Digital Radiography: Medical Informatics: PACS System and Quality Control-Assurance
Summary
TLDRThis video script delves into medical informatics, focusing on hospital information systems (HIS), radiology information systems (RIS), and picture archiving and communication systems (PACS). It highlights how these systems streamline patient data management, facilitate medical imaging processes, and enhance diagnostic capabilities. The script also touches on the importance of communication standards like HL7 and DICOM, which ensure interoperability between various healthcare systems. Additionally, it addresses the challenges of data security and privacy, emphasizing the role of HIPAA in safeguarding patient information.
Takeaways
- đ„ The Hospital Information System (HIS) is a central repository for all patient medical information, including billing, scheduling, and medical records, streamlining processes previously done manually.
- đ HIS assigns a unique medical record number to each patient, facilitating departmental interactions and information sharing.
- đ Attending physicians can enter orders for lab tests, imaging, and prescriptions through HIS, enhancing accessibility and efficiency.
- đ HIS supports clinical research and public health data collection, playing a crucial role in healthcare data management.
- đ€ The Radiology Information System (RIS) manages radiology-specific tasks like scheduling, billing, reporting, and quality assurance, interfacing with HIS for shared functions.
- đĄ Networks, particularly Local Area Networks (LAN) and Wide Area Networks (WAN), are essential for connecting healthcare devices and sharing resources and data.
- đŒïž Picture Archiving and Communication System (PACS) is a networked system for managing digital images, replacing traditional film-based methods and enabling remote access and image manipulation.
- đ PACS reading stations provide tools like pan, zoom, and magnify for radiologists to analyze images in detail, enhancing diagnostic accuracy.
- đ PACS measurement functions, such as distance and angle measurements, assist in the precise analysis of medical images.
- đŸ The implementation of PACS has eliminated issues like lost or misfiled images, allowing for efficient image storage, retrieval, and simultaneous multi-user access.
- đĄïž Standards like DICOM and HL7 facilitate communication between medical devices and systems, ensuring interoperability and data integrity.
- đ HIPAA regulations mandate strict security measures to protect patient privacy and data, requiring healthcare institutions to implement safeguards and employee training.
Q & A
What is the primary function of a Hospital Information System (HIS)?
-The primary function of a Hospital Information System (HIS) is to house all of a patient's medical information, including billing, scheduling appointments, and medical records. It also assigns unique medical record numbers to each patient for use across all departments.
How does the HIS facilitate communication between different departments within a hospital?
-The HIS allows attending physicians to enter orders for lab tests, diagnostic imaging, and prescriptions from various locations. It also communicates with other systems like the Radiology Information System (RIS) for shared functions, using software standards like HL7 for interoperability.
What is the role of the Radiology Information System (RIS) in a healthcare setting?
-The RIS houses radiology information and is responsible for radiology functions such as scheduling patient procedures, radiology billing, radiologist dictated reports, and quality assurance data. It communicates with the HIS for shared functions.
What are the basic communication systems used by HIS, RIS, and PACS?
-The basic communication systems used by HIS, RIS, and PACS involve networks and communication standards. They use local area networks (LANs) for small geographic areas and wide area networks (WANs) for larger areas. The HL7 software standards are used for communication between these systems and medical devices.
What is the significance of the Picture Archiving and Communication System (PACS) in radiology?
-PACS is a networked group of computers, servers, and archives used to manage digital imaging. It has replaced traditional x-ray file rooms and reading rooms, allowing for the storage, retrieval, and distribution of images, and enabling simultaneous access from various locations.
How does PACS enhance the radiologist's ability to analyze medical images?
-PACS provides radiologists with tools for post-processing manipulation and enhancements of images, including functions like pan, zoom, and magnify, which allow them to increase the size of specific areas and enhance the image for better diagnostic accuracy.
What are the common measurement functions available on PACS stations?
-Common measurement functions on PACS stations include distance measurement, which uses pixel size to measure structures on the image, and angle measurement, which is often used when reading spine studies.
How has the implementation of PACS impacted the traditional radiology file room?
-PACS has replaced the traditional radiology file room, which was costly and inefficient. PACS allows for image manipulation, simultaneous viewing from multiple workstations, and eliminates issues like lost or misfiled images, leading to better patient outcomes.
What is the importance of the DICOM standard in medical imaging?
-DICOM (Digital Imaging and Communications in Medicine) is a standard that facilitates the communication between all biomedical imaging files. It includes multiple parts from image display to storage and retrieval, and defines the functions a device can perform as a service class.
