Laurel Bridge Compass: DICOM & HL7 Routing Workflow Manager

Robust, Scalable, and Secure Medical Data Flow Management for Healthcare IT Systems

Published: May 27, 2025

By: Darwinist Team

Technical Brief: Laurel Bridge Compass DICOM & HL7 Routing Workflow Manager

1. Overview

Compass is a robust, scalable, and secure workflow routing solution designed to intelligently manage DICOM (Digital Imaging and Communications in Medicine) and HL7 (Health Level 7) data flows within and between healthcare IT systems. It facilitates high-throughput routing of medical images and messages, offering flexible, rules-based logic for clinical environments demanding reliability, auditability, and interoperability.

2. Core Functional Capabilities

A. DICOM Workflow Routing

  • Acts as both a Service Class User (SCU) and a Service Class Provider (SCP):
    • SCU initiates a DICOM operation (e.g., sending an image).
    • SCP responds to that operation (e.g., receiving and storing an image).
  • Supports standard DICOM operations including:
    • C-STORE: Used to send (store) medical images.
    • C-FIND: Used to search for patient records or images.
    • C-MOVE: Instructs one system to send images to another system.
  • Handles DICOMweb protocols:
    • WADO-RS: Web Access to DICOM Objects using RESTful Services
    • QIDO-RS: Query based on ID for DICOM Objects using RESTful Services
    • STOW-RS: Store Over the Web using RESTful Services
  • Allows routing based on DICOM tag values, AE titles, and image metadata.
  • Enables transfer syntax conversion, compression handling, and tag modification.

B. HL7 Messaging Support

  • Ingests HL7 messages via network ports, folders, and web sources.
  • Routes messages using rules based on message content (e.g., patient ID, procedure code).
  • Supports transformation of HL7 messages into DICOM SR (Structured Reports).
  • Enables integration with RIS (Radiology Information Systems), PACS (Picture Archiving and Communication Systems), and other clinical systems.

C. Data Caching and Persistence

  • Hierarchical cache stores data by Patient > Study > Series > Image.
  • Supports DICOM C-FIND queries against cached data.
  • Allows Hold, Retry, or Manual Release of routing jobs.
  • Implements separate Penalty Box for failed jobs, aiding in error review and correction.

3. Interfaces

A. Compass Client (Desktop GUI)

  • Provides full configuration access.
  • Monitors job queues, cache, system status, and logs.

B. Compass Web

  • Web-based dashboard for remote monitoring.
  • Offers views for jobs, cache, associations, audit logs, and order entry.
  • Accessible over secure HTTPS connections.

4. System Architecture

  • Comprised of a continuously running Windows service, a SQL Server backend, and user interfaces (Client and Web).
  • Supports clustering and failover for high availability.
  • Allows scheduled destination availability and bandwidth throttling.

5. Rule Engine

  • Uses powerful, conditional rules to determine routing logic.
  • Supports advanced filtering based on DICOM tags or HL7 fields.
  • Allows custom scripts and extensions.
  • Supports time-based scheduling, job duplication prevention, and rule-triggered actions.

6. Security & Compliance

  • Complies with HIPAA, DICOM Part 15, and industry data protection standards.
  • Features include:
    • Role-based access control (RBAC)
    • Encrypted communications (TLS)
    • Secure audit logging (via syslog or local storage)
    • Optional PHI (Protected Health Information) suppression
  • Integrates with Active Directory for user authentication.

7. Integration Capabilities

  • Compatible with systems like PACS, VNA (Vendor Neutral Archives), EMR (Electronic Medical Records), and AI platforms.
  • Facilitates ingestion and distribution of imaging studies, reports, and metadata.
  • Supports integration into AI development pipelines, research networks, and multi-site radiology setups.

8. Scalability & Performance

  • Designed for high-throughput environments (e.g., millions of messages/month).
  • Uses asynchronous, multi-threaded job processing.
  • Supports queue depth control, retry logic, and destination heartbeats.
  • Efficiently manages concurrent jobs across many nodes.

9. Advanced Features

  • DICOM tag editing, de-identification, and re-identification.
  • HL7 field extraction and custom message transformation.
  • Integration with cloud storage (e.g., Amazon S3).
  • Plugin support for extended rule actions and job processing.
  • Custom folder ingestion and serialization formats.

