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 Link to this message Roy Burnett  posted on Wednesday, January 14, 2015 - 11:53 am Edit Post Delete Post Print Post

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.
 Link to this message Neelam Dugar  posted on Wednesday, January 14, 2015 - 08:09 pm Edit Post Delete Post Print Post
Hi Roy,

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)
 Link to this message Robin Breslin  posted on Wednesday, January 21, 2015 - 03:42 pm Edit Post Delete Post Print Post
Hello Roy,

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.
 Link to this message Robin Breslin  posted on Wednesday, January 21, 2015 - 03:45 pm Edit Post Delete Post Print Post
oops, too many VANs and not enough VNAs in my post I see - less haste more speed ;)
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