How to Use DICOM Viewer in OpenEMR: Complete Beginner’s Guide

Are you new to using DICOM Viewer in OpenEMR? You probably might be wondering how to use it the right way. It is a tool within OpenEMR that standardizes the handling, storing, and transmitting of medical imaging information. For beginners, navigating DICOM viewers within OpenEMR can seem complex.

However, it is important to know this tool to enhance medical practice imaging capabilities. In this beginner’s guide, you’ll learn the step-by-step process of using the DICOM viewer in OpenEMR.

What is DICOM Viewer in OpenEMR?

DICOM Viewer is an integrated tool in OpenEMR to view and annotate DICOM Viewer images. 

This tool has been developed by Jerry Padgett and can be used within OpenEMR to let the user similarly communicate with imaging as one can communicate with a doctor. The tool is used to interact with medical images such as: 

• Computed Tomography scans 
• Radiography 
• Magnetic Resonance Imaging. 

However, the DICOM Viewer can be applied for preliminary view and annotation. 

The software is not intended to be used for diagnostic purposes unless has been certified for this use, although it is possible to use it for that purpose. Instead, it helps users determine whether further investigation with a certified viewer is necessary. 

Benefits of Using DICOM Viewer in OpenEMR

The biggest practical benefit is that it reduces context switching. 

• Instead of opening a separate imaging application for simple checks, providers can access compatible DICOM content closer to the patient chart and the rest of the clinical documentation. 
• OpenEMR originally introduced the feature as a way to upload, store, and view digital radiology images without requiring additional software, improving point-of-care access and time efficiency. 
• It also improves chart organization. The official HOWTO recommends using dedicated DICOM folders in the Documents tree, which makes studies easier to locate later and helps keep imaging records cleaner than storing them in generic document categories. 
• Another benefit is flexibility. OpenEMR supports both individual-file workflows and study-folder workflows. If your team only needs one image, a single .dcm upload works. 
• If the study contains many images, a folder upload can preserve the study as a grouped workflow. The main-menu viewer is also useful when opening local files is faster than loading a larger study through the chart. 
• The built-in viewer also supports the kinds of manipulations users expect from a modern web-based image viewer, including panning, zooming, filtering, tag inspection, and annotations. 
• That makes it useful for chart-side review, provider collaboration, and operational workflows, even when a full PACS environment remains the enterprise archive or diagnostic reading system. 

If your practice wants to reduce manual handling of medical images, improve access inside OpenEMR, or plan a more connected imaging workflow, this is the point where a technical assessment can save time later. 

A well-configured DICOM workflow is less about one viewer button and more about how documents, permissions, storage, and imaging operations work together.

Read More: HL7 & DICOM: Resolving Interoperability Challenges

How to Access the DICOM Viewer in OpenEMR (Step-by-Step)

Navigating to the Documents Tree

Before the DICOM Viewer can be utilized in OpenEMR, you have to import your DICOM files into the system. This can be done using the Documents Tree, which is a folder in which all sorts of documents important for patient records can be stored.

Navigate to the Documents Tree:

• Open your browser and Log into OpenEMR.
• Navigate to the patient’s profile which you would want to import the DICOM files into.
• Documents can be found and viewed in the Documents Tree which is located in the Patient’s profile; to view the Documents Tree, go to the “Documents” tab of the Patient.

Creating and Managing Dedicated DICOM Folders:

• To make it easier it is recommended to save DICOM files in a folder that was created for this specific purpose.
• The new button is located at the far right of the interface, and looks like an inverted triangle; clicking on the folder icon will create a new folder. 
• Name it properly, for instance: ‘DICOM Studies’, or ‘Radiology Images’ so that you can search for it in the future.

Uploading Individual DICOM Files or Folders

Once you have set up your dedicated DICOM folder, you can proceed to upload your files.

Viewing Uploaded DICOM Files or Studies

Uploading Individual Files:

• Click the “Choose Files” button.
• Select the .dcm files (DICOM files) you want to upload from your local computer.
• These files will be saved with their existing names in the folder you created.

Uploading a Folder Containing Multiple Files:

• Click on the second “Choose Files” button designed for folder uploads.
• Select the folder containing the .dcm files you wish to upload.
• OpenEMR will zip the folder to conserve server space. 
• In case no specific name is given to the zip file created, it will use the date and a serial number as the default name (for example 2026DicomStudy. zip-[uniqueID]).
• Simply click on the blue “Upload” button to begin with the uploading procedure.