What is the role of the Health Level 7 (HL7) standards in healthcare communication?
-HL7 standards govern the communication of most clinical and administrative data, such as patient demographics, reports, insurance claims, and physician orders. They aim to improve care delivery, optimize workflow, reduce ambiguity, and enhance knowledge transfer among stakeholders.
How does the Health Insurance Portability and Accountability Act (HIPAA) protect patient information in healthcare systems?
-HIPAA mandates security and training measures for healthcare institutions to protect patient privacy. It requires safeguards for all communications concerning medical information, including encryption or removal of patient identifiers for stored or transmitted data, and annual training for employees on HIPAA regulations.
Outlines
đ„ Hospital Information Systems (HIS)
The paragraph discusses the role of medical informatics in radiography, highlighting the Hospital Information System (HIS). HIS is a digital repository for all patient medical information, including billing, scheduling, and medical records. It assigns unique medical record numbers and automates tasks previously done manually, reducing the need for a large workforce. HIS facilitates orders for lab tests, imaging, and prescriptions from various locations and supports clinical research and public health data collection. It communicates with the Radiology Information System (RIS) and other systems using HL7 standards, which are developed by an accredited organization and are crucial for healthcare applications.
đ Networks and Communication in Healthcare
This section explains the importance of networks and communication standards in healthcare. It introduces the Radiology Information System (RIS), which manages radiology-specific data and communicates with HIS. The paragraph also covers the basics of local area networks (LAN) and wide area networks (WAN), which connect healthcare computers and devices. It emphasizes the need for understanding these systems for grasping the interconnectivity between HIS, RIS, and Picture Archiving and Communication System (PACS).
đ PACS: Revolutionizing Radiology
The paragraph focuses on the Picture Archiving and Communication System (PACS), which manages digital imaging in healthcare. PACS replaces traditional x-ray file rooms and reading rooms, allowing simultaneous access to images from various locations. It discusses PACS functions like image storage, retrieval, and distribution, as well as radiologist tools for image manipulation such as pan, zoom, and magnify. PACS also provides measurement tools and is essential for modern radiology departments, streamlining image management and enhancing diagnostic capabilities.
đ„ïž Medical Imaging Display and Standards
This section delves into the specifics of medical imaging display, emphasizing the importance of high-quality monitors for radiologists. It discusses the evolution of image acquisition and display software, leading to the establishment of the DICOM standard by the American College of Radiology and NEMA in 1983. DICOM facilitates communication between imaging equipment and PACS, with its standard defining device functions and image headers that include patient demographics and technical factors.
đĄïž Data Security and Compliance in Healthcare
The final paragraph addresses the challenges of data security and compliance in healthcare. It mentions the use of RAID and SAN for data storage to prevent loss, and the importance of HIPAA in ensuring patient privacy and data security. HIPAA mandates strict security measures for healthcare institutions, including employee training and data handling protocols to protect against unauthorized access and maintain confidentiality.
đ Continuing Education for Medical Professionals
The concluding paragraph promotes continuing education for radiologic technologists, offering resources such as webinars, guides, and courses to enhance professional excellence. It invites viewers to visit the website for more information on earning CE credits and accessing an all-access pass for unlimited credits.
Mindmap
Keywords
đĄMedical Informatics
đĄHospital Information System (HIS)
đĄRadiology Information System (RIS)
đĄPicture Archiving and Communication System (PACS)
đĄHL7 Standards
đĄDICOM
đĄLocal Area Network (LAN)
đĄWide Area Network (WAN)
đĄImage Manipulation
đĄHealth Insurance Portability and Accountability Act (HIPAA)
đĄRedundant Array of Independent Disks (RAID)
Highlights
Medical informatics encompasses a wide range of topics, with a focus on those most relevant to radiographers.
Hospital Information System (HIS) manages all patient medical information, including billing and medical records.
HIS assigns unique medical record numbers to streamline departmental interactions with patients.
Physicians can enter orders for lab tests and imaging from various locations through HIS.
HIS facilitates the collection of clinical research and public health information.
HL7 software standards, developed by the American National Standards Institute, are crucial for healthcare communication.
Radiology Information System (RIS) is responsible for scheduling, billing, and managing radiology reports.
Understanding networks and communication standards is key to grasping the interconnectivity of HIS, RIS, and PACS.
