As in many medical institutions, the physicians and clinicians of the University of Alabama Birmingham
Medical Center (UABMC) rely on film-based medical images to make diagnoses. This process, which is
almost wholly manual, is inefficient and expensive due to the costs of printing, proper film storage, time
lost in waiting for film delivery, and re-imaging patients due to lost films.
In order to improve patient care and eradicate these unnecessary costs, UABMC recently made a
decision to become a "film optional" medical center by instead relying on digital medical images. Explains
Dr. Bart Guthrie, associate professor of Neurosurgery at UABMC, "The needs of computer-assisted
surgery required that we develop the capability for electronic image capture and distribution. We
subsequently realized that immediate access to medical images enhances the delivery of care for any
specialty, not just Neurosurgery. Over the past year we have developed an electronic Clinical Image
Management System (CIMS) that enables the care provider to make quick, informed decisions and is
changing the way we work by opening up new avenues of response and care. By moving to digital
images, we improve patient care and cut costs - an often elusive coupling of benefits."
To get the medical images to the point of care, UABMC and ComFrame, a consulting company that
specializes in Java technology consulting and products for healthcare, built a application based on the Java 2
platform that allows physicians and clinicians to view medical images on any desktop throughout the
medical center. Through the use of Java technology, the application can retrieve DICOM images from an archive based
on patient name, medical record number, or type and date range, and transfers those images to a
desktop Java software-based application that allows clinicians to view and manipulate the images. The improved
imaging and performance capabilities of the Java 2 platform were crucial to creating an effective
application to help physicians and clinicians provide faster and better patient care.
Why the Java 2 Platform?
"Java technology was necessary for this application to meet needs and specifications," says Dr. Guthrie.
"In order to be effective, we needed to meet the needs of clients using MACs, Windows, and several
different UNIX platforms. The users of the application have very demanding performance requirements,
which we are striving to meet on all platforms."
Dr. Gary York of ComFrame concurs. "Java is an excellent object-oriented platform: it allowed us to build
a robust, scalable solution quickly with a small team, and the improvements of the Java 2 platform really
fueled this application. For example, we needed the improved image manipulation capabilities of the Java
2D API. Medical images are large and complex, and with JDK 1.1.6, some image manipulation operations
on the client took seconds. With the Java 2 platform, we've reduced manipulation time to sub-seconds -
essentially real time - using BufferedImage and the new fast indexed color models. We also use threads
heavily on the client to make the perceived performance higher, so the visual feedback is instantaneous.
This performance upgrade is appreciated by the physicians who depend upon this application for quick
decision making. The application was written completely with Swing, so we value the fact that Swing is
now part of Java 2 platform's core APIs."
Over 120 physicians and clinicians now use this electronic image management process, and UABMC
eventually plans to provide access for up to 1000 users. The UABMC will achieve this goal, in part by
developing a Web-based applet version of the application to target users such as general practitioners,
who only occasionally use imaging as an integrated part of their work.
ComFrame has merged with several other firms to form a company called Imageon Solutions, which will
continue to develop and market this software in close conjunction with UABMC.
For more information, contact:
University of Alabama Birmingham Medical Center:
Dr. Bart Guthrie, Associate Professor of Neurosurgery
Tele: 205-934-8136
ComFrame:
Dr. Gary York, Chief Architect
Tele: 205-222-7418
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