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Questions and Answers
What is the primary purpose of the ICD-10 content?
What is the primary purpose of the ICD-10 content?
Which organization publishes the Current Procedural Terminology (CPT) manual?
Which organization publishes the Current Procedural Terminology (CPT) manual?
Why are CPT codes considered more complex than ICD codes?
Why are CPT codes considered more complex than ICD codes?
What does the RadLex initiative focus on?
What does the RadLex initiative focus on?
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What type of systems assist in the verification of CPT codes?
What type of systems assist in the verification of CPT codes?
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What is the approximate number of diagnosis codes present in the ICD-10 Clinical Modification?
What is the approximate number of diagnosis codes present in the ICD-10 Clinical Modification?
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In what year did the Radiological Society of North America start the RadLex initiative?
In what year did the Radiological Society of North America start the RadLex initiative?
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What is the RadLex Playbook Identifier (RPID) used for?
What is the RadLex Playbook Identifier (RPID) used for?
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What is the primary purpose of medical imaging informatics?
What is the primary purpose of medical imaging informatics?
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What forms can medical data be recorded in?
What forms can medical data be recorded in?
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Which of the following is NOT a source of data in medical imaging informatics?
Which of the following is NOT a source of data in medical imaging informatics?
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What has significantly advanced to reduce data handling uncertainty in healthcare?
What has significantly advanced to reduce data handling uncertainty in healthcare?
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Medical data can be communicated to which of the following?
Medical data can be communicated to which of the following?
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What is the goal of electronic health records (EHR)?
What is the goal of electronic health records (EHR)?
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Which medical tests are included in the data sources for medical imaging informatics?
Which medical tests are included in the data sources for medical imaging informatics?
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What role does medical imaging informatics play in education and research?
What role does medical imaging informatics play in education and research?
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What is the primary purpose of standards in medical imaging informatics?
What is the primary purpose of standards in medical imaging informatics?
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Which organization is known for developing Internet standards?
Which organization is known for developing Internet standards?
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Which protocol suite is primarily used by the Internet for device communication?
Which protocol suite is primarily used by the Internet for device communication?
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What does the acronym DICOM stand for in the context of medical imaging?
What does the acronym DICOM stand for in the context of medical imaging?
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Which stakeholders contribute to the development of medical imaging standards?
Which stakeholders contribute to the development of medical imaging standards?
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Which of the following standards is NOT mentioned as relevant to medical imaging?
Which of the following standards is NOT mentioned as relevant to medical imaging?
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What is one role of the National Electrical Manufacturers Association (NEMA) in healthcare?
What is one role of the National Electrical Manufacturers Association (NEMA) in healthcare?
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Which aspect is NOT addressed by standards in medical imaging?
Which aspect is NOT addressed by standards in medical imaging?
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Which of the following is NOT one of the three most common message types in the imaging chain related to PACS?
Which of the following is NOT one of the three most common message types in the imaging chain related to PACS?
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What does the FHIR standard utilize for data storage and exchange?
What does the FHIR standard utilize for data storage and exchange?
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Which of the following correctly describes a primary characteristic of HL7 compared to DICOM?
Which of the following correctly describes a primary characteristic of HL7 compared to DICOM?
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Which segment type is related to actual observations or results?
Which segment type is related to actual observations or results?
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In the context of healthcare informatics, what does the engineering of HL7 interfaces involve?
In the context of healthcare informatics, what does the engineering of HL7 interfaces involve?
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Which of these is a characteristic of the infrastructure utilized in medical imaging informatics?
Which of these is a characteristic of the infrastructure utilized in medical imaging informatics?
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What is the primary purpose of the FHIR standard in healthcare informatics?
What is the primary purpose of the FHIR standard in healthcare informatics?
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Which component is NOT part of computer hardware used in medical imaging informatics?
Which component is NOT part of computer hardware used in medical imaging informatics?
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What is the primary function of a PACS in medical imaging?
What is the primary function of a PACS in medical imaging?
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Which component is critical for the interpretation of large matrix images in a PACS?
Which component is critical for the interpretation of large matrix images in a PACS?
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How do computer networks facilitate the functionality of a PACS?
How do computer networks facilitate the functionality of a PACS?
