FlexView vs. OHIF: A Comprehensive Comparison

Publish Date: 4 August 2023

By Rob Lewis, CEO, Radical Imaging

Sometimes when introducing FlexView, our new SaaS viewer product, I am asked if it’s basically just OHIF. The answer is a resounding, “NO!” FlexView is a commercial product that addresses needs that open-source OHIF can’t. Although FlexView isn’t free, it offers a number of key benefits that we’ll cover in the remainder of this post.

OHIF: An Open-Source Swiss Army Knife

The Open Health Imaging Foundation (OHIF) is a universal web-based medical imaging viewer framework resulting from the development collaboration between Radical Imaging and Massachusetts General Hospital (MGH) Department of Radiology. OHIF is widely used due to its extensibility, ease of use, clean interface, high performance and advanced imaging capabilities.

OHIF is:

  • A Basic Radiology Viewer: OHIF provides the most commonly used tools for radiology display and interpretation making it useful for many purposes.
  • Oncology Focused: While OHIF can be adapted to any workflow, its default configuration is optimized for oncology use cases because the majority of its funding comes from the National Cancer Institute.
  • Extensible: OHIF’s modular architecture provides a mechanism to add new tools and workflows, allowing OHIF to be adapted to various needs beyond general radiology and oncology.
  • Open-source: 100% of the source code is available under a permissive MIT license.
  • Free: The OHIF license is offered at no cost.
  • A repository of code

FlexView: Viewer-as-a-Service

FlexView is a professionally supported, SaaS cloud medical imaging viewer created by Radical Imaging. FlexView retains all of the great features of OHIF, but has been retooled for the cloud, making it a fully user-ready system. FlexView is a commercial-grade, production-ready solution that can easily be incorporated into any medical imaging system, seamlessly providing the viewing and analysis capabilities for any type of medical image or workflow.

FlexView is:

  • OHIF+: FlexView has all of the useful features of OHIF. More great features and improvements will be added over time based on feedback from our users. 
  • A Managed Hosted Service: FlexView can be used immediately without any need for programmers or IT professionals. New users can get up and running, connect to their image data and start visualizing within minutes. Ready-made datasource connectors are available for the three major cloud storage vendors.
  • Stable: As part of our effort to obtain regulatory approval for diagnostic use in the future, we have implemented rigorous engineering processes and a quality management system enabling us to make significant progress on FlexView’s software quality.
  • Secure: FlexView’s architecture and cloud-native implementation has elevated security to a 1st class attribute of the system. It  has passed an independent 3rd party penetration test.
  • Dynamic: FlexView adds to OHIF’s extensibility model by introducing the ability to deploy plugins at runtime. This is crucial to enable the addition of new features dynamically, such as AI-based tools, without causing disruptions or system down-time. Users will be able to discover, opt into and use these value-added services as they become available in our marketplace.
  • Professionally supported: FlexView offers a subscription model, providing continuous updates and customer support with an affordable pay-as-you-go cost model.

FlexView is not:

  • FlexView is not free: It costs money to host, maintain and provide customer support for FlexView as a production-quality, user-ready system.
  • Open-source

FlexView vs. OHIF - Comparison Table

FlexView™ OHIF
Application hosting included
No developers or IT needed
Provision and configure in minutes
Simple datasource config
AWS HealthImaging connector
Google Health connector
Microsoft Azure connector
Customer support
Subscription includes software updates
Runtime plugins
User management
Web application
No software to install
Easy to use
Advanced visualization
Hanging protocols
Digital pathology
Standards compliant
Open source

Conclusion: How to Choose?

Choosing between FlexView and OHIF depends on your priorities and available resources. 

OHIF offers a customizable, free, open-source option. OHIF would be a good option when the production of medical imaging viewers is your core business, and you have substantial resources and time available to make the necessary investment to take OHIF into commercial, production-ready territory.

Although not free, FlexView may wind up costing you less in the long-run, get you to market quicker and allow you to focus on your particular value add. Its secure environment gets your users interacting with images in minutes. FlexView’s pay-as-you-go subscription option may be more attractive and less risky as a lower, ongoing operational expense compared to large, up-front capital expenditures as well as the ongoing costs of staying current with the OHIF open source platform.

Radical’s Continued Commitment to OHIF

Another question I’m frequently asked is, “Now that you’re selling a product, are you going to abandon OHIF?” The answer is, “No, we are not.” 

Although we have ventured into the commercial product space, Radical’s commitment to OHIF and open-source remains firm. With the NCI grant award extending support for OHIF for an additional five years, we will continue for the foreseeable future to work with the team at MGH to enhance OHIF’s capabilities and support the OHIF community.

Radical Imaging

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