Laurel Bridge
Integrated DICOM Routing and Radiology AI Orchestration for NHS Radiology Departments
đź“Ś Executive Summary
Laurel Bridge is an advanced, next-generation medical imaging orchestration platform that integrates the robust routing capabilities of Compass with the automated prior retrieval and workflow orchestration of Navigator, purpose-built to meet the clinical, technical, and regulatory needs of NHS Trust Radiology Departments.
Designed for seamless integration with Radiology AI algorithms and NHS PACS/RIS infrastructure, Beagle serves as a central control plane for all DICOM-based data movement, ensuring secure, intelligent, and automated imaging workflows across legacy and modern systems.
🧠Key Capabilities
1. Unified DICOM Routing and AI Workflow Management
- Consolidates Compass’ DICOM routing engine and Navigator’s prior-fetch logic into a single platform.
- Enables AI-ready workflows, directing exams to AI inference engines, RIS/PACS, and storage archives in parallel or sequentially.
- Flexible support for Store and Forward and Direct routing logic with multi-destination orchestration.
2. Radiology AI Integration Framework
- Routes studies to AI analysis platforms based on modality, body part, patient demographics, or referring physician.
Supports round-trip workflows: ingestion → AI analysis → results returned as DICOM SR, PDF, or HL7 messages. - Advanced filtering and matching rules to ensure only clinically relevant cases are routed to AI endpoints.
- Customizable Job Actions to handle AI result re-ingestion, HL7 alerts, or smart routing to consultants.
3. Smart Prior Retrieval
- Automatically retrieves prior studies based on MWL, HL7, or RESTful triggers, optimized for NHS PACS configurations.
- Context-aware retrieval: filters priors by body part, modality, adjacency, and age of exam.
- Retention policies ensure transient caching to align with NHS data governance guidelines.
4. NHS IT and Security Compliance
- Native support for TLS 1.2/1.3, encrypted HL7, Active Directory/LDAP, and auditable role-based access control.
- End-to-end audit logging for every action, message, and routing event, aligned with DICOM PS3.15 security standards.
- Designed for high-availability and failover-ready installations, including support for Windows Server clusters.
🛠️ Technical Features
| Feature Category | Capability |
|---|---|
| Routing Engine | Store & Forward, Direct Routing, Multi-destination, Load Balancing |
| Trigger Sources | DICOM MWL, HL7 ADT/ORM, REST API, CSV Polling |
| Destination Types | DICOM SCU/SCP, AI Engines, PACS, VNA, RIS, Cloud (AWS S3, GCP, Azure) |
| Workflow Automation | Job Actions, Retry Logic, Custom Scripting (C#/.NET), Event Hooks |
| Security | FIPS-compliant TLS, Certificate-based Auth, Logging Suppression for PHI |
| Web Interface | Secure browser access to job queues, logs, sources/destinations, cache |
| Cache Management | Transient DICOM cache with purging policies, searchable via C-FIND |
| HL7 Integration | Bidirectional messaging with hospitals’ RIS, support for ACK/NAK, HL7 v2.x |
| AI-Specific Tools | Inference tracking, SR/PDF mapping, Confidence score filtering, delay logic |
🧩 Interoperability & NHS Alignment
- Fully supports IHE profiles (e.g., SWF, PIR, XDS-I) used in NHS systems.
- Compatible with PACS vendors like Sectra, GE, Agfa, and RIS systems commonly used across Trusts.
- Designed to function behind NHS N3/HSCN firewalls, supporting proxy configurations and network zoning.
- Adapts to Trust-specific governance, including Information Governance (IG) Toolkits, and DSCN compliance.
🚀 Deployment & Scalability
- Modular architecture: scale from a single-site hospital to multi-site Trust environments.
- Deployable on virtualized Windows environments or cloud-hosted infrastructures (with NHS Digital guidance).
- Silent install options and remote license management ease Trust-wide deployment.
- Integration-ready via Compass APIs, HL7 messaging, and RESTful endpoints.
đź“Š Use Cases in NHS Context
- Automated AI Integration: Automatically route chest X-rays to a triage AI for suspected COVID findings.
- Efficient Prior Study Retrieval: Pull 2-year priors for oncology follow-up imaging automatically before reporting.
- Teleradiology Routing: Direct night-time trauma scans to outsourced radiology providers based on rule conditions.
- Disaster Recovery Prep: Redirect studies to offsite VNA if PACS heartbeat fails.
