Transmission of Imaging and Data (TRIAD)

General Information

Technologies must be operated and maintained in accordance with Federal and Department security and privacy policies and guidelines. More information on the proper use of the TRM can be found on the TRM Proper Use Tab/Section.

Website:	Go to site
Description:	Transmission of Imaging and Data (TRIAD) is a standards-based system built by the American College of Radiology (ACR) for the exchange of images and data for accreditation, clinical trials, and registries. TRIAD supports the transmission of medical images and related electronic data for the multi-center clinical trials and other clinical research projects. This technology is used for image submission through the TRIAD Windows Client and includes Clinical Trials and Accreditation. TRIAD utilizes a proprietary database to communicate with Digital Imaging and Communications in Medicine (DICOM) devices.
Technology/Standard Usage Requirements:	Users must ensure their use of this technology/standard is consistent with VA policies and standards, including, but not limited to, VA Handbooks 6102 and 6500; VA Directives 6004, 6513, and 6517; and National Institute of Standards and Technology (NIST) standards, including Federal Information Processing Standards (FIPS). Users must ensure sensitive data is properly protected in compliance with all VA regulations. Prior to use of this technology, users should check with their supervisor, Information Security Officer (ISO), Facility Chief Information Officer (CIO), or local Office of Information and Technology (OI&T) representative to ensure that all actions are consistent with current VA policies and procedures prior to implementation.
Section 508 Information:	This technology has not been assessed by the Section 508 Office. The Implementer of this technology has the responsibility to ensure the version deployed is 508-compliant. Section 508 compliance may be reviewed by the Section 508 Office and appropriate remedial action required if necessary. For additional information or assistance regarding Section 508, please contact the Section 508 Office at Section508@va.gov.
Decision:	View Decisions

Decision Source:	TRM Mgmt Group
Decision Process:	One-VA TRM v24.1
Decision Date:	01/11/2024 at 15:55:37 UTC
Aliases:	Transfer of Images and Data (TRIAD)
Introduced By:	TRM Request
Vendor Name:	American College of Radiology

Vendor Release Information

The Vendor Release table provides the known releases for the TRM Technology, obtained from the vendor (or from the release source).

Version	Release Date	Vendor End of Life Date	Vendor Desupport Date
4.1	01/17/2014
Accreditation 4.3.x
CT 4.4.x	04/16/2015
CT 4.7.x
CT 4.8.x
CT 4.9.x	04/28/2017
CT 4.11.x	03/01/2018
Accreditation 4.5.x	01/17/2018
CT 4.13.x	11/01/2018
CT 4.14.x	03/26/2019
CT 4.16.x	04/02/2020
CT 4.17.x	10/22/2020
CT 4.18.x	02/08/2021
CT 4.19x	07/22/2021
CT 4.20.x	03/22/2022
CT 4.21.x
CT 4.25.x

Current Decision Matrix (01/09/2024)

Users must ensure their use of this technology/standard is consistent with VA policies and standards, including, but not limited to, VA Handbooks 6102 and 6500; VA Directives 6004, 6513, and 6517; and National Institute of Standards and Technology (NIST) standards, including Federal Information Processing Standards (FIPS). Users must ensure sensitive data is properly protected in compliance with all VA regulations. Prior to use of this technology, users should check with their supervisor, Information Security Officer (ISO), Facility Chief Information Officer (CIO), or local Office of Information and Technology (OI&T) representative to ensure that all actions are consistent with current VA policies and procedures prior to implementation.

The VA Decision Matrix displays the current and future VA IT position regarding different releases of a TRM entry. These decisions are based upon the best information available as of the most current date. The consumer of this information has the responsibility to consult the organizations responsible for the desktop, testing, and/or production environments to ensure that the target version of the technology will be supported. Any major.minor version that is not listed in the VA Decision Matrix is considered unapproved for use.

