Of the large number of medical practices shifting to Electronic Medical Records/EMR most are also updating older PCs at the same time. Updating to Windows 7 (generally 64-bit) raises compatibility problems with older medical imaging CDs and with current CDs created with older versions of software. In my case, I have two customers who’ve recently replaced many of their PCs with systems running Windows 7 x64, particularly for the physicians. Both experienced problems viewing diagnostic images (DICOM) on discs using eFilm Lite, but the same issues may apply to other packages as well. When this happens, it’s necessary to either use a different software package or (possibly) jump through some hoops to use a different version of the bundled software.
eFilm Lite is a DICOM viewing package from Merge Healthcare, a medical imaging software vendor. When medical imaging offices (MRI, CT, etc.) create CDs for patients, many use Merge’s eFilm Workstation product to create the CD with an included viewer, eFilm Lite. eFilm Lite versions prior to 3.3 (3.4 is the current version) are not compatible with 64-bit versions of Windows (Vista and Windows 7) and may experience issues on 32-bit Windows 7.
For home users working only with one or two CDs of their own images, the simplest solution may be to copy the entire CD onto the hard drive (in a folder of its own), then locate a copy of a newer (or possibly much older) version of the eFilm Lite software online and follow the instructions to replace the copy that was included with their CD. Much the same thing can be done by users who have multiple CDs where only some of them don’t work – a technically savvy patient, friend or relative should be able to copy the software from a newer CD to use with image files from an older one.
A tip for those attempting to use a different version of the software: use the file dates in Windows’ Detail view to help you determine which files are part of the software and which are part of the data. Data (image) files will generally have either the date of the study (MRI, CT, etc.) or the date on which the disc was created; program-related files will have other dates.
Large medical practices may have existing imaging systems into which they import patient images; those systems are beyond the scope of this article but you’re welcome to suggest them in the comments, particularly if they’re within the budget of small practices.
Small to midsize medical practices are likely to simply have doctors looking at diagnostic images on their PCs, and those practices may need local DICOM viewer software capable of opening a standard DICOM CD. Beyond allowing compatibility with CDs that include an incompatible viewer, having a locally-installed DICOM viewer package allows the physicians to get more familiar with the interface and may let them make better use of diagnostic images.
There are quite a few free DICOM viewer packages available (as well as lists of them), and I’ll add updates to this list as I get a chance to look at them and have a doctor or two try them.
MicroDicom is a Windows-based free DICOM viewer, compatible with both 32- and 64-bit versions of Windows including Windows 7 and Windows Server 2008. It has fairly quiet support forums, and a responsive developer. It’s available both with and without an installer. The website clearly states “This program has no CE mark (EU) or FDA approval (USA) nor any other national or international approval as medical device. It is therefore not to be used for clinical purposes and in any way to effect patient management.”