Viewing Uploaded DICOM Files or Studies:

• After uploading, the files will appear in the Documents Tree.
• Click on the. dcm or. That is why to open any of the files you have to use the option of the ‘zip’ file.
• Understand that uploading lots of files, or huge files, will take time, and your server may time-out if it does not expect a large time to be taken in the upload.

Opening the Viewer from the Main Menu

Alternatively, you can access the DICOM Viewer directly from the OpenEMR main menu for a potentially faster experience, especially for local files.

Using the File Open Control:

• From the OpenEMR main menu, navigate to “Miscellaneous” and select “DICOM Viewer.”
• Click the file icon to open the file control dialog.

Uploading Files or Folders:

• In the file control dialog, the options are “File”, or “Folder” they can be selected in the dialog box.
• If you wish to upload single files, click on the ‘File’ option, and for multiple files at once click on ‘Folder’.
• A new window will open for you to choose the files or folder to share, then click on the “Choose Files” tab you will select the files or folder from your local computer.

Managing and Viewing the Uploaded Files:

• After the file has been uploaded the viewer will then load the image.
• The controls of the software are accessed at the top right corner of the DICOM files which is a toolbar.

Read More: What is DICOM? 6 Use Cases for Pathology Practice

DICOM Viewer vs PACS: What’s the Difference?

A DICOM viewer and a PACS system are related, but they are not the same thing. A DICOM viewer is the display layer. It lets users open images, inspect them, and interact with them. 

• PACS is the larger imaging platform that stores, routes, retrieves, manages, distributes, and presents medical images across the organization. 
• NIST, citing the FDA definition of PACS, describes PACS as a Class II device with capabilities relating to acceptance, transfer, display, storage, and digital processing of medical images, and it also describes PACS as an authoritative repository of medical image information.

That difference matters in OpenEMR. The built-in DICOM Viewer is best when you want quick chart-based image access inside the EMR. PACS is the better fit when your organization needs enterprise imaging workflows, centralized archive, routing, modality integrations, or diagnostic reading environments. 

ONC guidance reflects the same distinction by noting that an EHR may store only links to images while the images themselves remain in PACS.

In plain language, OpenEMR’s DICOM Viewer helps the EMR display compatible imaging content. PACS helps the organization run imaging operations at scale. If the goal is fast chart access, the OpenEMR viewer is useful. If the goal is long-term archive, multi-site image management, and advanced radiology operations, PACS is the stronger category.

OpenEMR DICOM Viewer Troubleshooting Guide

While using the DICOM Viewer, you may encounter some common issues. Here’s how to address them:

Fixing DICOM Upload Speed and Timeout Issues

• Large files or a high number of files can slow down the upload process. Ensure that your network connection is stable and fast.
• If you experience timeouts, consider breaking up large folders into smaller batches or increase the server’s timeout settings if possible.

Why Large DICOM Files Load Slowly in OpenEMR

• For large DICOM files or zip files, the viewer may load slowly or the progress bar might stall.
• If this happens, try downloading the file to your local computer and opening it directly through the OpenEMR main menu to improve performance.

Common OpenEMR DICOM Viewer Errors and Fixes

• Ensure that the files are in the correct DICOM format (.dcm). The viewer may not recognize other formats.
• Verify that your version of OpenEMR is compatible with the DICOM Viewer version you are using. Updates to either system might affect functionality.

DICOM Viewer Customization Service by CapMinds

Want to get the most from the DICOM Viewer from your EMR systems? CapMinds is here to help you. 

We are a professional health tech company with years of experience in EHR, EMR, OpenEMR, HL7 FHIR, Mirth Connect, Health Interoperability, and More. Our DICOM customization service includes:

• Custom Layouts and Toolbars
• Advanced Image Processing Capabilities
• Comprehensive Data Visualization

Our team of experts will closely work with you to tailor every aspect of the DICOM viewer in your EMR system, ensuring a smooth workflow. 

Elevate your diagnostic capabilities and streamline your radiology practice with a DICOM viewer that truly puts you in control. 

Contact us today and experience the full potential of DICOM viewer for your Practice.