Case Study

Desktop-based Medical Imaging & Reporting Software

From raw video to PACS-connected diagnostic record — without leaving the procedure room.

Medical Imaging DICOM HL7 PACS Endoscopy .NET / WPF
~500 → 1,500+ Endoscopy systems in the field
6 months Delivery timeline
5.75 FTE Cross-functional team
DICOM + HL7 Native, in one codebase

Client & Context

Our client is the Indian arm of a global medical imaging and diagnostic systems manufacturer, with approximately 500 endoscopy systems already deployed across hospitals and diagnostic centres in India. To scale toward 1,500+ installations over the next few years, they needed a companion desktop application to ship with their hardware — one that takes the live endoscopic video feed from their capture systems and turns it into structured, archived, standards-compliant diagnostic records. NKORR built that software.

The Problem

The client's imaging systems captured excellent video, but stopped there — there was no integrated desktop application tying that live feed to the documentation and archiving workflow their hospital customers actually needed. Left without it, end users typed reports from memory or hand-annotated prints, saved images to local folders or burned them to CD, and re-keyed patient details by hand because nothing pulled from a Modality Worklist — so findings rarely flowed cleanly into the DICOM and HL7 backbone the rest of the hospital ran on. The client needed a product to ship with its systems: one that captured video, produced structured reports with embedded images, and spoke DICOM and HL7 natively. Off-the-shelf viewers could not do this — clinical imaging is live-video-first, and none integrated the clinical order-and-result flow.

Why NKORR

The client needed one partner who could handle clinical video capture and the DICOM and HL7 integration inside a single application — not stitch together three vendors. NKORR was the only team offering both: a production DICOM stack built on fo-dicom and a hand-built HL7 v2 engine, in one .NET codebase. Having already delivered a comparable medical-imaging product, the team understood clinical workflows and the standards involved from day one.

What We Built

We delivered a Windows desktop application (.NET 10, WPF) that turns a single workstation in the procedure room into a complete capture, reporting, and archiving hub for the client's imaging systems. It pulls live video off the device's video-capture card — via OpenCV, DirectShow, and a native Media Foundation transcoder — shows it on screen in real time, and lets the clinician grab snapshots, record clips, and add audio notes mid-procedure. Captured images drop straight into a structured report built on a DevExpress rich-text editor.
  • Full DICOM node — queries the Modality Worklist (MWL) so patient and order details arrive automatically instead of being typed, sends images and reports to PACS by C-STORE, and performs C-ECHO verification against connected DICOM peers.
  • Custom HL7 v2 engine — ORM orders in, ORU results out, with a Mirth-friendly listener and template parser wiring the workstation into the hospital information system.
  • Finished studies leave as standards-compliant DICOM — or by USB, CD, email, or WhatsApp — with no manual re-entry.
  • Clean layered architecture (separate domain, use-case, and adapter layers per module) over a PostgreSQL database with a dedicated schema-upgrade manager.
  • Every pull request runs through Bitbucket Pipelines with SonarQube static analysis.

Capture-to-Archive Flow

One workstation ties the imaging device, the hospital's HIS/RIS, and PACS together end to end.

Medical imaging capture-to-archive system map showing hospital systems and imaging hardware feeding a workstation, report, PACS, and clinical distribution.
Order data and live video enter the workstation; reports, images, and clinical outputs follow their own connected paths.

The Result

The client now has a complete desktop product to ship with its imaging systems: one workstation that runs the entire procedure-to-archive workflow from a single screen. Live video, images, and the diagnostic report sit in one place, so a study is reported and signed without leaving the room. Modality Worklist removes the manual demographic entry that causes identity mismatches; C-STORE and HL7 mean every finished study lands in PACS and flows back to the ordering physician automatically. Reports go out as standards-compliant DICOM, readable anywhere in the hospital, and can also reach a patient by USB, CD, email, or WhatsApp.

Team + Timeline

Role Count Duration
Project Lead 0.5 6 months
Technical Architect 0.25 6 months
Senior Lead Engineer 1 6 months
Software Engineer 3 6 months
Test Engineer 1 5 months
C# .NET 10 WPF PostgreSQL fo-dicom HL7 OpenCV DirectShow Media Foundation DevExpress

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