title: A Cloud Architecture for Teleradiology-as-a-Service.
abstract: BACKGROUND
  Telemedicine has been promoted by healthcare professionals as an efficient way to obtain remote assistance from specialised centres, to get a second opinion about complex diagnosis or even to share knowledge among practitioners. The current economic restrictions in many countries are increasing the demand for these solutions even more, in order to optimize processes and reduce costs. However, despite some technological solutions already in place, their adoption has been hindered by the lack of usability, especially in the set-up process.
  
  
  OBJECTIVE
  In this article we propose a telemedicine platform that relies on a cloud computing infrastructure and social media principles to simplify the creation of dynamic user-based groups, opening up opportunities for the establishment of teleradiology trust domains.
  
  
  METHODS
  The collaborative platform is provided as a Software-as-a-Service solution, supporting real time and asynchronous collaboration between users. To evaluate the solution, we have deployed the platform in a private cloud infrastructure. The system is made up of three main components - the collaborative framework, the Medical Management Information System (MMIS) and the HTML5 (Hyper Text Markup Language) Web client application - connected by a message-oriented middleware.
  
  
  RESULTS
  The solution allows physicians to create easily dynamic network groups for synchronous or asynchronous cooperation. The network created improves dataflow between colleagues and also knowledge sharing and cooperation through social media tools. The platform was implemented and it has already been used in two distinct scenarios: teaching of radiology and tele-reporting.
  
  
  CONCLUSIONS
  Collaborative systems can simplify the establishment of telemedicine expert groups with tools that enable physicians to improve their clinical practice. Streamlining the usage of this kind of systems through the adoption of Web technologies that are common in social media will increase the quality of current solutions, facilitating the sharing of clinical information, medical imaging studies and patient diagnostics among collaborators.
authors.affiliation: Eriksson J. Melício Monteiro, University of Aveiro, DETI / IEETA, 3810-193 Aveiro, Portugal, E-mail: eriksson.monteiro@ua.pt.
authors.forename: Eriksson J
authors.initials: EJ
authors.lastname: Melício Monteiro
authors.forename: Carlos
authors.initials: C
authors.lastname: Costa
authors.forename: José L
authors.initials: JL
authors.lastname: Oliveira
mesh_terms: D000067917:Cloud Computing; D020407:Internet; D011873:Radiology Information Systems; D061108:Social Media; D019112:Teleradiology; D013997:Time Factors
keywords: DICOM; PACS; Telemedicine; XMPP; cloud computing; medical imaging; teleradiology