Finals | PPT 2 Flashcards
1. COMPUTER SOLUTIONS FOR RADIOLOGY INFORMATION SYSTEMS 2. WORKFLOW
COMPUTER SYSTEMS (WORKSTATION AND
SERVERS)
A. DIAGNOSTIC WORKSTATIONS
B. ARCHIVE SERVERS
User interface that allows the desired functionality to occur
DIAGNOSTIC WORKSTATIONS
High performance personal computer, high- resolution, high brightness monitors
DIAGNOSTIC WORKSTATIONS
Holds and operates the study retrieval and study viewing software
DIAGNOSTIC WORKSTATIONS
DIAGNOSTIC WORKSTATIONS
The local PACS workstation is linked by (1) to the (2) and (3).
- standard networking
- PACS core
- archive
PACS core vs archive
PACS core: more on images
archive: more on textual info
File room of the PACS (online file room)
ARCHIVE SERVERS
ARCHIVE SERVERS are composed of a/n (1), (2), and a computer that controls the PACS workflow, known as a/n (3).
- database server or image manager
- short-term and long-term storage
- workflow manager
WIDS
Central part of the PACS and houses all of the historic data along with the current data being generated.
ARCHIVE SERVERS
Tool that most technologists and radiology administrators use for their daily activities.
RADIOLOGY INFORMATION SYSTEM
Multiple vendor choices.
RADIOLOGY INFORMATION SYSTEM
May be bundled with other HIS
RADIOLOGY INFORMATION SYSTEM
Must be able to seamlessly receive ordering information from HIS.
RADIOLOGY INFORMATION SYSTEM
Must allow radiology personnel to enter and alter orders.
RADIOLOGY INFORMATION SYSTEM
RIS uses — as its core communication protocol.
Health Level 7 (HL7)
Pre-visit administration
Register request
Schedule examination
Pre-fetch information
Register patient arrival
ReSched PreReg
Register request
Secretary
Office
RIS
Schedule examination
Secretary
Office
RIS
Pre-fetch information
(automated)
(—)
PACS
Register patient arrival
Receptionist
Reception
RIS
Image generation / exam.
Pre-examination viewing
Generate images
Post-examination quality check
Register billing data
VG QBill
Pre-examination viewing
Radiologist, radiographer
Exam room, any
Modality WS, SCD-WS, any WS
Generate images
Radiologist, radiographer
Exam room
Modality
Post-examination quality check
Radiologist, radiographer
Exam room, reading room, any
Modality WS, SCD-WS, any WS
Register billing data
Radiographer
Exam room, any
RIS
Post-exam administration
Pre-load images
Archive images
Pre-load images
(automated)
(—)
PACS
Archive images
(automated)
(—)
PACS
Image reading and reporting
Read images
Dictate report
Generate preliminary report
Read DP
Read images
Radiologist
Reading room
SCD-WS
Dictate report
Radiologist
Reading room
RIS/ Dictation system
Generate preliminary report
Radiologist
Reading room
RIS
Post-reporting administration
Transcribe report
Authorize report
Submit results
Billing
TAS Bill
Transcribe report
Secretary (automated)
Office (-)
RIS/Speech recognition system
Authorize report
Radiologist
Office, reading room, any
RIS, SCD-WS
Submit results
(automated)
(—)
RIS/PACS
Billing
(automated)
(—)
RIS/HIS
Post-visit image re-viewing
Prepare conference
Conferencing
Clinical viewing
Re-view images in radiology
Teaching
Viewing anywhere
PC CR TV
Prepare conference
Radiologist
Conference room
Conference-WS, any WS
Conferencing
Radiologist
Conference room
Conference WS
Clinical viewing
Referring clinician
Clinical dept.
Clinical WS
Re-view images in radiology
Radiologist
any
SCD-WS, any WS
Teaching
Radiologist
Conference room
any W S
Viewing anywhere
any physician
anywhere
any W S
GENERIC RIS WORKFLOW MODEL
- Requisition (patient ID and patient history)
- Order (RIS), RIS to PACS
- Prepares room, retrieve the patient, input of patient history on paper requisition or input electronically
- Perform examination, images sent to PACS device
- Reading of radiologist (comparing of previous images to current images)
- Report transcribing, signing
RIS when integrated with PACS, it includes — data and workflow.
patient- related PACS
RIS when integrated with PACS, it includes patient- related PACS data and workflow.
MAJOR TASK INCLUDES:
A. Process patient and film (image) folder records
B. Monitor the status of patients, examinations, and examination resources.
C. Schedule examinations
D. Create, format, and store diagnostic reports with digital signatures
E. Track film (softcopy) folders
F. Maintain timely billing information
G. Perform profile and statistics analysis
PM PM CTS
3 systems involved in INTERFACING PACS AND RIS
A. WORSTATION EMULATION
B. DATABASE-TO-DATABASE TRANSFER
C. INTERFACE ENGINE
EDI
Physical connection (cables) and data fromats (DICOM & HL7) to allow seamless data exchange
Interfacing
Process of replicating behavior of a system
Emulation
allows a WS of an information system to emulate a WS of a second system so that data from the second information system can be accessed by the first system.
WORSTATION EMULATION
allows two or more networked information systems to share a subset of data by storing them in a common local area.
DATABASE-TO-DATABASE TRANSFER
Query protocol
INTERFACE ENGINE
Responsible for analyzing the requested information, identifying the required databases, fetching the data, assembling the results in a standard format, and presenting them at the requested WS.
INTERFACE ENGINE
REASONS FOR INTERFACING PACS AND RIS
- DIAGNOSTIC PROCESS
- PACS Image Management
- RIS Administration
- Research and Training
DPR RT
Retrieval of not only images of interest but also pertinent textual information describing patient history and studies.
DIAGNOSTIC PROCESS
Along with the image data and the image description, a PACS also provides all the related textual information acquired and managed by the RIS and the HIS in a way that is useful to the radiologist during this reason for interfacing PACS and RIS
DIAGNOSTIC PROCESS
Some information provided by the RIS can be integrated into PACS image management algorithms to optimize the grouping and routing of image data via the network to the requesting locations.
PACS Image Management
The PACS can provide the image archive status and the image data file information to the RIS. RIS administration operations would also benefit from the HIS by gaining knowledge about patient ADT (admissions, discharges and transfers)
RIS Administration
patient ADT
admissions, discharges and transfers
Interfacing Common Guidelines
Each system (HIS, RIS, PACS) remains unchanged in its (1), (2), and (3).
- configuration
- data
- functions
Interfacing Common Guidelines
Each system is extended in both hardware and software for —.
allowing communications with other systems
Interfacing Common Guidelines
Only (1) are shared; (2) remain local. For example, RIS functions cannot be performed at the PACS or at the HIS WS. Keeping each system (3) and (4) will simplify the interface process, because (5) are not allowed at a global level.
- data
- functions
- specific
- autonomous
- database updates
What does it mean for funtions to remain “local”?
functions will remain within the hsopital only
Following these guidelines, successfully interfacing HIS, RIS, and PACS requires the following steps:
- Identify the subset data that will be shared by other systems. Set up access rights and authorization.
- Convert the subset data to HL7 standard form. This step, consisting of designing a high-level presentation, solving data inconsistencies, and naming conventions, can be accomplished by using a common data model and data language and by defining rules of correspondence between various data definitions.
- Define the protocol of data transfer (e.g., TCP/IP or DICOM).
TCP/ IP
Transmission Control Protocol (TCP)
Internet Protocol (IP)
Rules that allow computers to communicate on the internet
TCP/ IP
