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Comment by pc86 | Hacker News Reader

Hospital IT systems are incredibly locked down, especially from a network perspective. And DICOM images (the format things like x-rays are stored in) are very large, and not readable by most image readers. I honestly don't know if there are even free DICOM readers out there, but there probably are.

CD is honestly the easiest way for them to send the images to you, because you can give them to any doctor and they can load them within minutes. For the hospital to send them directly to another hospital would literally take weeks (at a minimum) of back and forth between two overworked and incompetent IT teams.

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There are multiple free DICOM readers, but each imaging device manufacturer has its own interpretation of what a "DICOM" file is, so there are a lot of quirks.

I've worked with DICOM files from at least 10 different sources. I was able to eventually parse/view all of them. I seem to remember trying almost as many open source libraries in the process, however. That's one of the many problems in healthcare - even the standards have competing standards.

All standards have competing standards unless actual interop happens.

> For the hospital to send them directly to another hospital would literally take weeks (at a minimum) of back and forth between two overworked and incompetent IT teams.

Last time I had imaging done, my doctor gave me a list of nearby imaging services, and the one I selected was able to electronically send files back to my doctor.

Heck I've witnessed my old dentist send x-rays over to my new dentist, it took like 5 minutes. Then again it seems like dentists are better at technology all around.

I can't speak at all to dental stuff as I've never worked with it. But to your first point, that's sort of expected - they're on a list already, the access has already been configured. They've already gone through all the nonsense.

The point is to send it to any arbitrary doctor they've never spoken to before, which requires offline media.

> I honestly don't know if there are even free DICOM readers out there, but there probably are.

If you've ever gotten a cd with your medical imaging on it, it will come with the software required to read it.

Yes, and that software requires some esoteric proprietary OS that I've banned from all of my memory. :D

The weird thing is that there are signs all over the clinic about how they now have Athena Health for telemedicine.

Cool dudes. Have you considered letting me download the x-rays I just paid for from that portal?

I'm not sure if "proper" DICOM files are different (DRM?) but during my undergrad I had a medical imaging class working with anonymized DICOM files and we used Pydicom (With Jupyter Notebook) to display the images and annotations: https://pydicom.github.io/pydicom/stable/index.html

There’s (luckily) no such thing as DRM in DICOM, but there is a billion ways to interpret the standard. Pydicom does work for the more common things but there’s some rare types of DICOM it unfortunately can’t handle.

I've worked in a medical image processing field and there's a few out there, Orthanc is the most featureful one I know of.

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