Local Area Networks (LAN) and Wide Area Networks (WAN) are the two major categories of networks in healthcare.
Picture Archiving and Communication System (PACS) manages digital imaging, replacing traditional x-ray file rooms.
PACS allows simultaneous access to images from various locations, enhancing diagnostic collaboration.
Radiologist reading stations in PACS enable post-processing manipulation and image enhancements.
PACS has become essential for image acquisition, display, storage, and retrieval in radiology departments.
DICOM, introduced in 1985 and standardized in 1993, facilitates communication between biomedical imaging files.
Health Level 7 (HL7) standards ensure interoperability and data exchange in healthcare.
Computer systems in healthcare are vulnerable to data loss, necessitating robust storage solutions like RAID or SAN.
HIPAA mandates security measures to protect patient privacy and confidentially in healthcare information systems.
Medical Professionals offers resources for radiology continuing education and professional development.
Transcripts
[Music]
medical informatics covers a multitude
of topics
the ones of most significant to
radiographers will be discussed in this
particular series
the hospital information system or his
houses all of the patients medical
information
including billing
scheduling appointments and medical
records
the his
assigns a unique medical records numbers
to each patient that is used by every
department for interactions with that
particular patient
these are functions that were previously
done
by hand and required a large workforce
and significant coordination among the
workforce
the his
allows attending physicians to enter
orders for lab tests
diagnostic imaging
and prescriptions for their patients
from many different locations
the his
also allows the collection of clinical
research
and public health
information in the health care system
the his communicates with the radiology
information system or r i s
and all other computered
shared systems within the institution
for shared functions
the
hl7 software standards
were set by the american national
standards
institute
they accredited the hl7 standards
developing organization
they are used in most
most healthcare applications
including the communication between
h i s
r i s
and other medical devices
the radiology information system or ris
houses radiology information
and is responsible for radiology
functions
such as the scheduling of patient
procedures
radiology billing
radiologist dictated reports
and quality assurance data
the system communicates with the
hospital information system or his
for shared functions
in order to understand the
interconnectivity
and the basic communication systems
used by his
ris
and the picture archiving and
communication system or pax
it is necessary
to have a basic understanding of
networks
and communication standards
the term network is used by a computer
scientists to describe the connection
between computers and other hardware
devices
that share resources
data and information
computers that are used in healthcare
institutions
are connected through networks
networks can be sorted into two major
categories
local area networks or lans lan
and wide area networks or wan w-a-n
local area networks are the most common
and serve a small
geographic area
such as a single facility or building
devices connected in a land
typically share one server
the pacs for an institution
is typically connected in a local area
network or
lan wide area networks can extend across
a city
a state
or country and even worldwide
computers connect using the services of
telecommunication
and cable companies
a picture archiving and communication
system
or pax
is defined as a
networked group of computers
servers
and archives that can be used to manage
digital imagings
according to carlton and adler
the pax is designed
to fit the particular needs of the
specific healthcare facility
but for the most part performs the same
general functions
of storing digital images
retrieval
and distribution of the images
in fact
the pax has replaced the traditional
x-ray file room
the radiology reading room
and the delivery services
previously utilized to distribute images
multiple users are able to access images
simultaneously
from various locations
including different cities
states and countries
johnston and fauber describe the pax as
an integral part of the radiology
department today
the pax provides a method for
communication
between the imaging modalities and the
storage and retrieval systems of the
radiology departments
in addition
radiologist reading stations allow the
radiologists to perform
post-processing manipulation
and enhancements
of the images that they are interpreting
pan
zoom and magnify
are functions used by the radiologist
to increase the size of a specific area
the magnify function is used to enhance
the square area of an image
this square can be moved around the
image to see various areas enlarged
zoom and pan functions are usually used
together
first the image is zoomed up to the
desired magnified level
then the pan icon is activated
so that the zoomed portion can be moved
around
allowing the radiologists
to view the different areas of the image
various measurement functions are
available on pax stations
the most common one
is the distance measurement
where the software uses the pixel size
which is a known measurement to measure
structures on the image
another common function
is the angle measurement
it measures the angle between two
structures
and is commonly used when reading spine
studies
the pax has become an essential part of
every radiology department
the system can be divided into image
acquisition
image display and image storage and
retrieval
pax basically
functions
as the radiology file room
and the radiology reading room
in the film screen environment
images could only be viewed on site or
copied and mailed out
lost or misfiled images had to be
