Intuitively, lossy compression seems an unwise path to tread.  We will probably be examining it although this does create a huge obstacle with non-uniform (vendor specific) JPEG compression algorithms.  Even at this early stage, despite no charge for consultations or opinions, it is clear that, due to very real financial constraints, to enable participation there can be no costs, other than the conference phone (optional), borne by the referring sites.  There are many operational concerns including security, final patient ownership, accountability, network security and accuracy.  All of which must be resolved satisfactorily.