1. Image Sharing Network Patients images are acquired and interpreted by a Radiologist at a facility Patients images and possibly other test results are reviewed by a specialist either at the same or a different facility Patients images and report are reviewed by primary physician Patient authorizes physicians to access Images and reports

2. CORE XDS.b + Manifest via (KOS??) Other – status, logging etc? HL7 feed Report plugin CFIND,CMOVE HL7 HL7 Qry Report plugin Other Report plugin Edge server concept Token Manager Database Image Storage Admin Token Association Site person or patient? Create (Token, accession) Edge Interface Administration Management Monitoring Configuration PHR Interface Clearning house concept Query Transfer (XDS.b?) Reports T < 30 days?? No UI by Edge Server No patient db by Edge server Plugins may be separable if IT polices require it Part or whole of Edgeserver in DMZ How do CFIND and CMOVE know the accession number?? What if site IT just wants to send and not query as part of Local IT policy ? CSTORE PHR How does PHR query? Can we use a modified version of XDS-I with Tokens instead of Patient ID ?? Can we use XDS.b to transfer the content ? Content Mgmt & Flow control

3. Software Architecture Edge Device RIS Broadcast CSTORE HL7 Pass thru No UI No DB Receiver Database Images & Reports XDS Query XDS Transfer PHR Token WebApp Mgmt App CLEARINGHOUSE Create tokens Assign Accessions to token – same app for all sites Content mgr Permanent Storage Ofc PC backend PACS Administration & Management

4. Software Architecture2 RIS Broadcast CFIND CMOVE HL7 Receiver Database Images & Reports XDS Query XDS Transfer PHR Token App Mgmt App Create tokens Assign Accessions to token – same app for all sites DICOM Server Permanent Storage Ofc PC backend PACS Transmitter Database Tk Research App Clinical research Administration & Management Acc Temporary Images & Reports Receiver Edge ServerClearinghouse Mgmt App Administration & Management Content mgr Database ST* Storage Manager

5. Software Architecture3 RIS Broadcast HL7 Receiver Database PHR Token App Create tokens Assign Accessions to token Permanent Storage PACS Transmitter Database Research App Clinical research Edge Server 3 rd Party Clearinghouse Pure XDS.b Store reports CFIND,CMOVE