(Then again, in mye xperience, most such specialized software is written by idiots, sadly.)
Unfortunately, that's probably the key point. Although even if the programmers were good, they may not have had the medical training to realize the implications of using JPEG. Heck, I've looked at my own X-Rays lots of times. And they still look like ghostly ink blots. I know I'd never notice that compression was degrading their fine detail.
And, you forget the impact of management on software projects:
Boss: "Hey, the radiologists are complaining that it takes to long to download the images!"
Programmer: "... But ..."
Boss: "No buts. The customer is always right!"
People who think "clown" is an insult have never met any.
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