--- title: Workstations | Avara description: Integrate specialty DICOM viewers with Avara — gateway sizing, WireGuard connectivity, C-FIND/C-MOVE worklists, and pay-per-study streaming. --- ## Overview In traditional imaging environments, **workstations** act as **DICOM nodes** paired with **specialty DICOM viewers** — advanced reading software for tasks beyond a standard diagnostic viewer. The Avara Clinical Platform includes a **built-in, web-based diagnostic DICOM viewer** that is highly performant for most reading workflows. For many sites, that eliminates the need for separate workstation infrastructure entirely. When your clinicians need capabilities the built-in viewer does not cover, Avara offers **full, seamless workstation integration**. Typical integrations connect viewers such as **TeraRecon**, **Circle Cardiovascular Imaging**, **3mensio**, **OsiriX**, and similar tools — especially where the viewer provides **specialty operations** like vessel tracking, plaque analysis, advanced cardiac quantification, or other modality-specific tooling. ## When to Use Workstations **Most organizations do not need workstations.** Avara’s built-in viewer covers routine diagnostic reading for the majority of sites. Reach for workstation integration only when a **third-party viewer** is required for a subspecialty workflow that depends on features outside Avara’s native viewer. For routine diagnostic reading, reporting, and patient-facing study access, the platform viewer is usually sufficient — no extra nodes, no gateway fees, no per-study streaming charges. Workstation integration is optional and scales with how many readers need external viewers, not with every user in your organization. ## How It Works Workstations are enabled under **Operations**. When you turn them on, you **select a cloud gateway size** for your clinic. Avara provisions a **dedicated cloud PACS node** for your organization — a gateway that sits between your on-site or remote specialty viewers and studies stored in Avara. Each node is **strictly isolated to your organization**, with security controls designed to meet requirements **stricter than HIPAA** — so workstation traffic never commingles with other tenants. Each **workstation entry is registered per user** — one reader, one workstation configuration, one worklist funnel into their viewer. Avara does **not** charge a per-user seat fee; instead, you size the **gateway** to match how many concurrent workstation users the clinic expects. Studies assigned to a workstation user flow through standard DICOM query/retrieve into the viewer. You can apply **additional filters** — for example limiting worklist results by **[appointment type](/clinical-platform/appointment-types/index.md)** — so each reader sees only the studies relevant to their role or subspecialty. ### DICOM Operations Avara workstation integration supports industry-standard DICOM services: - **C-FIND** — Query the worklist so the viewer discovers studies available to that workstation user - **C-MOVE** — Retrieve and **stream DICOM instances** from Avara’s archive through the gateway to the viewer for reading This is the same integration pattern specialty viewers expect from a local PACS — your viewer talks to an Avara-hosted DICOM node, not a legacy on-site archive. ## Gateway Sizing and Pricing Workstation pricing has two parts: a **flat monthly gateway fee** (one gateway per clinic) and a **pay-per-use study read fee**. ### Gateway sizing Gateway sizing is about the **EC2 instance type** provisioned for your clinic’s workstation node — **not** a monthly fee per workstation seat. Pick the tier based on how many workstation users you expect on that gateway. Instance type Monthly price Recommended workstations `c6gn.medium` $35/month 1–3 `c6gn.large` $70/month 4–8 `c6gn.xlarge` $140/month 9–15 `c6gn.2xlarge` $280/month 16–24 `c6gn.4xlarge` $560/month 25–40 When workstations are activated, the selected tier is billed as a **flat monthly gateway fee**. Scale up the instance type as you add readers who need specialty viewers; there is no separate charge for registering each workstation user. ### Per-study read fee Each time a study is retrieved through the gateway for viewing — a **C-MOVE** that streams DICOM to the workstation — Avara charges **$0.20 per study read**. This covers the cost of streaming imaging data through the cloud node on our side. Routine reading in Avara’s built-in viewer does not incur this fee; it applies to **workstation integration traffic** only. ## Secure Connectivity with WireGuard Many readers — especially **remote radiologists reading from a laptop** — need secure access to the workstation gateway without a traditional corporate VPN. Avara sets this up over an **encrypted WireGuard tunnel** between the reader’s machine and your organization’s workstation PACS node. WireGuard creates a **point-to-point encrypted tunnel** over the public internet. Traffic between the reader’s viewer and Avara’s workstation node travels inside that tunnel, so DICOM query and retrieve operations are protected end to end. Compared with conventional site-to-site VPNs, WireGuard is typically **lighter weight**, **easier to configure**, and **faster for sustained data transfer** — while providing **modern, audited cryptography** that is appropriate for clinical connectivity. There is **no separate VPN appliance** to maintain for workstation access. Each user connects with standard WireGuard client software. ### Setting Up WireGuard 1. **Install WireGuard** on the reader’s machine — clients are available for Windows, macOS, Linux, iOS, and Android. Download from the official [WireGuard installation page](https://www.wireguard.com/install/). 2. Open the **Workstations** tab in the Clinical Platform and **download the `.conf` credentials file** for that workstation user. 3. **Launch the WireGuard client**, import the configuration file (drag the `.conf` into the app or use the client’s import flow), and **activate the tunnel**. Once connected, the reader’s specialty viewer has **secure connectivity** from their workstation to Avara’s workstation PACS node — worklist queries and study streaming proceed over the encrypted channel as if the viewer were on your imaging network. ## Permissions and Support Workstation and gateway configuration is managed by users with **Can Manage PACS**. See [Inviting Users — Can Manage PACS](/clinical-platform/inviting-users/#can-manage-pacs/index.md) for access requirements. For gateway sizing, WireGuard rollout, or viewer-specific DICOM settings, the Avara team assists through provisioning and go-live — the same hands-on support model described for [Rooms & PACS](/clinical-platform/rooms-pacs/#setup-and-support/index.md) and [on-prem servers](/clinical-platform/on-prem-servers/index.md).