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 Link to this message Neelam Dugar  posted on Thursday, July 29, 2004 - 11:03 am Edit Post Delete Post Print Post
RIS/PACS- MODALITY integration issues for workflow in PACS

High level of integration would result in
1. immense workflow efficiency for radiographers (similar to the desk-top RIS-PACS-digital dictation integration that has brought about workflow benefits to radiologists)
2. PACS that is not only filmless but also paperless

The Advantage of RIS-PACS-Modality integration lies in the ability of radiographer/ sonographer uses only one computer to complete their work vs 3 computers to do the same job i.e.
1. modality computer (called ultrasound machine/CT console/CR console etc)
2. QA workstation (computer) from PACS
3. RIS computer (to sign off/read clinical details)


A. Information from RIS (Order-com) to modality workstation
1. Patient identifiers
Name
DOB
Sex
Address
NHS No
2. Patient current location (Ward/clinic/GP)
3. Patient primary location (Ward/clinic/GP)
4. Responsible consultant with Extn of Secretary
5. Name of referrer with bleep no.
6. Clinical history
7. *Pregnancy and LMP (if applicable)
8. *Investigation
9. *Urgency Level (urgent soon routine)
10. *Comments: by refferer/scheduling staff etc

B. * represents alterable/additional input by radiographer at modality workstation

C. Input at Modality by radiographer
1. name/ digital signature of radiographer/sonographer
2. dose/mas/kv
3. no. of images
4. name of radiologist/gen. list
5. Contrast type and amount (IVU, ANGIO, CT, MRI etc)

C. MPPS from modality to RIS/ PACS
This provides information to the RIS status of the procedure
Scheduled
In progress
Performed

(A, B and C would then update RIS/PACS)

D. This level of integration would only work if there is commitment by modality/RIS/PACS vendors to conform to the following IHE Standards. (Non-standard integration may prove to be more costly in the long run especially in a multi-vendor modality/workstation enviornment)
1. Scheduled Workflow
Maintain consistency of information between RIS/HIS and modality
2. Consistant presentation of images
Maintain the consistancy of presentation for grayscale and their presentation state information (user annotation (red dot) , shutter flip rotate,display area zoom, edge enhancement etc)
3. Presentation of grouped procedures
Allows the ability to view image sub-sets resulting from a single acquisition and relate each image sub-set to a different procedure.
 Link to this message Jim Barber  posted on Wednesday, February 02, 2005 - 09:12 am Edit Post Delete Post Print Post
Does anyone out there have a questionnaire for modality manufacturers to assess their dicomness?
I have a couple of hundred devices to attach and am sure I am not the first to do so.

Jim
 Link to this message Simon Waddington  posted on Wednesday, February 02, 2005 - 09:20 am Edit Post Delete Post Print Post
This is a revised version of one sent from NPfIT with changes by GE

Dear

Re Radiological Acquisition Modalities

As you are aware the National Programme for IT within the NHS has decided that PACS should become a "core" system within the programme, and has indicated that the LSP's designated PACS provider for the Southern Cluster will be implementing PACS in ?????? NHS Trust.

An important part of the programme is the need to connect PACS to acquisition modalities such as CT, MRI, Ultrasound, Angiography, etc. in order to ensure that all images are stored locally in the first instance, and then archived to the Cluster Image Store.

In order for the project to proceed ?????? need confirmation from you that the installed base of acquisition equipment at ?????? is DICOM 3.0 enabled.

Therefore, the Trust needs to seek the following written undertakings from you on your company's behalf:

1. Details of the installed DICOM 3.0 Services that the modality can currently perform, for example: DICOM Send, DICOM Modality Worklist, DICOM Print. 2. Likely costs of enablement which must include software, hardware and service capital and revenue costs where appropriate. 3. An indication if a modality is a purely analogue device with no possibility of digital output, i.e. a frame grabber and/or DICOM gateway solution is not feasible. 4. Written confirmation that you are willing to work in partnership with the LSP's chosen PACS Supplier.

I would be most grateful if you could respond to this request within 30 days of receipt. ..............

Yours
 Link to this message Simon Waddington  posted on Wednesday, February 02, 2005 - 09:21 am Edit Post Delete Post Print Post
Here is the original from NPfIT

Dear

Re: Radiological Acquisition Modalities

As you are aware the National Programme for IT within the NHS has decided that PACS should become a "core" system within the programme and has indicated that the LSP's designated PACS provider for the Southern Cluster (GE) may be implementing PACS in North Bristol NHS Trust as an "early win" for our Strategic Health Authority. This is still subject to full costing and business case development.

An important part of the programme will be the need to interface with acquisition devices and workstations for modalities such as CT, MRI, Ultrasound, Angiography etc. in order to ensure that all images are stored locally in the first instance and then sent to the National Store at periodic times.

For the project to proceed in NBT we need confirmation from you that the acquisition/viewing equipment that is in the installed base across NBT is HL7 Specific, DICOM 3.0 and IHE/IHE-E compliant.

Therefore, the Trust needs to seek the following written undertakings from you on your company's behalf:

1. A statement of the ability of your system and/or equipment to receive Demographic and other HL7 messages from an HL7 compliant RIS and to perform MERGE and UNMERGE functions from either the RIS or PAS. It is to be understood that the HL7 interface be bi directional since it is unacceptable to NBT for the status of the examination and report to be unknown to the RIS. 2. IHE/IHE-E (European version) statements 3. DICOM 3.0 conformance statements indicating any parts of the protocol that the system does support and specifying any parts of the standard that the system is not capable of supporting. 4. Likely costs of enablement which must include software and hardware capital and revenue costs where appropriate. 5. Written confirmation that you are willing to work in partnership with LSP's chosen PACS Supplier. 6. A statement about what cannot be upgraded to achieve any of the above conformance levels. 7. Clear differentiation in your response between what is able to achieve conformance as it exists now as opposed to what it could achieve with software switch enable / installed at a cost to NBT.

I would be most grateful if you could respond to this request within 30 days of receipt. Please do not hesitate to contact me with any questions you may have in respect to providing the above information.

Yours sincerely
 
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