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Comment by Damorian | Hacker News Reader

This is why I hate DICOM. DICOM itself is fine, it's just that every device manufacturer mucks it up. I remember once working with a device that claimed to meet a certain supplement. Got some sample data from a real world device, implemented the standard in our system, and started playing with it, but every image I got back was just a garbled mess. After tons of attempts, I eventually got in contact with a developer at the manufacturer who told me they encrypt the image data so that it can only be used by their supporting software...

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I think I know which manufacturer you are talking about, and this is super shady. They also go around in conferences talking about how "the data belongs to the patient" and how they "support standards".

Maybe now that the EU has started mandating data interoperability this could improve, but I have a feeling they will just find a way to tick that box without actually offering any diagnostically relevant data.

All manufacturers do this indeed. The “good” data is in the private fields that can only be read by the manufacturer’s proprietary software. The fields that are open for everyone usually have a lower quality version of the actual data. The latter is usually good enough for a small preview, but not good enough for proper diagnostic usage.

What sort of machines were you using?

My experience with research MRI/CT scanners is that the actual image data is usually where it's supposed to be.

This was an ultrasound machine. Philips would first have you import the data in their own QLab software and from there export a copy (which misses some of the data from the private fields). With GE reading the data was completely impossible.

Ugh. That may be one of the things on my post-pandemic todo list. Well, thanks for the heads up!

Is that even legal?

I suppose it could be false advertising to say you support a standard but only in a way that's meaningful to your software? As a 3rd party developer, it's hard to demand another company build something into their API, based on standards or otherwise. The best you can do is throw around your market share and lean on your mutual unhappy customers to make it happen.

I don't think it is, at least in the US. What most people forget about HIPAA is that the P stands for "Portability". The entire point behind it was that someone should be able to take their records from one hospital, doctor's office, or imaging clinic and then bring it to another one without having to go through another scan. DICOM was the industry's response to those portability requirements that our government put into place.

Are you sure about that timeline?

DICOM 3 (which was the first version using the DICOM name) dates back to 1993. HIPAA was signed in 1996.

I thought the “portability” part was meant to cover changes in jobs and life circumstances.

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