Center for Vein Restoration: A Decade of DICOM Partnership & Scalability | Case Study

The Center for Vein Restoration (CVR) is the nation’s largest physician-owned vein center. This case study demonstrates H.R.Z.’s commitment to long-term partnerships, evolving and scaling a mission-critical High-Performance DICOM Server with Modality Worklist SCP for PACS/VNA to a nationwide operation.

The Challenge: Building a Future-Proof, Highly Resilient Infrastructure

In 2015, CVR required a cost-effective system to manage and store growing medical imaging volumes while improving interoperability. The core requirement was an architecture that could rapidly scale and adapt as the company executed its aggressive expansion plan across the country, demanding: Longevity & Commitment: A vendor capable of supporting the system’s evolution for a decade or more. High Availability: A fully redundant system capable of serving hundreds of clinics connected through a VPN and covering the entire country. Device Agnosticism: A unified system to manage data from many different ultrasound models and vendors.

H.R.Z. Solution: ZiKiT’s Dynamic Mapping and High Availability

H.R.Z. delivered a customized, high-availability DICOM Server solution utilizing the ZiKiT Integration Suite and a custom post processing module built with our MODALIZER-SDK™: Fast Strike DICOM Toolkit. Our solution provides the two foundational DICOM services CVR requires: DICOM Storage and DICOM Modality Worklist (DMWL).

Technical Mastery and Specific Tasks: Scaled from 50 to 120+ Clinics

CVR’s nationwide imaging workflow played a key role in sharpening the capabilities and reliability of products and our DICOM software engineering capbilities The increasing real-world load and operational requirements pushed us to continuously refine and optimize our components so they would perform reliably at scale. Their team’s high expectations and consistent feedback helped strengthen the overall solution and demonstrated how valuable a long-term technical partnership can be.

High-Performance Load Balancing: ZiKiT DICOM Server is built with a multi-server architecture design and readily supports integration with external load balancers. The system evolved into a fully load-balanced cluster that supports Hot/Hot redundancy, which ensures maximum uptime and performance across all 120+ clinics. Dynamic DICOM Mapping Rules: The core of the solution lies in ZiKiT’s powerful dynamic DICOM mapping rules technology. This technology was used to customize the Modality Worklist (MWL) and DICOM Storage services for CVR. This is essential for integrating many different ultrasound models, as it allows our system to interpret, normalize, and validate varying DICOM tag combinations from every device on their network. For details on the standard, refer to the official DICOM documentation on MWL. Advanced Data Processing: We implemented advanced, customized processes for data extraction and transformation. This includes specialized handling for proprietary vendor tags and complex DICOM sequences, as well as automatic image extraction (JPEG/Cine Loops). This level of customization directly feeds CVR’s automated backend systems and advanced viewing and planning software, crucial for leveraging the full value of the CVR’s advanced ultrasound technology. Operational Stability: The resilient multi-server architecture and VPN compatibility ensure the system provides continuous service, successfully overcoming network instability across the entire country.

Results: Cost-Effective, Resilient Enterprise PACS

H.R.Z.’s partnership with CVR is defined by long-term commitment and technical agility, resulting in continuous growth and operational stability.

Rohan Vanjara, Director Of IT: “The real value of the HRZ solution is its stability and scalability. We’ve grown exponentially, and the multi-server, load-balanced architecture has handled the entire national network’s demands without a single failure impacting patient care or workflow efficiency.”