Selecting the Best, Scalable, Efficient, and Secure DICOM Router for Optimal DICOM Data Transmission and Enterprise Imaging Workflows

What is a DICOM Router and How Does it Work?

A DICOM router is a pivotal component in medical imaging, facilitating the smooth transmission of digital medical images and data within healthcare systems adhering to the Digital Imaging and Communications in Medicine (DICOM) standard. This specialized appliance efficiently routes DICOM-compliant images from diverse modalities—such as ultrasound, mammography, x-ray, and CT scans—to destinations like workstations, servers, or Picture Archiving and Communication Systems (PACS). DICOM routers are integral to the imaging infrastructure, streamlining workflows, improving the accuracy and efficiency of diagnoses, and enabling better patient care by ensuring DICOM data and information get to clinicians as quickly as possible. DICOM routers bridge the gap between decentralized data, geographical barriers, and healthcare entities. The effectiveness of a chosen DICOM router allows clinicians to promptly access and review essential imaging information, regardless of location. Organizations ranging from single-site hospitals, imaging centers, or teleradiology clinics to multi-site IDNs should evaluate the need for a DICOM router and select one tailored to their specific imaging workflow requirements. It’s also important to note that not all DICOM routers are created equal, and the chosen router must flawlessly and securely handle the imaging volume required without bottlenecks or latency issues.

What Are the Benefits of a DICOM Router, and How Does it Support Imaging Workflows?

Enterprise imaging workflows encompass the entire lifecycle of medical images, from acquisition and storage to interpretation and sharing. A DICOM Router supports imaging workflows in many ways, including

  • Seamless DICOM Data Transmission: A DICOM Router facilitates the secure and efficient transmission of images between healthcare providers, such as radiologists, referring physicians, and patients, and acts as the central hub for migrating DICOM images and data within healthcare facilities, imaging centers, or across different facilities. For example, in Emergency Situations, DICOM routers ensure quick image access, enabling emergency room staff to evaluate and respond promptly to urgent cases through expedited decision-making.
  • DICOM Standard Compliance: The DICOM Router adheres to the international DICOM standard for transmitting, storing, retrieving, printing, processing, and displaying medical imaging information. Since its first publication in 1993, DICOM has revolutionized radiology, allowing the replacement of X-ray film with a fully digital workflow.
  • Interoperability Across Modalities and Systems: Operating as a specialized appliance, a DICOM Router migrates DICOM-compliant data from diverse modalities, including ultrasound, mammography, x-ray, and CT scans, and integrates with EHR/EMR systems, to provide a comprehensive view of the patient’s medical history. Interoperability is critical for healthcare facilities as it allows for the seamless integration of various equipment and software solutions, streamlines the flow of medical data, and ensures that medical professionals can access and interpret patient images without compatibility issues. This capability is essential for consolidating imaging data from various sources and storing patient information across different platforms.
  • Consultations, Second Opinions, and Collaboration: DICOM Routers help bridge gaps in decentralized data, overcoming geographical barriers and connecting various healthcare systems Inter-hospital or from multiple locations to collaborate in real-time for accurate diagnoses and effective treatment planning. This technology provides remote access for teleradiology clinicians, enabling them to receive timely and precise diagnostic interpretations. Clinical professionals can leverage this advantage to seek second opinions from radiologists elsewhere, especially in intricate cases or when extra insights are required to enhance quality assurance, support diagnoses, and optimize treatment plans. Additionally, it promotes subspecialty consultations and cross-border collaboration, ultimately improving patient care and outcomes.
  • Secure Patient DICOM Data Storage: A DICOM Router ensures temporary storage and retrieval of images and other related information, such as patient demographic data, radiology reports, and relevant priors. A DICOM Router can work with a vendor-neutral archive (VNA) to ensure the data is securely stored and easily accessible. A DICOM Router can also interface with cloud-based storage solutions, enabling scalability and accessibility from anywhere with an internet connection.

