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 Link to this message Patricio  posted on Wednesday, December 31, 2008 - 01:40 am Edit Post Delete Post Print Post
Hello, we have developed a software tool that captures medical images from any device (CT, MRI, ECG, microscope, endoscope, etc). The tool converts all the images to DICOM in order to integrate them into any PACS (vendor-independent). Thus you can use your PACS as a centralised global image repository and incorporate non-radiological images into Patient Health Records. Always working in patient context.
 Link to this message Neelam Dugar  posted on Wednesday, December 31, 2008 - 10:48 am Edit Post Delete Post Print Post

Can you please elaborate this workflow. There is a lot of interest in sending
1. medical photography
2. endoscopic images etc
to a Dicom image archive

How is the Dicom modality worklist provided, so that images can be tagged with a
1. proper demographics and scheduling information from the relevant information system:
Endoscopy information system
Medical Photography Information system
2. Reports created in the Information System can be sent to the Image Archiving System
 Link to this message Patrick Ledesma  posted on Monday, January 05, 2009 - 12:04 pm Edit Post Delete Post Print Post
Hello Neelam, very interesting. In order to provide worklists we have 2 options:

1.- Our tool may act as DICOM WORKLIST PROVIDER (SCP and SCU) obtaining the demographic and scheduling data from the Information System.

2.- Our tool acts as a broker, so it doesn’t need worklist, or interfaces with the PACS or RIS to obtain or generate a proper accession number.

To send the reports to the PACS there are different ways:

1.- Using our virtual DICOM printer that converts the printed document to a DICOM image to be sent to PACS

2.- Using our virtual DICOM printer that converts the printed document to a DICOM structured report using the broker tool

We can get into more detail if you can provide further application needs. Kind regards.
 Link to this message Neelam Dugar  posted on Wednesday, January 07, 2009 - 11:40 pm Edit Post Delete Post Print Post
I think you have misunderstood the workflow
Let me give you a practical example. We wish to incorporate of screening mammography into existong radiology pacs. These are the hurdles
1. NBSS is the scheduling and report generating system and will be generating the accession numbers for us.
2. NBSS uses nhs no. as unique identifier but PACS uses the local PAS no.

A. Is the Pacs broker (which is responsible for dmwl capable of accepting scheduling information from more than 1 system)
B. Is the Pacs able to use more than 1 unique identifier
C. Is it possible to have unique identifier field to be less than 100% populated
D. There is a need to have a desk-top integration between NBSS and PACS for reporting
E. Once reports are generated on NBSS they need to be passed to PACS for display

Same workflow is required for incorporating cardiology images into radiology PACS with another scheduling and reporting system--CIS

Endoscopy/ecg/photography goes one step further where the modality is not dicom compliant so dicom boxes need to be put in to convert images to dicom and tag images to dicom scheduling information. But they too will have their own unique scheduling and reporting systems.

Hence, if Enterprises do consider PACS to be a strategic solution as a global image repository, the choice of PACs is really vital. Solutions implemented in England through CFH/lSP do not actually fit the bill.

The integration between multiple information(sceduling and reporting) systems and pacs needs to be standards based. Swf, pir, ccow and xds are the required standards. Time will tell which direction pacs companies will be heading
1. Will they try to sell you their own scheduling/ reporting or information systems tied with proprietary interfaces
2. Or will they indeed mature and truly wish to act as a true global image repository with use of standard interfaces
3. The other big question will be whether pacs companies will stop trying to force users to buy hardware (storage and Pcs) from them at ridiculous prices.
If and when pacs companies mature in these aspects then only will we see their real desire in being a global image repository. I do not that maturity has come as yet.

 Link to this message Patrick Ledesma  posted on Monday, January 12, 2009 - 05:52 pm Edit Post Delete Post Print Post
Hi Neelam,

Do you have any Enterprise Master Patient Index or table that can give us a relationship between NBSS nhs no. and local PACS no.?
 Link to this message Neelam Dugar  posted on Monday, January 12, 2009 - 06:44 pm Edit Post Delete Post Print Post
PAS will have give you a table with NHS no. and local PAS number.

1. All Local PAS no. will not have a NHS no.
2. Similarly all NHS numbers from NBSS will not have a local PAS number.

This is the dilemma.
 Link to this message Matthew Condron  posted on Tuesday, January 20, 2009 - 01:28 pm Edit Post Delete Post Print Post

Hi, it's Matthew from DeJatnette. We are involved in Canada providing a regional image repository and found this string interesting.

We have a product called xDL which can be used with any RIS and PACS or DICOM compliant device to share images and reports. We overcome the EMPI limitation by having our own embedded within the solution. This together with our data manipualtion tools enable us to match patients and share images and reports.

xDL has DICOM, HL7, XDS, XDS-I, PIX and PDQ interfaces to facilitate sharing.

We have also been approached to solve the sharing of non-DICOM objects such as Endoscopy, ecg and photography.

I would be happy to discuss this with you in more depth.
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