Andrew Casertano - Academia.edu (original) (raw)

Papers by Andrew Casertano

Research paper thumbnail of How Should Interfaces Specify Application Behaviors

Medinfo 2007: Proceedings of the 12th World Congress on Health (Medical) Informatics; Building Sustainable Health Systems, 2007

Abstract: A distinguishing feature of healthcare informatics in the 21st century has been the rec... more Abstract: A distinguishing feature of healthcare informatics in the 21st century has been the recognition that a patient-centric multi-enterprise health record is not only desirable but essential to the provision of safe, appropriate care. Systems exchange information both to document healthcare ...

Research paper thumbnail of Using IHE and HL7 conformance to specify consistent PACS interoperability for a large multi-center enterprise

PubMed, 2006

As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic ... more As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic imaging procedures at 141 medical centers and 850 outpatient clinics. VHA's VistA Imaging Package provides a full archival, display, and communications infrastructure and interfaces to radiology and other HIS modules as well as modalities and a worklist provider In addition, various medical center entities within VHA have elected to install commercial picture archiving and communications systems to enable image organization and interpretation. To evaluate interfaces between commercial PACS, the VistA hospital information system, and imaging modalities, VHA has built a fully constrained specification that is based on the Radiology Technical Framework (Rad-TF) Integrating the Healthcare Enterprise. The Health Level Seven normative conformance mechanism was applied to the IHE Rad-TF and agency requirements to arrive at a baseline set of message specifications. VHA provides a thorough implementation and testing process to promote the adoption of standards-based interoperability by all PACS vendors that want to interface with VistA Imaging.

Research paper thumbnail of Streamlining Importation of Outside Prior DICOM Studies into an Imaging System

Journal of Digital Imaging, Aug 2, 2011

A patient has an imaging study performed at one facility and has the study exported to portable m... more A patient has an imaging study performed at one facility and has the study exported to portable media. Later, the patient takes the media to a different institution. The study on that media may need to be imported into that new institution's imaging system. This would be done to avoid a repeat examination, or so that the study can be on file for reference purposes. Importing prior studies is best performed by creating a new order on the institution's imaging system and then associating the DICOM objects from the prior study with it. In this way the prior study is actually inserted into the imaging system's electronic health record (EHR) and is properly indexed so that it can be identified and later retrieved as needed. In the past at the Department of Veterans Affairs (VA), importing prior DICOM studies into the VA systems had been a very slow labor-intensive process that took anywhere from 10 to 30 min to import a single study. We have developed a new DICOM Importer application that reduces the manual effort to import a prior study to less than a minute. We have redesigned and automated the process to make it much more efficient for the user. The Importer also handles contract examinations that are ordered by the VA and performed at outside imaging facilities, with similar time savings. This work is important because is addresses one of the major unsolved problems with import reconciliation workflow: how to efficiently handle the importing of prior studies.

Research paper thumbnail of Advanced Medical Imaging Protocol Workflow—A Flexible Electronic Solution to Optimize Process Efficiency, Care Quality and Patient Safety in the National VA Enterprise

Journal of Digital Imaging, Jan 4, 2013

Radiologists routinely make decisions with only limited information when assigning protocol instr... more Radiologists routinely make decisions with only limited information when assigning protocol instructions for the performance of advanced medical imaging examinations. Opportunity exists to simultaneously improve the safety, quality and efficiency of this workflow through the application of an electronic solution leveraging health system resources to provide concise, tailored information and decision support in real-time. Such a system has been developed using an open source, open standards design for use within the Veterans Health Administration. The Radiology Protocol Tool Recorder (RAPTOR) project identified key process attributes as well as inherent weaknesses of paper processes and electronic emulators of paper processes to guide the development of its optimized electronic solution. The design provides a kernel that can be expanded to create an integrated radiology environment. RAPTOR has implications relevant to the greater health care community, and serves as a case model for modernization of legacy government health information systems.

