ROENTGEN WORKS is BRIT’s next generation Web server /PACS/RIS/VNA/ Image Sharing solution. It has been architected from the ground up to support multiple tenants using modern technologies, such as HTML-5, Cassandra, and ElasticSearch. It extends BRIT’s motto of any image, anywhere, anytime by providing a platform with no single point of failure, utilizing stateless applications and load balancers that work across geographically separate datacenters to provide near 100% availability. It also supports mobile devices, making reports and images available literally anywhere there is Internet across the globe. Clients access the system via HTML-5, zero foot-print browsers, making it easy to implement and readily available to users. Such technology becomes essential when extending access to mass numbers of users, as required with patient portals. Key modules and elements of the single database solution include:

Multi-facility support – each facility has its own users, password policies, active directories support, site defaults for viewer configuration and worklists, HL-7 connections, modalities, etc.

The VNA makes Roentgen Works a proxy server for all connected DICOM Servers: they only need to query Roentgen Works to receive a patient folder comprised of all studies from all connected PACS.

Image and Report Archive – each site has its own retention policies

The integrated viewer, WebWorks, removes hardware and operating system limitations from image and report viewing: all a user needs is an HTML-5 capable browser. Diagnostic enhancements, including 3D, are available.

The Patient Discovery Tool provides a “poor man’s MPI” to find patients regardless of the patient ID schema.

The DICOM Router, that can also route non-DICOM images and other files

Support for non-DICOM images enables the storage, viewing and distribution of a wide variety of images and documents to users and DICOM servers.

A WADO Server: Access via WADO allows users to access the studies directly from our server using their own browsers.
Critical Results Reporting and ER Discordance
Roentgen Workflow module, an enterprise worklist, that integrates with voice recognition products and third party workstations
Radiologist’s Reporting tool, integrates with VR or uses voice recorder.
A RIS that can be extended to ordering physicians and patients
Image Sharing Tools, anyone with a browser can upload studies, attach files, download studies, burn PDI compliant CDs with an optional viewer, send email links to studies and reports, view studies and reports.
HL-7 Engine – bi-directional and segregated by site.
Quality Control – with support for Image Object Change Management

Even large instances of Roentgen Works can be operational within a few days when deployed within the Amazon S3 cloud. Hybrid solutions of local and hosted instances are also supported, providing local performance and geographic redundancy protection. Big Data enabled with Cassandra clusters and ElasticSearch, the solution is quickly, easily, and massively scalable.

Roentgen Works use of Cassandra’s NOSQL database supports a flexible design schema allowing for the quick adaptation required to meet the rapidly evolving government regulations. Its design supports research queries for evidence based medicine, the advanced analytics that will be required in pay-for-performance, and implementing and navigating the knowledge engines required to run the government’s appropriateness criteria and determine ICD-10 billing.
Roentgen Works readily integrates into EMRs via a URL interface, set-up by a system manager, often without any support from BRIT. Built in URL configurations are available for Epic, Meditech and others, including support for the URL timeout features. The server stores medical images along with non-DICOM images and files and it readily connects to multiple PACS while providing a single timeline of all of a patient’s studies within WebWorks, the integrated viewer.