3: PACS Flashcards
Biomedical Informatics
- PACS
- Hospital Information System (HIS)
- Radiology Information System (RIS)
- Electronic Medical Record (EMR)
EMR/EHR (electronic health record)
contains all of the pts medical history
EMR/EHR is a part of
Hospital information system (HIS)
Why has PACS begun interfacing with EMR?
To present images to referring physicians through the same common system
HIPAA
confidentiality concerns with electronic transfer and reception of medical information
Hospital Information Systems (HIS)
- Database containing all patient medical record information except for radiology. For non-image data only.
- Patient information, billing records and orders
Radiology Information Systems (RIS)
- Radiology-specific database
- Communicates with PACS
Health Level Seven (HL7)
Standard language for exchange of patient demographic information among hospital information systems
identifies patients, processes orders, stores reports, and generates billing but does not manage medical image data
HL7
Communicates between HIS and RIS
HL7
Picture Archival and Communication System (PACS)
- stores all images, reports, patient information
- communicates with the various modalities via DICOM
All PACS consists of 3 main parts
Image Acquisition
Display Workstations
Archive Servers
First PACS:
- early 1980s
- served one modality
First full-scale PACS
installed at the VA Medical Center in Baltimore in 1993.
PACS consists of:
Digital acquisition (Picture)
Display workstations
Storage devices (Archiving)
Components are interconnected through an intricate network. (Communication)
Disaster Recovery
Disaster Recovery
keeping complete archive of images offsite in case of emergency
Electronic version of radiologist’s reading room
PACS
Digital Imaging and Communications in Medicine (DICOM)
Universally accepted standard(language) for exchanging medical images between the various modalities and PACS.
First version of DICOM completed
1985
DICOM:
Universally accepted standard
Laid the groundwork for the future development of integrated PACSs.
Now every modality and PACS communicates via DICOM.
Each vendor and modality boasts DICOM compatibility.
Each DICOM statement must be read carefully to
determine the extent of the compatibility
File room for PACS
Archive servers
Archive servers have:
- Database server or image manager
- Short-term and long-term storage
-Workflow manager
Central part of PACS
Archive servers
Houses all historic and current data
archive servers
May also serve as the centralized node that receives all images before interpretation
Archive Servers
Archive Query allows for:
Function allows retrieval of images from the PAC system based on the following:
- Date of exam
- Patient name or number
- Exam number
- Pathologic condition
- Anatomic area
Image Acquisition
Images are acquired in a digital format
- US
- CT
- MRI
- Nuc med
- CR
- Mammo
Image Aquisition Modality things
Ultrasound : Early ultrasound mini-PACS networks became a norm in many hospitals
Computed Tomography (CT): As the images sets increased in number, this necessitated the transition to soft-copy reading
Magnetic Resonance Imaging (MRI): As with CT as the numbers of images increased, reading on a monitor became a good alternative.
Workflow
How a process is done step by step or how a task is completed
How one completes an exam from order entry to transcribed report
Diff in every department
Image Display
Hard-copy
Soft-copy
Hard-Copy
Images on film
Laser printers and dry processors
Soft-Copy
Flat screen monitors
Many advantages
Display Workstation
any computer used to view a digital image
- Most interactive part of a PACS.
- Used inside and outside of the radiology department.
-Hands-on Component
-Diff hardware requirements for each system
Display station
- Receives images from archive or various radiology modalities
- Presents images to be viewed
Most interactive part of PACS
Display Workstations
Display Workstation consists of:
Monitor
Computer with a mouse and keyboard
