Since we went live with CRIS in January the clinical info that is entered on our (Meditech) PAS is not populating on PACS. It appears fine within CRIS.
1- does anyone else with HSS CRIS and GE PACS in LSP land have the clinical info populating in CRIS?
2- if so, where in the HL7 information is this located? Ours is in the NTE section which I am informed can be used to do the job, but nobody who is LSP has this set up and it would require a SR.
posted on Thursday, May 22, 2008 - 02:46 pm
I was just about to say our clinical (from Anglia ICE) populates our GE PACS system, however after double checking it would appear that since we upgraded to the LSP RIS we have now lost this functionality? I will let you know how we get on with the SR......
I think we will have to put in a service request too. But it seems odd that whilst we had PACS and our old RIS we had the clinical info populating, but now we don't - the messages from Meditech OE haven't been altered to my knowledge.
posted on Thursday, May 22, 2008 - 04:06 pm
Sounds similar to a problem we had with the NHS number. Our old CRIS sent the NHS number under a different section so when we "upgraded" PACS stopped receiving the NHS number completely. I would say it has nothing to do with your Meditech or our Anglia ICE, it is likely that the LSP RIS sends this information once again in a different section. I have asked our RIS manager to investigate. Neil
posted on Thursday, May 22, 2008 - 05:36 pm
We've just fixed the same problem between Meditech and Agfa Impax. Meditech send the NHS no using the Social Security No. Field ,and not one more commonly used by RIS suppiers.....
"The Meditech RIS is indeed sending the NHS number but not in the HL7 PID field ... It is being sent as the Social Security Number in PID-19. I had expected PID-2, PID-3 or PID-4".
I maybe off track here, but if the original HL7 message comes from the same (unchanged) OE system, then I would assume the message passed on by the 2 RIS systems would be of the same makeup, or can/does the RIS remake the message before it is passed on?
Hi Gareth - our HL7 messages from Meditech do not go through the Radiology module to the PACS, they go direct from Order Entry to PACS (and OE is separately integrated with the Radiology module of course). When you implemented CRIS I am guessing that you re-set the HL7 interface to send all the messaging to CRIS instead of direct to PACS; with the normal LSP CRIS to PACS messaging kicking in from there. A lot of assumptions, but is this correct? If so then HSS probably overlooked setting the clinical info to go into PACS in your case. Hopefully just a simple correction required via the Helpdesk? I presume your reports are pulled through into PACS okay? As you know, everyone with access rights in Meditech can see the clinical info and report on the screen prior to launching the image, but the NRA clinicians who use imaging told us it was important to them to have both the clinical information and the report available right there with the image - they didn't want the hassle of having to toggle back and forth. And since our Radiologists report direct from PACS, we had to have it set that way anyway!
By the way, Order Comms to PACS is the model I would expect to see once OE/Order Comms becomes standard in LSP land: does anyone know if this is the case?
posted on Tuesday, May 27, 2008 - 04:07 pm
HL7 messages are out of my depth but with regards to the "order comms straight to PACS" model, I'm not sure this would work for our trust as until an electronic order has been accepted through CRIS, our PACS does not know anything about an order at all. Which I assume is the way we wanted it from the start. I suppose this prevents a lot of unnecessary duplicate, unjustified requests and therefore empty folders in PACS. How does everybody else have theirs set up?
I was under the impression that Meditech OE was incapable of generating an accession number, so therefore the messages do (did in our case) go through the RIS module. =20
My thoughts, that if CRIS receives the clinical info in a format that it can translate into the information it needs then it the information is in the correct fields when it is sent on to PACS and should therefore be visible.
Hi Gareth, I think that the Order remains in Transmitted status until received in Radiology and allocated an accession number, which is when it changes to Ordered status. Once that happens the Order message goes to PACS. I could be wrong, but don't think so. Neil, I don't suppose it matters greatly how the orders are transferred, unless you are using a great deal of imaging via different Information Systems. Theoretically, in the model I describe, I suppose the "Ordered" status could be allocated at the time of IRMER verification, although there would be practical difficulties especially for CR. We certainly do get a lot of Cancelled exams on PACS; but it does reflect exactly what went on. The vast majority of requests are fulfilled, albeit some edited over to another Modality. Anyway, I'll check out the facts and let you know how it hangs together here - for idle interest if nothing else.