We propose to purchase a research picture archiving and communications system (PACS). PACS systems have become the foundation of the modern electronic radiology department. These systems are tailored to the needs and workflow of a radiology department by linking medical imaging systems with diagnostic displays and by providing long-term storage of patient images so that comparison studies may be efficiently retrieved. The standard clinical PACS, however, moves images in DICOM (digital imaging and communications in medicine) format along with the patient-identifying information that is essential to proper patient management. This patient information, known as protected health information (PHI) in the language of the Health Insurance Portability and Accountability Act (HIPAA), often must be anonymized prior to the research use of images and associated clinical information. Academic medical centers spend considerable resources to address the challenges imposed by the need for HIPAA compliance. The ideal environment would ensure that investigators never have access to PHI to avoid a potential breach of confidentiality. The standard clinical PACS also lack the ability to store and manage non-DICOM images and metadata such as small animal images, histopathology images, and microarray images. These images lack a standard archiving and viewing paradigm so that they effectively are inaccessible to anyone outside the local laboratory. Consequently, investigators in these domains are deprived of a resource that could greatly facilitate the conduct of their research. Coordination of interdisciplinary studies across multiple departments, robust organization of electronic data, and data-mining capabilities all suffer from this deficit. The proposed research PACS will provide a unified solution to both issues. Fully anonymized images will be stored in the research PACS along with metadata and other clinical data. Research findings may also be archived. Non-DICOM images, along with associated metadata and research findings, also will be stored in the research PACS. Local access for visualization and image manipulation will be possible through the PACS workstation that will be connected to the PACS server. Remote access by University of Chicago investigators will be achieved through a secure web-based interface. Completely HIPAA-compliant images may then be downloaded to an investigator's local computer for advanced, project-specific image analyses. Our long-term goal is to develop the research PACS into a resource for all biomedical imaging investigators at the University of Chicago. The system will reside within an existing, comprehensive network that links users and clinical databases through a gateway controlled by an electronic honest broker. The research PACS will provide a powerful instrument in this framework to integrate informatics, non-human images, and HIPAA- compliant biomedical research efforts. This advanced system will enhance the ability of imaging investigators to conduct interdisciplinary basic science, translational, and clinical studies to promote human health. Public Health Relevance: Research involving biomedical images generates an extraordinary amount of data that must be captured, analyzed, stored, and accessible for future evaluation, while at the same time the confidentiality of patients'identities must be secured when human subject's data are used. The proposed dedicated research picture archiving and communications system (PACS) will store and manage (1) fully anonymized medical images along with other clinical data and research findings obtained from approved human subjects research studies and (2) other images such as small animal images, histopathology images, and genetic microarray images, which currently lack a standard archiving and viewing approach so that they effectively are inaccessible to anyone outside the local laboratory. The dedicated research PACS will allow (1) coordination of interdisciplinary studies across multiple departments, (2) robust organization of electronic data, and (3) datamining capabilities that will directly enhance the ability of biomedical imaging investigators to conduct successful, interdisciplinary studies of a basic science, translational, or clinical nature designed to promote human health.
