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Imaging Studies on CDs – Why They Fail

October 19, 2011
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Clinicians, techs, and many patients have long known that sharing CDs with imaging files can be a challenging process.

The obvious ones include the time staff has to spend uploading the large files to the media, the transport expense if the CDs are express mailed or sent by courier, and the total time from upload to delivery, which can be days. On top of all this, CDs can get lost in transit.

Other problems pertain to the actual medium itself – essentially, the ability for recipient physicians to load, open, or read the CDs if they do arrive in time to be used.

A survey published in the January 2011 issue of the Journal of the American College of Radiology (JACR) provides some important insights into the messiness of file-sharing by CD. Lead author, Vivek Kalia, MS, from Johns Hopkins University, and colleagues identify the numerous troubles with CDs that provoked their survey's questions. These include:

 

  • CDs sometimes don't load because of proprietary formats.
  • CDs sometimes lack embedded viewer software.
  • If viewers are included, they may be difficult to use because of complex or unfamiliar interfaces (there is no standardization).
  • CDs that do load may take a long time to do so.

Plus:

  • Files that are not in the standardized formats DICOM or IHE PDI
  • Poor image quality
  • Wrong, missing, or incomplete studies
  • Images that can't be manipulated
  • Compressed data
  • Corrupted discs
  • Security measures at the recipient institution “that prevent auto-run and executable files on the recipient's workstation” (true at 20% of respondents' facilities)

 

Given all these potential hiccups, it’s no surprise that only about 60% of respondents claimed that most (75%-100%) outside digital media were readable or importable.

This also means that as much as 25% of media were not usable, in the experience of most respondents, and that the other 40% of respondents said their experience was even worse. Imagine if 25% of music CDs failed to play when you put them in a CD player. Do you think the format would ever have succeeded?

The survey unintentionally revealed one more important finding. The authors offered two future solutions that could help make the troublesome medical CD obsolete. One was the expanded use of virtual private networks (VPNs). But VPNs have their own issues. The other scenario they place their hopes on is the growth of regional health information organizations (RHIOs). But RHIOs, no longer a new idea, have never fulfilled the promise many held for them years ago -- and some have failed in part because they couldn't agree on a protocol for sharing electronic information.

Interestingly, the authors show no awareness of what we believe is the most logical solution to the data-sharing challenge: cloud-based services, as you might have guessed.

Services like eMix are being used successfully in a variety of ways and settings and addressing all the issues with CDs, including speed, reliability, interoperability, vendor neutrality, and so on. Perhaps a new survey is in order – on user satisfaction with sharing medical data via the cloud.

 

Last modified on October 19, 2011
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More in this category: « ONC Plan Misses Obvious Strategy: Cloud-based Medical Information Exchange eMix Connects the World »

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