From the May 2011 issue of HealthCare Business News magazine

From a technology standpoint, it’s easy to make something work in a single browser configuration or to install via the Web. But to cover many scenarios (all browser types and versions, a variety of operating systems, various firewall configurations and the like) the capabilities of “Web-based PACS” get hobbled. Work must be done to make the application run in the browser, and this nearly always involves an investment of time and money.

Efficiencies in moving from thick to thin
As the Internet advanced and technology evolved, many radiology practices moved to “thin-client” image distribution. Using a physician portal, a referring doctor simply logs into an application and pulls up an image and report for review. It’s important to note that radiologists and other clinicians who frequently interact with diagnostic images (cardiologists, pathologists, orthopedic surgeons, oncologists, etc.) have different needs from those of some specialist and most primary care physicians. The latter do not need the comprehensive advanced visualization functionality of a PACS. Hence a “thin-client” solution with limited functionality became a very attractive alternative to Web-based thick client PACS for this subset of clinicians.
Thin-client solutions minimize issues related to thick-client solutions but do not eliminate them completely. Thin-client solutions rely on browser-based plug-ins like Flash, Silverlight or applets, to provide viewing capabilities. Challenges can arise, if a Safari browser is used rather than Internet Explorer, or if the user is running an older version of IE. In some instances, applications can be downloaded and readily run on a PC, but not on a Mac.

In many organizations, thin-client technology has helped reduced delays and costs associated with CD distribution. Yet technical hurdles still exist, resulting in couriers or patients themselves serving as the CD transport mechanism.

Zero-client eliminates many challenges
Recently, health care organizations have turned to ”zero-client” solutions. To understand this concept, consider the use of Google Maps. For millions of people, Google offers an easy way to find a location, view surrounding areas, pan to a specific point and zoom to detailed information. With a single click, you can even bring up satellite images – to view a car in someone’s driveway, or catch a bird’s-eye view of a neighbor’s pool.

Now, draw a parallel to a physician who wants to view a CT image -- at a hospital bedside, at his office, at his home or en route to the golf course. Just as the Google Maps application allows people to view and manipulate map images, doctors can use the same type of ”zero-client” technology to view and interact with digital medical images.

May 2011 Magazine

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