Monday, 8 January 2007

The remote sites debate

PACS systems are typically housed in hospital on a LAN system with the odd remote "Tele Radiology Site" that sends images to a central server for analysis by a in hospital doctor. The situation my practice is faced with is slightly different. We have 1 main site and 6 remote sites. Of these 6 remote sites 2 are of a "Tele Radiology" size and the others require a little more as they are hospitals too. Now I know in more developed countries you can get data lines that will allow sites to link together at a relatively high speed, unfortunately our practice is not in one of these countries. The fastest fixed line internet service is 1024 kbps which is ADSL (Asynchronous) so it has an uplink speed of only 256 kbps, which will mean that the links will effictivly be 256kbps links. The service is also capped at 3GB. You can obviously buy a larger cap and such, but the service is just not adequate for our needs as they are sold as internet access solutions and not WAN links.

Now the other offerings from our fixed line operators are Diginet which at speeds of anything over 1Mbps are so expensive that it is crippling there is not much else on offer. Our other avenue of research has led us to a wireless solution, but this is not legal here. We sit now in a situation where we effectively have to have multiple smaller PACS installations on remote sites which sync with a main archive at our main branch.

The entire aim of implementing a PACS system for our practice is to try and allow for workload distribution throughout the sites by allowing all Radiologists to view a single work list and thereby having all our Radiologists working at maximum capacity or at lease spreading the workload so some are not sitting idle at a remote site. The mini PACS site solution effectivly destroys this whole notion as it would take a massive amount of time to pull images across a WAN line running at up to 1Mbps.

Is anyone out there aware of a solution to such a situation that would allow us to have a bandwidth friendly system. I know that the Philips iSite has a proprietary solution called iSyntax, but I believe that this solution is still aimed at alleviating traffic on a LAN link of 10Mbps, which is probably 10 times more than the bandwidth than we will be able to get!

Are there any WAN compression tools, QOS or any other services out there that others have implemented with success on a low bandwidth medium?