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What type of display is typically used for accessing the RIS database in a PACS?
What type of display is typically used for accessing the RIS database in a PACS?
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Why might a LAN adequate for a nuclear medicine miniPACS not be suitable for an entire imaging department?
Why might a LAN adequate for a nuclear medicine miniPACS not be suitable for an entire imaging department?
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What feature allows radiologists to manipulate images for interpretation within a PACS?
What feature allows radiologists to manipulate images for interpretation within a PACS?
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What aspect does the interpretation workstation enhance in relation to image display?
What aspect does the interpretation workstation enhance in relation to image display?
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What is a key component of PACS that ensures safety and security in data handling?
What is a key component of PACS that ensures safety and security in data handling?
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What is the primary function of the HyperText Transfer Protocol (HTTP)?
What is the primary function of the HyperText Transfer Protocol (HTTP)?
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Which protocol is used to synchronize clocks in computer systems?
Which protocol is used to synchronize clocks in computer systems?
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What does Uniform Resource Locator (URL) define?
What does Uniform Resource Locator (URL) define?
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Which of the following is a standard markup language for documents intended for web browsers?
Which of the following is a standard markup language for documents intended for web browsers?
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Which protocol allows email messages to include non-textual content?
Which protocol allows email messages to include non-textual content?
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What is a file server primarily used for?
What is a file server primarily used for?
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Which protocol is primarily responsible for the security of Internet transactions?
Which protocol is primarily responsible for the security of Internet transactions?
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What advantage does a virtual machine (VM) provide in a server environment?
What advantage does a virtual machine (VM) provide in a server environment?
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What is the purpose of the Syslog Protocol?
What is the purpose of the Syslog Protocol?
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What is XML primarily used for in the context of internet standards?
What is XML primarily used for in the context of internet standards?
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In a client-server relationship, which statement accurately describes a thin client?
In a client-server relationship, which statement accurately describes a thin client?
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What is the role of a cloud server?
What is the role of a cloud server?
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What are two terms used to describe different types of clients in a server environment?
What are two terms used to describe different types of clients in a server environment?
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Which component is NOT typically handled by server-side configuration in a PACS environment?
Which component is NOT typically handled by server-side configuration in a PACS environment?
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What is primarily managed by a print server?
What is primarily managed by a print server?
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What is the main benefit of using a virtual machine environment for servers?
What is the main benefit of using a virtual machine environment for servers?
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What is a key benefit of using irreversible compression for medical imaging?
What is a key benefit of using irreversible compression for medical imaging?
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What format is commonly used for long-term storage of medical images in a PACS?
What format is commonly used for long-term storage of medical images in a PACS?
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What does the Vendor-Neutral Archive (VNA) in enterprise storage do?
What does the Vendor-Neutral Archive (VNA) in enterprise storage do?
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What is the typical compression ratio achieved using standard schemes like JPEG without significant loss of quality?
What is the typical compression ratio achieved using standard schemes like JPEG without significant loss of quality?
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Why is archiving in a compressed format crucial for PACS?
Why is archiving in a compressed format crucial for PACS?
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What advantage does a thin client relationship offer in medical imaging informatics?
What advantage does a thin client relationship offer in medical imaging informatics?
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What is one primary use of cloud computing in medical imaging informatics?
What is one primary use of cloud computing in medical imaging informatics?
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What protocol is primarily associated with Microsoft's Active Directory?
What protocol is primarily associated with Microsoft's Active Directory?
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What is a key benefit of using cloud storage for medical imaging data?
What is a key benefit of using cloud storage for medical imaging data?
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Which statement accurately describes a thick client relationship in medical imaging?
Which statement accurately describes a thick client relationship in medical imaging?
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What is a characteristic feature of cloud computing in medical imaging?
What is a characteristic feature of cloud computing in medical imaging?
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How does Active Directory enhance security in medical imaging networks?
How does Active Directory enhance security in medical imaging networks?
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What role do multiple Graphics Processor Units (GPUs) serve in a thin client model?
What role do multiple Graphics Processor Units (GPUs) serve in a thin client model?
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What is the main function of Active Directory Domain Service (AD DS) in a Windows domain network?
What is the main function of Active Directory Domain Service (AD DS) in a Windows domain network?
