title: Interoperative fundus image and report sharing in compliance with integrating the healthcare enterprise conformance and web access to digital imaging and communication in medicine persistent object protocol.
abstract: OBJECTIVE
  To address issues in interoperability between different fundus image systems, we proposed a web eye-picture archiving and communication system (PACS) framework in conformance with digital imaging and communication in medicine (DICOM) and health level 7 (HL7) protocol to realize fundus images and reports sharing and communication through internet.
  
  
  METHODS
  Firstly, a telemedicine-based eye care work flow was established based on integrating the healthcare enterprise (IHE) Eye Care technical framework. Then, a browser/server architecture eye-PACS system was established in conformance with the web access to DICOM persistent object (WADO) protocol, which contains three tiers.
  
  
  RESULTS
  In any client system installed with web browser, clinicians could log in the eye-PACS to observe fundus images and reports. Multipurpose internet mail extensions (MIME) type of a structured report is saved as pdf/html with reference link to relevant fundus image using the WADO syntax could provide enough information for clinicians. Some functions provided by open-source Oviyam could be used to query, zoom, move, measure, view DICOM fundus images.
  
  
  CONCLUSIONS
  Such web eye-PACS in compliance to WADO protocol could be used to store and communicate fundus images and reports, therefore is of great significance for teleophthalmology.
authors.affiliation: Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention (MICCAI) of Shanghai, Shanghai 200032, China ; Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China.
authors.forename: Hui-Qun
authors.initials: HQ
authors.lastname: Wu
authors.affiliation: Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China.
authors.forename: Zheng-Min
authors.initials: ZM
authors.lastname: Lv
authors.affiliation: Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China.
authors.forename: Xing-Yun
authors.initials: XY
authors.lastname: Geng
authors.affiliation: Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China.
authors.forename: Kui
authors.initials: K
authors.lastname: Jiang
authors.affiliation: Department of Medical Image Engineering, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China.
authors.forename: Le-Min
authors.initials: LM
authors.lastname: Tang
authors.affiliation: Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention (MICCAI) of Shanghai, Shanghai 200032, China ; Department of Anatomy, Histology and Embryology; School of Basic Medical Sciences; Shanghai 200032, China.
authors.forename: Guo-Min
authors.initials: GM
authors.lastname: Zhou
authors.affiliation: Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China.
authors.forename: Jian-Cheng
authors.initials: JC
authors.lastname: Dong
keywords: integrating the healthcare enterprise; picture archiving and communication system; teleophthalmology; web access to DICOM persistent object