Filmless Imaging Technology

What Is FIT?

DDI Health working in collaboration with HCN has delivered an online imaging retrieval system dubbed Filmless Imaging Technology (FIT). Rather than the radiology provider generating a series of films or a CD, the images are made available via the Internet, direct to the clinicians computer.

To facilitate what DDI is marketing as “the last mile”, image streaming technology is used to great effect. [See Sidebar: Streaming Explained]. Using a broadband connection, images begin to appear in a matter of seconds. As the user zooms in and pans around the image, each screen refresh is completed in a similar timeframe.

Delivery Benefits

Internet based delivery of images has many benefits:

  • Turn around time is minimised, allowing images to be made available to the doctor as soon as the report is completed.
  • The patient doesn’t need to take responsibility for their films, eliminating problems associated with them being forgotten or misplaced.
  • Practices don’t have to store films, reducing the strain on typically overflowing practice shelf space.
  • Clinicians can access the images from any room with an Internet-connected computer, eliminating the reliance on a light box.

Viewing Benefits

DDI touts the ability to view both the report and the image “in context”( i.e. simultaneously on one screen) as a significant benefit not available using traditional means.

In addition to viewing the images on screen, the clinician has many display options not possible with film. Brightness, contrast, magnification and orientation can all be easily adjusted with simple mouse controls. Colour inversion, annotations and bone density determination is also possible.

MD3 Integration

At the time of writing, Medical Director 3 (MD3) is the only practice software with DDI’s FIT solution tightly integrated. If the radiology provider has FIT enabled, the images can be called up directly from the result screen, allowing for a seamless workflow. By default, the report is displayed side-by-side with the images, allowing the clinician to easily reference the report and show the image to the patient if appropriate.

A demonstration video highlighting this integration is available from the DDI website, as are sample radiology results that allow current MD3 users to view a selection of images.

Sharing Images

MD3 users can forward the radiologist’s investigation report to interested parties, allowing them to access images via Microsoft Internet Explorer 6. Unfortunately other browsers (and hence operating systems) are not currently supported.

A unique URL is embedded in the report that loads the image using an identical interface to that presented in MD3. Like the rest of the radiologist’s report, this URL should be shared only with authorised parties as it contains all the details needed to access the patient’s images.


As with existing radiology services, the radiology provider and patient bear the cost of the production and delivery of the clinical images. The only possible cost to the practice may come via an increased Internet data charge, though this can be mitigated by selecting an appropriate Internet plan with a large or unlimited transfer allowance.


FIT is reliant on having an active, stable Internet connection. In the unlikely event that your practice loses its connection, you will be unable to view the images. While this is an unavoidable limitation of all web services, the proliferation of broadband and consumer demand for stable Internet connections should ensure downtime is rare. As Peter Weston of DDI explained, “the chance of Internet downtime is significantly lower than the chance of films being misplaced, forgotten or otherwise being unavailable when required.”

Practices should note that Internet dependent solutions are rapidly growing in popularity (see page 26), meaning that Internet uptime will become increasingly important. The feasibility establishing a redundant Internet connection at your practice should be discussed with your IT provider.

FIT Evolved

Since Pulse IT first looked at FIT at the Sydney GPCE in late May, the DDI offering has undergone welcome cosmetic changes. With the assistance of an interface expert, DDI refined the navigation controls, making the program more intuitive and easier to use. Other important features have been added, including an indicator showing when data is being streamed. This is an important addition, and should ensure that clinicians make their assessments on completely loaded images, not on the lower resolution “interim” version displayed while the image is being refined.


HCN is marketing FIT as a major feature only available in MD3. The steady stream of practices converting to HCN’s flagship product should encourage more radiology providers to consider implementing the DDI solution. Symbiotically, as more radiology providers offer DDI’s FIT solution, one imagines that MD3 will become a more compelling proposition for MD2 users.

Because of its Internet lineage, it shouldn’t be technically difficult for other practice software vendors to integrate DDI’s solution into their products.

Patient confidentiality needs to be considered and both the provider and the user will need to ensure adequate security safeguards to limit access to both the images and the reports.

This system has significant benefits for both patients and clinicians in terms of rapid availability and user-friendly storage of all forms of medical imaging. As end-users embrace this and similar solutions, this type of technology will become a standard in general practice.

Posted in Australian eHealth

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