Diagnostic Imaging Systems: RIS and PACS PDF

Diagnostic Imaging Systems: RIS and PACS RDGY20260 Candice Whitfield – 17 September 2024 Topics Development of eHealth Systems Common eHealth Systems Data Flow: RIS and PACS RIS PACS PACS Components PACS Archives Integration of RIS/PACS RIS/PACS Housekeeping Developm...

Diagnostic Imaging Systems: RIS and PACS RDGY20260 Candice Whitfield – 17 September 2024 Topics Development of eHealth Systems Common eHealth Systems Data Flow: RIS and PACS RIS PACS PACS Components PACS Archives Integration of RIS/PACS RIS/PACS Housekeeping Development of eHealth Systems The idea of using computers in health started in the 1950s, for billing and finance reasons. In the 1960s and 70s, PASs (Patient Administration Systems) began to be developed, followed by CISs (Clinical Information Systems). But these systems were not linked creating inefficiencies. Data was shared using paper or other readable formats. There was a drive to reduce paper and share information electronically as well as becoming more efficient. In the 2000s and 10s, CISs were being used in the different departments for different reasons. Demographic feeds started to be developed not only locally but also nationally. Common eHealth Systems These are the commonly available systems showing their direction and overlap. Not all these systems are necessarily integrated, some may even be stand alone. There is currently a focus on providing for the needs of the patients and making information more readily available to them. It the future it is expected that patients may have direct access to these systems. Data Flow: RIS and PACS  RIS Radiology Information System. The first RISs were created simply to replace paper diaries. Can be described as a text-based system, hardware required to operate RIS is significantly smaller than a PACS. Why? Demographic data and textual data related to imaging procedures including examination details, attendance lists, appointments and reports. Can also be the holder of data required under Ionising Radiation Regulations. Examples? They are unique to Radiology. Some software manufacturers are incorporating RIS functionality into their other applications. Is there a future for stand alone RISs?  PACS Picture Archiving and Communication Systems. Developed to manage healthcare images acquired on the modalities. The images can be stored, distributed and viewed. PACS are not unique to radiology and can be used in other departments. Examples? NIMIS? Advantages? PACS are highly customisable, for example: Levels of data compression. Why? Retention periods. Volume and type of images stored.  PACS Components Typically. there are four separate parts in a PACS. Short-term Storage. Local Cache which is fast to allow for rapid viewing. Long-term Storage. The archive which can comprise of online or offline media. Typically, older images stored here. Rules for images to be deleted form short- term storage. Images retrieval can be configured in PACS. Viewer Application. Software program for viewing images. Can contain additional more advanced features (MPRs and 3D). Software can be installable or web-based. A streamlined version for users outside of Radiology with a more advanced version for radiologists. Hierarchical Database. Ensures data is stored in an organised structure manner.  PACS Archives Retention rules developed taking protocols into consideration. Examples? There are different types of archives: Vendor Neutral Archives. VNAs which can serve multiple applications. Essential to have shared patient identifier. There are five established levels of VNAs. Level Description 1 Standard historic PACS archive. All data in DICOM format identified by Accession Numbers. 2 Modern PACS, images can be saved and viewed in different formats. Still identified by Accession Numbers. 3 Multi-media Archive with universal acceptance of multi-media file formats. 4 Builds on level 3 with accessibility to several neighbouring sites. 5 Stores any digital file. Full interoperability for sharing data across multiple hospitals and regions. Supplier Neutral Archives. Similar to a VNA except the proprietary VNA software is not utilised. Enterprise Archives. Marketed separately with functionality of a level 4 or 5 VNA.  Integration of RIS and PACS The process of linking software applications and systems. By integrating systems, we: Become more efficient. MRM RIS CHC PACS Ordered Provide better access to users. Arrived Scheduled Improve quality. Started Improve user satisfaction. Filmed Reviewed Needs Over Read Statuses across the different Dictated systems for a study should match. Signed Reported Even though they may be named differently. RIS/PACS Housekeeping Housekeeping is essential. Usually undertaken by the PACS Manager. Departmental policy will define who has permission to undertake certain tasks. Common Housekeeping Tasks: Mismatching/Failed Verification/Unspecified Reunions. Worklist Maintenance Empty Exams and Unreported Studies Lists. Managing Disk space and Backups. Incident Investigation. Questions?