine. Initially called ACR-NEMA standard later converted to DICOM which stands for Digital Imaging and Communication in Medicine due to its international representations. The use of radiation (such as x-rays) or other imaging technologies (such as ultrasound and magnetic resonance imaging) to diagnose or treat disease is Radiology. The acronym PACS stands for Picture Archival and Communication System. In common usage, the term PACS refers to a computer system that is used to capture, store, distribute, and then display medical images. For diagnostic imaging applications, PACS technology can be utilized to achieve near filmless operation.

During the past 100 years, film has played a heroic role in which it has been versatile enough to capture, store, move, and display radiographic images. It has taken a full century for a twentieth-century computer technology, which has provided attractive alternatives to film. This has been accomplished using innovative approaches for image capture, high speed networks, powerful computer servers and workstations, and ultrahigh resolution monitors. The transition to filmless radiology provides the opportunity to break free from century-old constraints of film with regard to the acquisition, communication, storage, and display of images. Filmless radiology refers to a hospital or network-wide environment in which film has either completely or at least largely been replaced by an electronic system that acquires, archives, and communicates and displays images. Filmless radiology has the potential to provide two major benefits. The first is the improved accessibility, integration, and efficiency made possible by the incorporation of images into patient?s Electronic Medical Record (EMR). The second is the creation of new techniques to take advantage of the recent developments in image acquisition, display and image processing.

Why has the transition to filmless operation been so relatively slow? The most important factor has bees that the purchase of a PACS requires a complete reengineering of the operations of the radiology department. The entire workflow of the radiologists, technologists, and other clerical and technical personnel needs to be redesigned to acieve a successful PACS. Teleradiology can allow improved patient care by making specialists available to generalists regardless of their geographic locations. By integrating information access for patients, primary health care providers (primary care physicians [PCPs] and general radiologists), and specialists in an existing teleradiology system, the role of PCPs can be changed from a resource controller (gatekeeper) to a more effective triage officer (gateway). Similarly, the role of radiologist specialists can be enhanced from providing interpretations for diagnostic studies to providing advice on patient care and work-up. This system, which is designed around a well-defined process model of patient, generalist (eg. PCPs and general radiologists), and specialist interaction, will not only improve the speed and accuracy of diagnosis but also improve the quality of care and reduce health care costs by facilitating appropriate patient care and work-up.
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