Selecting a DICOM Router? 10 Key Features and Functionality to Consider

  1. Scalability: Consider the scalability of the DICOM router to accommodate the growing volume of medical imaging data and destinations required. It should be able to handle increased data traffic as imaging needs to expand. One of the biggest challenges for imaging is managing high throughput or large file sizes of tomosynthesis (3D mammography) studies, which can range from 450 MB to 3 GB. On-the-fly compression network transfer optimization and study prioritization with an enhanced routing queue are some features Unifier offers to help optimize transfer speed and turnaround time. Users can retrieve prior images, modify modality worklists, balance loads, prioritize studies, and migrate over 800,000 studies per day.* Read more about the results in this whitepaper.
  2. Number of Destinations: When evaluating the DICOM Router’s configuration, it’s crucial to determine the number of destinations needed. Traditional imaging sharing “hubs” may not support HL7 or transformation requirements. Dicom Systems provides three DICOM routing solutions catering to various scenarios. Whether a hub-and-spoke model or routing to multiple destinations, Dicom Systems offers solutions for any use case.
  3. Specialized Workflow Features: Outline the requirements for the DICOM Router to meet. Will HL7 integration be needed? Data transformation? De-identification? VNA? These features require configuration and a DICOM Router that can tackle the requirements.
    1. HL7 Integration: This centralized hub allows outside facilities to send any HL7 or FHIR message and modify the metadata. With FHIR or HL7 integration, healthcare organizations with multiple locations or remote access requirements can deliver files in the same standard so that they can easily be read or modified. With HL7 integration from Dicom Systems, healthcare providers can connect disparate systems like EHR/EMR, PACS/MIMPS, and RIS into a single framework and centralized messaging hub for sharing enterprise imaging-related data.
    2. Dicom Modality Worklist (DMWL): PACS/RIS and EMR/EHR are used in healthcare settings to manage various aspects of patient demographic information (PHI), healthcare operations, and exam scheduling. However, manual data entry from these systems into modalities like CT, MRI, Ultrasound, and others poses risks of errors and inefficiencies. The growing number of visual light imaging and mobile acquisition devices requires seamless integration with PACS and EMR/EHR. Unifier DICOM Modality Worklist (DMWL) creates a centralized scheduling database into a Worklist Server for Radiology encompassing modalities, image acquisition devices, archives, DICOM, and non-DICOM, on-premise and remote sites to the healthcare organization. Effortlessly integrate patient demographic information from diverse PACS or RIS systems into the EMR/EMR, even for studies generated at remote sites with Dicom Systems DMWL.
    3. Load Balancing: In complex healthcare settings, a DICOM router with load balancing capabilities can distribute data traffic evenly across the network, preventing bottlenecks and ensuring optimal performance. With Unifier, healthcare organizations can intelligently and proactively balance incoming DICOM data from external providers, modalities, or PACS/MIMPS. Load balancing rules are customized to specific preferences and requirements, contributing to timely, high-quality patient care while optimizing IT resources, application delivery, and overall scalability.
    4. Transformations: Data normalization is crucial for an enterprise to ensure that other applications and viewers can process the data seamlessly. The Unifier platform addresses these issues by providing robust transformation capabilities through dynamic tag morphing and on-the-fly data normalization, providing seamless integration and enhancing interoperability and usability across the healthcare ecosystem.
    5. Routing Proxy Functionality and Pulling Priors: A routing proxy feature helps seamless data routing and retrieval, optimizing the flow of medical images and information. This functionality pulls prior studies from various sources, streamlining the process for clinicians and radiologists. Whether retrieving historical patient data or transferring images between facilities, the DICOM routing proxy from Dicom Systems ensures swift and reliable communication while maintaining data integrity and security standards.
    6. State-of-the-Art Queuing Management and Multithreading: Inefficient queuing and processing delays hamper productivity and patient care. The Unifier platform integrates advanced queuing management, multithreading, and dynamic parameter adjustment functionalities to optimize task handling, maximize throughput, and minimize delays. Leveraging sophisticated multithreading algorithms, it adapts dynamically to varying workloads. With proactive queuing management and dynamic parameter adjustments, Dicom Systems enhances system stability, reliability, and operational efficiency, ensuring better patient care quality and timeliness.
  4. Vendor-Neutral Compatibility and Workflow Integration: Verify compatibility by ensuring the DICOM router aligns with imaging modalities, EHR, and PACS systems without causing disruptions to workflows. It should be able to route and transmit data between devices, PACS, and workstations without causing disruptions, bottlenecks, or latency. The Dicom Systems Unifier DICOM Router is vendor-neutral, ensuring smooth data exchange.
  5. Data Security: Prioritize security features. The DICOM router should support encryption protocols to ensure the secure transmission of sensitive medical imaging data, aligning with privacy regulations and standards. Use DICOM over TLS, as it is highly desirable and recommended. Dicom System used intelligent routing SSL-based DICOM and HL7 integration tools.
  6. Protocol Support: Verify that the DICOM router supports the necessary communication protocols, including TCP/IP, to enable interoperability and communication between devices and systems. The Unifier platform is optimized to meet the requirements of different types of connections, including high-speed connections with low latency, high-latency and high congestion environments, and satellite connections.
  7. Data Filtering and Pre-processing: Look for routers that offer data filtering capabilities. Filtering and pre-processing DICOM data can optimize the transmission of relevant information and enhance overall network efficiency. Dicom Systems offers data filtering and pre-processing as part of the Unifier platform.
  8. User-Friendly Interface: Choose a DICOM router with an intuitive, user-friendly interface that simplifies configuration, monitoring, and maintenance tasks to make it easier for healthcare professionals to manage and troubleshoot. Dicom Systems has a transparent, user-friendly WebGUI configuration tool and a set-up wizard.
  9. Audit Trail and Logging: An effective DICOM router should provide comprehensive audit trail and logging functionalities to ensure the traceability of imaging data transactions and aid compliance with regulatory requirements. Dicom Systems offers enterprise-wide configuration management, logging, and auditing for HIPAA.
  10. Vendor Support and Updates: Consider the reputation and support services offered by the DICOM router vendor. Regular software updates and responsive customer support are essential for maintaining the router’s effectiveness and security. Dicom Systems offers 24/7/365 highly responsive support across all time zones. Professional Services are available for configuration and custom function development.

