How Smips Works

Smips comes as a complete service, including custom configuration, installation and training. In most cases, you will not have to install any software yourself except for things like a viewer on your personal laptop or the iPad Visualizer from the app store.

Getting Started

The first step in the process is to schedule a call to discuss your needs, priorities and the equipment you would like to hook up to Smips. If you have someone who handles your IT matters for you, it is best to include them on the call so we can discuss technical issues.

Vendors handle EMR/PACS integration with varying degrees of sophistication and older equipment can present a bit of a challenge so we'll probably need temporary remote access to your systems to investigate their specific capabilities.

Some vendors jealously guard your images as if they own them and will only let you export canned reports (pdf files) instead of the underlying images. We do not approve of this paternalism but, regretfully, there is not much we can do about it. If we identify constraints or find that your existing software requires an upgrade or optional components to support integration we will let you know at this stage.

Planning Your System Architecture

The architecture of your system (what goes where, who talks to whom, where status is displayed, et cetera) depends on the number and types of your image sources, as well as the way you plan to access the images once they are loaded into Smips.

We are not in the business of forcing you to buy overpriced equipment and we make every attempt to reuse your existing hardware. At times, however, it may become necessary to acquire new PCs or upgrade existing ones - this may happen, for instance, because you have an older computer without the necessary disk space or because a vendor warranty will be voided if we install any software on 'their' computer.

In such cases, we strongly encourage you to purchase the necessary components from your local big-box computer supply store but we will acquire them on your behalf if you prefer.

Creating an Image Repository

The location and size of your repository depends on the nature of your practice. If you screen mostly healthy patients and refer them to specialists when indicated, you may only need to store a few images per visit. If you manage disease progression in complicated cases you may store hundreds of images per visit and collect years worth of data for each patient. While Smips will support any scenario, the size of your repository will be determined by the way you work.

Like your equipment, your repository belongs to you, we do not hold any of your data or charge by volume (unless we have to split the repository because it is so large or the traffic is too heavy). You may use the service provider of your choice to host your repository as long as they can meet the standard technical requirements for Smips (basically those of a standard Windows server). If you prefer, we can set you up with an account at our own hosting provider, they offer a range of competetively priced services to meet all needs.

For customers with full-time IT support, or an IT department, we can install the Smips repository on your own server. We don't do this for other customers because of security concerns (opening up private networks for remote access without supervision) and the danger of data loss if normal backup and disaster recovery support is not available.

Connecting the Pieces

Each source of images (camera or manual import station) has to be set up with a 'Loader' that knows how to to receive images and securely forward them to your repository. Like you, we prefer a painless one- or two-click method to move your images from camera stations to the central repository, pre-organized and available for review as rapidly as possible.

In most cases, we can achieve this outcome, particularly if the camera vendor has done a decent job of implementing the so-called 'DICOM' medical image communication standard. For more challenging cases, we have a variety of tools for automatically importing images and, in the worst case, you can simply drag-and-drop images or folders of images into our manual loader.

For legacy equipment which works just fine but only provides paper reports and costs an arm and a leg to replace, we have a couple of options. The cheaper of these is to use a scanner and import the images manually but, if you prefer, a 3rd party product is available which acts as a combination printer and text-recognition device. The software part of this product can be configured to extract patient data from the incoming print job and automatically forward it to Smips for processing.

Viewing your Images

Once your images have made their way to the repository they can only be accessed through the Smips Visualizers for PC or iPad, both of which use standard encryption to protect your data. Your repository cannot be accessed using an ordinary browser such as Internet Explorer or Safari because it does not have a conventional web site associated with it.

As prescribed in the DICOM standard, images are organized by Patient, Study, and Series (a study is a group of images collected during one visit to a diagnostic device and a series is a subset defined by the equipment vendor, such as filtered images, or a fluorescein dye sequence).

Depending upon your needs, you can look up patient records and retrieve current and/or historical studies or series as a background process, meaning that you can start working on them right away even if you are fetching a lot of images. Your display options are:

  • A single study in hanging order (if prescribed by the vendor) up to eight at a time (two on an iPad)
  • Images from two studies side-by-side (you can swap out studies while you work)
  • Overlaid images from one or more studies, two at a time, which allows for aligning images and observing changes more clearly
The images can be freely manipulated (moved, stretched, or rotated), locked for annotation, bookmarked for future recall, or shared on a per-patient basis with collaborating physicians

What We Can't Do

We do require you to have an office network with stable and reliable internet access. Unfortunately, we can't help you if, for instance, your network is running slower than usual, if you can't connect to your server at all, or if you lose your connection while walking from one area of your office to another which has a weak wifi signal.

While we strive to meet all your requirements, for legal reasons we cannot make any claims about the suitability of Smips for your specific situation. Our standard disclaimer is available here.