M7 Computers in Radiology

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COMPUTERS

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COMPUTERS

Integral part of many activities within a Radiology Department

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COMPUTERS

Used by different Radiologic Modalities to Acquire, Process & Post Process Imaging Data.

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DICOM

Developed by ACR & NEMA

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DICOM

A “Cooperative Standard” that allows compatibility between imaging systems, by connectivity of imaging & associated medical equipment's of different vendors

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American College of Radiology

ACR

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National Electrical Manufacturers Association

NEMA

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20

DICOM 2011 Standard is divided into _ parts

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PACS

 It enables integration of scanners, servers, workstation, printers, & network hardware from multiple vendors into a

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DICOM

Promotes the development of PACS & Image Networking in a LAN & WAN scenario

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Radiology

needs DICOM for its uniform set of rules for communication of digital images

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DICOM

Provides protocols for integration of image data between modalities, devices and systems

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DICOM or any electronic communication

is functionally divisible into a set of layers with each layer performing a defined set of functions

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DICOM Service Class

is defined as a group of operations that a user wants to perform on data from a modality.

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Print Management Service Class

that deals with printing images on film or paper printer, with flexible film formats

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Storage Service Class

that implies "sending" images

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Query/Retrieve Service Class

that deals with issues of "find, move and get" SOP (Service Object Pair) Classes.

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find

is used to query for images

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move and get

are used to commence a transfer

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Other Classes of Service

include Verification Service Class, Media storage, Study content notification, Print management, Patient management, Study management, Result management, Modality Performed Procedure Step management States and Structured reporting.

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DICOM Conformance

identifies specific DICOM capabilities of an equipment or medical device.

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Conformance Statement

allows: “a user to determine which optional components of the DICOM Standard are supported by a particular implementation & what additional extensions or specializations an implementation adds”

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Modern radiology

modalities generate an enormous amount of a variety of data.

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healthcare standards

To efficiently handle the sizeable data, and to improve workflow efficiency, ___ ____ have been created.

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Healthcare Standards

assists the exchange, management and integration of different medical data (including radiology), that supports patient care.

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workflow

It is important to understand that Radiology requires more than DICOM for

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DICOM, HL7 and IHE

Consequently, 3 Significant Health Care Standards important to a Radiologist are

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DICOM

Digital Imaging and Communications in Medicine

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IHE

Integrating the Health Enterprise

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HL7

Health Level Seven

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Integrating the Health Enterprise

An initiative by Healthcare Professionals And Industry to improve the way computer systems in healthcare share information.

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Integrating the Health Enterprise

Promotes the coordinated use of established standards such as DICOM and HL7 to address specific clinical needs in support of optimal patient care.

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DICOM and HL7

Promotes the coordinated use of established standards such as ___ and ___ to address specific clinical needs in support of optimal patient care.

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accordance with IHE

Systems developed in ___ ___ __ communicate with one another better, are easier to implement, and enable care providers to use information more effectively

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Health Level Seven

Provides protocols for exchange, management and integration of clinical and administrative electronic health data.

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Health level seven

is "an all-volunteer, not-for-profit" organization.

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1987

(HL7)Formed in ___, the accepted global standard for exchange, integration, sharing and retrieval of electronic health information in hospitals.

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global standard

Formed in 1987, the accepted ___ ___ for exchange, integration, sharing and retrieval of electronic health information in hospitals.

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A. Improve Care Delivery B. Optimize Workflow C. Reduce Ambiguity D. Enhance Knowledge Transfer

HL7 Mission is to provide standards for interoperability that:

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Clinical, Clinical Genomics, Administrative, Clinical Research, Electronic Claims Attachments, Public Health, Personal Health

Wide range of Healthcare Standards:

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Health Level "Seven"

has its origins based on a Seven-layer International Organization Of Standards (ISO) Communication Model.

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Layers 1-4

Deal with Communication; Comprising Physical, Data Link, Network And Transport Communication Layers.

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Layers 5-7

Deal with functions like Session, Presentation & Application.

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Highest Level or Seventh Level

is regarded as the Application Level, which deals with the definition of data to be exchanged

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Highest Level or Seventh Level

This Level supports varied functions, such as "Security Checks, Participant Identification, Availability Checks, Exchange Mechanism Negotiations and Data Exchange Structuring".

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HL7 Standards

are freely implementable, but have a strict copyright.