DICOM Routing from Dicom Systems

Dicom Systems presents a comprehensive suite of DICOM routing models tailored to address diverse healthcare scenarios. These three distinct routing models cater to different healthcare environments’ unique needs and complexities. Whether it’s the Rapid DICOM Router, the Rapid+ DICOM Router, or the Unifier platform, each model offers specific functionalities and capabilities to meet the demands of modern healthcare workflows. From streamlined interactions within hub-and-spoke models to the flexibility of routing to multiple destinations with identical rules, Dicom Systems ensures that healthcare providers have options to streamline imaging data flow, enhance efficiency, and improve patient care. With this range of routing options, Dicom Systems empowers healthcare organizations to choose the best solution to their specific requirements.

Rapid DICOM Router
The Rapid DICOM Router is a centralized, many-to-one, single-destination “spoke,” providing a fast and secure solution to connect multiple clinics and imaging sites to one central hub destination, the Unifier appliance, enhancing workflow efficiency. As a “spoke,” it harmonizes DICOM imaging data flow among various modalities and image sources, optimizing communication and coordination to streamline interactions within a hub-and-spoke model. Tailored for teleradiology requirements and remote site and connectivity, it expedites data transmission to a central Unifier, ensuring swift and effective workflow management while eliminating the need to establish or maintain VPNs. The Dicom Systems Rapid DICOM Router works best for clinics, teleradiology services, and remote sites that seek effortless integration with a central hub to simplify operations and within environments with limited resources or dedicated IT personnel. For scenarios requiring intelligent DICOM or HL7 routing and transformations, the Unifier platform goes beyond the “spoke” single destination model.

Dicom Systems Rapid DICOM Router.

Rapid+ DICOM Router
The Rapid+ DICOM Router builds upon the capabilities of the Rapid DICOM Router by extending its routing capabilities to three destinations, all governed by the same routing rules. Rapid+ is a centralized “spoke,” facilitating swift and secure connections between multiple clinics and imaging sites to a central Unifier appliance like its predecessor. This enhanced functionality allows for increased flexibility in directing DICOM imaging data flow while optimizing workflow efficiency within hub-and-spoke models. Ideal for teleradiology requirements and remote site connectivity, Rapid+ expedites data transmission to a central Unifier, ensuring seamless and proficient workflow management. While Rapid+ excels in scenarios requiring up to three destinations, Dicom Systems’ Unifier platform remains the solution for more complex scenarios necessitating intelligent DICOM or HL7 routing and transformations beyond the single destination model.

Dicom Systems Rapid+ DICOM Router.

The Unifier platform
Unifer® is a robust, vendor-neutral, and customizable enterprise imaging solution that seamlessly integrates and provides easy access to medical images and studies. This advanced and flexible platform offers a wide range of features, including intelligent DICOM and HL7 routing, DICOM Modality Worklist, de-identification of PHI, load balancing, vendor-neutral archiving (VNA), pulling relevant priors, and structured reporting. The Unifier platform is a robust and proven choice for ensuring swift and secure imaging operations with the flexibility to be deployed on-premise, in the cloud, or a hybrid environment.

Unifier Platform Enterprise Imaging Workflow Use Cases

Dicom Systems Unifier® platform.

To streamline enterprise imaging workflows and securely transfer large imaging volumes without bottlenecks or latency issues, consider a DICOM Router from Dicom Systems. Contact an enterprise imaging workflow expert to learn more about what can help you achieve greater efficiency and productivity in your imaging operations.