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From the minimal description provided, with the requirement for some basic search capabilities, I'll speculate that it would be best to design your application to run on a server with a database and server-side scripting. I'd probably use an Apache web server with PHP and MySQL. With the appropriate hardware, it should scale up to handle the number of users you envision. If the lifecycle of your software is several years and you're going to use contract developers, I'd recommend PHP over Perl for better maintenance over time.

Here is a book I recommend: MySQL Cookbook by Paul DuBois. This can give you some good ideas and save a lot of R&D time.

I assume that your scanned images are electronic replicas of paper forms, not scanned x-ray films or something where advanced image processing and high-fidelity are required. In that case, a web browser should be adequate for viewing the images. Keep in mind that TIFF images are larger that most image file formats used on the Internet, so you'll need adequate bandwidth. I've seen networks get bogged down on TIFF images. Image compression could help - if your browser can handle it.

For this type of application, it may be advisible to use a secure protocol on your web server, like "https". That will encrypt the data sent between the web server and browser.

You may need to become familiar HIPAA privacy regulations, and be mindful of those while designing your product.

It sounds like an interesting project, and I hope it will be financially rewarding for you. Good luck!

Want file type for images do you recommend over .tiff?

Yes I know HIPPA pretty decently. That is one of the problems with the current application. No log in and the file names and searches are done by the patient name. I would prefer to switch that to an anonymous record number.

The files being scanned in are 8.5x11 sheets that have printed forms on both sides that a doctor feels out and writes notes on. At the moment there is no standard on that. Also anything sheet of paper that a note may have been written on might be scanned in. It would be nice to be able to add notes via a tablet or workstation. But that can come later on.

Yes I thought about doing https:. The server will be behind a firewall and even if I colo the server than it will still be behind a firewall and a VPN connection would be necessary.