posted on Wednesday, January 14, 2015 - 11:53 am
Can anybody point me in the general direction of useful info re: store and forget and store and remember eg advantages/disadvantages of both etc
Tried googlng, but there isnt much out there, that i could find.
posted on Wednesday, January 14, 2015 - 08:09 pm
Interesting concept. VNA as a DICOM back-up archive is being bought by many Trusts replacing PACS.
Sound principles are important when implementing a VNA. VNA DICOM archive must be updated by 1. ADT feed from PAS to ensure that patient info remains up-to-date 2. ORM and ORU messages--as some of the DICOM tag information coming from modalities is not reliable 3. VNA should convert the ORU message of report into a DICOM structured report. The report will be visible as the 1st image of the study. Including report makes VNA a "complete" study--and VNA an independent DICOM archive. Thus DICOM push/ DICOM QR from VNA will always contain the report embedded. We get DICOM structured reports with images transferred via IEP.
DICOM structured report for radiology reports could be constructed using the following HL7 ORU fields: Intended Recipients of the Report—OBR28 Date and Time of Report—OBR22 Primary Reporter—OBR32 (name/ID/Specialty/Institution) 2nd Reporter—OBR33 (name/ID/Specialty/Institution) Transcriptionist name-OBR34 Narrative Text of the Report—OBX5 of ORU Abnormal Flag—OBX8 of ORU Result Status—OBR 25 (Finalised-F & Addendum-C)
I am wondering what it is you are aiming at. Neelam's answer rather assumes you are aiming at an overall architecture whereby you have a PACS that backs off its long term storage to a VAN - is this right?
If yes, and if your PACS doesn't have its own long term store too, you will probably want to implement store and remember from the PACS - that way the PACS doesn't have to reconstruct the contextual information around the old exams when they're retrieved.
However, I like Neelam's recipe. If you want to do store and forget then as Neelam says, you want to be sure the VAN is populated with enough data and contextual information to be able to build up a complete picture of the exam record when you come to look at it in the future.
The only details in Neelam's recipe I would consider would be point 3. You could find what your PACS (and other Information Systems) providers can give you in terms of structure reports outputs - or (dare I say it) use a broker. Neelam's method is probably more sure fire though. VNA providers are really adept at brokering data on import - it's in their interest to have clean and usable data in the VNA for the long term.