DICOM / DICOMweb

Status

Available

Region

Global

Data flow

Studies: your PACS → wawa. Worklists (Orthanc): wawa → your PACS

Connectivity

DICOMweb over HTTPS; Site-to-Site VPN or customer-managed public URL

Set up by

Clinic account administrator, values from your IT team

wawa does not run a DICOM server. It connects to yours over DICOMweb to:

1. Import ultrasound studies. Follicle-tracking and pregnancy scan measurements, from DICOM Structured Reports (SR), and images appear on the patient record without re-keying.
2. Push worklists (optional, Orthanc). Scheduled appointments become DICOM Modality Worklist entries, so scanners pull the day's patients instead of operators typing details in.

We recommend Orthanc as the server; any PACS with a standards-compliant DICOMweb interface works for study import.

Requirements

• DICOMweb (QIDO-RS and WADO-RS) served over HTTPS, with a public CA certificate or your internal root CA shared with us. Orthanc serves it under /dicom-web/; other servers may use a different path.
• Standard DICOM tags for SR reports and measurements. If your devices use custom tags, send documentation or sample data.
• Structured Reports. Image-only studies are imported without measurements; scanners must export SR.
• A secure service account for wawa (HTTP Basic):
  • Unique: used only by wawa, never by people or other systems. Don't share admin credentials.
  • Least privilege: read-only access to the DICOMweb endpoints and nothing administrative. Write access is needed only on /worklists if you use worklists.
  • Strong: a randomly generated password of at least 20 characters, not a memorable word.
  • Rotated at least annually, and immediately if you suspect compromise.
• A network path: a Site-to-Site VPN, or a customer-managed public URL restricted to wawa's egress IPs.
• Patient IDs on the scanners must carry the wawa patient identifier (a fixed suffix per site is supported).
• For worklists: the Orthanc REST Worklists plugin, and each scanner's AE Title and static IP.

What we need from you

Everything below is entered in wawa when the server is set up. Your IT team supplies the values; a clinic account administrator (or wawa, on your behalf) enters them.

Per DICOM server

Input	What to give us	Example
Name	A label for the server, usually the site name	Main clinic PACS
URL	The root of the server over HTTPS, without the DICOMweb path. Worklists and Orthanc's change feed are served from the root.	https://dicom.clinic.example
Username and password	The service account wawa uses (HTTP Basic)
DICOM time zone	The time zone of the server and its scanners. Used to read study times and to write worklist dates and times. Defaults to UTC.	Europe/London
Strip from Patient ID	Optional. Text your scanners append to the wawa patient ID, which wawa removes before matching (every occurrence)	-SITE2
DICOMweb path	Where DICOMweb is served, relative to the root. Leave the default for Orthanc; blank if DICOMweb is at the root.	dicom-web
Studies, series, instances, metadata and image paths	QIDO-RS and WADO-RS paths relative to the DICOMweb path. Pre-filled with the standard values; change them only for a non-standard PACS. No leading /.	studies/%{study_uid}/series
Orthanc server	Tick if the server is Orthanc. Required for automatic synchronisation and worklists.
Hostname the server answers to	Optional. Only if your server is on shared hosting that routes by name: wawa connects to the URL's address but sends this name for TLS (SNI) and the HTTP Host header.	pacs.example.azurecontainerapps.io
Automatic synchronisation	Orthanc only. wawa follows the server's change feed every 5 minutes. This setting applies to the whole account.
Default DICOM server	The server used for clinics without their own assignment

Per clinic (if you have several sites)

• Which DICOM server serves each clinic, or "Use default".

For worklists (Orthanc only)

Input	What to give us
Group name	A label for the scan room or group, for example Scan room 1
Worklist AE title	The AE Title that room's scanner queries its worklist for, usually the scanner's own AE Title. Up to 16 printable ASCII characters, no backslash, not *, unique within the clinic.
Clinic	The clinic the group belongs to
Default for the clinic	The group used when an appointment doesn't pick one. The first group of a clinic becomes its default.

Also tell us which appointment types are ultrasound scans: worklist entries are sent only for appointments in the ultrasound category.

Before go-live

• The validation checks pass against your server.
• Your scanners' patient IDs carry the wawa patient ID (after the optional strip).

Setting it up

1. Go to Settings → Integrations → DICOM and click Enable DICOM Integration.
2. On DICOM Servers, add each server with the inputs above.
3. On Clinic Assignments, choose the server for each clinic.
4. Once a server is marked as Orthanc, add groups on Worklist Groups.
5. Run Test Connection on each server.

How it works

Test Connection

Each server has Test Connection, which reports how many studies it found.

Result	Meaning
Studies found	Connected
"Plain study IDs instead of DICOM+JSON"	The DICOMweb path is wrong, so wawa is not calling the DICOMweb API
Warning about Structured Reports	The studies found have no SR data and will be skipped

How worklists behave

• When an ultrasound appointment is booked, wawa sends a worklist entry addressed to the AE Title of the appointment's worklist group, or the clinic's default group. Staff can pick a group when booking if the clinic has more than one.
• If the clinic has no worklist group, no entry is sent, so set a default group for every clinic that uses worklists.
• Re-sending an appointment updates its entry; cancelling removes it.
• Only appointments starting no more than three days ago, or later, are sent.
• Editing a group does not re-send entries already on the server.
• A generic (non-Orthanc) PACS supports study import only: no worklists and no automatic synchronisation.

Synchronisation

• Studies can be fetched on demand from the patient record for any DICOMweb server.
• With Orthanc, wawa also syncs changes automatically every few minutes from Orthanc's change feed.
• Only studies containing SR are imported as measurements.
• wawa never deletes studies from your server.

Your server, your responsibility

The clinic's IT team owns the imaging server: availability, security, patching and backups. wawa supports the integration, not the server itself.