PACS and CR implementation in a Level I Trauma Center Emergency Department (original) (raw)
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Completion of a hospital-wide comprehensive image management and communication system
Society of Photo- …, 1989
A comprehensive image management and communication (IMAC) network has been installed at Georgetown University Hospital for an extensive clinical evaluation. The network is based on the AT &T CommView system and it includes interfaces to 12 imaging devices, 15 workstations (inside and outside of the radiology department), a teleradiology link to an imaging center, an optical jukebox and a number of advanced image display and processing systems such as Sun workstations, PIXAR, and PIXEL. Details of network configuration and its role in the evaluation project are discussed. 1.0 INTROpUCTIOlY The management of the vast amounts of medical images and information generated by today's clinical services is a growing problem. The solution to the problem will increasingly require the use of advanced computer-based technologies U1I in data storage, image display and communication, and human engineering. The progress of individual technologies has been rapid; however, system integration and user acceptance have been slow in coming. Though the new imaging technologies have given the radiologist a powerful set of new diagnostic tools, the quality of radiology service has not experienced similar revolutionary improvements over the decade. In fact the use of many imaging modalities has imposed additional difficulties in managing films and data. New imaging systems have created a number of difficulties in managing radiology images and information because (a) they are often produced in physically distant locations, (b) images are presented in varying film formats, (c) radiology service is highly subspecialized and there is a greater need to review multimodality images, and (d) within large and complex medical care facilities there is an increasing number of competing demands for radiological images. It is generally accepted that the management of radiology images can be improved by using some computer based image system. However, opinions vary. What type of approach would be desirable? The possible solutions [2] will depend on such factors as the nature of radiology service, the types of images, and clinical workload. The use of computer based image management is becoming a major challenge and it is expected to generate a great deal of interest in the near future. How could this electronic technology enhance the quality and efficiency of radiology service? How should such technical capabilities be utilized to address the critical issues in a cost efficient way? Would the users, radiologists, and referring physicians embrace the use of this new technology? What kind of impact would IMAC technology have in the way that radiology service is performed. How should this technology be deployed to meet the combat casualty care needs of the Army? The project [3] at Georgetown University is designed to address these questions with close collaboration with a number of universities, government agencies, and military experts. While many specific technical issues involving display resolutions, image processing methods, and data compression techniques are an important part of the project, additional emphasis is placed on the system-wide issues of IMACS as an integral part of patient care.
Journal of Digital Imaging, 1993
In this report we present an integrated picture archiving and communication system (PACS)-radiology information system (RIS) which runs as part of the daily routine in the Department of Radiology at the University of Graz. Although the PACS and the RiS have been developed independently, the two systems are interfaced to ensure a unified and consistent Iong-term archive. The configuration connects four computer tomography scanners (one of them situated at a distance of 1 km), a magnetic resonance imaging scanner, a digital subtraction angiography unit, an evaluation console, a diagnostic console, an image display console, an archive with two optical disk drives, and several RIS terminals. The configuration allows the routine archiving of all examinations on optical disks independent of reporting. The management of the optical disks is performed by the RIS. Images can be selected for retrieval vŸ the RIS by using patient identification or medical criteria. A special software process (PACS-MONITOR) enables the user to survey and manage image communication, archiving, and retrieval as well as to get information about the status of the system at any time and handle the different procedures in the PACS. The system is active 24 hours a day. To make the PACS operation as independent as possible from the permanent presence of a system manager (electronic data processing expert), a rule-based expert system (OPERAS; OPERating ASsistant) is in use to Iocalize and eliminate malfunctions that occur during routine work. The PACS-RIS reduces labor and speeds access to images within radiology and clinical departments.
Journal of Digital Imaging, 2000
The interfacing of digital image acquisition modalities to the picture archiving and communication system (PACS) plays a major part in the conversion from a traditional film-based radiology practice to one that relies almost entirely on soft-copy reading, The Baltimore Veterans Affairs Medical Center (VAMC) is one of the first filmless hospitals in the world. Since 1993, it has used computed tomography (CT) scanners connected to a commercial PACS to provide digitized patient images for filmless reading. Over the years, the evolution of Digital Imaging and Communications in Medicina (DICOM) standards, advances in networking technologies, and enhancements in PACS and hospital information system (HIS) software have greatly improved this system's robustness and patient/ study identification accuracy. The result has been a major increase in productivity. This is a US government work. There ate no restrictions on its use.
