Using JPEG 2000 Interactive Protocol to Stream a Large Image or a Large Image Set

The electronic health record (EHR) is expected to improve the quality of care by enabling access to relevant information at the diagnostic decision moment. During deployment efforts for including images in the EHR, a main challenge has come up from the need to compare old images with current ones. When old images reside in a different system, they need to be imported for visualization which leads to a problem related to persistency management and information consistency. A solution consisting in avoiding image import is achievable with image streaming. In this paper we present, evaluate, and discuss two medical-specific streaming use cases: displaying a large image such as a digital mammography image and displaying a large set of relatively small images such as a large CT series.