Radiology PACS
Full acquisition-to-reading workflow for hospital and imaging-center radiology.
Medical Imaging & PACS
Medical imaging & PACS software built on DICOM and FHIR
We build picture archiving and communication systems, zero-footprint viewers, and imaging pipelines on DICOM, DICOMweb, and FHIR ImagingStudy — engineered for radiology-grade performance, not a repackaged open-source viewer.
HIPAA-ReadyDICOMwebFHIR R4Audit Logged
Trusted by global innovators
What medical imaging software actually involves
Imaging software lives or dies on how it moves and renders large studies. A modern PACS ingests DICOM from modalities and worklists, stores it in a vendor-neutral archive, and serves it to viewers over DICOMweb (WADO-RS, QIDO-RS, STOW-RS) so a radiologist can open a 2,000-slice CT without waiting on a full download. Generic document systems and off-the-shelf viewers were never built for this data profile.
The harder problem is context. A pixel study is only useful when it is linked to the right order, patient, and report — which is where FHIR ImagingStudy, DiagnosticReport, and ServiceRequest come in, bridging the imaging silo to the EHR. We architect the DICOM plane and the FHIR plane together so imaging becomes a first-class part of the clinical record instead of a disconnected archive.
What it is
PACS, VNA, and viewer — one imaging surface
A PACS acquires, stores, distributes, and displays medical images. A vendor-neutral archive decouples that storage from any single vendor so your data stays portable, and a zero-footprint viewer puts studies in any browser without a client install.
We build these as one coherent surface on DICOM and DICOMweb, then link it to the EHR through FHIR ImagingStudy so imaging is part of the record — not a disconnected island.
Imaging architecture
See how we design DICOM ingestion, vendor-neutral archives, DICOMweb serving, and FHIR ImagingStudy links across imaging platforms we build.
What we build for imaging platforms
Each capability pairs an imaging workflow with the standard that makes it interoperable.
DICOM & DICOMweb services
C-STORE, C-FIND, and MWL for modality connectivity, plus DICOMweb WADO-RS, QIDO-RS, and STOW-RS for browser-native retrieval — the transport layer every downstream viewer depends on.
Vendor-neutral archive (VNA)
A single archive that stores studies independent of any one PACS vendor, with tiered object storage, DICOM tag morphing, and lifecycle rules so imaging data outlives the system that created it.
FHIR ImagingStudy linkage
We expose FHIR ImagingStudy, DiagnosticReport, and ServiceRequest so studies map cleanly to EHR orders and reports, closing the loop between the imaging silo and the clinical chart.
Zero-footprint web viewer
Browser-based viewing with progressive loading, MPR, window/level, and measurement tools built on OHIF/Cornerstone patterns — no client install, no per-workstation plugin sprawl.
AI inference hooks
Integration points for FDA-cleared and research imaging models, with results written back as DICOM SR or FHIR observations and surfaced in the reading workflow rather than a separate tool.
Access control & audit
Role-based study access, break-glass logging, and immutable audit trails aligned to HIPAA — every image view, export, and share is recorded and reviewable.
Where it runs
Imaging use cases we build for
Teleradiology
Remote reading platforms with secure study distribution and worklist routing.
Enterprise imaging / VNA
Multi-department image consolidation across radiology, cardiology, and pathology.
Imaging AI products
MedTech platforms that ingest DICOM, run inference, and return findings to the reader.
Patient image access
Portal-based study sharing so patients and referring physicians can view images.
Research imaging
De-identified image repositories for trials, model training, and teaching files.
Imaging platforms that hold up under load
Imaging is where generic viewers and document stores fall over. We treat DICOMweb performance and archive design as first-class engineering from week one.
DICOMweb
WADO-RS / QIDO-RS / STOW-RS native
VNA
Vendor-neutral archive architecture
FHIR R4
ImagingStudy linkage to the EHR
Compliance-First Healthcare App Development Services Backed by Global Standards
15-Minute Scoping Call01
HIPAA
Health Insurance Portability and Accountability Act
Protect PHI with privacy-first architecture, encrypted storage and transmission, strict access controls, and traceable audit logs.
