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  Frequently Asked Questions . . .

TRIP™ (Transforming the Radiological Interpretation Process) is an initiative of The Society for Computer Applications in Radiology (SCAR) to spearhead research, education, and discovery of innovative solutions to the problem of information/image data overload. Burgeoning medical image data sets acquired by digital imaging devices requires the radiological community to shift its image interpretation and management processes. The SCAR TRIP™

Initiative will foster interdisciplinary research on technology as well as environmental and human factors to better manage and exploit the massive amount of information available.

TRIP™ will focus on three fundamental objectives:

1) Improving efficiency of interpretation of large data sets
2) Improving the timeliness and effectiveness of communication, and
3) Decreasing medical errors. 

The ultimate goal of the initiative is to improve the quality and safety of patient care.

Digital Imaging and Communications in Medicine (DICOM) is a standard for handling, storing, printing, and transmitting information in medical imaging. It includes a file format definition and a network communications protocol. The communication protocol is an application protocol that uses TCP/IP to communicate between systems. DICOM files can be exchanged between two entities that are capable of receiving image and patient data in DICOM format. The National Electrical Manufacturers Association (NEMA) holds the copyright to this standard. It was developed by the DICOM Standards Committee, whose members are also partly members of NEMA.


DICOM enables the integration of scanners, servers, workstations, printers, and network hardware from multiple manufacturers into a picture archiving and communication system. The different devices come with DICOM conformance statements which clearly state the DICOM classes they support. DICOM has been widely adopted by hospitals and is making inroads in smaller applications like dentists’ and doctors’ offices.

In medical imaging, Picture Archiving and Communication Systems (PACS) are computers or networks dedicated to the storage, retrieval, distribution and presentation of images. The medical images are stored in an independent format. The most common format for image storage is DICOM (Digital Imaging and Communications in Medicine).

PACS replaces hard-copy based means of managing medical images, such as film archives. It expands on the possibilities of such conventional systems by providing capabilities of off-site viewing and reporting (distance education, telediagnosis). Additionally, it enables practitioners at various physical locations to access the same information simultaneously, (teleradiology). With the decreasing price of digital storage, PACS systems provide a growing cost and space advantage over film archives.

PACS is offered by virtually all the major medical imaging equipment manufacturers, medical IT companies and many independent software companies.

The most difficult area for PACS is interpreting the DICOM image format. DICOM has enough latitude to allow various vendors of medical imaging equipment to create DICOM compliant files that differ in the internal tags used to label the data and the metadata. A feature common to most PACS is to read the metadata from all the images into a central database. This allows the PACS user to retrieve all images with a common feature no matter the originating instrument. The differences between vendors’ DICOM implementations make this a difficult task.

IHE (Integrating the Healthcare Enterprise) is an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information. IHE promotes the coordinates use of established standards such as DICOM and HL7 to address specific clinical need in support of optimal patient care. Systems developed in accordance with IHE communicate with one another better, are easier to implement, and enable care providers to use information more effectively.