Research paper thumbnail of An autoethnographic account of innovation at the department of veterans affairs

What is influencing the direction of innovation at the U.S. Department of Veterans Affairs (VA)? ... more What is influencing the direction of innovation at the U.S. Department of Veterans Affairs (VA)? I explore challenges at the VA Center of Innovation (VACI) as the US Government Accounting Office (GAO) has designated the VA at high-risk for being susceptible to waste, fraud, and mismanagement. My autoethnographic lens is applied to the VACI open source software application, the Radiology Protocol Tool Recorder (RAPTOR) that my team and I designed and developed from 2010 to 2017. RAPTOR is designed to work with the VistA Electronic Health Record (EHR), considered one of the most important open source healthcare software applications ever. The failure to launch RAPTOR is representative of these susceptibilities and an appropriate example to illustrate VA institutional issues. This poster advances a novel approach of understanding institutional culture and change, using autoethnographic methods to retrospectively analyze over ten years of experience at the VA. I propose three new research questions based on my understanding of VA innovation. The poster provides a structure to understand the major issues influencing information directions; identifies sources and determinants and categorizes attributes into organization, process, technology, and culture. My research is supplemented by the information literature, and I use a conceptual framework explaining the relationships between these factors and the direction of VA IT innovation. The proposed framework serves as a means by which government and public sector information systems managers / Chief Information Officers / Technology and business managers can conduct an introspective exercise within their organization

Research paper thumbnail of Consistency and Standardization of Color in Medical Imaging: a Consensus Report

Journal of Digital Imaging, Jul 9, 2014

This article summarizes the consensus reached at the Summit on Color in Medical Imaging held at t... more This article summarizes the consensus reached at the Summit on Color in Medical Imaging held at the Food and Drug Administration (FDA) on May 8-9, 2013, co-sponsored by the FDA and ICC (International Color Consortium). The purpose of the meeting was to gather information on how color is currently handled by medical imaging systems to identify areas where there is a need for improvement, to define objective requirements, and to facilitate consensus development of best practices. Participants were asked to identify areas of concern and unmet needs. This summary documents the topics that were discussed at the meeting and recommendations that were made by the participants. Key areas identified where improvements in color would provide immediate tangible benefits were those of digital microscopy,

Research paper thumbnail of An Autoethnographic Account of Innovation at the US Department of Veterans Affairs

The history of the U.S. Department of Veterans Affairs (VA) health information technology (HIT) h... more The history of the U.S. Department of Veterans Affairs (VA) health information technology (HIT) has been characterized by both enormous successes and catastrophic failures. While the VA was once hailed as the way to the future of twenty-first-century health care, many programs have been mismanaged, delayed, or flawed, resulting in the waste of hundreds of millions of taxpayer dollars. Since 2015 the U.S. Government Accountability Office (GAO) has designated HIT at the VA as being susceptible to waste, fraud, and mismanagement. The timely central research question I ask in this study is, can healthcare IT at the VA be healed? To address this question, I investigate a HIT case study at the VA Center of Innovation (VACI), originally designed to be the flagship initiative of the open government transformation at the VA. The Open Source Electronic Health Record Alliance (OSEHRA) was designed to promote the open innovation ecosystem public-private-academic partnership. Based on my fifteen...

Research paper thumbnail of Using IHE and HL7 conformance to specify consistent PACS interoperability for a large multi-center enterprise

Journal of healthcare information management : JHIM, 2006

As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic ... more As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic imaging procedures at 141 medical centers and 850 outpatient clinics. VHA's VistA Imaging Package provides a full archival, display, and communications infrastructure and interfaces to radiology and other HIS modules as well as modalities and a worklist provider In addition, various medical center entities within VHA have elected to install commercial picture archiving and communications systems to enable image organization and interpretation. To evaluate interfaces between commercial PACS, the VistA hospital information system, and imaging modalities, VHA has built a fully constrained specification that is based on the Radiology Technical Framework (Rad-TF) Integrating the Healthcare Enterprise. The Health Level Seven normative conformance mechanism was applied to the IHE Rad-TF and agency requirements to arrive at a baseline set of message specifications. VHA provides a thorough im...

Research paper thumbnail of How Should Interfaces Specify Application Behaviors

A distinguishing feature of healthcare informatics in the 21st century has been the recognition t... more A distinguishing feature of healthcare informatics in the 21st century has been the recognition that a patient-centric multi-enterprise health record is not only desirable but essential to the provision of safe, appropriate care. Systems exchange information both to document healthcare activities in comprehensive records, and to share information necessary for current patient care, either locally or remotely. This paper explains the application of the interfaces and their behaviours.