Legend:

White	Approved: The technology/standard has been approved for use.
Yellow	Approved w/Constraints: The technology/standard can be used within the specified constraints located below the decision matrix in the footnote[1] and on the General tab.
Gray	Unapproved: This technology or standard can be used only if a POA&M review is conducted and signed by the Authorizing Official Designated Representative (AODR) as designated by the Authorizing Official (AO) or designee and based upon a recommendation from the POA&M Compliance Enforcement, has been granted to the project team or organization that wishes to use the technology.
Orange	Divest: VA has decided to divest itself on the use of the technology/standard. As a result, all projects currently utilizing the technology/standard must plan to eliminate their use of the technology/standard. Additional information on when the entry is projected to become unapproved may be found on the Decision tab for the specific entry.
Black	Prohibited: The technology/standard is not (currently) permitted to be used under any circumstances.
Blue	Planning/Evaluation Constraint:The period of time this technology is currently being evaluated, reviewed, and tested in controlled environments. Use of this technology is strictly controlled and not available for use within the general population. If a customer would like to use this technology, please work with your local or Regional OI&T office and contact the appropriate evaluation office displayed in the notes below the decision matrix. The Local or Regional OI&T office should submit an inquiry to the TRM if they require further assistance or if the evaluating office is not listed in the notes below.

Release/Version Information:

VA decisions for specific versions may include a ‘.x’ wildcard, which denotes a decision that pertains to a range of multiple versions.

For example, a technology approved with a decision for 7.x would cover any version of 7.(Anything) - 7.(Anything). However, a 7.4.x decision would cover any version of 7.4.(Anything), but would not cover any version of 7.5.x or 7.6.x on the TRM.

VA decisions for specific versions may include ‘+’ symbols; which denotes that the decision for the version specified also includes versions greater than what is specified but is not to exceed or affect previous decimal places.

For example, a technology approved with a decision for 12.6.4+ would cover any version that is greater than 12.6.4, but would not exceed the .6 decimal ie: 12.6.401 is ok, 12.6.5 is ok, 12.6.9 is ok, however 12.7.0 or 13.0 is not.

<Past

CY2017

CY2018

CY2019

Future>

Release

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

Q1

Q2

Q3

Q4

4.1

Unapproved

Accreditation 4.3.x

Approved w/Constraints
[2, 3, 5]

Approved w/Constraints
[2, 3, 6]

Approved w/Constraints
[3, 7, 8]

Approved w/Constraints
[3, 7, 9]

Divest
[3, 7, 9]

Divest
[3, 7, 10]

Divest
[3, 7, 11]

Unapproved

CT 4.4.x

Approved w/Constraints
[2, 3, 5]

Approved w/Constraints
[2, 3, 6]

Divest
[2, 3, 6]

Divest
[3, 7, 8]

Divest
[3, 7, 9]

Unapproved

CT 4.7.x

Approved w/Constraints
[2, 3, 5]

Approved w/Constraints
[2, 3, 6]

Approved w/Constraints
[3, 7, 8]

Approved w/Constraints
[3, 7, 9]

Divest
[3, 7, 9]

Divest
[3, 7, 10]

Divest
[3, 7, 11]

Unapproved

CT 4.8.x

Approved w/Constraints
[2, 3, 5]

Approved w/Constraints
[2, 3, 6]

Approved w/Constraints
[3, 7, 8]

Approved w/Constraints
[3, 7, 9]

Divest
[3, 7, 9]

Divest
[3, 7, 10]

Divest
[3, 7, 11]

Unapproved

CT 4.9.x

Unapproved

Approved w/Constraints
[2, 3, 6]

Approved w/Constraints
[3, 7, 8]

Approved w/Constraints
[3, 7, 9]

Divest
[3, 7, 9]

Divest
[3, 7, 10]

Divest
[3, 7, 11]

Unapproved

CT 4.11.x

Unapproved

Approved w/Constraints
[3, 7, 9]

Approved w/Constraints
[3, 7, 10]

Divest
[3, 7, 11]

Accreditation 4.5.x

Unapproved

Approved w/Constraints
[3, 7, 9]

Approved w/Constraints
[3, 7, 10]

Approved w/Constraints
[3, 7, 11]

CT 4.13.x

Unapproved

Approved w/Constraints
[3, 7, 10]

Approved w/Constraints
[3, 7, 11]

CT 4.14.x

Unapproved

Approved w/Constraints
[3, 7, 11]

CT 4.16.x

Unapproved

CT 4.17.x

Unapproved

CT 4.18.x

Unapproved

CT 4.19x

Unapproved

CT 4.20.x

Unapproved

CT 4.21.x

Unapproved

CT 4.25.x

Unapproved

Decision Constraints


[1]	Projects using this technology must meet Veterans Affairs (VA) Directive 6500 and implement Federal Information Processing Standards (FIPS 199) for all laptop devices and National Institute of Standards and Technology Special Publication 800-53 for all desktop devices when VA sensitive information is involved, or additional mitigating controls must be documented in an approved System Security Plan (SSP) to prevent potential disclosure of PII/PHI data. Additionally, projects which interface with external VA partners must have a Memorandum of Understanding and Interconnection Security Agreements (MOU/ISA), which detail the security requirements for users and systems that share information and resources outside of the VA production network.