02
GDPR
General Data Protection Regulation
Implement lawful consent flows, data minimization, retention controls, and secure processing for sensitive health data.
03
FHIR
Fast Healthcare Interoperability Resources
Enable standardized health data exchange across apps, care teams, and systems through robust FHIR-ready APIs.
04
HL7
Health Level Seven International
Support enterprise-grade interoperability with HL7-based integrations for records, events, and clinical messaging workflows.
05
HITRUST
Health Information Trust Alliance
Align security programs to healthcare-specific control and risk management practices trusted by providers and ecosystem partners.
06
HITECH
Health Information Technology for Economic and Clinical Health Act
Design with breach notification readiness, digital record safeguards, and operational controls that support regulated care programs.
07
SaMD
FDA Software as a Medical Device
Plan software quality, traceability, and documentation pathways for products that may require SaMD review and submission.
08
MDR (EU)
Medical Device Regulation (European Union)
Prepare EU market-ready processes for risk classification, evidence tracking, and lifecycle governance under MDR expectations.
09
SAMHSA
Substance Abuse and Mental Health Services Administration
Apply confidentiality controls and consent-aware sharing models for behavioral and mental health data experiences.
Standards we build against
Imaging standards in our SDLC
DICOMFHIRHL7IHEHIPAA
Our Process
How we ship imaging platforms
Modality connectivity, archive design, and viewer performance run as parallel tracks so the platform reaches production reading, not just a demo.
1.
Discovery & modality mapping
We inventory modalities, worklists, and target EHRs, then map the DICOM tags, transfer syntaxes, and FHIR resources the platform must speak before any code is written.
Standards-first design
2.
Archive & DICOMweb core
We stand up the vendor-neutral archive, object storage tiers, and DICOMweb services, validating C-STORE ingestion and WADO-RS retrieval against real study volumes.
Radiology-grade performance
3.
Viewer & FHIR integration
We build the zero-footprint viewer and wire FHIR ImagingStudy and DiagnosticReport into the EHR so studies, orders, and reports stay in sync.
Clinical context
4.
Deployment & monitoring
Phased go-live with retrieval-latency dashboards, storage lifecycle automation, and alerting on failed modality transfers as study volume grows.
Always audit-ready
Featured case study
Read Case StudyLera Health: compliant women's health platform
Related proof of compliant delivery: for Lera Health we built the privacy-first data layer, secure clinical workflows, and patient experience end to end — the same rigor around PHI handling, access control, and audit that an imaging platform demands.
Why Partner With Us
15-Minute Scoping CallWhy teams build imaging with us
Imaging is unforgiving about performance and standards. We bring both, plus the compliance discipline PHI-heavy pixel data requires.
Compliance-first by default
HIPAA-aligned access control, encryption, and audit logging designed into the archive and viewer from sprint one — not bolted on before launch.
DICOM & FHIR depth
We speak DICOMweb, transfer syntaxes, and FHIR ImagingStudy natively, so your team isn't teaching us the standards mid-project.
Performance-obsessed delivery
Progressive loading, tiled retrieval, and storage tiering tuned so radiologists open large studies fast, not after a spinner.
Interoperable by design
Vendor-neutral architecture keeps your imaging data portable across PACS vendors and connected to the EHR record.
Frequently Asked Questions
Most imaging builds run as staged engagements. A focused DICOMweb viewer or VNA connector is a smaller, weeks-long effort, while a full PACS with archive, viewer, and EHR linkage is a multi-month program. We scope by modality count, study volume, and integration surface, then price in phases so you fund a working slice at a time.
Planning a PACS, VNA, or imaging-AI build?
Share your modalities, study volume, and EHR landscape. We'll return a phased plan covering DICOMweb architecture, archive design, and FHIR ImagingStudy integration.
contact@agnotic.com
Partnerships
contact@agnotic.com