System Requirements

There are several technology components that work in tandem to create an environment that can appropriately send and receive large radiographic images.

Following are the necessary components for teleradiology. Click on each link, or scroll down, to read the detailed requirements for each one. You may also view sample costs and providers for establishing an infrastructure that can support teleradiology.

Workstation Specifications

The minimum workstation requirements are as follows:

Operating System Windows XP, 2000, NT 4.0 or Windows 98

Note: The InteleViewer has not been tested with Windows 2003 and is not compatible with Citrix or Linux servers.
Virtual PC If workstation is a MAC/Apple PC, it must have Virtual PC loaded.
Java Version 5.00.3810 for Windows 2000 (SP4 or higher) or Windows XP (SP1 or higher).

Note: Java will need to be installed if not already on your workstation.
Memory 256 MB of RAM
Processor Pentium II 450 MHz
Disk Space 50M
Video Card 8 MB on board RAM
Internet Connection DSL, cable or any other high-speed connection (e.g. T1).

Note: A 56K modem is adequate to view reports only
Browser Internet Explorer 5.5 or 6

Note: Pop-Ups blockers may create installation problems
Firewalls Open ports for SSH 5020-5022
SSL 443

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DICOM Capable Modality

Digital Imaging and Communications in Medicine, or DICOM, is a standard format among most modalities today. Your scanners must have the ability to DICOM “send” images via a local imaging network. Prior to 1997 most modality vendors sold DICOM capability as a separate module to the device.

Converters

Modalities that do not have DICOM “push” capability may use a DICOM converter. A DICOM protocol converter unit such as “frame-grabber” or “Merge Box” can perform this functionality.

Dicom converters vary greatly in price, depending on number of modalities needing to convert image type.Typically these units range in cost from $10,000 to $20,000.

Ethernet Connection

Ethernet or Fast Ethernet on the local network to each submitting modality is also a necessity. Where an imaging network does not exist, one can be built with minimal effort and at a low cost. Typically, network cabling and hardware cost range from $200 to $2000.

JPEG Compression Capability

Images must be compressed to be sent to the RIA reading center. JPEG compression is a non-proprietary compression algorithm used to compress and decompress DICOM images. The contracted vendor of the sending modality should be able to answer any question regarding JPEG compression capability.

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High Speed Internet Connection

Radiographic images can be rather large, and even with compression your site(s) will need at least 512 kbps upstream internet access to move images to the RIA reading center in an acceptable timeframe. While the internet is cost effective, robust, reliable, and secure (using Virtual Private Networking) for transporting images, the speed of transfer can be greatly diminished by your internet service provider’s “backbone” to the Internet, the distance and number of “hops” to the destination, and DICOM inherent overhead that requires checks and balances to make sure that no image quality or data is lost in the transfer.

To overcome the degradation in transfer rates, your site will need a high bandwidth access point to the internet. Typically the hospital Information Services or Technology department will maintain a T1 (1.54 Mbps) to the internet. Most of our customers rely on the hospitals internet access to send images to the RIA reading center. While radiographic exams are rather large, the traffic is quick by nature and infrequent, limited to the number of procedures performed in the late evening and early morning hours. Therefore the internet bandwidth consumption will be minimal in most cases.

For sites that do not have current internet access meeting this requirement there are several options to consider. These services usually requires a fixed upfront investment of $1000 -$10000, and a monthly fee.

Internet Access Options

Following are two common options for internet access:

  1. Business Cable or DSL - Price varies greatly from market to market. You should expect $50 to $250 per month for service. Ensure that upstream bandwidth meets the 512 kbps requirement.

    Qwest DSL and Comcast Cable have competitive plans that meet all bandwidth requirements.

  2. Full T1, “Burstable”, or Tiered TI access - We recommend you choose a reliable top tier vendor or your local telephone company. Cost will range from $300 $1,000 per month. Customers that have multiple sites may also wish to consider linking each site with point-to-point (PTP) high bandwidth links like frame-relay, or PTP T1 lines. In these circumstances, traffic can be “back-hauled” to the site that has high bandwidth internet access.

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Static Public IP Addresses

Any current internet service provider or internet access vendor must allocate at least 2 static public IP addresses. One IP is required for the internet router and one for the public interface of the firewall. If this is not possible, please call your project implementation engineer. Static IP’s are typically included in Business DSL, Cable, and all T1 offerings.

Site to Site Virtual Private Network (VPN)

VPNs ensure that data is sent privately and securely. We can help build site-to-site VPNs using most firewalls and VPN capable machines. If your site does not have VPN capability, a small firewall, like the Cisco PIX 501, can be purchased for approximately $600. RIA IT engineers can configure the firewall for your site (additional fees may apply).

Your RIA support specialist can answer specific technical requirements regarding your site.

Please see the topology diagram below which depicts the flow of imaging data from modality to radiologists at our reading site.

Click to enlarge.

Technical Contact Person

A technical contact person must be present at the site during implementation. Our IT professionals will work closely with your technical contact person to ensure that implementation goes as smoothly as possible.

There are minimum requirements for your workstation to ensure it’s robust enough to handle the large images that are transmitted for teleradiology. You must have a high speed internet connection to engage in teleradiology.