Emergency and InterHospital Teleradiology RCR PACS Teleradiology Special

Emergency and Inter-Hospital Teleradiology RCR PACS & Teleradiology Special Interest Group

Introductions Marco Crispini n Cypher IT Ltd Personal service company Southampton University Hospitals marco. crispini@nhs. net marco@cypherit. co. uk

What will you gain? Alleviate frustration! Why can’t we use cheap broadband? Understand NHSIA restrictions Identify OUR question, and its answer Handouts to enable DIY Downloads from www. cypherit. co. uk

Outline Network definitions Introduce scenarios Protecting Data Practical Information

Internet, NHSNet & Trust nets Big firewall Internet NHSNet Firewall Hosp Network Hosp 2 Firewall

NHSIA restrictions Internet Big firewall supplier X NHSNet Firewall Hosp Network Hosp 2 Firewall

How is Remote Support done? Internet NHSNet Big firewall supplier Firewall

Modems NHSNet Big firewall Firewall Hosp network

Broadband Internet bb ISP

Question Posed to NHSIA Q. Broadband please? A. Linking networks. Q. Just broadband from internet to consultants’ homes – trusts already have a big pipe out to the internet.

NHSIA Answer Internet NHSNet Big firewall BB ISP Firewall

Alternative Answer Internet bb ISP Big firewall cypherit NHSNet Firewall

Mobility of Alternative PULL images from internet using BB Viewing software if needed

No Broadband Available? Send only key images Compression - image quality vs size Accept a long wait Satellite

Consumer-level Satellite Ordinary modem connection But download direction is routed via satellite link eg web request upload web page downloaded

Consumer-level Satellite Internet cypherit normal ISP sat ISP

Satellite pros and cons Speed Any location Installation cost Dial-up ISP also required Immobile

Taking Stock PUSH to a 3 rd party website Download using broadband

Protecting data DP Act – “appropriate measures” encryption “over any network” Internet? Trust network? NHSNet? Definitely yes

Encryption Options Weak vs strong encryption Win. ZIP is weak encryption NHSIA list of encryption products PGP is free

DICOM send via a firewall Private vs Public IP addresses Network Address Translation (NAT) Your Trust Firewall 83. 10. 5. 1 NHSNet 10. 16. 0. 1

What to ask for Their AE Title Their PUBLIC IP address Their Port number Ping (think submarines!) You need to give them the same

Encrypted Send Encrypt with PGP – no longer DICOM Send using ftp Port number is standard (23) Just requires the PUBLIC IP address

Implications for PACS receipt Workstation vs PACS Unverifieds/Profiling But exam isn’t in your RIS statistics

Summary Better broadband solution for on-call Radiologists Satellite broadband Hospital to hospital teleradiology bb. Rad from Cypher IT Handouts to help you to DIY Digital Imaging Book

Digital Imaging