Zero Footprint Image Viewers For Mobile Devices

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Zero Footprint Image Viewers For Mobile Devices John Kingan Unrestricted Internal Use 2011, Carestream Health

The good old days p.2

p.3 Emergence of Mobile Technology When Computers were Computers and Mobile Phones were for talking Mobile devices are ubiquitous Laptops, Netbooks, Smart Phones, Tablets... USB Desktop Aquariums With many devices, come many OS Desktop - Windows, OSX, Linux, different versions of each Mobiles - Android, ios, Blackberry, Windows Mobile 6.5, Windows Mobile 7, Symbian Introduction of Tablets, Smart Phones and other Mobiles devices means we need to find a way to access data using these devices, with a consistent interface. An application built for Android (Java) wont run on an ipad (Objective C) and will look different! What about 2014 or after? What next!? One platform we know will be there is The Web

p.4 Zero Footprint == Web Browser Zero Footprint Image Viewing truly addresses the needs using client-server visualisation architecture and utilises standard browsers and built-in H/W virtualisation to enable viewing images in real time A Zero Footprint Image Viewer means no client side installation or download, allowing for viewing of documents and images within the native browser, harnessing the true capabilities of the browsers built-in plug-ins and their interaction with the device itself A Zero Footprint Image Viewer allows viewing natively in the web browser regardless of the type of browser, version, location, machine, device, software or hardware. Since the Viewer does not store anything on the end-users machine, there are no storage or technology requirements for users' mobile devices or even remote workstations...

p.5 Mobile Development Playground Access to PACS images has been a playground of different technologies - often because of the bit-depth of DICOM images Web browsers are not capable of displaying 16-bit gray images (65536 gray values), but only 8-bit grey values (256 gray values). Therefore, Windowing/Levelling is used to transform 16-bit to 8-bit image Vendors have taken advantage of different technologies, such as Java, Silverlight, Adobe Flash, Active-x (embed feature set into a web page) to achieve PACS workstation usability in a web browser The concepts are often known as plug-ins - because the web browser has to download a (DICOM/image) viewer plug-in and run it inside the browser... GOAL: To have a real plug-in-less concept where image rendering can be realised directly in the browser without downloading anything except HTML code

p.6 Explosion of HTML5 HTML4 was for writing and linking scientific documents HTML5 more an application language and allows us utilise H/W. Canvas elements, video elements all part of HTML5 and avoid the need for plug-ins We can easily control and view video, audio, interactive painting (which previously required app development for) without a plug-in Expose technology inside the browser - which is available on your OS - whatever the OS Annotations and measurements, for example, can take advantage of client-side HTML5 capability and reduce or minimise network usage

p.7 True Power of HTML5 Canvas element - allows for dynamic, scriptable rendering of shapes and images - JavaScript code can access this canvas area through a full API If desired, this allows us to execute zooming, windowing/levelling etc. if the 16-bit image was available on client Allows higher performance manipulating data - zoom on client rather than server rendered (Moore's law) Web workers - browsers don't have a concept of threading (off the UI thread) - JavaScript is single threaded... new API which provides means to run scripts in web browser background thread - allows asynchronous image loading Offline storage and WebSQL - new API for storing data in web browser for offline use (replaces cookies!) Standard fluid layout, Drag and drop, Style sheets etc.

p.8 Security Protocol Security HTTPS (web application server), public certificates - akin to Amazon! which we all use and trust Simple and understood by IT departments... Web security - built in to heart of web Can't access HDD's - in the future, mobile devices will go this way Apps can share data - OAuth (twitter, show me my first tweet), cross origin resource sharing Web now supports permissioning, such as Geolocation - traditionally it didn't we can detect if user has gone away from computer Digital Rights Management - requests from Microsoft, Google, Netflix etc. to provide view only documents, control printing, navigation, saving content etc.

p.9 Performance Browsers don't have a concept of threading (off the UI thread) - Image manipulation using JavaScript can cause pause and a message of process unresponsive Performance of JS has increased dramatically, Browsers can now do 3D graphics! Faster than it was - JavaScript performance benchmark:- Firefox (2004) - 1802ms" Chrome7 (2010) - 10ms" DOM Rendering benchmark Firefox (2004) ~ 111ms (9 ops/sec)" Chrome7 (2010) ~ 2ms (460 ops/sec)" 2-way streaming with Web Socket - bi-directional, full duplex communications over TCP/IP

p.10 The Facts Mobile is changing everything, Web makes sense as a platform that spans mobile platforms Whole internet is moving away from static images to moving images on client Tech Companies are abandoning Flash and Silverlight and Media Players for HTML5 Internet Explorer 9 could not avoid using HTML5 and left Microsoft needing to explain why Silverlight is not going to be their premium choice Windows 8 - targeted for mobile devices - will use HTML5 and JavaScript - touted as the new way to create applications Application that can be deployed to iphone, Android, Palm, Blackberry

p.11 Take-away Browsers are evolving rapidly - actually appear to be getting simpler over time Chrome is asking if we really need a UI, ensuring real-estate is maximised New technology called Canvas - Arbitrary rendering opens up what browsers can do Using web technologies applications now appear to the user as a native application Hand-held devices don t have human interaction to report daily from these devices Clinical results show a mobile image is good enough for reporting - but human experience is not the same and therefore good enough for routine work Ability to reach out to referrers and patients, using technology and interfaces they are familiar with, without VPN s or dedicated secure networks

Questions?

p.14 What it must do Zero Footprint Viewer utilises imaging with dynamic client-server architecture to display images in a rich application experience, with minimal latency Zero Maintenance - as enterprises grow, more users carry a phone, tablet and PC, it becomes increasingly difficult to install client S/W on each machine and provide maintenance and upgrades time consuming, complex and inefficient Zero Time To Load - streaming concept - imagine if every time you hit a website you had to wait for the entire page or if you go to YouTube and view a video, you have to wait for the entire video before playing - Zero FP is built on the same streaming concept on-demand, instead of downloading the whole document on the users machine