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workflow

It is important to understand that Radiology requires more than DICOM for

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DICOM and HL7

Existing standards like ___ and ___ have been established and are in place. These standards lay down that interoperability is possible.

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Integrating Information Systems

in Radiology Departments can be complex.

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DICOM and HL7

When standards like __ and __ are applied on ground, there are ambiguities and conflicting interpretations.

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IHE

steps in to fill a gap between what is theoretically possible and what can be achieved in practice on ground in Radiology Departments.

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IHE

solves issues involving "Multiple, Heterogeneous Information Systems" by way of consensus and cooperation between existing healthcare standards agencies.

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IHE

It coordinates the use of established standards like DICOM and HL7 but answers issues that remain unresolved within the scope of DICOM and HL7.

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Integrating The Healthcare Enterprise

The core strategy of "__ __ __ __" is integrating radiology workflow within a healthcare setup, using existing standards like DICOM and HL7.

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IHE

By a "multi-year initiative that creates the framework for integrating applications, systems and settings across the entire healthcare enterprise" the IHE initiative improves workflow

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A. Interoperability Problem Identification B. Integration Profile Specification C. Implementation and Testing at Connectathon D. Integration Profile Conformance Statements

IHE accomplishes this by a four stage process:

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Consistent presentation of images profile which ensures images are displayed as similarly as physically possible on different displays like film on view box, workstation, or PC

Typical examples of a few successfully implemented IHE Integration Profiles in Radiology Departments include:

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KEY IMAGE NOTES PROFILE

which is used for flagging images of Radiologic Procedures

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Key Image

is practically useful, for example in a CT Scan of the abdomen, where out of the nearly 200 slices, useful information may be available in only four images.

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four images

in a CT Scan of the abdomen, where out of the nearly 200 slices, useful information may be available in only

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Flagging

of these four images enables referring clinicians across a PACS to quickly access them, thereby saving time and increasing efficiency

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  1. Scheduled Work Flow

  2. Patient Information Integration Reconciliation

  3. Post Processing Workflow,

  4. Charge Posting

  5. Simple Image And Numeric Reports

  6. Presentation Of Grouped Procedures

  7. Access To Radiology Information

  8. Exception Management Workflow

  9. Basic Security

  10. Integration Profile

Other IHE Integration Profiles include:

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RADIOLOGY

is a ubiquitous healthcare service that derives, processes, offers and distributes data in an electronic format.

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DICOM, HL7 and initiatives like IHE

have been created to improve workflow efficiency in a networked radiology department, across a multivendor system environment.

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DIGITAL IMAGING

Integral to current Radiology practice, wherein images are acquired, processed, post-processed and displayed, in black and white, gray scale, or colour, using binary numbers.

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Digital Imaging in Radiology

The sources of ___ ___ __ ____ are very varied and diverse, when compared with other specialities.

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UTZ, CR, DR, CT, MRI

They comprise imaging equipment like

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digital camera or scanners, interface hardware connecting devices and computers

input devices like

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output devices like

printers, monitors and video projectors.

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Pixels, Gray Scale, Bit Depth, Colour & Resolution

Digital Imaging has few important performance parameters like

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parameters

These ____ are distinctly different for image acquisition equipment when compared with image output and viewing devices.

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WORKSTATION

‘Viewing Boxes ’ of a Modern Radiologist

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WORKSTATION

They are at the very core of a Radiologist’s daily work and central to the business of manufacturing medical imaging equipment’s

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workstation

The modern radiologist often reads an image at a ____, by manipulating it to extract useful information out of the voluminous dataset of a given patient from a specific modality

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Image overload

is another area considered as the single biggest challenge in radiological services.

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3D processing

The only method to tame this deluge of image data is to effectively use __ ___ in workstations

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Placing and replicating

workstations in every modality, reading room, office, and hospital sites like Ward and ICU is not economically feasible or practical.

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Thin and Thick Clients

Fundamental difference between __ and __ __ is based on the location of the software applications

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NETWORK

exists when two or more computers are connected together, thereby allowing them to share data, equipment, and other digital electronic resources.

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Seamless

Such '____' Workflow features in a Radiology network are made possible by means of a combination of network software and network hardware.

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type of a network

The __ __ _ ____gives an idea of the size and its scale in a geographical area.

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Personal Area Network

PAN

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Local Area Network

LAN

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Metropolitan Area Network

MAN

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Wide Area Network

WAN

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