Research paper thumbnail of An autoethnographic account of innovation at the department of veterans affairs

iConference 2019 Proceedings, 2019

Research paper thumbnail of Using IHE and HL7 conformance to specify consistent PACS interoperability for a large multi-center enterprise

As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic ... more As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic imaging procedures at 141 medical centers and 850 outpatient clinics. VHA's VistA Imaging Package provides a full archival, display, and communications infrastructure and interfaces to radiology and other HIS modules as well as modalities and a worklist provider In addition, various medical center entities within VHA have elected to install commercial picture archiving and communications systems to enable image organization and interpretation. To evaluate interfaces between commercial PACS, the VistA hospital information system, and imaging modalities, VHA has built a fully constrained specification that is based on the Radiology Technical Framework (Rad-TF) Integrating the Healthcare Enterprise. The Health Level Seven normative conformance mechanism was applied to the IHE Rad-TF and agency requirements to arrive at a baseline set of message specifications. VHA provides a thorough im...

Research paper thumbnail of Open Source Radiology Dashboard Improves Clinical Workflow and Protocol Decision Support

Research paper thumbnail of Using IHE and HL7 conformance to specify consistent PACS interoperability for a large multi-center enterprise

Journal of Healthcare Information Management Jhim, Feb 1, 2006

As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic ... more As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic imaging procedures at 141 medical centers and 850 outpatient clinics. VHA's VistA Imaging Package provides a full archival, display, and communications infrastructure and interfaces to radiology and other HIS modules as well as modalities and a worklist provider In addition, various medical center entities within VHA have elected to install commercial picture archiving and communications systems to enable image organization and interpretation. To evaluate interfaces between commercial PACS, the VistA hospital information system, and imaging modalities, VHA has built a fully constrained specification that is based on the Radiology Technical Framework (Rad-TF) Integrating the Healthcare Enterprise. The Health Level Seven normative conformance mechanism was applied to the IHE Rad-TF and agency requirements to arrive at a baseline set of message specifications. VHA provides a thorough implementation and testing process to promote the adoption of standards-based interoperability by all PACS vendors that want to interface with VistA Imaging.

Research paper thumbnail of Longitudinal Patient Dosimetry Records and Reporting: Current Challenges, Proposed Solutions, and Introduction of a VA Prototype Project

Research paper thumbnail of Using IHE and HL7 conformance to specify consistent PACS interoperability for a large multi-center enterprise

Journal of healthcare information management : JHIM, 2006

As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic ... more As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic imaging procedures at 141 medical centers and 850 outpatient clinics. VHA's VistA Imaging Package provides a full archival, display, and communications infrastructure and interfaces to radiology and other HIS modules as well as modalities and a worklist provider In addition, various medical center entities within VHA have elected to install commercial picture archiving and communications systems to enable image organization and interpretation. To evaluate interfaces between commercial PACS, the VistA hospital information system, and imaging modalities, VHA has built a fully constrained specification that is based on the Radiology Technical Framework (Rad-TF) Integrating the Healthcare Enterprise. The Health Level Seven normative conformance mechanism was applied to the IHE Rad-TF and agency requirements to arrive at a baseline set of message specifications. VHA provides a thorough im...

Research paper thumbnail of Consistency and Standardization of Color in Medical Imaging: a Consensus Report

Journal of Digital Imaging, 2014

This article summarizes the consensus reached at the Summit on Color in Medical Imaging held at t... more This article summarizes the consensus reached at the Summit on Color in Medical Imaging held at the Food and Drug Administration (FDA) on May 8-9, 2013, co-sponsored by the FDA and ICC (International Color Consortium). The purpose of the meeting was to gather information on how color is currently handled by medical imaging systems to identify areas where there is a need for improvement, to define objective requirements, and to facilitate consensus development of best practices. Participants were asked to identify areas of concern and unmet needs. This summary documents the topics that were discussed at the meeting and recommendations that were made by the participants. Key areas identified where improvements in color would provide immediate tangible benefits were those of digital microscopy,

Research paper thumbnail of Advanced Medical Imaging Protocol Workflow—A Flexible Electronic Solution to Optimize Process Efficiency, Care Quality and Patient Safety in the National VA Enterprise

Journal of Digital Imaging, 2013

Radiologists routinely make decisions with only limited information when assigning protocol instr... more Radiologists routinely make decisions with only limited information when assigning protocol instructions for the performance of advanced medical imaging examinations. Opportunity exists to simultaneously improve the safety, quality and efficiency of this workflow through the application of an electronic solution leveraging health system resources to provide concise, tailored information and decision support in real-time. Such a system has been developed using an open source, open standards design for use within the Veterans Health Administration. The Radiology Protocol Tool Recorder (RAPTOR) project identified key process attributes as well as inherent weaknesses of paper processes and electronic emulators of paper processes to guide the development of its optimized electronic solution. The design provides a kernel that can be expanded to create an integrated radiology environment. RAPTOR has implications relevant to the greater health care community, and serves as a case model for modernization of legacy government health information systems.

