How to Simulate and Troubleshoot Medical Imaging Transfers

Learn how to deploy and simulate PACS systems with DICOM image transfers, troubleshooting, and understand security implications of each modality.

In this tutorial we’ll be covering how to setup and deploy a small medical imaging client-server based network using a combination of free and open source tools. In addition, we’ll troubleshoot some common interoperability issues between such systems; and also provide recommendations for Health Information Technology (HIT) professionals.

At the end of this article you should be able to:

• Have a fundamental understanding of a common medical imaging protocol
  and standard
• Be able to deploy two different client / server vendor software
  utilizing that standard
• Troubleshoot basic network and configuration support requirements
  between the two vendors
• Understand the security implications and compensating controls needed
  around these systems

Medical Imaging Systems 101

As a security professional, and former penetration tester; it always baffled me as to how I was able to compromise many internal healthcare imaging related systems so easily. When I presented critical findings to the administrators that would have to deploy and manage these systems; you could just see the look of despair on their faces. This is far different from the typical Windows systems administrator that may just push additional patches or a GPO config in a fire-and-forget fashion.

So why are medical imaging systems so much more difficult to manage than typical IT corporate systems? First, we need to understand 2 critical pieces of imaging components. In the industry, technology professionals specific to healthcare supporting technologies call these types of collection of technologies Picture Archive and Communication Systems (PACS).

These types of networks are specific around varying systems and components called modalities to upload, edit, save, and transfer medical specific images around. The most common imaging standard as a file object and as a protocol specification is called: Digital Imaging and Communications in Medicine (DICOM).

Many HIT administrators that have to utilize the DICOM standard over their PACS networks…