ASMIS: Advanced Surgical Media Information System

ASMIS is a central storage solution for surgical images and videos, which is installed as an intermediate "buffer" between the imaging in the OR and the hospital's long-term archive (e.g. PACS). The basic idea is that the existing long-term archive is not be "flooded" with unwanted or uninteresting videos from the OR, but only the desired video sequences that are necessary for documentation are stored here. For this purpose, ASMIS has a large number of intelligent functions built in that support the clinical workflow. ASMIS was developed in close cooperation with surgeons, biomedical staff and hospital IT managers to ensure practical relevance and seamless integration into heterogeneous medical device and Health-IT environments.


The still images created by the surgeon during the procedure should usually be sent directly to the PACS as the central image management system. However, long-term archiving of long video sequences with their very large data volume in the PACS is neither required nor economical. The intelligent HCI ASMIS archive management offers a solution for exactly this purpose. The images and videos from the OR are already transmitted to the central ASMIS video server while the procedure is ongoing. ASMIS forwards photos and short video sequences to the PACS, where they are available via the existing clinical image distribution, the Dicom Viewer. Long videos, for example the complete surgical documentation from cut to suture, are forwarded to the ASMIS video archive. ASMIS provides web-based surgical image and video review for easy video editing, adding comments and annotations and structured documentation. Videos of a study can be called directly from the Dicom or HIS viewer. And after an individually adjustable retention period, for example 6 months, the videos are automatically deleted from the ASMIS video server.

HCI ASMIS VideoServer: Features and functions
  • Central media archive with individually configurable rules for retention time and selection of the target archive
  • Supported image and document formats: JPEG, PNG, GIF, PDF
  • Supported video formats: MPEG2 / MPEG4 (H.264 and H.265) in different containers: MP4, AVI, MOV, with video resolution in SD / HD720 / HD1080 / 4K / 8K, with up to 120fps
  • Import of media objects from surgical Dicom modalities, e.g. digital endoscopy video processors, using ASMIS Dicom SCP function
  • Import of media objects via SMB share
  • User upload of images and videos via the web interface
  • 3rd party / external call of ASMIS studies via URL-Call, for integration into existing HIS / PACS / VNA image distribution
  • Presefined rules (policies) for automatic management of media files: Files are either automatically deleted, sent to the PACS or copied to another archive at the end of their retention time according to the policies; this can be individually set per file type, user, group or modality
  • Export function for media files (automatically according to policy or user controlled): DICOM store to PACS (DICOM-SCP) and/or USB export in "open" format to a local client disk/drive
  • Video conference and live streaming with the easyCapture workstations in the Operating Rooms
  • Mobile HTML application "mobileCapture" (Dicom photo app) for iOS and Android, for Dicom photo documentation in outpatient and nursing care, e.g. wound documentation / diabetic foot


Intelligent video documentation "Movie around Snap": Automatic video segmentation for clinically relevant video documentation without extra workload or training effort for the surgeon

ASMIS creates automatically short video sequences at intraoperatively generated marker or snapshot positions, e.g. 1 minute before the snapshot was taken and 1 minute after, resulting in 2 minute videos "around the snap", with the marked event in the middle of the video. This means that the structured surgical documentation takes place already during the procedure, there is no need for manual video editing to create clinically relevant video documentation. The created still images and the resulting small 2-minute videos "around the snap" are now automatically transferred to the PACS or Vendor Neutral Archive based on the ASMIS policies. They consume only little storage space, as they have been cleaned of clinically irrelevant sequences, and they show only what the surgeon has defined as "worth recording" during the procedure.




ASMIS web-client features

  • HTML5 based user interface, supports all common browsers on desktop PCs, terminal servers, tablets and smartphones
  • Video cutting function: Cut or cut and merge video sequences
  • Structured documentation with the marker and comment function "Info-Pins": Within a video, markers, so-called info pins, can be set at interesting points. Info-pins can be individually tagged with a short comment / descriptive keyword. The video playback in the browser is paused briefly at an info pin position, and the corresponding comment text is displayed. Additionally, the server creates a single still image (JPEG) at each info pin position when exporting the video. In the PACS, a new series is created that contains the additional images, automatically generated at each info pin position. The stored comment text at each info pin then appears per image in the DICOM tag "Image Comment". Thus, the PACS database can be searched for these commentary texts, e.g. for statistics or education and training



Installation requirements and technologies used

Engine:                 HCI ASMIS runs as a service under Microsoft Windows Server 2016 and 2019, also in virtual server environments

REST Server:        RESTful engine with documented REST-API

Database:            MySQL 5.7, internal or as schema external on existing SQL server

Web server:         Microsoft Internet Information Server internal on port 80/443, or external on existing http/https server infrastructure

User interface:     HTML5 GUI, multilingual, based on HTML stylesheets, therefore customizable for admins and integrators

HTML5 video:      ASMIS creates Adaptive Streaming Filechunks (MPEG-TransportStreams) for all videos according to the HLS standard (HTTP Live Streaming). This enables the playback of the videos via HTML5 also via Citrix on PCs and ThinClients as well as on common mobile devices (iOS and Android)

LDAP/AD:            Role-based user rights (individual or group based), synchronization of user accounts via Active Directory / LDAP

Dicom Export:     Any number of Dicom SCPs (PACS servers) can be configured, each with its own IPs, ports and AETs