[2]	Veterans Affairs (VA) users must ensure VA sensitive data is properly protected in compliance with all VA regulations. All instances of deployment using this technology should be reviewed by the local ISO (Information Security Officer) to ensure compliance with VA Handbook 6500.

[3]	Technology must remain patched and operated in accordance with Federal and Department security policies and guidelines in order to mitigate known and future security vulnerabilities.

[4]	Due to National Institute of Standards and Technology (NIST) identified security vulnerabilities, extra vigilance should be applied to ensure the versions remain properly patched to mitigate known and future vulnerabilities. The local ISO can provide assistance in reviewing the NIST vulnerabilities.

[5]	This technology should only be used when required by a Veterans Affairs (VA) business partner for an approved VA Project. Use of this technology must comply with ESCCB requirements which include: Signed Interconnection Agreements/Memorandum of Understanding agreements (MOU/ISA) with each external business partner, compliance with VA Handbook 6500, and must implement appropriate National Institute of Standards and Technology (NIST) Federal Information Processing Standards (FIPS) requirements for all devices interacting with this technology. All instances of deployment using this technology should be reviewed by the local ISO (Information Security Officer) to ensure compliance with VA Handbook 6500 and National Institute of Standards and Technology (NIST) standards and an ISO Risk Based Decision (RBD) must be approved by the local ISO/CIO before it can be used in the VA Production Environment. In cases where the technology is used for external connections, a full Enterprise Security Change Control Board (ESCCB) review is required in accordance VA Directive 6004, VA Directive 6517 and VA Directive 6513. The local ISO can advise on the ESCCB review process and ensure privacy of information compliance protections are in place.

[6]	This technology should only be used when required by a Veterans Affairs (VA) business partner for an approved VA Project. Use of this technology must comply with ESCCB requirements which include: Signed Interconnection Agreements/Memorandum of Understanding agreements (MOU/ISA) with each external business partner, compliance with VA Handbook 6500, and must implement appropriate National Institute of Standards and Technology (NIST) Federal Information Processing Standards (FIPS) requirements for all devices interacting with this technology. All instances of deployment using this technology should be reviewed by the local ISO (Information Security Officer) to ensure compliance with VA Handbook 6500 and National Institute of Standards and Technology (NIST) standards. As of January 27th, 2017, Risk-based Decisions (RBD) will be handled per VAIQ # 7769667. In cases where the technology is used for external connections, a full Enterprise Security Change Control Board (ESCCB) review is required in accordance VA Directive 6004, VA Directive 6517 and VA Directive 6513. The local ISO can advise on the ESCCB review process and ensure privacy of information compliance protections are in place.

[7]	Veterans Affairs (VA) users must ensure VA sensitive data is properly protected in compliance with all VA regulations. All instances of deployment using this technology should be reviewed by the local ISO (Information Security Officer) to ensure compliance with VA Handbook 6500.

[8]	This technology should only be used when required by a Veterans Affairs (VA) business partner for an approved VA Project. Use of this technology must comply with ESCCB requirements which include: Signed Interconnection Agreements/Memorandum of Understanding agreements (MOU/ISA) with each external business partner, compliance with VA Handbook 6500, and must implement appropriate National Institute of Standards and Technology (NIST) Federal Information Processing Standards (FIPS) requirements for all devices interacting with this technology. All instances of deployment using this technology should be reviewed by the local ISO (Information Security Officer) to ensure compliance with VA Handbook 6500 and National Institute of Standards and Technology (NIST) standards. As of January 27th, 2017, Risk-based Decisions (RBD) will be handled per VAIQ # 7769667. In cases where the technology is used for external connections, a full Enterprise Security Change Control Board (ESCCB) review is required in accordance VA Directive 6004, VA Directive 6517 and VA Directive 6513. The local ISO can advise on the ESCCB review process and ensure privacy of information compliance protections are in place.

