Standardization in Health Informatics and DICOM

Over the last decades, information and communication technologies have become more and more integrated into all areas of healthcare. Such technologies facilitate an organization's work flows both in administrative areas and with regard to patient treatment. Patient and treatment data are managed via Hospital Information Systems and medical images are stored in digital archives and analysed on screens. Medical images may be sent electronically to remote medical experts, who can then evaluate them.
The speed of technological developments has to be balanced with the requirement for reliable long-term availability of medical data. Securing investments for an appropriate number of years is also an essential requirement given the increasing costs of the healthcare sector. An expensive new MRI machine that successfully exchanges data with a Radiology Information System today should be able to do that even after the later has been replaced or updated.

These requirements can only be met with standards. Since the healthcare sector is highly distributed and partitioned, the standardization of interfaces from the conceptional level down to technical levels is of great importance. This is also relevant for the development of new services, e. g. in telemedicine.

The following international committees are engaged in the development of standards for health informatics:

1. DICOM Committee: The DICOM Committee is the publisher of the DICOM standard (Digital Imaging and Communications in Medicine) which has become the most important standard for medical image management since its initial publication in 1993.
2. Comité Européen de Normalisation: The Technical Committee CEN/TC251 Health Informatics at the European Committee for Standardisation develops information models for medical information systems, standards for knowledge representation and terminology, for security and safety as well as for image and signal processing in medicine.
3. International Organisation for Standardization: The ISO Committee ISO/TC215 Health Informatics has been founded in 1998 with a scope similar to that of CEN/TC251, but not limited to Europe. In this committee, models for medical information systems as well as standards for knowledge representation, terminology, security and safety in medicine are developed. These are partly based on CEN standards.

Medical image communication involves distributed, heterogenous and highly available systems. Long operating times of devices as well as medically and legally relevant archiving periods have to be considered. A Conformance Statement provides information about what services are offered by a system that conforms to the DICOM standard.