desk-top integration clinical requirements€¦ · the uk pacs & teleradiology group single...

Neelam Dugar

Chair of

Desk-top IntegrationClinical Requirements

The UK PACS & Teleradiology Groupwww.pacsgroup.org.uk

http://www.pacsgroup.org.uk


Definition



Single sign-on

A single sign-on should authenticate an individual to all applications required by him with a single log-in and password

A radiologists needs access to the 4 applications for purpose of reporting—RIS, PACS, DD/VR, 3D etc



Single Sign on--Not Present

Log-in process—approx 1 minute.

4 separate log-ins---(4X1) 4 minutes

5 log-ins per day--- (5X4) 20 minutes

Log-ins per week---(20X5)= 100 minutes

Log-ins per year---(100X45)= 4,500 minutes



Single Sign on--Present

Log-in process—approx 1 minute.

5 log-ins per day--- (5X1) 5 minutes

Log-ins per week---(5X5)= 25 min

1 hr 15 mins saving per week per person

56 hrs 15 mins saving per year for each individual

Huge savings and efficiency gains for a tax-payer funded public service.



Context for Synchronisation for DTI

Unique episode number--Accession no for radiology

Unique patient identifier--NHS number/PAS no.



Uses of DTI in radiology

Reporting of radiology exams

Acknowledgement of radiology reports

Integration of 3D/PET-CT/CT colonoscopy etc application with PACS



Radiology Exam Reporting

RIS: Demographics/Scheduling information

PACS: Radiology Images display

Digital Dictation/Voice recognition application

Scanned request card viewer application

Specialist Applications (sometimes)



Title of Subject

Current Chest XCurrent Chest X--rayray

Current Chest X-ray

Previous Chest XPrevious Chest X--rayray

Previous Chest X-ray

Reporting WorkflowReporting Workflow

Reporting Workflow

Request cardRequest card

RISRISImaging historyImaging history

DD/VRDD/VR



Reporting Workflow

RIS or PACS Worklist

Criteria for worklist creation

We use “intended radiologist” as the main criteria for creating worklists

Neelam Dugar

Hotseat



PACSPACS

PACSTitle of Subject

PACSPACS

PACS

RISRIS

RIS

RIS Worklist for RIS Worklist for HOTSEAT HOTSEAT

UrgentUrgent1. Joe Bloggs1. Joe Bloggs--MAUMAU--Chest XChest X--rayray2. Bob Wilson2. Bob Wilson--SAUSAU--Abdomen XAbdomen X--rayray3. Sarah Jenkins3. Sarah Jenkins--Ward 12Ward 12-- Hand XHand X--rayray

NonNon--UrgentUrgent1. Hannah Floris-GP- Foot X-ray2. Joanne Hampson-OPD- Pelvis X-ray3. James Bond- 007- Gun X-ray



Automatic Reporting workflow

Click on a patient episode from RIS worklist for reporting

Automatic Synchronised application display for that episode (linked by a unique number)

RIS is the master whilst others are slaves

RIS —demographics and scheduling info

PACS —image display with relevant prior rule

DD/VR to record and process a voice file

Scanned request card/OCM info



Title of Subject


Current Chest X-ray




Reporting Workflow

Request card Request card or OCMor OCM

RISRISImaging historyImaging historyscheduling infoscheduling infodemographicsdemographics

DD/VRDD/VR



Automatic Reporting Workflow

Single click should automatically close all 4 applications and bring back to worklist/next episode



Efficiency Gains

With automatic DTI and automatic prior display—RIS, PACS, DD and SRC---100% increased productivity can be achieved with high volume CR reporting.

Increased productivity also seen with CT/MR reporting



Exceptions to Automatic Synchronization

Radiologist in middle of a long report: disturbed by a doctor/radiographer to review an image on different patient

Need for RIS and DD/VR to be static, but PACS to display another patient’s image ( loss of synchronization)

By a manual “show images” icon on RIS, once again the applications can be synchronized.

PACS to RIS synchronization should NOT be automatic


The UK PACS & Teleradiology Groupwww.pacsgroup.org.ukException

Title of SubjectTitle of Subject

Title of Subject

Request cardRequest cardfor Joe Bloggsfor Joe Bloggs

RIS info forRIS info forJoe Bloggs Joe Bloggs

Digital Digital Dictation in Dictation in

progressprogress

SHOW IMAGESSHOW IMAGES

Title of Subject

Hand XHand X--ray for John Smithray for John Smith

Hand x-ray for John Smith






Reporting WorkflowTitle of Subject


Current Chest X-ray

Request card Request card or OCMor OCM

RISRISImaging historyImaging historyscheduling infoscheduling infodemographicsdemographics

DD/VRDD/VR



Careful Planning(Bi-directional DTI)

RIS to PACS is automatic

PACS to RIS is manual synchronization

PACS to RIS enquiry--ensure that there is no incomplete dictation on RIS



Other Uses of Manual DTI

Results acknowledgement system →PACS

PACS → 3D/PET-CT Fusion/CT colon App

RIS or PACS → pathology results

RIS or PACS → clinical documents/letters



Results Acknowledgement SystemResults Acknowledgement SystemWORKLIST FOR ABWORKLIST FOR AB(CONSULTANT ORTHOPAEDIC (CONSULTANT ORTHOPAEDIC

SURGEON)SURGEON)UrgentUrgent1. Joe Bloggs1. Joe Bloggs--MAUMAU--Chest XChest X--rayray2. Bob Wilson2. Bob Wilson--SAUSAU--Abdomen XAbdomen X--rayray3. Sarah Jenkins3. Sarah Jenkins--Ward 12Ward 12-- Hand XrayHand Xray

NonNon--UrgentUrgent1. Hannah Floris1. Hannah Floris--GPGP-- Foot XFoot X--rayray2. Joanne Hampson2. Joanne Hampson--OPDOPD-- Pelvis XPelvis X--rayray3. James Bond3. James Bond-- 007007-- Gun XGun X--rayray

Results Acknowledgement S...


The UK PACS & Teleradiology Groupwww.pacsgroup.org.ukResults Acknowledgement Sy...Results Acknowledgement Sy...

Joe BloggsJoe Bloggs

Chest XChest X--rayray

There are bilateral lung There are bilateral lung metastasis. I note that the metastasis. I note that the patient is known to have patient is known to have kidney tumour.kidney tumour.

Acknowledge Acknowledge and File Awayand File Away

PACSPACS

Results Acknowledgement S...PACS



Title of Subject

PET CT on PACSPET CT on PACS

PET CT

PET CT Fusion AppPET CT Fusion App

PET CT Fusion


Reporting Workflow

Request cardRequest card

RISRISImaging historyImaging history

DD/VRDD/VR

FUSIONFUSION


The UK PACS & Teleradiology Groupwww.pacsgroup.org.ukDesk-top Integration or

Context Synchronization

Important for patient safety

Vital for productivity

Significant cost savings in a tax-payer funded health service.

Pivotal to a integrated health record in a multi-vendor environment



Thank YouAny Questions?


desk-top integration clinical requirements€¦ · the uk pacs & teleradiology group single...

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