Academic Radiology, 2012
The availability of the Picture Archiving and Communication System (PACS) has revolutionized the practice of radiology in the past two decades and has shown to eventually increase productivity in radiology and medicine. PACS implementation and integration may bring along numerous unexpected issues, particularly in a large-scale enterprise. To achieve a successful PACS implementation, identifying the critical success and failure factors is essential. This article provides an overview of the process of implementing and integrating PACS in a comprehensive health system comprising an academic core hospital and numerous community hospitals. Important issues are addressed, touching all stages from planning to operation and training. The impact of an enterprise-wide radiology information system and PACS at the academic medical center (four specialty hospitals), in six additional community hospitals, and in all associated outpatient clinics as well as the implications on the productivity and efficiency of the entire enterprise are presented.
Radiological work practices by PACS (Picture Archive and Communication System) and transforming from film-based to filmless operations has become more and more challenging as medical imaging studies expand in size and complexity. To adapt to these changes radiologists must actively develop new workflow strategies to deal with increasing work demand. It illustrates that when PACS was introduced not only technical devices were integrated, but the people, work practices and organizations as well.
Journal of Digital Imaging, 1993
Information relevant to radiological applications is commonly managed by several autonomous medical information systems including hospital information systems (HIS), radiological information systems (RIS), and picture archiving and communications systems (PACS). In this report, we expiain the need to coordinate these systems and to provide some framework in which they can exchange information. In the first half of this report, we describe the integration of a PACS system into a hospital operation. Next, we present the interfacing methods between the HIS and the RIS, and between the RIS and the PACS. Two methods are further detailed for the communication between the RIS and the PACS (1) the triggered database to database transfer, and (21 the query protocol. The implementation of the first method successfully allows RIS reports, procedure and patient demographic information to be displayed at the request of the user along with the associated images at a PACS workstation. The query protocol allows a PACS to dynamically query RIS information. It will be eventually integrated into the design of a scientific multimedia distributed medical database system built on top of the HIS, the RIS, and the PACS.
Coping with PACS downtime in digital radiology
Journal of Digital Imaging, 2000
As radiology departments become increasingly reliant on picture archiving and communication systems, they become more vulnerable to computer downtime that can paralyze a smoothly running department. The experiences and strategies developed during various types of picture archiving and communication system (PACS) downtime in a large radiology department that has completely converted to soft copy interpretation in all modalities except mammography are presented. Because these failures can be minimized but not eliminated, careful planning is necessary to minimize their impact.
Technologies for image distribution in hospitals
European Radiology, 2006
After the establishment of web-based image distribution, three challenges for image distribution can be identified today. Firstly, PACS (picture archiving and communication system) and the distribution of radiological images and reports need to be integrated with the emerging electronic medical record. Secondly, report and image data should be available on mobile devices like PDAs (personal digital assistants) or smartphones in the future. Thirdly, future systems must be available not only to transmit sectional images, but also to allow access to three-and four-dimensional data that are produced by multidetector CT and modern MR scanners.
Digital image management and communication in medicine
Computerized Medical Imaging and Graphics, 1994
With the rapid development of digital imaging modalities in medicine, there is an increasing need for an efficient management and archival of medical images in digital form. Picture Archiving and Communication Systems (PACS) are becoming an essential component of medical imaging equipment, allowing for medical images to be accessed and stored directly in digital form. This paper describes a hospital-wide PACS currently under development at the University Hospital of Geneva, based on an open architecture, regrouping equipment from different vendors in a distributed topology. The image archival is organized in multiple locations geographically distributed in the hospital. The PACS database is fully integrated with the concurrent Radiology Information System (RIS) and Hospital Information System (HIS). A standard image storage format called the PAPYRUS format was developed for the storage of medical images from a variety of imaging modalities. To provide a more uniform user interface on a variety of different workstations, a common platform for image display and manipulation called OSIRIS was developed.