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Which of the following best describes the Internet of Things (IoT)?
Which of the following best describes the Internet of Things (IoT)?
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What is a key challenge associated with the implementation of IoT in healthcare?
What is a key challenge associated with the implementation of IoT in healthcare?
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What role does interoperability play in IoT for healthcare?
What role does interoperability play in IoT for healthcare?
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Which of the following items is part of a PACS?
Which of the following items is part of a PACS?
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What potential risk arises from not regularly patching and updating IoT devices in healthcare?
What potential risk arises from not regularly patching and updating IoT devices in healthcare?
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What is a collection of software and databases specifically used for the management of medical images?
What is a collection of software and databases specifically used for the management of medical images?
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Which issue is notably important for ensuring the security of IoT devices in healthcare?
Which issue is notably important for ensuring the security of IoT devices in healthcare?
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What is the main purpose of DICOM in medical imaging?
What is the main purpose of DICOM in medical imaging?
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Which organization manages the DICOM standards?
Which organization manages the DICOM standards?
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What is the primary focus of HL7 standards?
What is the primary focus of HL7 standards?
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Which version of HL7 is predominantly used by most health systems?
Which version of HL7 is predominantly used by most health systems?
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What is a key characteristic of DICOM compared to HL7?
What is a key characteristic of DICOM compared to HL7?
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What is a challenge associated with HL7 for newcomers?
What is a challenge associated with HL7 for newcomers?
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What is the significance of interoperability in medical imaging standards?
What is the significance of interoperability in medical imaging standards?
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What aspect of healthcare does DICOM primarily support?
What aspect of healthcare does DICOM primarily support?
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What is one primary function of the ICD-10 codes in healthcare?
What is one primary function of the ICD-10 codes in healthcare?
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Which of the following is a feature of the Current Procedural Terminology (CPT) coding system?
Which of the following is a feature of the Current Procedural Terminology (CPT) coding system?
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What distinguishes RadLex from other coding systems in radiology?
What distinguishes RadLex from other coding systems in radiology?
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Which organization was responsible for the development of the RadLex initiative?
Which organization was responsible for the development of the RadLex initiative?
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What is an important role of CPT codes in healthcare settings?
What is an important role of CPT codes in healthcare settings?
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Why are ICD-10 codes essential for statistical analysis in healthcare?
Why are ICD-10 codes essential for statistical analysis in healthcare?
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What aspect of RadLex contributes to its specificity in radiology?
What aspect of RadLex contributes to its specificity in radiology?
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How many diagnosis codes does the ICD-10 Clinical Modification include?
How many diagnosis codes does the ICD-10 Clinical Modification include?
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What is the main benefit of using RadLex in radiology?
What is the main benefit of using RadLex in radiology?
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What is the primary purpose of LOINC in medical informatics?
What is the primary purpose of LOINC in medical informatics?
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Which organization is responsible for coordinating standards development in the US?
Which organization is responsible for coordinating standards development in the US?
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Which of the following statements about medical imaging standards is false?
Which of the following statements about medical imaging standards is false?
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Why is radiation dose tracking important in medical imaging?
Why is radiation dose tracking important in medical imaging?
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What role does the Regenstrief Institute play in LOINC?
What role does the Regenstrief Institute play in LOINC?
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What challenge do proprietary interfaces pose in medical imaging IT environments?
What challenge do proprietary interfaces pose in medical imaging IT environments?
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How do standards contribute to the operation of medical imaging systems?
How do standards contribute to the operation of medical imaging systems?
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What is the main role of the motherboard in a computer?
What is the main role of the motherboard in a computer?
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Which of the following best describes a local area network (LAN)?
Which of the following best describes a local area network (LAN)?
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In what way do application programs differ from systems software?
In what way do application programs differ from systems software?
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Which of the following is a characteristic of wide area networks (WANs)?
Which of the following is a characteristic of wide area networks (WANs)?
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What function does a server perform in a computer network?
What function does a server perform in a computer network?
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Which type of software specifically performs tasks for end users?
Which type of software specifically performs tasks for end users?
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What is the primary purpose of computer networks in the context described?
What is the primary purpose of computer networks in the context described?
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Which component is NOT typically associated with external input and output peripherals?
