New specification: QR code instead of patient CD

The days of the patient CD are numbered—the move to digital imaging portals is nevertheless proving highly frustrating for hospitals. Help is coming by the fall of 2024 in the form of a technical specification being developed by a DIN working group acting under the initiative of the IT working group of the German Radiological Society. 

The move from patient CDs to digital imaging portals actually promises greater efficiency and comfort—but Dr. Marc Kämmerer hears one thing above all else at the moment: frustration. “The processes currently in place to import CDs don’t work for QR codes. It is also difficult if not impossible to define uniform new processes because existing software solutions do not have a unified user interface,” explains the Head of Innovation Management at VISUS, who is also a member of the board of the IT working group of the German Radiological Society (AGIT). In concrete terms, what is expected of users when they scan a QR code to download diagnostic images differs from portal to portal. Even the different processes for logging in are confusing, and users have to reorient themselves to a different user interface every time: what images are concealed behind the QR code? What is the directory structure in which they are organized? And where is the download button? 

Hospitals lose valuable time

These are just some of the questions that hospitals lose valuable time trying to answer at the moment. For Marc Kämmerer one thing is true: “There has rarely been such a huge need in radiological IT as there is with this issue.” The situation is comparable to the introduction of the patient CD almost a quarter of a century ago. Just like the current situation, there was no clear standard back then. For the compact disc, certification by the German Radiological Society provided the necessary breakthrough. The transformation to a fully digital world should go just as smoothly. Under the initiative of AGIT, a DIN working group was established at the German Radiology Congress in 2023. The group started its work in October under the leadership of Marc Kämmerer as the representative of the Radiology Standards Committee. The working group is represented equally by users and manufacturers. The aim is to jointly develop a technical specification (DIN/TS) for online provision of imaging data.

The advantage of a technical specification over a standard or an IHE profile is that this type of standardization is much quicker and easier to implement in practice. The working group has set itself a rather ambitious schedule. A draft should be complete by June with the final version published in the fall. This DIN/TS can then become a foundation for requirements when calling for tenders for imaging portals. The professional public will have opportunity beforehand to check the specification as part of a four-week commentary phase. “This is not really necessary but we think it is important so we can build as much acceptance as possible,” according to the head of the working group. 

The framework conditions are clarified

Considering the tight timing and subsequent acceptance, the experts agreed in advance on some pragmatic framework conditions: wherever useful and possible, any existing standards in the radiological IT world will be incorporated into the specification, and the zip file format widely used in the IT world will be incorporated as the choice of the data container. It was also specified that users must be able to find a download option for the entire directory as well as an overview of all studies on the first level of the user interface.

The 16 members of the working group are currently developing recommendations in four working teams: One is working on questions related to automated downloads; another is working on formalities and the scope of application; a third is working on the transfer medium and access; and a final team is working with end users and the user interface. “Defining the use cases was easy; the challenge lay in how,” said Marc Kämmerer, who is nonetheless optimistic that the general uncertainty will soon pass. “We’re making good progress.”