iSite 3.5: Exam Linking

Table of Contents Objectives Terminology Introduction Technologist Worklist Exam Linking Exam Unlinking

Objectives Understand the purpose of Exam Linking Understand how to link exams

Terminology PACS (Picture Archive and Communications System) Information Systems designed to manage, store and distribute medical images and related information throughout the healthcare enterprise HIS (Hospital Information System) Information Systems designed to manage patient records, including patient registration, billing and order entry RIS (Radiology Information System) Information Systems designed to manage exams (orders), including filling orders and scheduling

Terminology DICOM (Digital Imaging COmmunication in Medicine) DICOM is the predominant communication standard between imaging equipment throughout the Healthcare Enterprise HL7 (Health Level 7) HL7 is the predominant messaging standard for exchanging key sets of administrative and clinical data in the healthcare enterprise

Terminology MRN (Medical Record Number) A unique patient identifier (also known as Patient ID) used for auditing of billing and scheduling for patients Accession Number (ACCession Number) A unique exam identifier (also known as an order number or requisition number) used for auditing of billing and scheduling of scheduled procedures SUID (Study Instance Unique IDentifier) A unique study identifier used for auditing of performed imaging service requests

Introduction

Exam Linking Linking Exams provides the ability to associate multiple exams (orders) with a single study (image acquisition) Linking Exams is necessary in an environment where multiple orders and multiple dictation events are created for a single image acquisition sequence Linking Exams permits the association of a single image acquisition (ex. CT Chest, Abdomen, Pelvis) with multiple exams as demonstrated on the Patient Directory and Patient History Timeline * Exam Linking is preferably performed prior to image acquisition by the performing Radiologic technologist; however, exam linking may be performed after acquiring images. Without using the Exam Linking feature, the exams not associated to the study will show on the Patient History Timeline with an ‘X.’ There is no indication to iSite users to look for the images under another exam. Exam Linking solves that problem. Once linked, those exams now have the same image reference.

Technologist Worklist

Technologist Worklist In iSuite or iSite Enterprise from the Folder List Access the Technologist Worklist to find your exams

Technologist Worklist Select an accession number to view images from the Clinical Exam Notes

Technologist Worklist Select the ‘view’ button to view images Users will not have the option to view images from the Clinical Exam Notes in iSite Enterprise. Images should be viewed from selecting the exam in the Patient Directory.

Exam Linking

Exam Linking Linking Exams does not link reports It is not possible to “link” exam notes to linked exams For example: When CT CHEST, ABDOMEN, PELVIS exams are linked and a user creates an Exam Memo attached to the CHEST exam, the Memo will not show up in the Worklist and canvas page associated with the ABDOMEN and PELVIS exams Caution: A note might contain information in regards to the linked exams that will be missed by the reading physician or clinician

Exam Linking Exams may be linked by selecting the box next to the patient’s name when there are multiple exam orders associated with a single image acquisition event Exam linking is performed within the Technologist Worklist. Exam Linking is an essential step of the Technologist Workflow, however it is also a daily management task of the iSite PACS Administration team. The administrators need to make sure exam linking is being performed by the technologists and is being performed properly.

Exam Linking The system will not allow linking of multiple patients Exam linking is performed within the Technologist Worklist. Exam Linking is an essential step of the Technologist Workflow, however it is also a daily management task of the iSite PACS Administration team. The administrators need to make sure exam linking is being performed by the technologists and is being performed properly.

Exam Linking If the exam status is ‘In Progress’ or ‘Scheduled’ select ‘link & begin’ Note: If ‘link & complete’ is selected this may cause the exams to prematurely populate Worklist filters

Exam Linking ‘link & complete’ may safely be used after image acquisition and when the exam status is already set to ‘Completed’ by the RIS

Unlinking Exams To Unlink: Select the exam(s) you wish to unlink The Linked Exams dialog will appear automatically

Unlinking Exams To Unlink: Select the exam(s) you wish to unlink and press unlink

Unlinking Exams Warning: Technologists can unlink an image study from an exam in D (Dictated), P (Preliminary), F (Finalized), A (Addended) or R (Revised) status If a technologist unlinks an image study from an exam with one of these statuses, the radiologist's diagnostic report may be effected because the report was dictated when the images were originally linked to the exam For example, a report may make reference to or include a diagnosis based upon the image to which it was once linked If this is the case and the image study is no longer linked to the exam/report, the image reference is lost if not re-linked to the appropriate exam

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