title: Internationalization of healthcare applications: a generic approach for PACS workstations.
abstract: OBJECTIVE
  Along with the revolution of information technology and the increasing use of computers world-wide, software providers recognize the emerging need for internationalized, or global, software applications. The importance of internationalization comes from its benefits such as addressing a broader audience, making the software applications more accessible, easier to use, more flexible to support and providing users with more consistent information. In addition, some governmental agencies, e.g., in Spain, accept only fully localized software. Although the healthcare communication standards, namely, Digital Imaging and Communication in Medicine (DICOM) and Health Level Seven (HL7) support wide areas of internationalization, most of the implementers are still protective about supporting the complex languages. This paper describes a generic internationalization approach for Picture Archiving and Communication System (PACS) workstations.
  
  
  METHODS
  The Unicode standard is used to internationalize the application user interface. An encoding converter was developed to encode and decode the data between the rendering module (in Unicode encoding) and the DICOM data (in ISO 8859 encoding). An integration gateway was required to integrate the internationalized PACS components with the different PACS installations. To introduce a pragmatic example, the described approach was applied to the CHILI PACS workstation.
  
  
  RESULTS
  The approach has enabled the application to handle the different internationalization aspects transparently, such as supporting complex languages, switching between different languages at runtime, and supporting multilingual clinical reports.
  
  
  CONCLUSIONS
  In the healthcare enterprises, internationalized applications play an essential role in supporting a seamless flow of information between the heterogeneous multivendor information systems.
authors.affiliation: German Cancer Research Center, Division of Medical and Biological Informatics, H0100, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany. R.Hussein@DKFZ-Heidelberg.de
authors.forename: R
authors.initials: R
authors.lastname: Hussein
authors.forename: U
authors.initials: U
authors.lastname: Engelmann
authors.forename: A
authors.initials: A
authors.lastname: Schroeter
authors.forename: H P
authors.initials: HP
authors.lastname: Meinzer
mesh_terms: D005858:Germany; D038622:Internationality; D011873:Radiology Information Systems / Q000458:organization & administration* / Q000592:standards; D012985:Software Design; D014584:User-Computer Interface