[optimal] Re: From Denice regarding DICOM interface for Spectralis
- From: Joe Warnicki <warnickij@xxxxxxxxxxxxx>
- To: optimal@xxxxxxxxxxxxx
- Date: Fri, 28 Sep 2012 15:09:36 -0400
Denice,
DICOM in general is a great idea. But as the old joke goes the
definition of a camel is a horse designed by committee. Well in the case
of DICOM it is more like an elephant.
The DICOM standard is huge. It makes the Manhattan phone directories
look puny. There are volumes of embedded standards for everything. The
initial idea was to develop a standard for x-ray manufactures to
exchange digital information using a common standard. Now every time a
new digital device is developed a new committee or sub-committee is
established.
About 15 years ago Paul and I were invited to the newly established WG9
(work group 9) committee, which is DICOM's Ophthalmology's committee
supported by the AAO. They meet once or twice a year and send
representatives to the main DICOM committee, I think this lead committee
has the number WG6. (No I don't know why they did not start at #1, but
they probably have guidelines that explain it.)
Our group has as its members physicians, commercial vendors, technical
specialists and other interested parties. Usual about 40-50 people show
at a meeting. As expected fundus, fa, s-l, and external photography were
the first priorities and were established by the work group. Initially
ophthalmology had to defend why it needed its own group and not just be
included in the already established WG13 for visual light imaging.
Anyhow, creating an IOD standard is a complicated process and I have not
been in the loop for OCT so maybe someone that is can take over here and
explain what data is saved in the OCT object and what features it has.
One interesting point that is very important is that it is relatively
easy to be "DICOM compatible" but it is quite another thing to use DICOM
in an effective and useful way.
As an example Zeiss and Topcon have probably been using DICOM in their
fundus cameras the longest in Ophthalmology. So long that they preceded
the WG9 standards. There only choice at that time was to use the visual
light standard and make some modifications. I think they were putting fa
timing in the comments area since there was no specific area for it. It
worked and it allowed FA's to be exported to other DICOM equipment. The
changes they made were not compatible with today's WG9 standards. That
was long ago and Zeiss and Topcon have long complied with the new
standards, However, I am sure there are clinics that still own and
operate these "visual light" systems.
That is a simple example but my point is that compatibility especially
between competing companies should not be taken for granted and should
either be proven with a test system or very specifically in writing
specifying the systems that you own and expect to exchange data with,
including a guarantee that they will work together. There are such
things as "DICOM Conformance Statements" but they can be very difficult
to understand as they are very technical and can be 40 pages or more for
each piece of equipment. You do not want to hear each company blame the
other for an incompatibility or say that it will require custom software
that is not included.
I will be presenting a class at OPS Chicago in November on an
Introduction to DICOM and other EMR standards. Please join us.
***********************************************************************************************************
Speaking of my course, I am also looking for an additional speaker or
two to present ideas and to possibly talk about experiences in
transitioning to an EMR.
Please contact me off list. Yes, I know I'm asking late. :-)
Thanks.
Joe
On 9/27/2012 4:27 PM, CPMC Ophthalmic Diagnostic Center wrote:
Can someone "splaine" me the new DICOM interface for Spectralis and
how this works with third party instruments?
I understand this would allow Spectralis information to flow into
hospital EHR systems and PACS. But what does it do to incorporate
OTHER modalities of images ( Ultrasound, visual fields, etc) into
Spectralis software?
*/Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS/*
/Ophthalmic Diagnostic Center/
/CPMC Department of Ophthalmology/
/2100 Webster Street Suite 212///
/San Francisco CA 94115/
/(415) 600-3937 FAX (415) 600-6563/
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