Planning and Management of Cross Hospital of PACS Systems and Remote Reports for Healthcare Sharing- An Example of Min-Shuang Hospital Group
Abstract:
1.Introduction
2. Related Work
2.1 The medical image stores systematic planning and management:
• The medical image stores primary element research, DICOM standard, HL7 (Health Level Seven) Standard, IHE ( Integration Healthcare Enterprise) standardize the procedure.
• Checking all modality should be support DICOM standard of images and store.
• Analysis of the procedure of the systematic hardware environmental state, such as network ,computer ,security.
2.2 The integrated of Hospital Information System :
• According to the IHE, the PACS system must be combined with Hospital Information System , include the basic information of patients, patient examination information.IHE scheduled work-follow profile check item :
1. Registration: Register patient information on HIS System.
2. Patient information/Order placed: Order exam case on RIS system.
3. Examination order/order filled : Transfer patient information and exam information data to Image Manager/Archive.
4. Image Manager/Archive: DICOM images store and management.
5. Acquisition /Modality : Modality Group.
6. Diagnostic Workstation: Diagnostic image of report workstation .
7. Report Repository : The final report respond to HIS system.
• The check Hospital Information System database .
• The Min-Shuang Hospital Group consists of over 100 hospitals in the world, in which modality resources will be shared by the hospital group, DICOM images will be transferred to the Image Data Center (IDC) for image storing and backup, and radiology doctors will finish their reports and transfer them back to source hospital by requirement.
• The IDC, consider on storing and managing the images of checking each hospital, can improve medical quality and keep more lowering costs.
3. Result
The following fig 3 picture show, each Branch Min-Shuang hospital have Cache Server system for receive DICOM images and patient exam data and report exchange. Most of images will store on IDC PACS system and provider report service.
Fig. 3. IDC PACS structure chart
The alliance’s hospital HIS system and IDC PACS system using ‘Table form was for data exchange. Fig 4 shows, service of main and alliance’s hospital and outside clinic by different MWLWL table exchange, PACS Broker will check different source service to into in PACS main Database . After patient finished exam, its images will store by network of transmission. IDC Server should be check different source and provider images shared.
Fig. 4. Exchange the structure chart
Start button : Begin to exchange HIS with PACS system.
Table Setting : MWLWL define .
Save : Save HIS and PACS database configure.
Item 1 :
HIS Source (Table ) : Source Table name
Search Command : : SQL command for Search .
Update Command : :SQL command for Upgrade the state.
Item 2:
Order (MWLWL):: Enable insert into MWLWL table.
3.3 IDC PACS report data exchange management:
IDC PACS system provider ‘Web Report’ for report entry, fig 9 web report picture.
The Web report was easy to achieve Tele-Radiology ,It can use any place and any work station in hospital or outside, have expanded the doctor’s service time, even can finish the report at home.
The procedure of whole system is as Fig.10 shows, we design report Text file for data exchange and let doctor free for HIS report system or PACS report system to finish their report job. Whether which system , the report text file will save to Inbound or Outbound folder for data exchange.
Fig.10 Report Exchange
GE3980708004|992037|20090709|1353|M2005|Head CT for brain study performed without contrast injection.
FINDINGS:
1.no focal density change within visible brain parenchyma.
2.no obvious ICH.
3.the size and shape of ventricles are normal.
4.no definite bony change.
IMPRESSION:
no obvious intracranial lesion.Please correlate with clinical history and exam. |
GE3980709006|1599148|20090709|1504|M0363|PROCEDURE: FINDINGS: IMPRESSION:
|
DICOM offers Web Access to DICOM Persistent Ojects standard ,WADO using HTML (HyperText Markup Language) Page or XML (eXtensible Markup Language) for DICOM image execute, HTTP (HyperText Transfer Protocol) /HTTPs(HyperText Transfer Protocol,secured) Protocol about use DICOM UIDs ( Unique Identifiers) to query .
http://wado_server/WebPush/WebPush.dll?PushWADO?requestType=WADO&contentType=image/jpeg&rows=256&objectUID=1.2.410.200010.200601180252196784.20060118.1.1
Image size: 256 (Size of image).
Image UID: instance uid.
The WADO command can easy combine the image + report ,Please check fig 12 shows.
Fig. 13. Physician office doctor request imaging report & study from Enterprise A picture.
References
[1] Digital Imaging and Communications in Medicine (DICOM 3.0) 2003 Standard Document.
[2] DICOM Standard “ Part 15 Basic Security “ ,”Part 18 Web Access to DICOM Persistent Objects (WADO) “ (2004)
[3] http://www.e-ms.com.tw:8989/APCenter/ServletController.
[4] http://www.cgmh.org.tw/ .
[5] http://www.tzuchi.com.tw/tzuchi/mainpage/Default.aspx.
[6] http://www.tpech.gov.tw/.
[7] http://www.show.org.tw/ .
[8] www.hl7.org Health Level Seven Web Site. Health Level Seven Standard,Version 2.4 Standard Document.
[9] http://www.sph.sc.edu/comd/rorden/dicom.html DICOM Standard
[10] http://www.ihe.net IHE Web Site, Integration the Healthcare Enterprise (IHE).
[11] IHE Technical Framework Revision 5.5-For Trial Implementation April 7,2003.
[12] IHE Technical Framework Volume I Integrate Profile – “ Basic Security” V5.5 2003.
[13] D. B. Baker, R. M. Barnhart, and T. T. Buss, "PCASSO: applying and extending state-of-the-arts security in the healthcare domain," Proceedings of the 13th Annual of Computer Security Applications Conference, 1997, pp.251-260
[14] INFINITT company STARPACS HL7Gateway Administrator Guide。
[15] INFINITT company STARPACS-HIS-RIS-Interface-Concept-Manual.pdf 。
[16] INFINITT company STARPACS-Server-Conformance Statement.pdf。
[17] INFINITT company STARPACSHL7 Broker-ConformanceStatement.pdf。
[18] INFINITT company STARPACS NetWork Gateway-
ConformanceStatement and Administrator Guide.pdf。
[19] INFINITT company STARPACS Worklist Gateway- Broker-ConformanceStatement and Administrator Guide.pdf。
[20] David S. Platt, 2001, "Web Services: Building Reusable Web Components with SOAP and ASP .NET", Microsoft MSDN Magazine, February 2001, Retrieved 2001/08/21, from http://msdn.microsoft.com/library/en-us/dnmag01/html/webcomp.asp
[21] http://www.rsna.com/IHE/index.shtml RSNA IHE web site.
[22] http://www.dell.com.tw PowerEdge 6850、PowerEdge 2950 DELL company web site.
[23] http://www.doh.gov.tw, DOH web site,Taiwan Medical Information Planning.
[24] http://www.oracle.com/global/tw/index.html Oracle web stie.