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🧩 Differentiators
| Laurel Bridge | Other Solutions |
|---|---|
| Combines routing + prior + AI logic | Typically siloed across multiple platforms |
| Workflow-aware DICOM/HL7/REST orchestration | Rudimentary DICOM routing only |
| Built-in compliance tooling for NHS | Requires third-party add-ons |
| Supports local + cloud-based AI engines | Limited cloud support or rigid integrations |
📦 Packaging & Licensing
- Available in Base, Enterprise, and AI-Enhanced editions.
- Perpetual or annual license models available for NHS procurement.
- Site-based pricing to fit within NHS Trust budget structures.
đź“ž Support & Services
- Backed by Laurel Bridge’s Tier-3 support team with NHS project experience.
- Optional onboarding packages, site assessments, and custom HL7/DICOM mapping services.
- Regular software updates with support for NHS LTS (Long-Term Support) Windows platforms.
Use Cases
1. AI Triage for Emergency Radiology Cases
Use Case: AI-Driven Prioritisation of Chest X-rays in A\&E
Scenario:
An NHS Trust A\&E department receives a high volume of chest X-rays, many of which require urgent attention (e.g., suspected pneumothorax or pulmonary embolism).
How Laurel Bridge Helps:
- Automatically routes CXR exams from A\&E to an AI inference engine upon acquisition.
- Applies DICOM filters (modality = CR/DR, body part = Chest, source = A\&E).
- AI-generated structured reports are ingested, and critical findings (e.g., high confidence pneumothorax) trigger escalation workflows.
- HL7 messages or SMS/email alerts are sent to on-call radiologists or consultants.
Outcome:
Faster triage of critical cases improves clinical response time, patient safety, and supports 24/7 diagnostic services.
2. Smart Prior Retrieval for Oncology Follow-Up
Use Case: Automatically Fetch Relevant Priors for MDT Reviews
Scenario:
Patients undergoing cancer treatment require regular imaging reviews. Radiologists need historical scans to evaluate disease progression.
How Laurel Bridge Helps:
- On receiving a new oncology CT exam (via MWL or HL7 trigger), Laurel Bridge retrieves relevant priors (e.g., last 12 months, same body part).
- Filters priors based on anatomy, modality, or referrer.
- Delivers the new study and selected priors to the reporting workstation or PACS in one unified job.
Outcome:
Saves radiologists time, reduces manual search errors, and ensures better diagnostic accuracy for MDT meetings and follow-up reviews.
3. AI Result Integration and Data Governance
Use Case: Structured AI Outputs as DICOM SR into PACS
Scenario:
Trusts deploying AI (e.g., stroke detection or mammography CAD) often receive results in PDFs or external formats.
How Laurel Bridge Helps:
- Intercepts AI results and maps them to DICOM SR or PDF Encapsulated objects.
- Inserts these into the correct patient/study folder in PACS using HL7 mapping and accession number reconciliation.
- Supports anonymisation or tagging for research, audit, or QA initiatives.
Outcome:
Enables clean and standards-compliant integration of AI results into the existing NHS infrastructure and audit trail, essential for governance and clinical documentation.
4. Disaster Recovery and Business Continuity
Use Case: Seamless Routing to Offsite VNA During PACS Downtime
Scenario:
A Trust’s PACS is undergoing planned maintenance or experiences unplanned downtime.
How Laurel Bridge Helps:
- Monitors PACS availability using heartbeat sensing.
- On failure, Laurel Bridge automatically reroutes incoming DICOM exams to an offsite VNA or backup PACS.
- Sends HL7 notifications to RIS or staff indicating temporary redirection.
Outcome:
Ensures zero-interruption diagnostic services, data integrity, and reduces manual intervention during outages.
5. Outsourced and Night Hawk Reporting
Use Case: Conditional Routing for After-Hours Radiology Services
Scenario:
During overnight shifts or weekends, NHS Trusts often rely on teleradiology providers for out-of-hours coverage.
How Laurel Bridge Helps:
- Based on schedule and trigger conditions (e.g., 6 PM–8 AM, modality = CT Head, location = ED), Laurel Bridge routes exams to an external teleradiology service.
- Ensures return of reports or structured data into the Trust’s RIS/PACS automatically.
- Supports secure DICOM transmission over TLS and patient data logging for IG compliance.
Outcome:
Facilitates safe, efficient outsourcing without sacrificing control, compliance, or traceability.