# MIDOM--A DICOM-Based Medical Image Communication System
## 3 Midom
### Overview  
The system primarily targets medical specialists and enables inter-specialist consultations with colleagues from other institutions or locations, with focus on delivering healthcare to places which lack a wider range of medical specialists and to generally underdeveloped parts of the world. The novelty of MIDOM is the usage of mobile technologies to bridge the gap between a diagnosing physician and a specialist who provides the required expertise in the interpretation of the diagnostic medical data in the form of a medical image. Exchanged data are in the form of studies and consultation requests, which can be consisted of various types of multimedia content.  
To completely describe MIDOM as a system, its components, and functionalities, we introduce the following keywords:  
* **Study--**A basic set of diagnostic data created with the purpose of exchange in the system;
* **Consulation Request (CR)--**A request for medical advice, opinion, or feedback for the existing study;
* **Administator--**A system user tasked with user administration, management of system settings, and application-specific tasks;
* **Study Provider (SP)--**A physician or other medical professional who is in charge of creating medical studies and issuing consultation requests for medical specialists;
* **Medical Specialist (MS)--**A physician or domain expert who can accept or reject consultation requests and provide feedback to the requesting study provider.  
Block diagram in Figure 3 presents a high-level overview of MIDOM. Different Hospital Information Systems, HIS 1 and HIS 2, are connected to MIDOM, each with an independent PACS 1 and PACS 2 subsystems, and disjunct medical personnel, SP, MS 1, and MS 2. Medical professional outside HIS can still access MIDOM, and are depicted under acronyms MS 3, MS 4, and SP 3. Parts of the figure that are shaded in blue represent MIDOM, while orange-shaded parts represent PACS components. Green-shaded components and arrows are implemented as part of this work.  
In order to provide and support good performance and user experience, the system emphasizes these three aspects:  
1. On-demand server-side compression of medical images of ultra-high-resolution--Algorithms for lossless compression of one or series of images comprising a study, adaptation of such algorithms for multicore and many-core systems, the performance of such algorithms for different compression levels;
2. Client-side decompression of medical images of ultra-high-resolution--Capabilities of Android mobile platform for high storage and computing requirements posed by the application;
3. Adaptation to current environmental characteristics--Strategies and techniques for different communication channel throughput and client platform capabilities. Adaptation mechanisms as a specific feature of MIDOM consider three main challenges, user experience, data transmission cost (in particular for clients connected through mobile networks), and throughput capabilities of client devices.  
A collaborative environment has been realized in the form of a MIDOM application server and several client applications in a Web interface and mobile application for the Android platform.