Research paper thumbnail of How Should Interfaces Specify Application Behaviors?

… : Proceedings of the …, 2007

Abstract: A distinguishing feature of healthcare informatics in the 21st century has been the rec... more Abstract: A distinguishing feature of healthcare informatics in the 21st century has been the recognition that a patient-centric multi-enterprise health record is not only desirable but essential to the provision of safe, appropriate care. Systems exchange information both to document healthcare ...

Research paper thumbnail of Streamlining Importation of Outside Prior DICOM Studies into an Imaging System

Journal of Digital Imaging, 2012

A patient has an imaging study performed at one facility and has the study exported to portable m... more A patient has an imaging study performed at one facility and has the study exported to portable media. Later, the patient takes the media to a different institution. The study on that media may need to be imported into that new institution's imaging system. This would be done to avoid a repeat examination, or so that the study can be on file for reference purposes. Importing prior studies is best performed by creating a new order on the institution's imaging system and then associating the DICOM objects from the prior study with it. In this way the prior study is actually inserted into the imaging system's electronic health record (EHR) and is properly indexed so that it can be identified and later retrieved as needed. In the past at the Department of Veterans Affairs (VA), importing prior DICOM studies into the VA systems had been a very slow labor-intensive process that took anywhere from 10 to 30 min to import a single study. We have developed a new DICOM Importer application that reduces the manual effort to import a prior study to less than a minute. We have redesigned and automated the process to make it much more efficient for the user. The Importer also handles contract examinations that are ordered by the VA and performed at outside imaging facilities, with similar time savings. This work is important because is addresses one of the major unsolved problems with import reconciliation workflow: how to efficiently handle the importing of prior studies.

Research paper thumbnail of How Should Interfaces Specify Application Behaviors

Medinfo 2007: Proceedings of the 12th World Congress on Health (Medical) Informatics; Building Sustainable Health Systems, 2007

Abstract: A distinguishing feature of healthcare informatics in the 21st century has been the rec... more Abstract: A distinguishing feature of healthcare informatics in the 21st century has been the recognition that a patient-centric multi-enterprise health record is not only desirable but essential to the provision of safe, appropriate care. Systems exchange information both to document healthcare ...

Research paper thumbnail of Using IHE and HL7 conformance to specify consistent PACS interoperability for a large multi-center enterprise

PubMed, 2006

As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic ... more As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic imaging procedures at 141 medical centers and 850 outpatient clinics. VHA's VistA Imaging Package provides a full archival, display, and communications infrastructure and interfaces to radiology and other HIS modules as well as modalities and a worklist provider In addition, various medical center entities within VHA have elected to install commercial picture archiving and communications systems to enable image organization and interpretation. To evaluate interfaces between commercial PACS, the VistA hospital information system, and imaging modalities, VHA has built a fully constrained specification that is based on the Radiology Technical Framework (Rad-TF) Integrating the Healthcare Enterprise. The Health Level Seven normative conformance mechanism was applied to the IHE Rad-TF and agency requirements to arrive at a baseline set of message specifications. VHA provides a thorough implementation and testing process to promote the adoption of standards-based interoperability by all PACS vendors that want to interface with VistA Imaging.

