1. DVS Consulting 1 DICOM Providing Solution for Hospitals for Over 10 Years DICOM Anniversary Conference 2003 Presented by Donald E. Van Syckle DVS Consulting, LLC www.dvsconsult.com

2. Donald Van Syckle DVS Consulting, LLC DICOM Anniversary Conference - 2003 2 DICOM - The Early Years First implementations of DICOM focused on the ability to send/receive images (i.e. Storage) Hospitals first used images from CT, MR, CR and Secondary Capture, primarily in Radiology US, NM, X-ray quickly followed Many modalities were connected via a DICOM Conversion Box – this still exists today Secondary Capture used by framegrabbers, film digitizers, etc. – this still exist today Storage enabled the first true multi-vendor image integration

3. Donald Van Syckle DVS Consulting, LLC DICOM Anniversary Conference - 2003 3 DICOM - The Early Years Most common image transfer was between modalities and workstations PACS archive products did exist but mostly based upon proprietary designs (receive DICOM then convert) DICOM Query/Retrieve was used to pull images from modalities (mainly only CT, MR) Query/Retrieve from PACS archive typically only used via 3 rd party workstation – often true today Image transfer is the first DICOM feature for all medical imaging specialties

4. Donald Van Syckle DVS Consulting, LLC DICOM Anniversary Conference - 2003 4 DICOM – Middle Years DICOM Print became widely used in 97-98 (even film-less hospitals need print as backup to PACS) Storage used in Cardiology, Radiation Therapy DICOM specifications for dentistry, pathology, ophthalmology, endoscopy, and more PACS starting to integrate with information systems (RIS), starting with Modality Worklist To achieve real advancements in workflow, it became evident that RIS integration is a must

5. Donald Van Syckle DVS Consulting, LLC DICOM Anniversary Conference - 2003 Modalities send images to archiveModalities send images to archive Workstations query/retrieve imagesWorkstations query/retrieve images Archive may be achieved via printing films or PACSArchive may be achieved via printing films or PACS Images sent to other departments, ER, ICU, teleradiology…Images sent to other departments, ER, ICU, teleradiology… Many hospitals and clinics use Storage, Query/Retrieve and Print to manage department DICOM STORAGE DICOM PRINT Local Area Network DICOM QUERY/RETRIEVE DICOM STORAGE Image Transfer Workflow Laser Printer DICOM STORAGE Shared Archive Radiology ICU, ER Modality

6. Donald Van Syckle DVS Consulting, LLC DICOM Anniversary Conference - 2003 6 DICOM – Recent Years Storage, Print, and Query/Retrieve becoming very close to Plug and Play in Radiology Modality Worklist expected feature in Radiology Focus shifted to image management features IHE Scheduled Workflow Integration Profile helps understanding of MPPS and Storage Commitment Begin work on Structured Reporting, Presentation State, General Purpose Worklist and more PACS installed in all sizes of hospitals and clinics (big, medium, and small)

7. Donald Van Syckle DVS Consulting, LLC DICOM Anniversary Conference - 2003 7 An Integrated Environment RIS Modality Worklist Worklist Worklist PACS Archive Store Images Storage Commitment MPPS Status = Completed Performed CT Head Complete List of Images Pat Name/ID, Accession #, Study UID ModalityPerformed Procedure Step Match Procedure with OrderMatch Procedure with Order Update IS SchedulingUpdate IS Scheduling Support Billing Based on MPPSSupport Billing Based on MPPS Reliable ArchivingReliable Archiving HIS HL7

8. Donald Van Syckle DVS Consulting, LLC DICOM Anniversary Conference - 2003 8 Why Has DICOM Been So Successful?

9. Donald Van Syckle DVS Consulting, LLC DICOM Anniversary Conference - 2003 9 Too Many Reasons to Cover, But…. It starts with the DICOM Committees themselves Worked long hard hours to provide specifications that can be practically implemented Committees consist of vendors and users that are competitors but are able to put aside differences to provide a high quality standard World wide participation DICOM is truly an international standard Thanks to all my colleagues in all the DICOM Committees and NEMA!

10. Donald Van Syckle DVS Consulting, LLC DICOM Anniversary Conference - 2003 10 Early and Continued DICOM Demonstrations RSNA played an important role to educate and showcase DICOM to hospitals and vendors Live DICOM picture images at RSNA (94) Mallinckrodt and Oldenburg CTN software for testing and use Demonstrations in Europe and Japan Support of the US Department of Veterans Affairs RSNA and HIMSS IHE continues to showcase DICOM

11. Donald Van Syckle DVS Consulting, LLC DICOM Anniversary Conference - 2003 11 The Technical Reason? Service/Object Pair (SOP) Class is what allows us to successfully implement DICOM Its what the DICOM Standard specifies Its what the software developers implement to Its what vendors test in their labs Its what we integrate in our hospitals Its our communication tool (I need my modalities to integrate with the my RIS, ok, you implement Modality Worklist SOP Class) SOP Class DICOMs Most Important Design Concept

12. Donald Van Syckle DVS Consulting, LLC DICOM Anniversary Conference - 2003 12 Thank You and See You in 2013