PACS / Image Management Systems Flashcards
PACS
Picture Archiving and Communications System
What are the primary functions of PACS?
to store, distribute, and display digital medical images
How does a good PACS system add value to a facility?
It adds improvements to diagnostic capability and operational efficiency
When and by whom was PACS first conceptualized?
1972
Dr. Richard Steckel
When and where was the first large-scale PACS system implemented?
University of Kansas in 1982
NEMA
National Electrical Manufacturers Association
ACR
American College of Radiology
DICOM
Digital Imaging and Communications in Medicine
Who created an interoperability standard across imaging platforms in 1980?
What was this standard called?
- ACR (American College of Radiology) and NEMA (National Electrical Manufacturers Association)
- DICOM (Digital Imaging and
Communications in Medicine)
Specialized Workstations
image post-processing systems
may be part of a modality, a stand-alone computer, or the radiologist reading stations
What can be done on specialized workstations?
Additional image post-processing
(3D Recons, image annotations by Rad, etc.)
VLAN
Virtual Local Area Network
May be segregated from other enterprise data traffic
Where is PACS traffic configured within the network and why is it set up this way?
- On a VLAN
- This increases performance, through-put, and creates high reliability. Additionally, this improves information security
Archive
refers to data storage
Synonyms for Short-term Storage
Online, near-line, hot, and active
Synonyms for Long-term Storage
Offline, passive, and cold
What is short-term storage?
A type of data storage designed to make data quickly accessible
Why is short-term storage generally smaller in size?
Because of the the higher costs associated with specified fast-performing storage media
What is long-term storage?
A type of data storage that is generally inactive or infrequently used
Gateways
the point of entry for devices external to a defined network
What is the role of a Gateway?
they act as the protocol convertor which allows data to flow between networks
(the gateway acts as a crucial point of enforcement for NAC policies)
Switches
devices that connect multiple devices on the network
using packet switching to receive
and forward data to network destinations
Packet Switching
a method where data is broken down into smaller units called packets, which are then transmitted independently across the network
Routers
e devices that analyze the contents of packets transmitted within the network and determine the best route for information to travel
What is the “heart” of PACS?
The database
What is the PACS database responsible for?
the organization
and management of images and their
associated information within the system
How are routers and gateways used within a PACS system?
They help to evenly distribute image ingestion and archive exportation. They also assist in balancing the workload of the database
What are the two main models of image viewing software?
- Web-based and thin client viewers often called “clinical” viewers
- Web-deployable or designated workstation thick clients called “diagnostic” viewers
How do web-based and thin client (clinical) viewers work?
They utilize existing web technologies to render image data
for display
How do web-deployable or designated workstation thick clients (diagnostic) viewers work?
They have direct licensing and increased hardware dependencies
In terms of system management how web-based image viewers compare to web-deployable image viewers?
Web based (thin-client) are easy to access and manage
Web-deployable (thick-client) require more overall support
What is used to track exams in PACS?
unique exam accession numbers
RIS
Radiology Information System
HIS
Health Information System
EMR/EHR
Electronic Medical Record / Electronic Health Record
HL7
Health Level 7
What protocol does RIS use for communicating with other systems?
HL7
What is the role of the PACS Broker?
It is responsible for processing
messaging
between PACS and other connected systems (RIS, HIS, EMR, EHR, and VR)
What is another term for PACS Broker?
Interface Engine
How does the Interface Engine process messaging between PACS and other connected systems?
It converts HL7 messages in DICOM format and vice versa
What is EMR/EHR integrated storage?
A form of image storage within the EMR/EHR itself
What is another term for EMR/EHR integrated storage?
Enterprise Content Management (ECM)
What is EMR/EHR integrated storage primarily used for?
medical document management, but can also be used for storing photos like those captured in dermatology or surgical wound care
What is HL7?
a comprehensive
framework/standard for the exchange, integration, sharing, and retrieval of electronic health information
Departmental/ specialty image storage can also be referred to as what?
mini-PACS
What is mini-PACS and what do they offer?
PACS systems used by specialty departments (derm, cardiology, etc.)
They offer targeted image review tools, typically with limited capabilities for integrating with the HIS, EMR, or EHR
Do specialties have to use a mini-PACS?
Not necessarily, in some instances they may piggyback off of the full radiology PACS system for their image storage
POCUS
Point-of-care Ultrasound
What is point-of-care ultrasound?
small inexpensive US machines that can be used by healthcare providers outside of the radiology department
Does POCUS used traditional PACS?
No, POCUS vendors offer focused application software with associated storage configurations for use with their devices.
The workflow for such devices varies greatly from the PACS workflow
VNA
Vendor Neutral Archive
Why are VNAs and enterprise archives popular?
These repositories are capable of ingesting and storing data objects in both DICOM and non-DICOM formats
This allows for integrated image storage at the enterprise level
In what decade were the first PACS systems put into place?
the 1990s
The primary functions of PACS are storage, _________, and display of images.
A. Integration
B. Distribution
C. Quality assurance
D. Interpretation
B
The PACS database is responsible for managing which pertinent data elements?
Select all that apply:
A. Patient demographics
B. Associated reports
C. Where the images are stored in the archive
D. Where the images should be sent
ABC
Which of the following advances, when part of PACS or other image management systems, gives attending radiologists the ability to share important or
interesting cases with residents for future review?
A. Integrated programmed peer review
B. Digital teaching fles
C. Incorporated advanced visualization technologies
D. Teleradiology
B
