title: iMAGE cloud: medical image processing as a service for regional healthcare in a hybrid cloud environment.
abstract: OBJECTIVE
  To handle the emergence of the regional healthcare ecosystem, physicians and surgeons in various departments and healthcare institutions must process medical images securely, conveniently, and efficiently, and must integrate them with electronic medical records (EMRs). In this manuscript, we propose a software as a service (SaaS) cloud called the iMAGE cloud.
  
  
  METHODS
  A three-layer hybrid cloud was created to provide medical image processing services in the smart city of Wuxi, China, in April 2015. In the first step, medical images and EMR data were received and integrated via the hybrid regional healthcare network. Then, traditional and advanced image processing functions were proposed and computed in a unified manner in the high-performance cloud units. Finally, the image processing results were delivered to regional users using the virtual desktop infrastructure (VDI) technology. Security infrastructure was also taken into consideration.
  
  
  RESULTS
  Integrated information query and many advanced medical image processing functions-such as coronary extraction, pulmonary reconstruction, vascular extraction, intelligent detection of pulmonary nodules, image fusion, and 3D printing-were available to local physicians and surgeons in various departments and healthcare institutions.
  
  
  CONCLUSIONS
  Implementation results indicate that the iMAGE cloud can provide convenient, efficient, compatible, and secure medical image processing services in regional healthcare networks. The iMAGE cloud has been proven to be valuable in applications in the regional healthcare system, and it could have a promising future in the healthcare system worldwide.
authors: Information Center, Affiliated Hospital of Jiangnan University, No.200, Huihe Road, Wuxi, 214062, China.
authors: Li
authors: L
authors: Liu
authors: Wuxi Municipal Commission of Health and Family Planning, Wuxi, 214023, China.
authors: Weiping
authors: W
authors: Chen
authors: AccuRad Healthcare Network Co.,Ltd. Xi'an, Ascendas Innovation Hub B, No.38 Gao Xin 6 Road, Xi'an Hi-tech Industrial Development Zone, Xi'an, 710075, China.
authors: Min
authors: M
authors: Nie
authors: Information Center, Affiliated Hospital of Jiangnan University, No.200, Huihe Road, Wuxi, 214062, China.
authors: Fengjuan
authors: F
authors: Zhang
authors: AccuRad Healthcare Network Co.,Ltd. Xi'an, Ascendas Innovation Hub B, No.38 Gao Xin 6 Road, Xi'an Hi-tech Industrial Development Zone, Xi'an, 710075, China.
authors: Yu
authors: Y
authors: Wang
authors: Information Center, Affiliated Hospital of Jiangnan University, No.200, Huihe Road, Wuxi, 214062, China.
authors: Ailing
authors: A
authors: He
authors: Comprehensive Health Care Department, Hangzhou First People's Hospital, Hangzhou, 310006, China.
authors: Xiaonan
authors: X
authors: Wang
authors: Department of Radiology, Affiliated Hospital of Jiangnan University, No.200, Huihe Road, Wuxi, 214062, China. gyan@stu.edu.cn.
authors: Gen
authors: G
authors: Yan
mesh_terms: D002681:China; D000067917:Cloud Computing / Q000706:statistics & numerical data*; D057286:Electronic Health Records / Q000295:instrumentation*; D007091:Image Processing, Computer-Assisted; D012984:Software
keywords: Cloud computing; Electronic medical record; Medical image processing; Regional healthcare; Virtual desktop infrastructure