MACS at the Rothschild Foundation - PARIS. How to organise medical multimedia?


Modern medicine produces more and more multimedia content with every consultation. Although often associated with radiology, medical imaging today includes other disciplines, such as dermatology, ophthalmology, cardiology, neurology etc. These are just some examples of departments that generate large amounts of data (OCT, Visual field, ECG, EEG, wound photography, etc.) that the hospital must be able to acquire, store and archive.
The need to respond to requests from each of these departments has, in the past, sometimes led those responsible for digital biomedical data to employ multiple, varied solutions. It is not uncommon today to see more than 200 different digital applications used in a single hospital. It seems natural to consolidate and simplify this diversity of applications into horizontal tools, common to all users and physicians in the hospital: not just for cost-related reasons, but also to simplify user training, interfacing and maintenance.


Electronic patient records are a key component of modern hospitals, and are intended to be the backbone of hospital information. They are rarely designed to store, archive, and display content such as images, high-resolution video, and all other specialised imaging from medical devices, however.
It is clear that databases and systems for storing large files are not designed in the same way, nor is structured text data. Based on a wealth of experience in medical image management for nearly 20 years, Telemis has developed a MACS system - Multimedia Archive and Communications System - which enables all hospital DICOM and non-DICOM multimedia to be retrieved. In practice, this system connects to various medical devices (ophthalmology, ECG, EEG, ultrasound, endoscopy, etc.) to continuously retrieve all output and integrate it to a single database.

This does not simply mean integrating file formats, such as PDF, or expecting medical equipment to push information, but involves ongoing, detailed work to analyse each device, as well as its image production and potential compliance, cleaning the data produced so that it's ready for doctors to use, for optimum time-efficiency. This sometimes means consolidating several images into a single image (100 images to be consolidated to a single stack for ophthalmological OCT exams, for example), performing automatic rotation on some documents, identifying anatomic regions (left eye, right eye, based on PDF file names), and integrating read-only proprietary formats using a third-party tool. Not to mention the consequent work to retrieve the existing databases for consolidation and long-term archiving.
This MACS system has already been implemented in several institutions. Philippe Rouilhac, Head of IT at the Rothschild Ophthalmological Foundation, testifies: "Outside of radiology, the domain of medical imaging is less standardized, less organized - in the IT sense of the word. We need an extremely flexible but extremely effective system, from an organisational perspective. This system must be able to handle the volume of patients treated at the Foundation, and the expertise of our practitioners. With such high requirements (more than 1,200 ophthalmology consultations a day), connecting a department to MACS is a human and technological project, with specific, essential support."
And in conclusion: "Today, MACS, along with patient records, is a major and essential mainstay of everyday operations. It significantly simplifies management, maintenance and archiving tasks." In addition, the all-inclusive approach adopted by Telemis in terms of service, enables total control over all costs and deployments.


Modern hospitals must have three complementary elements: DPI for structured data, an image storing system, and a document store for the rest.
MACS enable various multimedia formats, now an integral part of the "patient record", to be managed. Connected to each other, these two elements simplify life for users, and enable them to save precious time. This combined software reduces research and training time to a minimum, as well as the support and maintenance required for users, all while reliably archiving the data. The keywords of this philosophy are flexibility, integration and cost-containment.