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Medical Image Management: DICOM Images Sharing Process

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5 minutes, 29 seconds read

For modern healthcare organizations, extending better patient care across the service continuum involves new challenges that surround sharing information over a distributed network. Effectively sharing patient information remains a challenge. However, the inability to access these records in a time-sensitive manner results in re-imaging and re-testing the patients. It affects both — ‘time-to-treatment’ and the bottom line. Effective medical image management thus becomes crucial for every digital healthcare enterprise. 

The release process for medical images is altogether complicated — brimming with security related-risks. Images (such as X-Ray Scans, MRI scans, PET scans, etc.) are created and released across several departments and systems while being purposefully kept ‘out-of-reach’ from a host of unauthorized users.

Training & controls on release policies and procedures require ‘health information management’ expertise. It’s because image Handling (electronically) can become susceptible to data corruption, complex accessibility/sharing issues and high-security risks. All of these raise potential red flags for health information management (HIM) professionals.

So how does Medical Image sharing work in this environment? What, if any — are the safeguards surrounding the ‘release’ process?

Medical Image Management: Sharing DICOM Images across healthcare enterprises

Before we go further, let’s delve into the term ‘Medical Imaging’. According to the WHO, the technique embodies different imaging modalities and processes to image the human body (creating visual representations) for diagnostic and treatment purposes. — making it crucial for improving public health initiatives across all population groups.

First, the image is captured using a medical imaging device (routine imaging techniques like ultrasound, MRI, etc.). Then it is necessary to archive and store the images for future use and further processing. Unlike regular images (.png, .jpeg), medical images use DICOM format for storage. DICOM is Digital Imaging and Communication in Medicine standard. The medical practitioner responsible for acquiring and interpreting such medical images is a ‘Radiologist’. And the system they rely on for storing electronic image data is ‘PACS’ (Picture Archiving and Communication System).

If a healthcare organization or an outside consultant (physician, clinician) needs access to an individual patient’s medical images, then the access and retrieval will have to go through PACS. Typically, a Radiologist has authority to control and operate PACS.

Here is a simple process diagram of a medical imaging system —

medical imaging system process diagram

A Typical HIPAA-compliant Medical Imaging Management System places a request (for a specific file) to ‘PACS’ via an intermediary system known as ‘Edge Server’. The sole purpose of the Edge Server is to function as a request-node so that other hospitals or physicians can contact the particular radiologist (who possesses the images stored in PACS) and place a request to access a copy of the file in question.

[Related: Modern Medical Enterprises Absolutely Need Test Automation. Here’s Why.]

Medical image sharing use cases

Critical use cases arise for medical image sharing involving support for:

  • Remote image viewing (out of network)
  • Specialist consults
  • Telehealth (examples such as teleburn, telestroke)
  • Trauma transfers
  • Ambulatory image review

Typically, PACS store digital medical images locally for retrieval. A PACS consists of four major components: 

  1. The imaging modalities such as X-ray plain film (PF), CT and MRI 
  2. a secure network for the transmission of patient information
  3. workstations for interpreting and reviewing images
  4. archives for the storage and retrieval of images and reports. 

To communicate with the PACS server we use DICOM messages that are similar to DICOM image ‘headers”, but with different attributes. The Edge Server manages several functions that allow users to sort through hundreds of thousands of large-volume data and retrieve a specific file from a database either stored in ‘PACS’ or on the ‘MIMS’.

Each of the three highlighted sections (see diagram) can perform various functions, while communication is defined through specific rules and standards that are legally enforced and universally followed.

DICOM medical image sharing via PACS and MIMS

Through the ‘Edge Server’, we can access images stored in PACS. The ‘Management Services’ operation is the first and foremost feature. It means that a user can control & maintain the complete functionality of the server through this. Using ‘Remote Authentication’, users can obtain centralized authorization and authentication to request files from PACS. Please note, Remote Authentication is a networking protocol operating by way of specific ports.

