A middleware architecture to improve the efficiency of web-based telemedicine application

A middleware architecture had been proposed to resolve data access and interactive communication problems in web-based medical applications. The middleware was used to prepare multiple channels for, data access, manage on-line end-users' requests, and provide a programming interface. In contrast with traditional CGI architecture without middleware, the middleware architecture could realistically improve the stability and performance of data retrieval (reducing processing time by 50%), and achieve a 100% successful connection it could thus not only improve data access efficiency, but also reduce the chance connection failure to an amazing extent. A web-based telemedicine system was built based on the middleware architecture. This system could display DICOM-formatted images using an ActiveX-based viewer, and permits real-time interactive consultation via a PC-based videoconference system. It had been used experimentally at National Taiwan University Hospital in order to confirm its functioning.