Research paper thumbnail of Streamlining Importation of Outside Prior DICOM Studies into an Imaging System

Journal of Digital Imaging, Aug 2, 2011

A patient has an imaging study performed at one facility and has the study exported to portable m... more A patient has an imaging study performed at one facility and has the study exported to portable media. Later, the patient takes the media to a different institution. The study on that media may need to be imported into that new institution's imaging system. This would be done to avoid a repeat examination, or so that the study can be on file for reference purposes. Importing prior studies is best performed by creating a new order on the institution's imaging system and then associating the DICOM objects from the prior study with it. In this way the prior study is actually inserted into the imaging system's electronic health record (EHR) and is properly indexed so that it can be identified and later retrieved as needed. In the past at the Department of Veterans Affairs (VA), importing prior DICOM studies into the VA systems had been a very slow labor-intensive process that took anywhere from 10 to 30 min to import a single study. We have developed a new DICOM Importer application that reduces the manual effort to import a prior study to less than a minute. We have redesigned and automated the process to make it much more efficient for the user. The Importer also handles contract examinations that are ordered by the VA and performed at outside imaging facilities, with similar time savings. This work is important because is addresses one of the major unsolved problems with import reconciliation workflow: how to efficiently handle the importing of prior studies.

Research paper thumbnail of Advanced Medical Imaging Protocol Workflow—A Flexible Electronic Solution to Optimize Process Efficiency, Care Quality and Patient Safety in the National VA Enterprise

Journal of Digital Imaging, Jan 4, 2013

Radiologists routinely make decisions with only limited information when assigning protocol instr... more Radiologists routinely make decisions with only limited information when assigning protocol instructions for the performance of advanced medical imaging examinations. Opportunity exists to simultaneously improve the safety, quality and efficiency of this workflow through the application of an electronic solution leveraging health system resources to provide concise, tailored information and decision support in real-time. Such a system has been developed using an open source, open standards design for use within the Veterans Health Administration. The Radiology Protocol Tool Recorder (RAPTOR) project identified key process attributes as well as inherent weaknesses of paper processes and electronic emulators of paper processes to guide the development of its optimized electronic solution. The design provides a kernel that can be expanded to create an integrated radiology environment. RAPTOR has implications relevant to the greater health care community, and serves as a case model for modernization of legacy government health information systems.

Research paper thumbnail of An autoethnographic account of innovation at the department of veterans affairs

What is influencing the direction of innovation at the U.S. Department of Veterans Affairs (VA)? ... more What is influencing the direction of innovation at the U.S. Department of Veterans Affairs (VA)? I explore challenges at the VA Center of Innovation (VACI) as the US Government Accounting Office (GAO) has designated the VA at high-risk for being susceptible to waste, fraud, and mismanagement. My autoethnographic lens is applied to the VACI open source software application, the Radiology Protocol Tool Recorder (RAPTOR) that my team and I designed and developed from 2010 to 2017. RAPTOR is designed to work with the VistA Electronic Health Record (EHR), considered one of the most important open source healthcare software applications ever. The failure to launch RAPTOR is representative of these susceptibilities and an appropriate example to illustrate VA institutional issues. This poster advances a novel approach of understanding institutional culture and change, using autoethnographic methods to retrospectively analyze over ten years of experience at the VA. I propose three new research questions based on my understanding of VA innovation. The poster provides a structure to understand the major issues influencing information directions; identifies sources and determinants and categorizes attributes into organization, process, technology, and culture. My research is supplemented by the information literature, and I use a conceptual framework explaining the relationships between these factors and the direction of VA IT innovation. The proposed framework serves as a means by which government and public sector information systems managers / Chief Information Officers / Technology and business managers can conduct an introspective exercise within their organization

Research paper thumbnail of Consistency and Standardization of Color in Medical Imaging: a Consensus Report

Journal of Digital Imaging, Jul 9, 2014

This article summarizes the consensus reached at the Summit on Color in Medical Imaging held at t... more This article summarizes the consensus reached at the Summit on Color in Medical Imaging held at the Food and Drug Administration (FDA) on May 8-9, 2013, co-sponsored by the FDA and ICC (International Color Consortium). The purpose of the meeting was to gather information on how color is currently handled by medical imaging systems to identify areas where there is a need for improvement, to define objective requirements, and to facilitate consensus development of best practices. Participants were asked to identify areas of concern and unmet needs. This summary documents the topics that were discussed at the meeting and recommendations that were made by the participants. Key areas identified where improvements in color would provide immediate tangible benefits were those of digital microscopy,

Research paper thumbnail of An Autoethnographic Account of Innovation at the US Department of Veterans Affairs

The history of the U.S. Department of Veterans Affairs (VA) health information technology (HIT) h... more The history of the U.S. Department of Veterans Affairs (VA) health information technology (HIT) has been characterized by both enormous successes and catastrophic failures. While the VA was once hailed as the way to the future of twenty-first-century health care, many programs have been mismanaged, delayed, or flawed, resulting in the waste of hundreds of millions of taxpayer dollars. Since 2015 the U.S. Government Accountability Office (GAO) has designated HIT at the VA as being susceptible to waste, fraud, and mismanagement. The timely central research question I ask in this study is, can healthcare IT at the VA be healed? To address this question, I investigate a HIT case study at the VA Center of Innovation (VACI), originally designed to be the flagship initiative of the open government transformation at the VA. The Open Source Electronic Health Record Alliance (OSEHRA) was designed to promote the open innovation ecosystem public-private-academic partnership. Based on my fifteen...

