System links fax to PACS automatically

Accessing patient information remains a challenge in teleradiology settings, but researchers have found a way to incorporate this information in DICOM image files.

Current solutions to this problem generally take the form of faxing clinical paperwork to teleradiologists. This method, however, is cumbersome, requires manual intervention, and is untenable once more than a few patients are involved.

Radiologists at Complete Radiology Reading Services (CRRS) have developed software called DICOMfaxadder, or DFA, specifically designed to incorporate nondigital clinical faxes directly into DICOM image files.

"DFA allows our teleradiology client sites to simply fax handwritten patient paperwork directly to our PACS or DICOM server, where it automatically becomes part of the appropriate patient's imaging examination, without manual intervention," said CRRS radiologist Dr. Allen Rothpearl.

DFA works by querying its DICOM server at regular intervals, Rothpearl said. When it detects the arrival of a new study, it examines the originating institution name and matches it to a fax number and/or e-mail address for that facility.

DFA then faxes or e-mails a specially coded page to that facility. The page is put in front of patient paperwork and used as a fax cover for it. The cover and paperwork are then faxed back to DFA, which encodes the cover sheet, transforms the fax to DICOM format, and sends the paperwork via DICOM SCU storage service back to its DICOM server to attach to the correct exam.

"The paperwork then becomes series 0 in the examination, being the first images the radiologist sees when the case is opened for interpretation," Rothpearl said.

DFA was developed and tested under Windows XP Professional or Windows Server 2003.

"No special equipment is required," Rothpearl said.

At CRRS, DFA runs on a Windows server box with a mirrored failover in case of hardware failure.

"For sending the outgoing fax cover sheets to client sites, you can use a fax-modem attached to the computer running DFA, or use a fax server," Rothpearl said.

To receive the faxes for decoding by DFA, any attached fax modem or fax server such as Snappy Fax, RunFAX, or any other fax software that generates multipage TIFF files can be used, he said.

CRRS intends to market the DFA system. The software and documentation can be downloaded for a 30-day free trial.