Transcript M Crispini PACS SIG 25 Jun 03

Emergency and Inter-Hospital
Teleradiology
RCR PACS & Teleradiology
Special Interest Group
Introductions
Marco Crispini

Cypher IT Ltd
Personal service company
Southampton University Hospitals
[email protected]
[email protected]
What will you gain?
Alleviate frustration! Why can’t we use
cheap broadband?
Understand NHSIA restrictions
Identify OUR question, and its answer
Handouts to enable DIY
Downloads from www.cypherit.co.uk
Outline
Network definitions
Introduce scenarios
Protecting Data
Practical Information
Internet, NHSNet & Trust nets
Big firewall
Internet
NHSNet
Firewall
Hosp
Network
Hosp
2
Firewall
NHSIA restrictions
Internet
Big firewall
supplier
X
NHSNet
Firewall
Hosp
Network
Hosp
2
Firewall
How is Remote Support done?
Internet
NHSNet
Big firewall
supplier
Firewall
Modems
NHSNet
Big firewall
Firewall
Hosp
network
Broadband
Internet
bb ISP
Question Posed to NHSIA
Q. Broadband please?
A. Linking networks.
Q. Just broadband from internet to
consultants’ homes – trusts already
have a big pipe out to the internet.
NHSIA Answer
Internet
NHSNet
Big firewall
BB ISP
Firewall
Alternative Answer
Internet
bb ISP
Big firewall
cypherit
NHSNet
Firewall
Mobility of Alternative
PULL images from internet using BB
Viewing software if needed
No Broadband Available?
Send only key images
Compression - image quality vs size
Accept a long wait
Satellite
Consumer-level Satellite
Ordinary modem connection
But download direction is routed via
satellite link
eg web request upload
web page downloaded
Consumer-level Satellite
Internet
cypherit
normal
ISP
sat ISP
Satellite pros and cons
Speed
Any location
Installation cost
Dial-up ISP also required
Immobile
Taking Stock
PUSH to a 3rd party website
Download using broadband
Protecting data
DP Act – “appropriate measures”
encryption “over any network”
Internet?
Trust network?
NHSNet?
Definitely yes
Encryption Options
Weak vs strong encryption
WinZIP is weak encryption
NHSIA list of encryption products
PGP is free
DICOM send via a firewall
Private vs Public IP addresses
Network Address Translation (NAT)
Your
Trust
Firewall
83.10.5.1
NHSNet
10.16.
0.1
What to ask for
Their AE Title
Their PUBLIC IP address
Their Port number
Ping (think submarines!)
You need to give them the same
Encrypted Send
Encrypt with PGP – no longer DICOM
Send using ftp
Port number is standard (23)
Just requires the PUBLIC IP address
Implications for PACS receipt
Workstation vs PACS
Unverifieds/Profiling
But exam isn’t in your RIS
RIS statistics
Summary
Better broadband solution for on-call
Radiologists
Satellite broadband
Hospital to hospital teleradiology
bbRad from Cypher IT
Handouts to help you to DIY
Digital Imaging Book
Digital Imaging