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David E Avrin

Publications and source records attributed to David E Avrin.

8 recordsLinked to original sources
PubMed2002

RIS minus PACS equals film.

Web-based integration methods can be used to resolve a fundamental issue in the transition from film to a picture archiving and communication system (PACS): the identification of relevant prior studies only available on film. Even in the most ambitious conversions from a film-based environment to PACS, there are issues regarding prior studies not on PACS. Failure to compare with prior exams is one of the known risk factors for malpractice in radiology. While most commercial PACS systems today have some degree of RIS integration, knowledge of prior studies is usually limited to an awareness of studies in the PACS. On the other hand, most RIS systems today do not or cannot distinguish between studies on film and those in PACS. We made the observation, from a set theory perspective, that in general: Therefore we sought to create a system that would query both the RIS and PACS and reconcile the results using the above set operation. The query is initiated from a display station via the invocation of a Web browser installed on that station. The process of starting the browser is implemented using a scripting language provided by the workstation vendor, though the use of other mechanisms, such as the CCOW (Clinical Context Object Workgroup) or IHE (RSNA Integrated Healthcare Enterprise) interfaces, can be supported by this architecture. The medical record number, which identifies the current patient and is the primary parameter of the query, is passed as part of the URL (Universal Resource Locator) used to launch the browser. Once running, the browser connects to a Web server that hosts a JSP (Java Server Page) page that performs a DICOM query of the PACS and an HL7 query of the RIS, and then collates the results using the set operation described above. Both the DICOM and HL7 functionality are provided by Java-based toolkits developed in house. The results are returned to the client's browser as a standard HTML page with a tabular format detailing which studies are on PACS and which are available only on film. The responsiveness of the system in terms of time required to complete the two queries and display the results was measured. In addition, the number of diagnostic reports, whose retrieval was triggered by the results of the queries, was monitored to determine the overall performance and use of the system. This project demonstrates that, with minimal modification of commercial software, Web-based integration methods exist to enable patient-context sensitive queries from the diagnostic workstation that identify relevant prior studies that exist only on film and are unknown to the PACS. As a result radiologist workflow is enhanced by the elimination of the need to consult a physically separate system for this type of information. In addition, quality of service is improved by providing more accurate and easier identification of relevant prior studies.

Information Storage and Retrieval↗
PubMedDate not supplied

Informatics in radiology (infoRAD): Vendor-neutral case input into a server-based digital teaching file system.

Although digital teaching files are important to radiology education, there are no current satisfactory solutions for export of Digital Imaging and Communications in Medicine (DICOM) images from picture archiving and communication systems (PACS) in desktop publishing format. A vendor-neutral digital teaching file, the Radiology Interesting Case Server (RadICS), offers an efficient tool for harvesting interesting cases from PACS without requiring modifications of the PACS configurations. Radiologists push imaging studies from PACS to RadICS via the standard DICOM Send process, and the RadICS server automatically converts the DICOM images into the Joint Photographic Experts Group format, a common desktop publishing format. They can then select key images and create an interesting case series at the PACS workstation. RadICS was tested successfully against multiple unmodified commercial PACS. Using RadICS, radiologists are able to harvest and author interesting cases at the point of clinical interpretation with minimal disruption in clinical work flow.

Computer-Assisted Instruction↗