In addition, the server is integrated with two external mass storage devices for short- and long-term storage. The remaining two modules continue normal operation with no adverse effects on data flow or system performance. The server makes use of a triple modular redundancy (TMR) system with a simple majority voting logic that automatically identifies a faulty module and removes it from service. A simple, low-cost, continuous-availability (CA) PACS archive server was designed and developed. The operational reliability of the picture archiving and communication system ( PACS) server in a filmless hospital environment is always a major concern because server failure could cripple the entire PACS operation. Liu, Brent J Huang, H K Cao, Fei Zhou, Michael Z Zhang, Jianguo Mogel, Greg Informatics in radiology (infoRAD): A complete continuous-availability PACS archive server. As a result, the recently renovated neurosurgical ICU will be filmless and use only AMICAS workstations for mission-critical patient care. During that time, it has been a reliable component of the evolving digital image distribution system. AMICAS has been installed at MGH since March of 1997. This teleradiology capability is integrated into the DICOM network and the PACS thereby eliminating the need for special teleradiology workstations. Using wavelet compression and Internet standards as its native formats, AMICAS creates a bridge to the DICOM networks of remote imaging centers via the Internet. Each AMICAS includes: a Java-based interface to the IDXrad radiology information system (RIS), a DICOM autorouter to tape-library archives and to the Agfa PACS, a wavelet image compressor/decompressor that preserves compatibility with DICOM workstations, a Web server to distribute images throughout the enterprise, and an extensible interface which permits links between other HIS and AMICAS. A fifth AMICAS receives teleradiology studies via the Internet. Four AMICAS Web/Intranet Image Servers were installed as the default DICOM destination of 10 digital modalities. A novel, Web-based enterprise PACS architecture introduced at Massachusetts General Hospital provides a solution. The integration of images with existing and new health care information systems poses a number of challenges in a multi-facility network: image distribution to clinicians making DICOM image headers consistent across information systems and integration of teleradiology into PACS. Enterprise-scale image distribution with a Web PACS.

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