Which component is NOT typically associated with external input and output peripherals?
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What is the primary function of a file server?
What is the primary function of a file server?
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Which of the following best describes a 'thin client'?
Which of the following best describes a 'thin client'?
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In a server environment, what is a virtual machine (VM) primarily used for?
In a server environment, what is a virtual machine (VM) primarily used for?
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Which component is essential for a cloud server operating in a cloud computing environment?
Which component is essential for a cloud server operating in a cloud computing environment?
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What advantage does using multiple operating systems (OSs) in a virtual machine environment provide?
What advantage does using multiple operating systems (OSs) in a virtual machine environment provide?
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Which server type is responsible for handling tasks like data extraction and image rendering in a PACS environment?
Which server type is responsible for handling tasks like data extraction and image rendering in a PACS environment?
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What role does a client computer typically serve in a client-server relationship?
What role does a client computer typically serve in a client-server relationship?
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What does the term 'thick client' imply in the context of client-server computing?
What does the term 'thick client' imply in the context of client-server computing?
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Study Notes
Medical Data
- Medical data records information regarding a person's health status and medical treatment
- Medical data can be recorded on paper or digitally
- It is collected and stored in hospitals and clinics, but can be communicated to public health authorities
Medical Imaging Informatics
- Medical Informatic's purpose is to collect, analyze, store, and communicate patient data
- The information is used to provide appropriate care, ensure well-being, and support education and research
- The evolution of informatics has addressed the uncertainty associated with data handling, by converting analogue data into digital format
- This has created an authoritative source for demographics and record, through the implementation of digital databases
Ontologies - ICD
- In the United States, ICD-10-CM and ICD-10-PCS are the variant manuals for coding diagnoses and procedures
- ICD-10-CM contains over 69,000 diagnosis codes and ICD-10-PCS contains over 70,000 procedure codes
- The ICD-10 content is used for
- categorizing conditions and diseases
- forming the foundation for healthcare decision-making and statistical analysis
- billing for services performed in hospital inpatient settings
Ontologies - CPT
- The Current Procedural Terminology (CPT) is a medical code manual published by the American Medical Association
- CPT is used to describe procedures performed on patients, including diagnostics, laboratory, radiology, and surgical procedures
- Physicians use these codes to bill for services performed in hospital, office, or other service settings
Ontologies - RadLex
- RadLex (Radiology Lexicon) is a radiology specific lexicon of terms developed by the Radiological Society of North America
- It contains vocabulary related to anatomy, procedures, and protocols used in medical imaging diagnosis
- RadLex Playbook assigns RPID (RadLex Playbook Identifier) tags to the terms
Standards Organizations
- Medical imaging informatics rely on standards developed through consensus between key stakeholders
- These stakeholders include medical imaging equipment manufacturers, medical data software manufacturers, professional societies, and end users
- Standards define communications protocols, structures, and formats to ensure interoperability and communication between healthcare systems
Standards Organizations - Internet Standards
- The Internet protocol suite (TCP/IP) is used to connect devices worldwide
- The Internet Engineering Task Force (IETF) is responsible for developing hardware, protocol, and software standards
- Important message types for PACS include:
- ORU - Results
- ORM - Orders
- ADT - Admission, Discharge, and Transfer
- Important segment types include:
- OBR - Observation Request
- OBX - Observation/Result
Standards Organization - HL7
- HL7 is a less formally structured standard (compared to DICOM), which allows flexibility but requires redefining implementations
- A significant amount of effort in healthcare is devoted to developing and maintaining HL7 interfaces
- HL7 is being updated to a more general model of interoperability
Standards Organization - HL7
- Fast Health Interoperability Resources (FHIR) is a new standard in the HL7 community
- It is based on web services and RESTful interfaces, using APIs and open standard file formats like XML or JSON
- FHIR can meet the needs of previous HL7 standards and provides benefits in interoperability, interfaces, and access to data
Computers and Networking
- Computer hardware refers to the physical components of a computer such as the power supply, cooling fans, and motherboard
- A PACS includes a digital archive to store images, display workstations for viewing images, and a computer network for transferring data
- A database program tracks image locations, and software allows for manipulation of images for interpretation by radiologists and referring physicians
Picture Archiving and Communication System
- Image display is a key component of the PACS
- Interpretation workstations for large matrix images are commonly equipped with two high-luminance displays for image comparison
- A consumer-grade display provides access to the RIS database, patient information, reading worklist, dictation system, EHR, and the internet
Picture Archiving and Communication System
- Computer networks enable the exchange of images and related information between imaging devices, the PACS, display workstations, and other information systems
- A PACS may have its own LAN or share a medical center LAN
- Bandwidth requirements depend on the imaging modalities and their workloads
Internet Standards
- HyperText Transfer Protocol (HTTP) is the foundation of data communication for the World Wide Web.
