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Integration: DICOM

Integrate with your DICOM server to automate the pulling of data – such as from ultrasound scan machines.

Kiera Frances Martin avatar
Written by Kiera Frances Martin
Updated over a week ago

1. DICOM Integration

Wawa does not operate a DICOM server, but we are able to integrate with your DICOM server in order to automatically pull data – for example from ultrasound machines.

2. Prerequisites from your DICOM server

​DICOMWeb support:

The server must support the DICOMWeb standard (QIDO-RS, WADO-RS).

Working endpoints:

The provider should supply a set of tested endpoints for retrieving studies, series, instances, metadata, and images. These must follow the DICOMWeb standard.

Network access:

There are several ways to make the DICOM Web Server accessible to Wawa, including VPN, Direct HTTPS with controlled firewall rules or Reverse-proxy solutions. In this guide, we share how do connect via a Cloudflare VPN; it is up to the clinic to select the preferred one based on the internal policies.

HTTPS encryption:

The DICOM Web Server must be accessible via HTTPS. We recommend using a certificate issued by a globally trusted Certificate Authority (e.g., Let’s Encrypt).

DICOM tag compliance:

The server should use standard DICOM tags for SR reports and measurement data. If custom tags are used, documentation or sample data must be provided.

⚠️ Before starting, make sure that your DICOM server (PACS/Orthanc...) is accessible on the local network (e.g., http://127.0.0.1:8042).

2.1. Connection via a Cloudflare VPN (example)

Since the DICOM Web Server is usually hosted on an internal IP address, it must be securely exposed to the internet.

Steps to configure:

  1. Create an account in Cloudflare and register a domain

  2. Install cloudflared 

    # Debian / Ubunto
    wget https://github.com/cloudflare/cloudflared/releases/latest/download/cloudflared-linux-amd64.deb
    sudo apt-get install ./cloudflared-linux-amd64.deb
    cloudflared -v

    # Windows
    winget install Cloudflare.cloudflared

  3. Authenticate

    It opens a browser login page and you need to select the domain you have created

    cloudflared tunnel login

  4. Create a tunnel

    Generates a Tunnel UUID and a JSON credentials file.

    cloudflared tunnel create dicom-wawa

  5. Configure the tunnel

    /etc/cloudflared/config.yml

    tunnel: <TUNNEL-UUID>
    credentials-file: /etc/cloudflared/<TUNNEL-UUID>.json

    ingress:
      - hostname: dicom.yournewdomain.com
        service: http://127.0.0.1:8042
      - service: http_status:404

  6. Route DNS

    $ cloudflared tunnel route dns dicom-wawa dicom.yournewdomain.com

  7. Run as a Service

    # Linux
    sudo cloudflared --config /etc/cloudflared/config.yml service install
    sudo systemctl enable --now cloudflared
    systemctl status cloudflared

    #Windows
    cloudflared service install

3. Configuring the Integration

Once the prerequisites are met, you are in a position to configure the integration, so you need to navigate to the "Integrations" section in the settings of your wawa account.
​
From here, you select the "DICOM" integration.

  1. Enter Authentication Details

    1. Provide your username and password

    2. Enter the base URI for your DICOM server.

  2. Configure Standard Paths

    1. Studies Path

    2. Series Path

    3. Instances Path

    4. Metadata Path

    5. Image Path

    These paths follow DICOM standards and should align with commonly used open-source configurations (e.g., Orthanc).

  3. Save and test the connection

⚠️ The %{study_uid}, %{series_uid}, %{instance_uid}, and %{frame_number} are placeholders.

3.1. Default Orthanc DICOMWeb Paths

If you are using Orthanc as your PACS server, please make sure the integration is configured with the following paths:

base_uri: "https://<your-domain>/dicom-web/" all_studies_uri: "studies" all_series_uri: "studies/%{study_uid}/series" all_instances_uri: "studies/%{study_uid}/series/%{series_uid}/instances" instance_metadata_uri: "studies/%{study_uid}/series/%{series_uid}/instances/%{instance_uid}/metadata" instance_image_uri: "studies/%{study_uid}/series/%{series_uid}/instances/%{instance_uid}/frames/%{frame_number}"

👉 For example, if your domain is https://dicom.yourclinic.com, then your Base URI should be: https://dicom.yourclinic.com/dicom-web/

You should not replace them manually — Wawa automatically fills these values when querying the PACS.

4. Testing and Validation

After configuration and access are in place, you can perform a simple test by inputting a patient ID of choice in the test field, and clicking "Test Connection".

→ Successful configuration will result in a green box, informing you how many studies were found for that patient.

For a full guided walkthrough, see the video below:

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