Radiologists at Shanghai First Hospital in China are reporting good results in the integration of all digital imaging modalities with a DICOM-based PACS and RIS.
In a poster presentation at the 2001 RSNA meeting in Chicago, Dr. Yonghao Tao and colleagues shared their experience with a completely digital department at a 1,250-bed teaching hospital, which sees between 3,000 and 5,000 patients a day. The implementation process began in October 1999. Implementation was conducted in two phases.
In the first phase, CT, MRI, angiography, and a film digitizer were connected to a central archive, including a 300-GB RAID and a roundabout 3-TB DVD jukebox. At the same time, a Chinese-language RIS was installed to "implement the computerized management for workflow."
"We developed a Chinese RIS on-site. The PACS came from Rogan Medical Systems," Tao told AuntMinnie.com. "Between RIS and PACS, we have a one-way data exchange [via] an HL7 interface. The [patient demographic] information was transmitted to the PACS server for validation."
For the second phase, three new modalities were implemented: digital radiography, digital fluoroscopy, and digital mammography.
"Usually, the mammography interpreting procedure was implemented based on soft-copy [reading], with a mammography workstation that has a dual screen (Advantage Workstation 3.1, GE Medical Systems, Waukesha, WI)," Tao explained. "Every gray-scale monitor can provide a 2K x 2.5 K x 12-bit display quality. We also make a hard copy for every patient to take [home]."
All images are archived electronically. Radiologists browse the images by means of a Web server, which integrates the diagnostic report with the relevant image series. Central and distributed image storage management, and an auto-routing procedure, have been employed to reduce network traffic and improve system response.
"As soon as the archiving procedure for every image series is finished on the PACS server, the auto-routing thread forwards this copy to our image browser server, which is a local Web server at our department. It also has a small-scale archive built in," Tao said. "Image series are forwarded to different destinations by the auto-routing thread on the PACS server. We also performed the auto-routing process to forward image series to a specified interpreting room, e.g. the outpatient reading room. The Web server integrated the interpreting report from the RIS server also, so the clinicians could browse medical images and diagnosis reports [at the same] time."
Staggering the implementation over a period of time is the best way to achieve a full digital radiology department, the authors advised. They concluded that RIS plays an important role in bridging various complex medical information systems.
By Shalmali PalAuntMinnie.com staff writer
December 17, 2001
Related Reading
PACS-RIS integration moves forward at RSNA, December 7, 2001
PACS workflow integration is the last, longest mile, August 8, 2001
PACS/RIS integration saves time and money, June 1, 2001
RIS/PACS integration defeats data duplication, May 11, 2001
Copyright © 2001 AuntMinnie.com