- HyperText Markup Language (HTML) is the standard markup language for web documents displayed by web browsers.
- Uniform Resource Locator (URL) is the standard for specifying and accessing resources on the internet.
- Network Time Protocol (NTP) synchronizes clocks in computer systems for accurate timestamping of events.
- Simple Mail Transfer Protocol (SMTP) and Internet Message Access Protocol (IMAP) are protocols used for email transactions.
- Multipurpose Internet Message Extensions (MIME) protocol extends email to include non-textual content, including medical images.
- Transport Layer Security (TLS) and its predecessor Secure Sockets Layer (SSL) secure internet transactions with cryptography.
- Syslog Protocol is used to convey event notifications for auditing and logging purposes.
- Extensible Markup Language (XML) is a free, open standard for encoding structured data, used in many new standards for distributed systems.
Servers
- A file server is a computer with a large array of magnetic disks that acts as a storage device for other computers on a network.
- There are various types of servers for different functions, such as print servers, application servers, database servers, email servers, web servers, and cloud servers.
- Most servers are now implemented in a virtual machine (VM) environment, emulating a physical computer but in a centralized location.
- Virtual Machines (VM) allow for flexibility in resource allocation and can support multiple operating systems, CPUs, and storage space within a single server.
- A cloud server is a virtual server hosted and delivered through a cloud computing platform like Google's Gmail for email services or Dropbox for cloud storage.
- Configure a cloud server for a PACS (Picture Archiving and Communication System) to handle various image management tasks, such as data extraction, DICOM conversion, image rendering, storage, and load balancing.
- Clients are computers within a network that utilize a server for various functions.
- Thick clients rely heavily on client computer processing, while servers primarily store data.
- Thin clients rely on servers for most information processing while the client mainly displays data.
- An example of a thin client is a server processing the rendering of volumetric images from CT scans and sending them to a workstation for display.
- Thin clients can utilize less powerful and less expensive workstations, with specialized software and hardware hosted on a single server for various tasks.
Cloud Computing
- Cloud computing utilizes a network of remote servers and software hosted on the internet to deliver services.
- Cloud storage services like Dropbox offer remote storage and backup capabilities for local data.
- Medical imaging software vendors are utilizing cloud computing to provide client services and databases over the internet, with storage and archiving provided by the cloud provider.
Active Directory
- Lightweight Directory Access Protocol (LDAP) is an open protocol used for accessing and managing directory information services over an IP network.
- Active Directory is a directory service developed by Microsoft that is included in Windows Server OS and utilizes LDAP for authentication, authorization, and security policy enforcement.
- A server running Active Directory Domain Service (AD DS) authenticates and authorizes users and computers on a domain network and enforces security policies.
Internet of Things (IoT)
- Internet of Things (IoT) encompasses devices connected to the internet with unique identifiers (UIDs) that collect and share data about their environment and usage.
- IoT devices range from self-driving cars to home light switches and medical devices.
- IoT applications in healthcare include remote monitoring, smart sensors, and integration of medical devices in diverse departments.
- Interoperability is crucial for effective patient care in IoT, but presents security challenges and data privacy concerns.
- Maintaining security patches and updates on IoT devices is critical for patient health and safety, especially devices outside a hospital network.
Picture Archiving and Communication System (PACS)
- A PACS is a system that incorporates software, interfaces, workstations, and databases to store, transfer, and display medical images.
- Image compression can be irreversible, where some information is lost, or reversible, where no information is lost.
- Irreversible compression allows for higher compression ratios, up to 30:1, with minimal image quality loss.
- Archives are locations for storing records and documents of historical importance.