Research paper thumbnail of Using IHE and HL7 conformance to specify consistent PACS interoperability for a large multi-center enterprise

Journal of healthcare information management : JHIM, 2006

As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic ... more As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic imaging procedures at 141 medical centers and 850 outpatient clinics. VHA's VistA Imaging Package provides a full archival, display, and communications infrastructure and interfaces to radiology and other HIS modules as well as modalities and a worklist provider In addition, various medical center entities within VHA have elected to install commercial picture archiving and communications systems to enable image organization and interpretation. To evaluate interfaces between commercial PACS, the VistA hospital information system, and imaging modalities, VHA has built a fully constrained specification that is based on the Radiology Technical Framework (Rad-TF) Integrating the Healthcare Enterprise. The Health Level Seven normative conformance mechanism was applied to the IHE Rad-TF and agency requirements to arrive at a baseline set of message specifications. VHA provides a thorough im...

Research paper thumbnail of How Should Interfaces Specify Application Behaviors

A distinguishing feature of healthcare informatics in the 21st century has been the recognition t... more A distinguishing feature of healthcare informatics in the 21st century has been the recognition that a patient-centric multi-enterprise health record is not only desirable but essential to the provision of safe, appropriate care. Systems exchange information both to document healthcare activities in comprehensive records, and to share information necessary for current patient care, either locally or remotely. This paper explains the application of the interfaces and their behaviours.

Research paper thumbnail of An autoethnographic account of innovation at the department of veterans affairs

iConference 2019 Proceedings, 2019

Research paper thumbnail of Using IHE and HL7 conformance to specify consistent PACS interoperability for a large multi-center enterprise

As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic ... more As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic imaging procedures at 141 medical centers and 850 outpatient clinics. VHA's VistA Imaging Package provides a full archival, display, and communications infrastructure and interfaces to radiology and other HIS modules as well as modalities and a worklist provider In addition, various medical center entities within VHA have elected to install commercial picture archiving and communications systems to enable image organization and interpretation. To evaluate interfaces between commercial PACS, the VistA hospital information system, and imaging modalities, VHA has built a fully constrained specification that is based on the Radiology Technical Framework (Rad-TF) Integrating the Healthcare Enterprise. The Health Level Seven normative conformance mechanism was applied to the IHE Rad-TF and agency requirements to arrive at a baseline set of message specifications. VHA provides a thorough im...

Research paper thumbnail of Open Source Radiology Dashboard Improves Clinical Workflow and Protocol Decision Support

Research paper thumbnail of Using IHE and HL7 conformance to specify consistent PACS interoperability for a large multi-center enterprise

Journal of Healthcare Information Management Jhim, Feb 1, 2006

As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic ... more As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic imaging procedures at 141 medical centers and 850 outpatient clinics. VHA's VistA Imaging Package provides a full archival, display, and communications infrastructure and interfaces to radiology and other HIS modules as well as modalities and a worklist provider In addition, various medical center entities within VHA have elected to install commercial picture archiving and communications systems to enable image organization and interpretation. To evaluate interfaces between commercial PACS, the VistA hospital information system, and imaging modalities, VHA has built a fully constrained specification that is based on the Radiology Technical Framework (Rad-TF) Integrating the Healthcare Enterprise. The Health Level Seven normative conformance mechanism was applied to the IHE Rad-TF and agency requirements to arrive at a baseline set of message specifications. VHA provides a thorough implementation and testing process to promote the adoption of standards-based interoperability by all PACS vendors that want to interface with VistA Imaging.