[9]	This technology should only be used when required by a Veterans Affairs (VA) business partner for an approved VA Project. Use of this technology must comply with ESCCB requirements which include: Signed Interconnection Agreements/Memorandum of Understanding agreements (MOU/ISA) with each external business partner, compliance with VA Handbook 6500, and must implement appropriate National Institute of Standards and Technology (NIST) Federal Information Processing Standards (FIPS) requirements for all devices interacting with this technology. All instances of deployment using this technology should be reviewed by the local ISO (Information Security Officer) to ensure compliance with VA Handbook 6500 and National Institute of Standards and Technology (NIST) standards. As of January 27th, 2017, Risk-based Decisions (RBD) will be handled per VAIQ # 7769667. In cases where the technology is used for external connections, a full Enterprise Security Change Control Board (ESCCB) review is required in accordance VA Directive 6004, VA Directive 6517 and VA Directive 6513. The local ISO can advise on the ESCCB review process and ensure privacy of information compliance protections are in place.

[10]	In cases where the technology is used for external connections, a full Enterprise Security Change Control Board (ESCCB) review is required in accordance VA Directive 6004 , VA Directive 6517, and VA Directive 6513. The local ISO can advise on the ESCCB review process.

[11]	Per the May 5th, 2015 memorandum from the VA Chief Information Security Officer (CISO) FIPS 140-2 Validate Full Disk Encryption (FOE) for Data at Rest in Database Management Systems (DBMS) and in accordance with Federal requirements and VA policy, database management must use Federal Information Processing Standards (FIPS) 140-2 compliant encryption to protect the confidentiality and integrity of VA information at rest at the application level. If FIPS 140-2 encryption at the application level is not technically possible, FIPS 140-2 compliant full disk encryption (FOE) must be implemented on the hard drive where the DBMS resides. Appropriate access enforcement and physical security control must also be implemented. All instances of deployment using this technology should be reviewed to ensure compliance with VA Handbook 6500 and National Institute of Standards and Technology (NIST) standards. It is the responsibility of the system owner to work with the local CIO (or designee) and Information Security Officer (ISO) to ensure that a compliant DBMS technology is selected and that if needed, mitigating controls are in place and documented in a System Security Plan (SSP).

Note:

At the time of writing, version 4.25.2 is the most current version, released 11/09/2023.

References

The following reference(s) are associated with this entry:
Type	Name	Source	Description
Vendor Provided*	Windows Client Installation and User Guide		This webpage contains information on how to install and utilize this software.
*NOTE: Vendor provided information is subject to the accuracy of the manufacturer.

Technology Components

Note: This list may not be complete. No component, listed or unlisted, may be used outside of the technology in which it is released. The usage decision for a component is found in the Decision and Decision Constraints.
Name	Description
No components have been identified for this entry.

VA Categories View the VA Categorization Framework

Domain Area	Category	Customer Guidance	Category Locked By ELT Date
Health Care Administrative	Health Delivery Support
Health Care Health Services	Imaging

Operating Systems Supported by the Technology

Windows Client - Approved w/Constraints

Technologies/Standards Relationships

Runtime Dependencies:

Microsoft .NET Framework
Microsoft Word - (required for some configurations)
Visual C++ Redistributable Package

Comparable Technologies:

Clinical Trials Processor (CTP)

Companion Technologies/Supported Standards:

General Analysis

Adoption Benefits

At the time of writing, no National Institute of Standards and Technology (NIST) vulnerabilities had been reported and no VA Cyber Security Operations Center (CSOC) bulletins had been issued for the latest versions of this technology.
This product may allow healthcare providers to preserve diagnostic quality images.
This technology may enhance the flow of data between clinicians and patients.
There are minimal other TRM-approved technologies that provide the same functionality.
This technology utilizes built-in Authentication and Authorization (A&A) capabilities.
This technology supports several industry standard file formats.
This is a well-documented technology.

Adoption Risks

There is no indication based on available vendor documentation that this technology is Federal Information Processing Standard (FIPS) 140-2 compliant.
This technology may utilize external data connections.
This technology can integrate with and alter database technologies.
Due to the rapid release schedule of this technology, the VA may be unable to update to the most recent patch and may require a deployment model requiring the use of specific versions.
The potential exists to store Personally Identifiable Information (PII), Protected Health Information (PHI) and/or VA Sensitive data and proper security standards must be followed in these cases.

Architectural Benefits

This technology supports Digital Imaging and Communications in Medicine (DICOM) options to reduce transcription errors.

Architectural Risks

This technology is not portable as it runs only on Windows platforms.
This technology does not use a VA-preferred database to store data.

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