Military university moves teaching files to head of the class

An online database-driven image library and teaching file program allows healthcare professionals to share an organized, cataloged, and searchable database of captioned and annotated medical images.

The system, called MedPix, was developed by the departments of radiology and medical informatics of the U.S. Uniformed Services University.

"The vision of MedPix was to take the teaching file out of the closet and create a collaborative tool for organizing and displaying teaching file cases between geographically separated institutions using the existing Internet infrastructure," said Dr. James G. Smirniotopoulos, chair of radiology and nuclear medicine at Uniformed Services University of the Health Sciences (USUHS) in Bethesda, MD.

MedPix works as a Web-enabled, cross-platform database, integrating images and textual information. It is aimed at a target audience of radiologists, radiology residents, practicing clinicians, medical students, graduate nursing students, and other postgraduate trainees. No special software other than a standard Web browser is required.

Material in the MedPix database -- organized by disease category, disease location (organ system), and patient profile -- can be searched through multiple internal text search engines. Users can browse the image database through a slide-sorter that displays selections as a collection of thumbnails.

Smirniotopoulos cited four goals of the program:

• Create a completely digital image library that would satisfy the Radiology Residency Review Committee's criteria for a training program teaching file

• Ensure that the MedPix system runs entirely on a standard Internet client Web browser, without requiring the use of any additional software or plug-ins

• Have controlled access and peer review for every case

• Control all functionality through a database architecture that provided security, flexibility, and scalability

The original database design of MedPix, developed jointly by Smirniotopoulos and Henry Irvine, a USUHS medical student, evolved from a hierarchical note-taking program written in Visual Basic in 1995.

MedPix development has progressed through several stages over the past two years. The initial database-driven Web site was written as a text-only program under Linux. The image uploading and downloading facilities were added next. The Teaching File component was launched in November 2000.

The site already features a Radiology Case of the Week, and Smirniotopoulos has plans to add a Pathology Case of the Week soon.