Clinical Networks

Clinical networking is an industry on its own and an AI engineer will probably be exposed to a very small subset of that. So, it’s important to understand the basics - what are the systems that are important to a clinical network and how do they all fit together.

New Vocabulary

PACS - Picture Archiving and Communication System. An archive for medical images. A PACS product typically also includes “diagnostic workstations” - software for radiologists that is used for viewing and reporting on medical images.
VNA - Vendor Neutral Archive. A PACS that is not tied to a particular equipment manufacturer. A newer generation of PACS. Often deployed in a cloud environment.
EHR - Electronic Health Record. A system that stores clinical and administrative information about the patients. If you’ve been to a doctor’s office where they would pull your information on a computer screen and type up the information - it is an EHR system that they are interacting with. EHR system typically interfaces with all other data systems in the hospital and serves as a hub for all patient information. You may also see the acronym “EMR”, which typically refers to the electronic medical records stored by the EHR systems.
RIS - Radiology Information System. Think of those as “mini-EHRs” for radiology departments. These systems hold patient data, but they are primarily used to schedule patient visits and manage certain administrative tasks like ordering and billing. RIS typically interacts with both PACS and EHR.

In addition to DICOM protocol there are two more (among many) that you might run into:

HL7 - Health Level 7. A protocol used to exchange patient data between systems as well as data about physician orders (lab tests, imaging exams)
FHIR - Fast Healthcare Interoperability Resources. Another protocol for healthcare data exchange. HL7 dates back to the '80s and many design decisions of this protocol start showing their age. You can think of FHIR as the new generation of HL7 built for the open web.

Let’s see what a more realistic network scenario could look like, and what could be the possible integration points for AI technology: