Rayavaran Co. RIS / PACS Integration CIS/HIS/RIS Solutions

Rayavaran Co. RIS / PACS Integration CIS/HIS/RIS Solutions
Presented by: Safa Fathi Amini, MD 21st Iranian Congress of Radiology Tehran, Jan, 2006 Rayavaran Co. CIS/HIS/RIS Solutions

21st Iranian Congress of Radiology, Tehran, 17-20 Jan, 2006
RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links “RIS and PACS are more like twins separated accidentally at birth.” Fred Prior, Ph.D., the Mallinckrodt Institute of Radiology ,St. Louis. 21st Iranian Congress of Radiology, Tehran, Jan, 2006

Another function of RIS
RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Radiology Information System (RIS) , 1960’s Picture Archiving and Communication System (PACS), 1970’s Digital image management: Another function of RIS 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Common database and Workflow engine Improved workflow Improved productivity Improved patient care 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Image Request 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Modality Worklist 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links New Image Acquisition 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Reporting 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Images Back to RIS/CIS 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Integrated RIS/PACS 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Radiologist/Reporting physician All RIS/HIS/CIS information Demographics, medical record number Orders, results Allergies, special precautions Other relevant data (priority, clinical indication, transport methods, …) Prior reports and images Full patient history Full imaging history 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Radiologist/Reporting physician
Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Radiologist/Reporting physician Better flow of images Complete request workflow Automatic pre-fetch Immediate distribution of reports Immediate access to images and reports for physicians No separate RIS terminal No identity confirmation 6 to 36-fold increase in time savings! 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Radiologist/Reporting physician Better integration of other systems Transcription Voice recognition 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Real-time decision making Requesting Physician
Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Requesting Physician All prior images of the patient Advice on duplicate requests Advice on possible contra-indications No need to wait for the signed transcription Real-time decision making 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Technologist RIS supports all DICOM services Automatic entry in the DICOM Modality Worklists directly from RIS Automatic entry of patient demographics and study-related information Automatic verification Reduced risk of inconsistent data Reduced risk of “broken studies” Guaranteed accuracy Improved workflow 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Clinic Reduced film usage, reprinting, copying, processor chemicals, service contracts, film room staffing, film storage, and archival costs Increased patient throughput Increased catchment area Increased operating room turnaround Reduced lengths of stay Competitive advantage with insurance contract negotiations Reduced costs Increased efficiency 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Clinic Better services to referring physician community Reduced errors Marketing advantage 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Increased satisfaction Patient
Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Patient Imaging records always available Improved safety Decreased cost Increased satisfaction 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Overall: Clinical goals Patient safety and satisfaction Physician satisfaction Operational goal Going filmless and paperless 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Integration Levels: No integration Physical integration Messaging level Application level 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links No Integration: More than one computer on a physician's desk. No change in workflow or resources Start point to upgrade to higher levels of integration 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Physical Integration: Visual integration! Single computer / OS Different applications Different workflow Advantages: Less usage of space and power Disadvantages: No real integration No communication among applications No effective change in workflow 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Message Level Integration: Context integration Different applications sharing common context A "context manager" passes any context changes between applications Information exchange as defined by the CCOW (Clinical Context Object Working group) standard Advantages: Provides some degree of integration 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Message Level Integration: A common user interface through standard messaging (DICOM, HL7, …) A “broker” software/hardware to do the “translation” Seamless integration requires the definition of standard “profiles” 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Message Level Integration: Advantages: Different products with different capabilities can coexist and communicate The basis for more distributed architecture Disadvantages: Very precise and complex translation/mapping required Increased data management Higher purchase and maintenance costs 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Application Level Integration: API/Procedure call level The application can talk both HL7 and DICOM Directly connects RIS to different modalities Advantages: Most reliable solution Less purchase and maintenance costs compared with “brokered” solutions Less points of failure True “desktop”, bidirectional integration Disadvantages: Needs retirement of old RIS Does not allow systems from different vendors 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links HIS/RIS/PACS Integration Connectivity vs. integration Bi-directional data exchange requires common language Health Level-7 (HL7) between RIS and HIS/EPR The Digital Communications in Medicine Standard (DICOM) between imaging modalities and PACS HL7 to DICOM barrier inhibits data flow to PACS 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration HIS/RIS/PACS Compatibility Issue Introduction
Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links HIS/RIS/PACS Compatibility Issue 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links The Broker A software and hardware device Accepts HL7 messages from the RIS Translates, or maps, the data to produce DICOM messages for transmission to the PACS 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Uni-directional Brokered Integration Introduction
Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Uni-directional Brokered Integration 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Technologist workflow:
Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Technologist workflow: Patient and exam information from the RIS to broker Modality Query for Patient and Exam Information 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Broker-based Workflow Problems Source (RIS) is unaware of updates Risk of being out of date Must be kept synchronized Requires data mapping Increased data management 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Data Mapping A one to one relationship between the components of the two databases A precise and strict mapping of HL7 elements to DICOM elements 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Mapping of HL7 Elements to DICOM Elements
Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Mapping of HL7 Elements to DICOM Elements 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links IHE Integrating the Healthcare Enterprise Established by the Hospital Information Management Systems Society (HIMSS) and the Radiological Society of North America (RSNA) Establishes a set of common integration protocols Provides a framework for the standards to communicate more easily Recognizes HL7, DICOM, CCOW, MPI,… IHE Integration Profiles are sets of the two standards with the exact specifications on how to map the specific attributes between the two standards 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Importance of IHE Vendors can explicitly state their products’ integration capabilities Users can hold vendors to their IHE commitment Promotes systems integration Promotes the use of standards Enables interaction among multiple systems Improves communication standards by removing excessive flexibility Enables systems to communicate more efficiently Provides a clear integration framework 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Non-brokered Solutions RIS RIS-driven workflow controls the PACS RIS natively supports DICOM (DMWL) Image data verification directly by RIS Pre-fetching and auto routing directly by RIS PACS PACS sends updates to the RIS PACS directly queries the RIS to access full patient data and not just the data in the broker Broker The broker is absent or reduced to interface engine and not data storage 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Bi-directional Non-brokered Integration
Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Bi-directional Non-brokered Integration 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Non-brokered Solutions Advantages RIS directly integrates to imaging modalities RIS has bi-directional communication to PACS Full desktop integration is achieved to enable the PACS workstation to access full RIS information The Electronic Patient Record (EPR) is “image-enabled” 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Conclusion Most configurations do not offer optimal integration Fully examine dataflow and workflow before making purchase decisions Require vendor accountability for system integration as part of the contracting process 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Buyer Beware! Does the system support bidirectional integration? Which system drives the radiologist workflow, the PACS, the RIS, or paper? Are radiology reports duplicated (or stored temporarily) in any system other than the RIS? Does the integration include desktop integration between the RIS and PACS and, if so, what level of desktop integration? Will paper be required for any part of the workflow (technologist, radiologist, report generation, etc.)? 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and links Buyer Beware! Does the PACS support DICOM queries and requests from third-party systems, including the RIS? How are dictation/report creation systems integrated? How are images verified (against the RIS directly or by a duplicated database)? Does the EPR support integration to third-party PACS viewing systems? 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message Level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and Links References and Links Boochever SS, HIS/RIS/PACS integration: getting to the gold standard, Radiology Management, 2004 May-Jun;26(3):16-24; quiz 25-7, [PMID: ] Nogah Haramati, MD, PACS and RIS: Approaches to Integration, Journal of Healthcare Information Management, vol. 14, no. 3, Fall 2000, HIMSS Kinsey TV, Horton MC, Lewis TE, Interfacing the PACS and the HIS: Results of a 5-year Implementation, Radiographics, 2000 May-Jun;20(3):883-91, [PMID: ] Mulvaney J, The case for RIS/PACS integration, Radiology Management, 2002 May-Jun;24(3):24-9, [PMID: ] Bellon E, Feron M, Deprez T, Integrating images into a central medical information system, Stud Health Technol Inform. 2002;93: [PMID: ] Worthy S, Rounds KC, Soloway CB, Strengthening your ties to referring physicians through RIS/PACS integration., Radiol. Manage Mar-Apr;25(2):18-22., [PMID: ] de Azevedo-Marques PM, Integrating RIS/PACS: the web-based solution at University Hospital of Ribeirao Preto, Brazil. J Digit Imaging Sep;17(3): Epub 2004 Jul 13., [PMID: ] Oosterwijk H., DICOM versus HL7 for modality interfacing., J Digit Imaging Aug;11(3 Suppl 1): Review., [PMID: ] 21st Iranian Congress of Radiology, Tehran, Jan, 2006

RIS/PACS Integration Introduction Benefits Radiologist Physician Technologist Clinic Patient Levels Physical Message Level Application Level Solutions Barriers Brokered Problems Data Mapping IHE Non-brokered Advantages Conclusion Buyers’ Guide References and Links References and Links Herman Oosterwijk, The seven levels of PACS integration, 2004, Keith Foord, A Powerful Tool in Advancing Healthcare – Picture Archiving and Communication System, 2000, Nicholas Joseph Jr., Introduction to Picture Archiving & Communication, 2004, Integrating the Healthcare Enterprise, John S. Webster, Solving the Data Sharing Dilemma, April 2005, Unified Architecture Means True PACS/RIS Integration, June 2004, RIS/PACS integration -- what is it and what are its benefits?, June 2003, _____________________________________________ Link to this presentation: RIS/PACS Integration, 21st Iranian Congress of Radiology, Tehran, Jan, 2006

21st Iranian Congress of Radiology CIS/HIS/RIS Solutions
RIS / PACS Integration 21st Iranian Congress of Radiology Tehran, Jan, 2006 Rayavaran Co. CIS/HIS/RIS Solutions

Rayavaran Co. RIS / PACS Integration CIS/HIS/RIS Solutions

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Rayavaran Co. RIS / PACS Integration CIS/HIS/RIS Solutions

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Presentation on theme: "Rayavaran Co. RIS / PACS Integration CIS/HIS/RIS Solutions"— Presentation transcript:

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