- PACS archives store medical images in DICOM format on disks and tapes for long-term storage.
- Vendor-Neutral Archive (VNA) is a repository for various data types, including DICOM and non-DICOM images, non-image data, and other content, within an enterprise storage environment.
- Data and images are typically archived in a compressed format for efficient storage and data transmission.
ICD-10
- ICD-10-CM, the US version, is a clinical modification with over 69,000 codes for diagnoses.
- ICD-10-PCS has over 70,000 procedure codes for inpatient procedures.
- ICD-10 content is used for:
- Assigning codes for procedures, services, conditions, and diagnoses
- Categorizing conditions and diseases
- Forming the foundation for healthcare decision-making and statistical analysis
- Billing for inpatient services
CPT
- CPT is a medical code manual published by the American Medical Association.
- It describes procedures performed on patients during the interaction, including diagnostic, laboratory, radiology, and surgical procedures.
- Physicians bill and are paid based on these codes.
- Human coding teams or automated software tools verify and validate codes for specific procedures and reimbursement.
- CPT codes are more complex than ICD codes and get updated yearly.
RadLex
- RadLex (Radiology Lexicon) provides a radiology-specific set of terms created by RSNA since 2005.
- RadLex is used to describe anatomy, procedures, and protocols utilized in medical image diagnosis.
- RadLex Playbook assigns RPID (RadLex Playbook IDentifier) tags to those terms.
- RadLex is widely adopted in radiology, including the ACR Dose Index Registry.
LOINC
- LOINC (Logical Observation Identifiers Names and Codes) is a broader standard covering tests and measurements in many medical domains.
- It was initiated by the Regenstrief Institute, a medical research organization associated with Indiana University.
- LOINC is being harmonized with RadLex to use LOINC codes as the primary identifiers for radiology procedures.
- A unified vocabulary standard will improve accessibility of radiology procedure data to clinicians.
DICOM
- DICOM is a set of standards-based protocols for exchanging and storing medical imaging data, including images and associated text.
- Managed by the Medical and Imaging Technical Alliance (MITA), a division of NEMA.
- It is a public standard and information for DICOM-based software applications is defined and regulated by public committees.
- DICOM is crucial for interoperability and communication of medical imaging data between systems and databases.
HL7
- HL7 is a set of international standards governing the exchange, integration, sharing, and retrieval of electronic health information.
- HL7 International, an ANSI-accredited organization, develops these standards.
- The goal is to create coherent, extensible standards for exchanging structured, encoded healthcare information between applications.
- Version 2 (V2.8.2) is most commonly used in health systems.
- HL7 is a critical standard for automated textual information exchange in healthcare IT.
Computers and Networking
- Software programs consist of sequences of instructions executed by a computer.
- Software is categorized as application programs or system software.
- Applications are programs that perform specific functions for a user.
- Computer networks allow information transfer, enabling services like email, file transfer, and access to distant computers.
- LANs connect computers within a department, building, and occasionally nearby buildings.
- WANs connect computers over long distances.
- The Internet is the largest WAN.
Servers
- A server provides a service to other computers on a network.
- A file server provides data storage for other computers with large magnetic disk arrays.
- Servers can include print servers, application servers, database servers, email servers, web servers, and cloud servers.
- Most servers are now “virtual machines” (VMs) based on a centralized physical computer architecture.
- VMs can provide multiple operating systems, CPUs, storage space, and meet enterprise specific needs, offering flexibility, efficiency, and adaptability for resource allocation.
Cloud Servers
- Cloud servers are virtual servers running in a cloud computing environment.
- Accessed via the Internet remotely.
- They require several component servers for various tasks, including:
- Data extraction
- DICOM conversion
- Image rendering
- Storage
- Load balancing
Clients
- A client is a computer on a network that utilizes a server.
- Typically a workstation.
- “Thick client” means the client computer handles most information processing, while the server primarily stores information.
- “Thin client” describes the situation where the server handles most of the information processing, and the client mainly displays the information.
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Description
This quiz explores key concepts in medical data management and imaging informatics. It covers the significance of health records, the transition from analogue to digital data, and the role of coding manuals like ICD-10. Test your understanding of how these elements contribute to patient care and public health.