Exchanging Images Within a Specific Health Information Exchange Domain

Type	Standard / Implementation Specification	Standards Process Maturity	Implementation Maturity	Federally required	Cost	Test Tool Availability
Standard	Digital Imaging and Communications in Medicine (DICOM®)	Final	Production	No	Free	No
Standard	DICOMweb Store (STOW) and Query/Retrieve (WADO) - PS3.18 DICOM Standard – Part 18: Web Services	Final	Production	No	Free	No
Implementation Specification	IHE-PDQ (Patient Demographic Query)	Final	Production	No	Free	Yes Yes
Implementation Specification	IHE-PIX (Patient Identifier Cross-Reference)	Final	Production	No	Free	Yes Yes
Implementation Specification	IHE Cross Enterprise Document Sharing for Images (XDS-I.b)	Final	Production	No	Free	Yes Yes
Implementation Specification	RESTful HL7® FHIR® Document Reference-based API Specifications	Final	Feedback requested	No
Emerging Implementation Specification	IHE - Patient Identifier Cross-reference for Mobile (PIXm)	Balloted Draft	Pilot	No	Free	No
Emerging Implementation Specification	IHE – WIA (Web-based Image Access)	Balloted Draft	Pilot	No	Free	No

Limitations, Dependencies, and Preconditions for Consideration	Applicable Security Patterns for Consideration
IHE-PIX and IHE-PDQ are used for the purposes of patient matching and to support this interoperability need. To survey implementations of RESTful DICOMweb services to store, query, retrieve, an internet search for the relevant service (STOW-RS, QIDO-RS, WADO-RS) and the phrase “DICOM Conformance Statement” will typically return links to specific products. STOW-RS "dicom conformance statement" QIDO-RS "dicom conformance statement" WADO-RS "dicom conformance statement"	Secure Communication – Create a secure channel for client-to-server and server-to-server communication. Secure Message Router – Securely route and enforce policy on inbound and outbound messages without interruption of delivery. Authentication Enforcer – Centralized authentication processes. Authorization Enforcer – Specifies access control policies. Credential Tokenizer – Encapsulate credentials as a security token for reuse (e.g., SAML, Kerberos). Assertion Builder – Define processing logic for identity, authorization and attribute statements. User Role – Identifies the role asserted by the individual initiating the transaction. Purpose of Use – Identifies the purpose for the transaction.

Limitations, Dependencies, and Preconditions for Consideration

Applicable Security Patterns for Consideration

IHE-PIX and IHE-PDQ are used for the purposes of patient matching and to support this interoperability need.
To survey implementations of RESTful DICOMweb services to store, query, retrieve, an internet search for the relevant service (STOW-RS, QIDO-RS, WADO-RS) and the phrase “DICOM Conformance Statement” will typically return links to specific products.
- STOW-RS "dicom conformance statement"
- QIDO-RS "dicom conformance statement"
- WADO-RS "dicom conformance statement"

Secure Communication – Create a secure channel for client-to-server and server-to-server communication.
Secure Message Router – Securely route and enforce policy on inbound and outbound messages without interruption of delivery.
Authentication Enforcer – Centralized authentication processes.
Authorization Enforcer – Specifies access control policies.
Credential Tokenizer – Encapsulate credentials as a security token for reuse (e.g., SAML, Kerberos).
Assertion Builder – Define processing logic for identity, authorization and attribute statements.
User Role – Identifies the role asserted by the individual initiating the transaction.
Purpose of Use – Identifies the purpose for the transaction.

Comment

Submitted by John Moehrke on 2021-09-08

IHE - Document Sharing

As indicated XDS-I provides the link to the Imaging world from a Document Sharing exchange. The Document Sharing exchange is not sufficiently described in the section. I recommend that Document Sharing exchange be more comprehensively expressed thru use of the IHE Whitepaper on Health Information Exchange. Thus removing mentions of PIX and PDQ as these are just a fragment of needed infrastructure that also includes Security, Privacy, Discovery, Retrieve, and management.

https://profiles.ihe.net/ITI/HIE-Whitepaper/index.html#

Submitted by lisaspellman on 2019-09-24

Comments_Exchanging Imaging…

Comments_Exchanging Imaging Documents Within an HIE Domain_DICOM

There are IHE Connectathon testing results for Web-based Image Capture (which uses STOW-RS)

(See image in uploaded document)

and Web-based Image Access (which uses QIDO-RS and WADO-RS).

