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White Paper
Integrating Mac Systems into
a Medical IT Infrastructure
IT Organization and Guidelines
Adding new systems to the IT infrastructure requires a strict control process to ensure
new components comply with general IT regulations and special Department of
Clinical Radiology regulations.
User and system administration. The infrastructure organizes users and resources
in several separate Windows domains. At the time of publication, an eort to migrate
to an Active Directory (AD) structure was under way, with completion expected by
the second half of 2007. In the tree-type AD structure, each organizational unit is rep-
resented by a subtree domain, containing objects (such as computers or users) that
are uniquely identied by their names and sets of attributes. This eases the burden of
administering users and systems throughout the hospital.
IT security. The hospital’s security policies comply with the international IT security
guidelines outlined by the ISO 27001 certication standard. The German Federal Oce
for Information Security (BSI) provides guidelines and manuals based on this standard
that give detailed instructions on how to generate a threat analysis for a given IT infra-
structure and how individual needs for system security and data protection can be
fullled.
As a result, all of the hospital’s IT systems are equipped with an enterprise virus detec-
tion application (Sophos Anti-Virus)
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and device-controlling software (SecureWave
Sanctuary Device Control 3.01).
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Systems that are not compliant cannot be used
within the medical environment, especially for applications that deal with patient data.
These restrictions include the viewing and reporting workstations used in radiology.
Requirements for Integrating Radiology Workstations
At the University Hospital of Mannheim, radiology workstations must meet several
criteria before they are approved for use in clinical work. In addition to common
controls on electromagnetic elds and workplace security, the hospital’s evaluation
criteria cover:
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Integration into the given computer and user infrastructure. The computer must
be integrated into the existing domain or AD structure, allowing the use of authentica-
tion services and le/print access.
•
Device access control. For data protection and virus prevention, access to removable
media, network resources, and CD/DVD burning devices must be managed at the user
level. The system’s rmware also must be secured to deny access to the hard disk.
•
Virus detection. Workstations must feature client versions of the hospital’s enterprise
virus protection software and then integrate them with software and signature update
services.
•
Monitor calibration, conformity, and constancy testing. In many countries, displays
used for the reporting of radiological images are strictly governed by law and, in many
cases, by radiological societies. Depending on the types of images displayed, a monitor
must be able to achieve minimal values for resolution, brightness, contrast, and
homogeneity. Grayscale representation also must match a specic nonlinear Display
Function.
•
Certied viewing software and PACS integration. Radiological imaging software
must be certied for use in a professional medical environment.
•
Access to Hospital and Radiology Information System. In Mannheim, the Radiology
Information System (RIS) is connected to the Hospital Information System (HIS), so a
dedicated HIS client is not needed on report workstations. But access to RIS is crucial,
because radiology sta require direct access to RIS work lists, reports, and online
speech recognition functionality.
Including Mac OS X in Germany’s IT Manuals
The German Federal Oce for Information
Security (BSI) publishes IT manuals oering
detailed threat analyses and operating instruc-
tions for various major operating systems. But
current manuals do not cover Mac OS X. After
consulting with BSI specialists, we used the
sections “General client system” and “UNIX
client” from the BSI IT manuals to determine
the requirements and measurements necessary
to integrate the Mac-based OsiriX workstation.
We then made an ocial request to BSI to devel-
op a chapter in the manual that focuses on Mac
OS X. BSI accepted the request, and a Mac OS X
chapter will be included in a future release of
the manuals.
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