OpenRIMS offers open RIS/PACS architecture

The popularity of open source software has been more evident in other industries and medical groups, but it may be growing in the medical imaging community. A new paper (J Digit Imaging 2002 Sep 26) describes a project using open source in the development and dissemination of RIS and PACS software.

"Considerable time, money, and effort are expended to electronically integrate the modern radiology practice," said Steve Langer, Ph.D., an assistant professor of radiology at the University of Washington. "Much of this is due to redundant efforts, by vendors duplicating each other and also within the department by multiple overlapping databases that must communicate with each other via disparate protocols."

Langer is developing OpenRIMS, an open radiology information management system designed to provide an integrated, open source solution to manage all data flowing through the department.

In the current radiology department, exam orders are placed via the house RIS, which knows department resources and schedules, billing codes, and reports. The RIS then passes orders to PACS and patient work lists to the imaging modalities.

"This messaging is often accomplished via a broker that converts RIS HL7 messages to DICOM protocol for the modalities and PACS," Langer said. "At least three independent database servers are involved, largely populated with redundant data."

OpenRIMS does it all, without the redundancy:

?accepts orders
?schedules exams
?provides DICOM work list information to modalities
?archives studies
?supports DICOM query/retrieve from third-party viewing software

OpenRIMS' multitiered architecture uses a single database communicating via an open database connectivity bridge to a Linux server with HL7, DICOM, and HTTP connections. Department personnel interact with OpenRIMS via a browser, whereas other informatics systems communicate over the HL7 and DICOM links, Langer said.

While the system is still under construction, the primary database schema is complete, as are the principal pieces of the Web user interface. Additional work is still needed on the DICOM/HL7 interface broker and completion of the bas DICOM service class, according to Langer.

"OpenRIMS is intended to demonstrate a reference platform for a simple, robust, and inexpensive alternative to the complex multitiered systems currently deployed throughout the radiology market," he said.

OpenRIMS is based on commodity hardware and software, and the completed code will be released under the Free Software Foundation (gnu public license).