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Integrating external data in your PACS or EPR

A patient with data on CD, now what?. Integrating external data in your PACS or EPR. Jan Willem Kuiper, Kees Broekman Leen de Baat, Peter Speksnijder Rotterdam, The Netherlands. INTRODUCTION The Rotterdam situation. Data production radiology: 10 Tb year

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Integrating external data in your PACS or EPR

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  1. A patient with data on CD, now what? Integrating external data in your PACS or EPR Jan Willem Kuiper, Kees Broekman Leen de Baat, Peter Speksnijder Rotterdam, The Netherlands

  2. INTRODUCTIONThe Rotterdam situation • Data production radiology: 10 Tb year • Full redundant environment installed over 2 Main Equipment Rooms (MER) in separated buildings • Mirrored working storage with uncompressed data: 15 Tb and counting …. • SAN archive (compressed) data: 10 Tb and counting …. • 45 modalities including 64-, 16- and 4-slice CT scanners • 35 diagnostic viewing stations at radiology • >1200 medical workstations • >1200 potential EPR users EuroPACS-MIR 2004

  3. INTRODUCTIONgeneral reference data • 160.000 annual first outpatient visits • Estimate: 10% with data from referring hospitals • 70% of Dutch hospitals with a full radiology PACS • Amount of incoming digital data is increasing dramatically • That means: a lot of CD’s! EuroPACS-MIR 2004

  4. PROBLEMSexternal data on CD • Security/Administrative: no CD drive in medical workstations • Images cannot be viewed in doctor’s office, but only in private quarters on personal PC’s • Many different user interfaces in viewers • Some viewers don’t work • The clinician’s need to archive images temporary or permanent can’t be fulfilled • Images not available in Radiology PACS for comparison or second-opinion consult EuroPACS-MIR 2004

  5. PROBLEMS”just archive the data in your PACS” • Some patients not registered in HIS • Patients not registered in RIS • Results in extra administrative work (radiology) • Images not always in DICOM available • Radiology is not responsible for storing these images (producer’s responsibility) • More need for temporary storage, deleting images in radiology PACS not possible after archiving (legal issue) • 16.000 CD’s annually is a lot of work and data EuroPACS-MIR 2004

  6. SOLUTIONS”short term solutions in Erasmus MC” • Extra PC’s in clinic and ER with CD player for reviewing images, stand-alone systems • In Radiology extra PC’s for reviewing images drawback • Results in extra cost for hardware • Clinicians need to be able to handle various viewers • Still no solution for storing images in EPR • Current ß-version PACS viewer (Philips MS IDS5-web) not yet available as standard viewer • Standard for storing radiology data on CD (vendors)? EuroPACS-MIR 2004

  7. SOLUTIONS”current solutions in Erasmus MC” • Locally developed ‘shell’ for Hospital Information System incorporates viewers for various clinical applications including PACS data. EuroPACS-MIR 2004

  8. EPD EPD EPD Workstation Workstation Workstation CD drive DICOM workstation SOLUTIONS”Data flow in Erasmus MC” External data on CD’s In Erasmus MC HIS PACS Server PC Medical Docter HIS Registration No Administrator 8-5 new X No Readable? Adapt DICOM header with HIS patient ID HIS Registered? Yes Yes Archive needed? End No Yes

  9. SOLUTIONS”CD Data integrated in EPD” • Locally developed ‘shell’ for Hospital Information System incorporates viewers for various clinical applications including PACS data. • Video animation showing external data radiology viewer EuroPACS-MIR 2004

  10. FUTURE NEEDS”for solving the CD problem” • Awareness that there is a problem with data on CD • One web based viewer for all radiology images • Possibility to use viewer in stand-alone situation • Standardization needed for CD Data • DICOM and no proprietary vendor specific formats • DICOM Dir in main directory • Connecting all local and national hospitals and implementing nationwide unique patient ID number • Have “old-fashion” hardcopy films available as long as needed. EuroPACS-MIR 2004

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