Research paper thumbnail of Longitudinal Patient Dosimetry Records and Reporting: Current Challenges, Proposed Solutions, and Introduction of a VA Prototype Project

Research paper thumbnail of Using IHE and HL7 conformance to specify consistent PACS interoperability for a large multi-center enterprise

Journal of healthcare information management : JHIM, 2006

As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic ... more As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic imaging procedures at 141 medical centers and 850 outpatient clinics. VHA's VistA Imaging Package provides a full archival, display, and communications infrastructure and interfaces to radiology and other HIS modules as well as modalities and a worklist provider In addition, various medical center entities within VHA have elected to install commercial picture archiving and communications systems to enable image organization and interpretation. To evaluate interfaces between commercial PACS, the VistA hospital information system, and imaging modalities, VHA has built a fully constrained specification that is based on the Radiology Technical Framework (Rad-TF) Integrating the Healthcare Enterprise. The Health Level Seven normative conformance mechanism was applied to the IHE Rad-TF and agency requirements to arrive at a baseline set of message specifications. VHA provides a thorough im...

Research paper thumbnail of Consistency and Standardization of Color in Medical Imaging: a Consensus Report

Journal of Digital Imaging, 2014

This article summarizes the consensus reached at the Summit on Color in Medical Imaging held at t... more This article summarizes the consensus reached at the Summit on Color in Medical Imaging held at the Food and Drug Administration (FDA) on May 8-9, 2013, co-sponsored by the FDA and ICC (International Color Consortium). The purpose of the meeting was to gather information on how color is currently handled by medical imaging systems to identify areas where there is a need for improvement, to define objective requirements, and to facilitate consensus development of best practices. Participants were asked to identify areas of concern and unmet needs. This summary documents the topics that were discussed at the meeting and recommendations that were made by the participants. Key areas identified where improvements in color would provide immediate tangible benefits were those of digital microscopy,

Research paper thumbnail of Advanced Medical Imaging Protocol Workflow—A Flexible Electronic Solution to Optimize Process Efficiency, Care Quality and Patient Safety in the National VA Enterprise

Journal of Digital Imaging, 2013

Radiologists routinely make decisions with only limited information when assigning protocol instr... more Radiologists routinely make decisions with only limited information when assigning protocol instructions for the performance of advanced medical imaging examinations. Opportunity exists to simultaneously improve the safety, quality and efficiency of this workflow through the application of an electronic solution leveraging health system resources to provide concise, tailored information and decision support in real-time. Such a system has been developed using an open source, open standards design for use within the Veterans Health Administration. The Radiology Protocol Tool Recorder (RAPTOR) project identified key process attributes as well as inherent weaknesses of paper processes and electronic emulators of paper processes to guide the development of its optimized electronic solution. The design provides a kernel that can be expanded to create an integrated radiology environment. RAPTOR has implications relevant to the greater health care community, and serves as a case model for modernization of legacy government health information systems.

Research paper thumbnail of How Should Interfaces Specify Application Behaviors?

… : Proceedings of the …, 2007

Abstract: A distinguishing feature of healthcare informatics in the 21st century has been the rec... more Abstract: A distinguishing feature of healthcare informatics in the 21st century has been the recognition that a patient-centric multi-enterprise health record is not only desirable but essential to the provision of safe, appropriate care. Systems exchange information both to document healthcare ...

Research paper thumbnail of Streamlining Importation of Outside Prior DICOM Studies into an Imaging System

Journal of Digital Imaging, 2012

A patient has an imaging study performed at one facility and has the study exported to portable m... more A patient has an imaging study performed at one facility and has the study exported to portable media. Later, the patient takes the media to a different institution. The study on that media may need to be imported into that new institution's imaging system. This would be done to avoid a repeat examination, or so that the study can be on file for reference purposes. Importing prior studies is best performed by creating a new order on the institution's imaging system and then associating the DICOM objects from the prior study with it. In this way the prior study is actually inserted into the imaging system's electronic health record (EHR) and is properly indexed so that it can be identified and later retrieved as needed. In the past at the Department of Veterans Affairs (VA), importing prior DICOM studies into the VA systems had been a very slow labor-intensive process that took anywhere from 10 to 30 min to import a single study. We have developed a new DICOM Importer application that reduces the manual effort to import a prior study to less than a minute. We have redesigned and automated the process to make it much more efficient for the user. The Importer also handles contract examinations that are ordered by the VA and performed at outside imaging facilities, with similar time savings. This work is important because is addresses one of the major unsolved problems with import reconciliation workflow: how to efficiently handle the importing of prior studies.