To verify basic DICOM connectivity to the server — i.e, to check if the server is live or not, a C-Echo message is sent to ping the server, after which it will wait for its response. Once identifying the server as live, a user can perform querying and retrieval-based operations. Next, the user can begin the process of requesting DICOM images from the Medical Image Management System — known as ‘Ingestion’. DICOM Ingestion involves pre-assigned IP and port addresses (default ports are 2104-2111).

Basic DICOM Operations

Client: First, it’s important to check the location of the specific image(s) on a particular server. For this, a query-based C-FIND operation sends a request to the server. The user establishes a network connection to the PACS server and prepares a C-FIND request message (which is a list of DICOM attributes). The user then fills in the C-FIND request message with ‘keys’ that match. (E.g. to query for a patient ID, the user fills the patient ID attribute with the patient’s ID.) Then, the C-FIND request message is sent to the server.

Server: The server reverts a list of C-FIND response messages. Each of these messages contain a list of DICOM attributes with values for each match. It then initiates C-MOVE request using the DICOM network protocol to retrieve images from the PACS server. 

One can retrieve images at the Study, Series or Image (instance) level. The C-MOVE request specifies where the retrieved instances should be sent (using separate C-STORE messages). The C-STORE operation, also known as DICOM Push simply pushes (sends) the images to the PACS server (or P2P — Push to PACS). 

C-STORE message implements the DICOM storage service. The SCU sends a C-STORE-RQ (request) message to the server, which includes the actual dataset to transfer. The server answers by returning a C-STORE-RSP (response) message to the user, communicating success or failure of the storage request.

DICOM Images Benefits

Using DICOM images, health management professionals, physicians, and radiologists can utilize secure protocols in handling confidential medical image data. It extends the ability to view such images discreetly and instantly; avoiding duplication costs; and reducing unnecessary radiation exposure to patients.

Medical Image Sharing furthers the “Health 2.0” initiative by being able to instantly and electronically exchange medical information between physicians, as well as with patients — improving communication within the industry.

[Related: How AI is innovating healthcare sector?]

About the author: Rijin Raj is a Senior Software Engineer-QA at Mantra Labs, Bangalore. He is a seasoned tester and backbone of the organization with non-compromising attention to details.

Related:

DICOM FAQs

What is the DICOM Image format?

DICOM stands for — Digital Imaging and Communication. It is a medical standard for sharing a patient’s MRI, X-ray, and other image files over the internet.

How are DICOM Images stored?

Unlike regular images (png, jpg, etc.) DICOM is a secure format for storing confidential medical images. Usually, PACS (Picture Archiving and Communication System) and MIMS (Medical Image Management System) are used to store DICOM Images.

What is DICOM used for?

DICOM is used for securely storing and retrieving confidential images in distributed networks (internet).

Why is DICOM important?

Using DICOM images, health management professionals, physicians, and radiologists can securely handle confidential medical image data.

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Empowering Frontline Healthcare Sales Teams with Mobile-First Tools

In healthcare, field sales is more than just hitting quotas—it’s about navigating a complex stakeholder ecosystem that spans hospitals, clinics, diagnostics labs, and pharmacies. Reps are expected to juggle compliance, education, and relationship-building—all on the move.

But, traditional systems can’t keep up. 

Only 28% of a rep’s time is spent selling; the rest is lost to administrative tasks, CRM updates, and fragmented workflows.

Salesforce, State of Sales 2024

This is where mobile-first sales apps in healthcare are changing the game—empowering sales teams to work smarter, faster, and more compliantly.

The Real Challenges in Traditional Field Sales

Despite their scale, many healthcare sales teams still rely on outdated tools that drag down performance:

  • Paper-based reporting: Slows down data consolidation and misses real-time insights
  • Siloed CRMs: Fragmented systems lead to broken workflows

According to a study by HubSpot, 32% of reps spend at least an hour per day just entering data into CRMs.

