M7 Computers in Radiology

COMPUTERS

Integral part of many activities within a Radiology
Department

COMPUTERS

Used by different Radiologic Modalities to Acquire,
Process & Post Process Imaging Data.

DICOM

Developed by ACR & NEMA

DICOM

A “Cooperative Standard” that allows compatibility
between imaging systems, by connectivity of imaging
& associated medical equipment's of different vendors

American College of Radiology

ACR

National Electrical Manufacturers Association

NEMA

20

DICOM 2011 Standard is divided into _ parts

PACS

 It enables integration of scanners, servers,
workstation, printers, & network hardware from
multiple vendors into a

DICOM

Promotes the development of PACS & Image Networking
in a LAN & WAN scenario

Radiology

needs DICOM for its uniform set of rules for
communication of digital images

DICOM

Provides protocols for integration of image data
between modalities, devices and systems

DICOM or any electronic communication

is functionally
divisible into a set of layers with each layer performing a
defined set of functions

DICOM Service Class

is defined as a group
of operations that a user wants to perform on data from
a modality.

Print Management Service Class

that deals with
printing images on film or paper printer, with
flexible film formats

Storage Service Class

that implies "sending" images

Query/Retrieve Service Class

that deals with issues of
"find, move and get" SOP (Service Object Pair) Classes.

find

is used to query for images

move and get

are used to commence a transfer

Other Classes of Service

include Verification Service
Class, Media storage, Study content notification, Print
management, Patient management, Study
management, Result management, Modality Performed
Procedure Step management States and Structured
reporting.

DICOM Conformance

identifies specific DICOM capabilities of
an equipment or medical device.

Conformance Statement

allows:
“a user to determine which optional components of the
DICOM Standard are supported by a particular
implementation & what additional extensions or
specializations an implementation adds”

Modern radiology

modalities generate an enormous
amount of a variety of data.

healthcare standards

To efficiently handle the sizeable data, and to improve
workflow efficiency, ___ ____ have been
created.

Healthcare Standards

assists the exchange, management
and integration of different medical data (including
radiology), that supports patient care.

workflow

It is important to understand that Radiology
requires more than DICOM for

DICOM, HL7 and IHE

Consequently, 3 Significant Health Care
Standards important to a Radiologist are

DICOM

Digital Imaging and Communications in Medicine

IHE

Integrating the Health Enterprise

HL7

Health Level Seven

Integrating the Health Enterprise

An initiative by Healthcare Professionals And Industry to
improve the way computer systems in healthcare share
information.

Integrating the Health Enterprise

Promotes the coordinated use of established standards such
as DICOM and HL7 to address specific clinical needs in support
of optimal patient care.

DICOM and HL7

Promotes the coordinated use of established standards such
as ___ and ___ to address specific clinical needs in support
of optimal patient care.

accordance with IHE

Systems developed in ___ ___ __ communicate with
one another better, are easier to implement, and enable care
providers to use information more effectively

Health Level Seven

Provides protocols for exchange, management and
integration of clinical and administrative electronic
health data.

Health level seven

is "an all-volunteer, not-for-profit"
organization.

1987

(HL7)Formed in ___, the accepted global standard for exchange, integration, sharing and retrieval of electronic health information in hospitals.

global standard

Formed in 1987, the accepted ___ ___ for
exchange, integration, sharing and retrieval of
electronic health information in hospitals.

A. Improve Care Delivery
B. Optimize Workflow
C. Reduce Ambiguity
D. Enhance Knowledge Transfer

HL7 Mission is to provide standards for interoperability that:

Clinical, Clinical Genomics, Administrative, Clinical Research, Electronic Claims Attachments, Public Health, Personal Health

Wide range of Healthcare Standards:

Health Level "Seven"

has its origins based on a Seven-layer
International Organization Of Standards (ISO) Communication Model.

Layers 1-4

Deal with Communication; Comprising Physical, Data Link, Network
And Transport Communication Layers.

Layers 5-7

Deal with functions like Session, Presentation & Application.

Highest Level or Seventh Level

is regarded as the
Application Level, which deals with the definition of data to be
exchanged

Highest Level or Seventh Level

This Level supports varied functions, such as "Security Checks,
Participant Identification, Availability Checks, Exchange
Mechanism Negotiations and Data Exchange Structuring".

HL7 Standards

are freely implementable, but have a
strict copyright.

workflow

It is important to understand that Radiology requires
more than DICOM for

DICOM and HL7

Existing standards like ___ and ___ have been
established and are in place. These standards lay down
that interoperability is possible.

Integrating Information Systems

in Radiology Departments can be complex.

DICOM and HL7

When standards like __ and __ are applied on
ground, there are ambiguities and conflicting
interpretations.

IHE

steps in to fill a gap between what is
theoretically possible and what can be achieved in
practice on ground in Radiology Departments.

IHE

solves issues involving "Multiple, Heterogeneous
Information Systems" by way of consensus and cooperation
between existing healthcare standards agencies.

IHE

It coordinates the use of established standards like DICOM
and HL7 but answers issues that remain unresolved within
the scope of DICOM and HL7.

Integrating The Healthcare Enterprise

The core strategy of "__ __ __ __" is integrating radiology workflow within a healthcare setup, using existing standards like DICOM and HL7.

