I'm trying to find out the best way to phrase an invitation to tender so that quotes are for fully DICOM functional equipment, not something that needs to be enabled or switched on after installation at additional cost.
This is the old issue of DICOM "compatible" but not "enabled". Stick to functional specifications in plain English that cannot be misinterpreted by technical people. I think too many radiologists feel they have to become experts in IT and DICOM in order to purchase a PACS. Siegel from Baltimore made it very clear years ago that we should tell them what we want the equipment to do, and not specify to them technically how to achieve this.
We have taken the approach of specifying what we want the equipment to do. The problem is what to specifiy for something you want it to do in the future, and a statement that we want it to interface with a future PACS system and workstations is a bit too nebulous.
I've already replied to Martin off board on this but I thought I'd share a couple of phrases we put in our CT operational requirements document. I've also uploaded the DICOM functionality which we included in the teleradiology/communications appendix based on the DICOM specifications used in the PACS OBS.
The system must be fully DICOM conformant. Potential suppliers must provide full DICOM conformance statements for the scanner and workstations supplied. The connection and configuration of the DICOM services available on the system at the time of purchase will be included in the offer, even if the other end of the service is not available at the time of installation and a return visit to the site is required.
Suppliers are advised to clarify the communications/networking requirements above with the department and the capabilities with the existing equipment suppliers. If there are any workstations with which DICOM communications (SCU, SCP, Query/retrieve) are know to be a problem then this must be clearly stated. If, on delivery, the communications do not meet the standards outlined in the tender response then the supplier must accept all the financial implications of achieving that standard.
Advice from anyone who has become unstuck on this would be appreciated.
I have just completed a DICOM training course given by Merge e-Film. They say that the DICOM standard will require detailed information of modular 'add-ons' to be included in future Conformance Statements. - So that should help!
It may be worth asking whether the modality supports the following IHE integration profiles
IHE PROFILES RELEVANT TO MODALITIES
"Scheduled Workflow (SWF) The Scheduled Workflow Integration Profile establishes the continuity and integrity of basic radiological data. It specifies a number of transactions that maintain the consistency of patient and ordering information as well as providing the scheduling and imaging acquisition procedure steps. This profile also makes it possible to determine whether images associated with a particular performed procedure step have been stored (archived) and are available to enable subsequent workflow steps, such as reporting
Consistent Presentation of Images (CPI) The Consistent Presentation of Images Integration Profile specifies a number of transactions that maintain the consistency of presentation for grayscale images and their presentation state information (including user annotations, shutters, flip/rotate, display area, and zoom). It also defines a standard contrast curve, the Grayscale Standard Display Function, against which different types of display and hardcopy output devices should be calibrated. It thus supports hardcopy, softcopy and mixed environments.
Presentation of Grouped Procedures (PGP) Presentation of Grouped Procedures (PGP) Integration Profile addresses what is sometimes referred to as the linked studies problem: viewing image subsets resulting from a single acquisition and each image subset is related to a different requested procedure (e.g. CT chest, abdomen and pelvis). It provides a mechanism for facilitating workflow when viewing images and reporting on individual requested procedures that an operator has grouped (often for the sake of acquisition efficiency and patient comfort). A single acquired image set is produced, but the combined use of the scheduled workflow transactions and the consistent presentation of images allows separate viewing and interpretation of the subset of images related to each of the requested procedures. As a result, reports can be produced that match the billing policies of the healthcare facility, without additional manual intervention.
Using IHE can make systems integration faster, more efficient, less expensive and more successful. Standards-based integration solutions like the ones IHE defines also are more flexible, longer-lived and easier and less expensive to maintain than proprietary methods."
For Modality IHE profiles to be of any use PACS and RIS need to support SWF. RIS, PACS and workstations need to support PGP. Similarly workstations and PACS need to support CPI.