10. Deployment Requirements

  • OS: Windows Server 2016 or newer.
  • .NET Framework 4.8.
  • SQL Server 2017+ (Express or Enterprise).
  • Open network ports for DICOM, HL7, and Web traffic.
  • Licensing based on nodes, volumes, and features.

11. Use Cases

  • Multi-site DICOM routing and consolidation.
  • HL7-driven order and report workflow orchestration.
  • AI integration and research image anonymization.
  • Clinical trial imaging ingestion.
  • Disaster recovery and remote teleradiology support.

12. Conclusion

Laurel Bridge Compass™ offers a reliable, flexible, and secure way to route and manage clinical imaging and messaging workflows. Its rich feature set supports modern healthcare IT environments, ensuring smooth data exchange between diverse systems while maintaining compliance and performance. With native support for key DICOM and HL7 operations (like SCU/SCP, C-STORE, C-FIND, C-MOVE), Compass stands out as a critical tool for health networks seeking to modernize and optimize their imaging infrastructure.

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Use Case 1: Multi-Site Image Consolidation

Problem: A healthcare network operates several imaging centers, each with separate PACS systems. Clinicians want access to a patient’s full imaging history, regardless of where the exam was performed.

Solution with Compass and Navigator:

  • Compass routes all DICOM studies from remote imaging centers to a central VNA (Vendor Neutral Archive).
  • It normalizes metadata across studies (e.g., patient IDs, study descriptions) using configurable DICOM tag filters.
  • Automatically retries failed transfers and caches images locally until successful.

Benefits:

  • Seamless access to comprehensive imaging records.
  • Reduced reliance on CDs or manual image transfer.
  • Improved clinical decision-making through complete image availability.

Use Case 2: HL7-Driven Workflow Automation

Problem: A hospital’s RIS sends HL7 messages for imaging orders.

Solution with Compass:

  • Compass listens for HL7 ORM (Order) messages and uses them to route studies to designated PACS, workstations or AI SaMD.
  • When the DICOM images arrive, Compass matches them with HL7 metadata (e.g., Accession Number) and applies routing rules.

Benefits:

  • Automated and intelligent image routing tied to clinical workflow.
  • Ensures accurate routing to radiologist destinations.
  • Reduces errors and manual intervention.

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Use Case 3: AI Model Integration for Clinical Imaging

Problem: A hospital wants to evaluate AI tools that detect pathologies in CT images, but must ensure only de-identified, high-quality data is sent to the AI vendor.

Solution with Compass:

  • Compass applies rules to identify relevant CT series.
  • Performs on-the-fly de-identification of PHI (e.g., names, IDs, dates).
  • Sends the filtered, anonymized images to the AI engine or cloud container via DICOM or S3.
  • Receives and routes AI results, and may apply reidentification, (e.g., DICOM SR or PDF overlays) back to PACS or report repositories.

Benefits:

  • Streamlines clinical AI integration without burdening IT.
  • Protects patient privacy and maintains auditability.
  • Enables feedback loops between AI systems and clinical workflows.

Use Case 4: Disaster Recovery and Teleradiology Routing

Problem: A radiology practice needs to redirect imaging workflows to offsite readers during system outages or after-hours coverage.

Solution with Compass:

  • During regular hours, Compass routes studies to the local PACS.
  • After hours or during a system failure, Compass automatically reroutes new studies to a teleradiology provider or alternate data center.
  • Uses rules to trigger routing changes based on time of day, system availability (heartbeats), or job failures.

Benefits:

  • Provides high-availability and business continuity.
  • Ensures uninterrupted patient care even during outages.
  • Reduces manual reconfiguration and downtime risk.

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Use Case 5: Clinical Trial Imaging Data Management

Problem: A hospital participating in a multi-center clinical trial must collect, anonymize, and forward relevant imaging studies according to sponsor requirements.

Solution with Compass:

  • Detects trial-related studies using specific DICOM tag values or HL7 order details.
  • Applies site-specific anonymization scripts (e.g., remove PHI, remap IDs).
  • Formats and sends studies to the clinical trial image repository or CRO (Clinical research organization) via DICOM.
  • Logs and audits every transfer for compliance reporting.

Benefits:

  • Speeds up trial onboarding and data submission.
  • Ensures deterministic anonymization across patients and sites.
  • Enables regulatory compliance (e.g., FDA, HIPAA, GDPR).
Tags: DICOM HL7 Medical Imaging Workflow Automation Healthcare IT PACS Data Routing
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