IHE

By a "multi-year initiative that creates the framework for
integrating applications, systems and settings across the entire
healthcare enterprise" the IHE initiative improves workflow

A. Interoperability Problem Identification
B. Integration Profile Specification
C. Implementation and Testing at Connectathon
D. Integration Profile Conformance Statements

IHE accomplishes this by a four stage process:

Consistent presentation of images profile which
ensures images are displayed as similarly as
physically possible on different displays like film on
view box, workstation, or PC

Typical examples of a few successfully implemented
IHE Integration Profiles in Radiology Departments
include:

KEY IMAGE NOTES PROFILE

which is used for flagging images of Radiologic Procedures

Key Image

is practically useful, for example in a CT Scan
of the abdomen, where out of the nearly 200 slices, useful
information may be available in only four images.

four images

in a CT Scan
of the abdomen, where out of the nearly 200 slices, useful
information may be available in only

Flagging

of these four images enables referring clinicians
across a PACS to quickly access them, thereby saving time
and increasing efficiency

1. Scheduled Work Flow
2. Patient Information Integration Reconciliation
3. Post Processing Workflow,
4. Charge Posting
5. Simple Image And Numeric Reports
6. Presentation Of Grouped Procedures
7. Access To Radiology Information
8. Exception Management Workflow
9. Basic Security
10. Integration Profile

Other IHE Integration Profiles include:

RADIOLOGY

is a ubiquitous healthcare service that derives, processes,
offers and distributes data in an electronic format.

DICOM, HL7 and initiatives
like IHE

have been created to improve workflow
efficiency in a networked radiology department,
across a multivendor system environment.

DIGITAL IMAGING

Integral to current Radiology practice, wherein images
are acquired, processed, post-processed and displayed,
in black and white, gray scale, or colour, using binary
numbers.

Digital Imaging in Radiology

The sources of ___ ___ __ ____ are very
varied and diverse, when compared with other
specialities.

UTZ, CR, DR, CT, MRI

They comprise imaging equipment like

digital camera or scanners, interface hardware connecting devices and computers

input devices like

output devices like

printers, monitors and video projectors.

Pixels, Gray Scale, Bit Depth, Colour & Resolution

Digital Imaging has few important performance
parameters like

parameters

These ____ are distinctly different for image
acquisition equipment when compared with image
output and viewing devices.

WORKSTATION

‘Viewing Boxes ’ of a Modern Radiologist

WORKSTATION

They are at the very core of a Radiologist’s daily work
and central to the business of manufacturing medical
imaging equipment’s

workstation

The modern radiologist often reads an image at a
____, by manipulating it to extract useful
information out of the voluminous dataset of a given
patient from a specific modality

Image overload

is another area considered as the single biggest challenge in radiological services.

3D processing

The only method to tame this deluge of image data is to effectively use __ ___ in workstations

Placing and replicating

workstations in every
modality, reading room, office, and hospital sites
like Ward and ICU is not economically feasible or
practical.

Thin and Thick Clients

Fundamental difference between __ and __ __ is based on the location of the
software applications

NETWORK

exists when two or more computers
are connected together, thereby allowing them to
share data, equipment, and other digital electronic
resources.

Seamless

Such '____' Workflow features in a Radiology
network are made possible by means of a combination of network software and network hardware.

type of a network

The __ __ _ ____gives an idea of the size and its
scale in a geographical area.

Personal Area Network

PAN

Local Area
Network

LAN

Metropolitan Area Network

MAN

Wide Area Network

WAN

Global Area Network

GAN

LAN

cover a small geographic area, like a
Radiology Department or hospital buildings.

LAN

in contrast to WANs, have a much higher data
transfer rates, a smaller geographic range, and no
dependency on leased telecommunication lines.

Ethernet technology

Most LANs are based on

PICTURE ARCHIVAL & COMMUNICATION SYSTEMS

PACS

PACS

A system for digital storage, transmission and retrieval of
radiology images.

PACS

Have both software and hardware components and directly
interface with imaging modalities.

Radiology Images.

The PACS System archives & stores

1. Cost Saving
2. Time Saving
3. Access
4. Applications
5.Integration
6. Convergence
7. Data Handling
8. CAD
9. Advanced Analysis
10. Security and Privacy

PACS has multiple advantages over film-based:

A. Computer Aided Diagnosis | CAD
B. Data Mining Intelligence
C. PACS Connectivity On Mobile Phones

Over the next decade, PACS systems is expected to transform
themselves to more intelligent, mobile and secure systems that
can incorporate:

TELERADIOLOGY

Refers to the practice of a Radiologist interpreting medical
images while not physically present in the location where
the images are generated

TELERADIOLOGY

Hospitals, mobile imaging companies, urgent care facilities
and even some private practices utilize

a. Efficient transfer of image data
b. Accurate representation of the graphic image at the remote site
c. Optimal utilization of radiologist time
d. Systems and processes leading to an overall increase in Radiologist
productivity

TELERADIOLOGY FOCUSES ON:

PACS Workstation and a RIS platform

The technology required for Teleradiology consists of a

PACS Workstation

for imaging viewing and interpretation

RIS platform

for report generation and archival