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Maximizing the Power of Centricity PACS Audit Data. Bill Gregg, MS, CIIP, CPSA PACS Administrator/IIP LSU Health Sciences Center Shreveport, LA.

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Maximizing the power of centricity pacs audit data

Maximizing the Power of Centricity PACS Audit Data

Bill Gregg, MS, CIIP, CPSA

PACS Administrator/IIP

LSU Health Sciences Center

Shreveport, LA


  • The materials, presentations and content herein are the opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.


Overview
Overview opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Start Simple

  • Historical perspective

  • Basic concepts regarding events and data

  • Look at basic data with the PACS Auditor

  • Finish up with workflow analysis

  • Goal is to give everyone something to take home today


Getting started
Getting Started opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • HIPAA (2004) – audit access to PHI

  • With Centricity 2.0 GE started providing XML audit log files

  • Direct conversion of XML to Excel wasn’t working for me

  • Wanted to work in the .NET environment

  • Used Visual Basic .NET to read audit files and load into MS Access


Getting started1
Getting Started opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • First version of the PACS Auditor application Nov 2004

  • IHE value growing, looked at ATNA

  • Used this platform for a poster presentation at SCAR/SIIM 2005 that was later published in the JDI

  • Found data useful for QC as well

  • What else can we do with this?


Time line
Time Line opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • 11/04 Created first iteration of Audit Log app

  • 4/05 SCAR/SIIM GE/Eric Feingold talk

  • 7/06 Offered PACS Audit Log app as open source to GE User Community (SupportCentral)

  • 11/07 Added workflow analysis


Talk objectives
Talk Objectives opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Objective 1: Understand how to get Centricity audit log files and what is in them  

  • Objective 2: Understand ways to access and manipulate the data  

  • Objective 3: Understand how to utilize this data to support HIPAA requirements and QC efforts


Term definitions

Database opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

Audit Log

XML file

Elements/Attributes

Events

ENM Table

MS Visual Basic .NET

MS Visual Studio

MS Access

MS SQL Server/SSE

Oracle, Sybase

Term Definitions


Why care about audit data
Why Care About Audit Data? opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • To satisfy HIPAA requirements

    • Who looked at what

  • To support QC projects

    • Who verified/dictated that exam?!

    • Who rejected those images?

    • How long does it take to verify an exam?!

  • To Monitor DICOM events (not implemented)

    • Who created/changed KIN, ED, PGI

  • To support ILM (Information LifeCycle Management) (not yet implemented)

    • Who created/implemented/changed rules

    • What exams were deleted/moved


Hugged your audit data today
Hugged Your Audit Data Today? opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Audit data has a lot of value today

  • As more information is added to it, more value will be derived tomorrow


Level i the basics
Level I: The Basics opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • GE documents on audit data, events and fields (documentation folder)

  • What does this show us

  • How can we utilize the data (xml, spreadsheets, db)


Centricity 2 0
Centricity 2.0 opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Centricity RA1000, some Exam Manager events logged

  • Start with initial set of audit data

  • Order event is not included

  • Must set 4 of the events in CA Tool

    • LogIn/Out, Exam Print, Exam View


Centricity 2 1 x
Centricity 2.1.x opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Started capturing events from Centricity Web connections also

  • Added additional events in 2.1.3 that must be set in the CA Tool

    • User\ Created, LoginFailure, RoleChanged, StatusChanged, PasswordChanged, ExamPresentationSaved, ReportViewed

  • Some quirks where didn’t complete the XML file

  • Order event not included


Centricity 3 0
Centricity 3.0 opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Added additional data events/elements that must be set in CA Tool

  • Order event now included giving the complete picture

  • Important shift in architecture to a DICOM view in v3.x

  • This allows us to start capturing data regarding DICOM events

  • Take a look at the events


Basics
Basics opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Note that in Exam Manager, EM and PM events are logged, as well as status changes (such as verify, unverify etc.), but no event if change patient name or MR directly.

  • Also note that my app now includes the 2.x/3.x events and data fields.


Audit files
Audit Files opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • XML files

  • File structure

  • How do you get them? (your FE)

  • Be aware that the ENM table only holds a set number of days of data, it is NOT a permanent repository

  • That is why they give it to you

  • Also be aware that the event data is 2 days behind


Level i summary
Level I Summary opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Basic terms

  • PACS Audit Events/data from ENM

  • Getting the audit log files from GE

  • Discussed version differences

  • Looked at XML file


Level ii tools
Level II: Tools opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Have basic understanding of the audit data

  • Multiple ways to access the data

  • Multiple tools to access the data

  • PACS Auditor tool on SupportCentral site


Installing the audit logger
Installing the Audit Logger opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Documentation (go ahead, read it…)

  • Need to have .NET 2.0 installed

  • File location structure

  • Issue with fixed db locations

  • Fix using UDL files

  • Need to change driver for Access 2007

  • Just need to re-link tables in Access fe


Auditor trivia game
Auditor Trivia Game! opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Frontend/Backend database

  • Access allows a file size of about 2 Gb

  • This holds approximately 2.9 million audit records (currently on my 3rd)

  • You can create front ends that limit access

  • You can implement some reasonable security


Your pal
Your ‘PAL’ opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Loading files

  • Safeguards

  • Troubleshooting


The pacs auditor database
The ‘PACS Auditor’ Database opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Basic front end (GUI) for immediate queries

  • Search fields

  • How the date fields work

  • Report buttons

  • Exam 2020, Patients 1228, 2003


Level iii workflow
Level III: Workflow opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Have basic reporting capabilities that can help address HIPAA requirements

  • Can answer basic questions about who did what using discrete event data

  • Take the data and extract more information from it by looking at time spans between events


Workflow reports
Workflow Reports opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Going past event data to look at workflow

  • Time Reports

  • Issues with data

    • Start and end dates can caused partial spans

    • Accession range more complete

    • Skipped status levels (Arrived-Dictated etc.)

    • Manual manipulations (Unverify, Verify)

    • How these affect counts


Update for 2 x 3 x data
Update for 2.x/3.x Data opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Completed the update to include 2.x/3.x data fields

  • Requires a database conversion

  • Will need to load prior archived db’s into a new empty database

  • New db won’t hold entire old ‘full’ db

  • Created routine to help import, but IMPORTANT to follow the documentation


Future work
Future Work opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Create new reports/views based on 2.x/3.x data fields

    • Login Failures

    • Image rejects

    • Any other suggestions?

  • Move from Access to SQL Express/SQL Server

  • Build in creation of summary data for use with pivot tables

  • Create de-identified data sets for research use


Summary
Summary opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Centricity PACS audit data

  • Satisfying HIPAA requirements

  • Satisfying basic QC needs

  • Using the Time Reports to satisfy advanced QC needs


We can maximize the power of centricity pacs audit data

We Can Maximize the Power of Centricity PACS Audit Data opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.


Where is it
Where is it? opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Both the documentation and the application can be downloaded from GE’s SupportCentral site or our Radiology site

  • Everything we talked about today is in the documentation

  • You get it all as an open source app, but it can be used ‘out of the box’.

  • No logo’s in it, you can put in your own!


Protected healthcare information
Protected Healthcare Information opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Have proper policies and procedures set up for access to this data

  • Limit user access where you can with specific front end forms


Contact information
Contact Information opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  • Do have a day job, there is documentation

  • [email protected]

  • http://www.shreveportradiology.com/department/pacs/downloads (look at end of list)

  • Also have a forum on the GE SupportCentral site


Thank you for joining this presentation today. opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

Any Questions?


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