  • Managing Visits: Visits require planning, which may involve a lot of stress since doctors have a busy schedule, making it difficult for sales reps to meet them.
  • Inconsistent feedback loops: Managers struggle to coach and support reps effectively
  • Compliance gaps: Manual processes are audit-heavy and unreliable

These issues don’t just affect productivity—they erode trust, delay decisions, and increase revenue leakage.

What a Mobile-First Sales App in Healthcare Should Deliver

According to Deloitte’s 2025 Global Healthcare Executive Outlook, organizations are prioritizing digital tools to reduce burnout, drive efficiency, and enable real-time collaboration. A mobile-first sales app in healthcare is a critical part of this shift—especially for hybrid field teams dealing with fragmented systems and growing compliance demands.

Core Features of a Mobile-First Sales App in Healthcare

1. Smart Visit Planning & Route Optimization

Field reps can plan high-impact visits, reduce travel time, and log interactions efficiently. Geo-tagged entries ensure field activity transparency.

2. In-App KYC & E-Detailing

According to Viseven, over 60% of HCPs prefer on-demand digital content over live rep interactions, and self-detailing can increase engagement up to 3x compared to traditional methods.
By enabling self-detailing within the mobile app, reps can deliver compliance-approved content, enable interactive, personalized detailing during or after HCP visits, and give HCPs control over when and how they engage.

3. Real-Time Escalation & Commission Tracking

Track escalation tickets and incentive eligibility on the go, reducing back-and-forth and improving rep satisfaction.

4. Centralized Knowledge Hub

Push product updates, training videos, and compliance checklists—directly to reps’ devices. Maintain alignment across distributed teams. 

5. Live Dashboards for Performance Tracking

Sales leaders can view territory-wise performance, rep productivity, and engagement trends instantly, enabling proactive decision-making.

Case in Point: Digitizing Sales for a Leading Pharma Firm

Mantra Labs partnered with a top Indian pharma firm to streamline pharmacy workflows inside their ecosystem. 

The Challenge:

  • Pharmacists were struggling with operational inefficiencies that directly impacted patient care and satisfaction. 
  • Delays in prescription fulfillment were becoming increasingly common due to a lack of real-time inventory visibility and manual processing bottlenecks. 
  • Critical stock-out alerts were either missed or delayed, leading to unavailability of essential medicines when needed. 
  • Additionally, communication gaps between pharmacists and prescribing doctors led to frequent clarifications, rework, and slow turnaround times—affecting both speed and accuracy in dispensing medication. 

These challenges not only disrupted the pharmacy workflow but also created a ripple effect across the wider care delivery ecosystem.

Our Solution:

We designed a custom digital pharmacy module with:

  • Inventory Management: Centralized tracking of sales, purchases, returns, and expiry alerts
  • Revenue Snapshot: Real-time tracking of dues, payments, and cash flow
  • ShortBook Dashboard: Stock views by medicine, distributor, and manufacturer
  • Smart Reporting: Instant downloadable reports for accounts, stock, and sales

Business Impact:

  • 2x faster prescription fulfillment, reducing wait times and improving patient experience
  • 27% reduction in stock-out incidents through real-time alerts and inventory visibility
  • 81% reduction in manual errors, thanks to automation and real-time dashboards
  • Streamlined doctor-pharmacy coordination, leading to fewer clarifications and faster dispensing

Integration Is Key

A mobile-first sales app in healthcare is as strong as the ecosystem it fits into. Mantra Labs ensures seamless integration with:

  • CRM systems for lead and pipeline tracking
  • HRMS for leave, attendance, and performance sync
  • LMS to deliver ongoing training
  • Product Catalogs to support detailing and onboarding

Ready to Empower Your Sales Teams?

From lead capture to conversion, Mantra Labs helps you automate, streamline, and accelerate every step of the sales journey. 

Whether you’re managing field agents, handling complex product configurations, or tracking customer interactions — we bring the tech & domain expertise to cut manual effort and boost productivity.

Let’s simplify your sales workflows. Book a quick call.

Further Reading: How Smarter Sales Apps Are Reinventing the Frontlines of Insurance Distribution

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