O3-DPACS system: challenges and original solutions in developing an open source project for the PACS critical system.

Within the context of the Open Three Consortium project, a new version of the Picture Archiving and Communication System (PACS) was developed in order to take advantage of new technologies and comply as best as possible to some requirements for a state-of-the-art health information system. Such requirements are the result of ten years of research run by the Bioengineering and ICT group from the University of Trieste. The requirements include the use of open source technologies, but developing a PACS system using such approach and model generates some issues, since a PACS represents always a critical system. The main issue is the opposition that Open Source has to face in literature and market due to doubts concerning its reliability. The requirements also include the use of open standards, portability and scalability. This paper describes the state-of-the-art in literature as seen under the light of the mentioned requirements and how the author faced the challenges to make O3-DPACS achieve the best degree of satisfaction to those requirements, taking care of each of them as early as from the software design phase and using original solutions. Original solutions were developed for great scalability and portability, granting the execution of the software on different Application Servers. Real world success stories are reported and compared. Moreover, the architecture of the software is analyzed, proposing it as a model for the development of open source critical systems. The solutions implemented in O3-DPACS seem to make it the system which best fits the requirements to date, and we think the software architecture proposed, coupled with organizational arrangements, is able to take reliability and quality into healthcare open source applications. [ABSTRACT FROM AUTHOR]