(See image in uploaded document)

So for DICOMweb, we suggest at least Medium if not High, definitely not Low.

Examples with DICOMweb™ support

Agfa
- Main page: https://global.agfahealthcare.com/main/miscellaneous/interoperability/dicom_connectivity/
- Conformance statement mentioning DICOMweb: http://www.agfahealthcare.com/global/en/he/library/libraryopen?ID=53821200
Sectra
- Main page: https://medical.sectra.com/knowledge-center/conformance-statements/
- Conformance statement mentioning QIDO/WADO: https://sectramedical.blob.core.windows.net/uploads/2019/03/pacs-dicom-conformance-statement-21.1.pdf
GE
- Main page: https://www.gehealthcare.com/products/interoperability/dicom
- Conformance statement mentioning DICOMweb: https://www.gehealthcare.com/-/media/7527e637d6ca478c8f94aca52580e75b.pdf?la=en-us
Vital
- Main page: https://www.vitalimages.com/customer-success-support-program/compliance-documents/
- Conformance statement mentioning DICOMweb: https://www.vitalimages.com/wp-content/uploads/VLC-10295-A-Vitrea-View-7.5-DICOM-Conformance-Statement_.pdf
Orthanc (open source)
- Main page: https://www.orthanc-server.com/static.php?page=documentation
- Page mentioning DICOMweb support: https://docs.google.com/spreadsheets/d/e/2PACX-1vSBEymDKGZgskFEFF6yzge5JovGHPK_FIbEnW5a6SWUbPkX06tkoObUHh6T1XQhgj-HqFd0AWSnVFOv/pubhtml?gid=654036639&single=true
DCM4CHEE (open source)
- Main page: https://dcm4chee-arc-cs.readthedocs.io/en/latest/introduction.html
- Page mentioning QIDO/WADO/STOW: https://dcm4chee-arc-cs.readthedocs.io/en/latest/networking.html

Examples with DICOMweb™ support but not in Conformance statement

Philips
- Main page: https://www.usa.philips.com/healthcare/resources/support-documentation
- Mentions DICOMweb here: https://www.philips.ae/healthcare/product/HCAPP035/dicom-web
Merge
- Main page: https://www.merge.com/Support/Resources/DICOM-Conformance-Statements.aspx
- Mentions DICOMweb AND the latest supplement in DICOMweb on thumbnails: https://www.merge.com/Solutions/Toolkits/Merge-DICOM-Toolkit.aspx
Intelerad
- Main page: https://www.intelerad.com/en/resources/regulatory-compliance/
- Mentions DICOMweb support here: https://www.intelerad.com/en/press-releases/intelerad-launches-cosmosone-living-medical-archive/
Hyland
- Main page: https://www.hyland.com/en/healthcare/conformance-and-standards
- Mentions DICOMweb support here: https://www.hyland.com/en/healthcare/enterprise-imaging/acuo-vendor-neutral-archive

This list is based on initial research and not complete as there are likely many more.

Comments_Exchanging Imaging Documents Within an HIE Domain_DICOM.docx

Submitted by lisaspellman on 2019-09-24

Exchanging Imaging Documents Within a Specific HIE Domain

Exchanging Imaging Documents Within a Specific Health Information Exchange Domain

Recommend XDS-I.b adoption be increased to 2?

Recommend listing IHE WIA which profiles the use of DICOMweb

Recommend DICOMweb adoption be increased to 3

To survey implementations of RESTful DICOMweb services to store, query, retrieve, an internet search for the relevant service (STOW-RS, QIDO-RS, WADO-RS) and the phrase “DICOM Conformance Statement” will typically return links to specific products.

STOW-RS "dicom conformance statement"

QIDO-RS "dicom conformance statement"

WADO-RS "dicom conformance statement"

To survey implementations of IHE profiles, a search at the IHE Connectathon Results database (connectathon-results.ihe.net) will return lists of vendors that have successfully tested either a product or a prototype product. An internet search for the profile acronym (WIA, MHD-I) and the phrase “integration statement” will often return links to specific products

Exchanging Imaging Documents Within a Specific Health Information Exchange Domain_DICOM_ODonnell.docx