repeated
leading to unnecessary exposure to the
patient
implementation of pacs has eliminated
these problems
pax allows for image manipulation and
simultaneous viewing of images from a
number of workstations
referring positions
consulting specialists
and radiologists
can now view images from different
locations
and perhaps
more effectively
reach a diagnosis and a treatment plan
leading to better outcomes for the
patient
pax has replaced the traditional
radiology file room
which was a costly operation
and not an efficient method of managing
medical images and reports
the traditional file room
occupied a great deal of space
within the institution
and was labor intensive
in large medical centers
trauma centers or teaching hospitals
the file room needed to be staffed 24
hours per day
every day of the year
today's radiology room file room can be
operated out of a small office
with space for a workstation
printer
digitizer and dry laser for copying
images
here we see a sample of lcd monitors
which predominate in medical imaging due
to the size
price
and quality
workstation monitors for medical imaging
must be of higher quality than monitors
used for other applications
monitor resolution is dependent on the
number of pixels in the display
the greater the number of pixels the
higher the resolution
pixels are arranged in a matrix
a larger matrix size means more pixels
which equals better resolution
radiologists require the highest
resolution monitors for the particular
modality
prior to
1983
computers used in medical imaging
departments
used vendor-specific software
for image acquisition and display
as pacs became the norm in medical
imaging departments
and with multiple vendors and equipment
types in the marketplace
all operating on their own software
language
problems
arose some vendors did not communicate
with some pax platforms
vendors began to make available software
programs
that would facilitate
the communication between imaging
equipment
and the pacs
for an additional cost
in
1983
the american college of
radiology and the national electrical
manufacturers association
or nema
joined together in an effort to
establish a standardized public format
and
protocol
for communication between all
biomedical imaging files
according to carlton and adler
dicom was first
introduced in 1985
and became the standard in 1993.
the dicom is made up of multiple parts
from image display
to storage and retrieval
the dicom standard defines the functions
a device can perform as a service class
a device can be a service class user
or a service class provider or both
the functions
a device can perform
are spelled out in the devices dicom
conformance standard
dicom is digital imaging and
communications in measure in medicine
the dicom header is part of each image
acquired
the information recorded in the header
includes the patient demographics
such as name
medical records identification number
and the referring physician
the header also records the number of
images
in the study
the technical factors used for the image
and the exposure index for the exposure
in all
but psp systems
according to carter and veal
any image manipulation
is also recorded in the header
and radiographers should be aware
that he or she is legally responsible
for any image manipulation that occurs
the dicom standards is not the only
standard governing communication
between various computer systems
health level 7 international
is an ansi standard developing
organization
the stated
purpose of hl7 standards
is
to provide standards for
intraoperability
that improve care delivery
optimize work
flow
reduce ambiguity
and enhance knowledge transfer
among all our stakeholders
hl7 standards
govern the communication
of most clinical and administrative data
such as patient demographics reports
insurance claims
and physicians orders
according to carter and veal the ris
can either pull patient information
through a dicom interface
or
through a gateway that creates an
interface with the hl7 device
and the dicom device
computer systems that store medical
information and images
are vulnerable to loss or corruption of
files
through the crashing of computer hard
drives
electrical malfunctions
file corruption
institution fires floods or other
natural disasters
therefore
to prevent the loss of patient
information
a storage system must be in place
such as redundant array of independent
disks
or raid
or a storage area network or s-a-n
the use of computers in health care has
seen rapid expansion
and that trend will only continue to
grow while there are many advantages to
electronic access to medical information
including medical imaging
there are some drawbacks
the main concern
is
unauthorized and ill illegitimate access
to information
through a computer workstation
or information that is transmitted
over the internet
hipaa
first enacted in 1996
mandates the security and training that
healthcare institutions
and other covered entities
must have in place to protect
patient privacy
under hipaa
all communications concerning medical
information
must be must have safeguards that cover
both the identity of a patient
and the confidentiality of the
information being communicated
patients must give their authorization
for the release of their information
and health care facilities may only
disclose the minimum necessary
information for the purpose of the
disclosure
information that is stored
electronically by the institution
or any covered entity affiliated with
the institution
for example a billing company
or a medical devices company
must either be encrypted
have all patient identifiers removed
or be scrubbed of all except the
relevant data fields according to
carlton and adler
health care facilities
must have procedures in place
that control access and security of
patient information
all employees must have documented
annual training
that is related to hipaa regulations and
safeguards
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