3. PACS Flashcards
what does PACS stand for
picture archiving & communications system
what were the benefits of digitising medical data and waht are some examples
- manage surge in patients
- interoperability
- continuity of care
- efficiency of care
examples = medical imaging, OCR, voice recognition for dictation, lab reports etc
does a gamma camera work on a dead patient
no
what is DICOM
standard for handling, storing & printing info in medical imaging
also a file format def & network communications protocol
what are the PACs levels
dept, hospital, state
what is CMRGlu
cerebral metabolic rate of glucose consumption - used for dementia
what is EIR
enterprise imaging repository where patients can be searched and their imaging viewed
central repository across state-wide public hospitals
why do we need digitisation of medical data
- manage the surge of patients
- collect massive amounts of data
- use data to improve standard of care
-ageing population
what are some structural medical images
xray, OCT (optical coherence tomography), US
what are functional medical images,with examples
any medical image that examines changes in metabolism, blood flow, chemical consumption & absorption
cardiac MRI, functional MRI, dynamic PET
what is the diff between PET and CT
CT shows the anatomical structure while PET shows the physiology of a metabolic structure e.g. the blood supply of a tumour
what is an issue with all of the advancements in imaging
data explosion = multiple scans = more data
more sophisticated imaging * more patients =
PETs generate > 40TB of data a day (imagine the cost)
what is PACS purpose
storage & communication of imaging data
what does PACs integrate with
EMR (institute level/hospital)
also follows HL7
what are PACS features
- standardisation (DICOM, HL7)
- cost-effectiveness
- fault tolerance
- connectivity (multi-disciplinary teams can access their respective modalities)
- architecture
what are the 4 levels of dicom data
- patient
- study
- series (PET, CT)
- image (CT has 128 slices)
what is PMS
pharmacy management system
why are big PACS vendors less popular
they have restrictive software, that makes data heterogeneous, whereas smaller companies are more open source so the imaging data can be more homogenous
why are DICOM web-based viewers popular now
different images require different types of visualisations e.g. there are more greys in a radiologists visualisation, which may be different to a histologist, who needs more colours
what is a PACS thick client model
- stand-alone
- images automatically sent to designated diagnostic & review WS
- short term cache
what is a PACS thin client model
- client server
- images centrally archived in PACS server
- each client WS can access imaging from PACS
- no local storage, images flushed after reading
what is a PACS web based model
- similar to client side but only a web browser is needed
- hardware can be platform independent
- viewed anywhere
- limited functionality & performance
describe the interaction between PACS & PHR
- PHR can have links to the full PACS archive
- image compression is lossless
- includes diagnostic report with key images
what is DICOM-SR & it’s purpose
- DICOM structured reporting
- rules for encoding, transmitting & storing imaging diagnostic reports
- structured doc containing text and links to waveforms (ECG), spatial & temporal coordinates (pathology location), images
- purpose is for it’s coding to enable integration with EHR
image of DICOM-SR
what is PACS customisation
the same software, with tuned features for a specific specialty. based on:
- patient volume
- number of interpretation areas
- diagnostic locations
- cost
what is a major paradigm shift in PACS
vendor neutral archives (VNA):
- simplifies data migration issues
- inter-departmental data exchange
- long term enterprise wide storage
Questions for Review
- A hospital has an existing EHR system and several other HISes. They wish to
establish an on-site PACS for their radiology department that integrates
with the existing infrastructure. Explain how this establishment and
integration can be achieved? - With the use of an example provide two benefits of Cloud PACS.
- You have been asked to design a new PACS solution for your hospital.
Select your preferred solution (standalone or cloud), justifying your
selection by contrasting the limitations of standalone PACS and Cloud
PACS.
