A thin client is any computer system basically, that uses an application for whom all processing occurs on a central server, with just the results shipped back to the client for sisplay. Data storage is never performed on the client machine.

This paradigm is ideal for medical data, which is of an obviously sensitive nature and not the sort of thing to be stored willy nilly on a thousand different computers around the world, as it is passed from expert to expert.

It is perhaps surprising thusly, that utilising thin clients for medical data is a very young concept, first coming in thanks to the work of Mercury Computer Systems at the very end of 2008. The company trialled the first such medical data client, which they call Visage.

Visage 3.1, the first widely deployed medical thin client

In addition to keeping medical data safe and centralised, a medical thin client setup allows any number of computers, no matter their specification, to connect and manipulate data. All that is needed is the physician's access authority - which increasingly is provided by biometric data. In this way, a patient's records can be worked on on a desktop computer, laptop, palmtop, even a web enabled phone. Use can flip from device to device as the medical professional travels about, or passed to another professional on the other side of the world, instantly and easily.

Mercury's offering, is designed as a diagnostioc tool, helping to virtualise healthcare, by manipulating PACS compatible diagnostic data from a variety of sources - CAT scans, X rays, ultrasound, ECGs... In fact almost every computerised medical tool, permitting the professional to overlay data, combine data, enhance it, create 3D variants and rotate. Everything designed to give far more useful information than a 2D slice taken from any one angle, and all in real-time.

As Visage is the only such system on the market at time of writing, it is hard to compare the offerings of different systems. However, it is safe to say that this system sets the bar very high indeed. The following, taken from the company's brochure, lists the type of data that can be remotely manipulated in this manner:

• Multiple new 2D and 3D ROI types
• Time-value curves for arbitrary ROIs
• Semi-automatic editing tools for separating vessels, bone, and other structures
• Curved reformatting with the possibility of generating curved stacks and rotations
• Significantly enhanced 3D slab as well as editing and visualization of 3D segmentations
• Calcium scoring, coronary artery and left ventricle analyses
• Powerful 3D editing functions
• Automatic chest wall removal
• Myocardial mass calculation
• Temporal MIP and MinIP (tMIP)
• Mean transit time (MTT)
• Time to peak (TTP)
• Cerebral blood volume
• Cerebral blood flow (CBF)
• ROI-based symmetry analysis
• PET/CT SUV calculation for 2D and 3D ROIs
• Different SUV types and manual editing of SUV parameters
• Semi-automatic 3D segmentation of small lesions in CT, MR, and PET-CT

Further Reading

Wikipedia on Thin Clients

Visage? CS Thin Client/Server brochure (PDF)
Please note the brochure is slightly outdated, as it states the client is pending US FDA approval - this has since been granted.

Visage Press Release