1. 醫學影像儲存及傳輸系統 PACS

2. 自我介紹 奇美醫院─醫學工程師─兩年 台南市立醫院─醫工組組長─四年 成大資訊所─視覺系統實驗室 友信行─PACS專員─一年
多種醫學影像融合研究、物件化程式設計、電腦繪圖及網路架構
專利─心導管室微電腦汽球清洗機

3. PACS vs. IMACS PACS(Picture Archiving and Communication System)
A computer system for storing and retrieving radiology images, then making them available, with reports, on a high speed DICOM network, in web format on the hospital Intranet and even Internet, with data security.

4. PACS vs. IMACS IMACS(Image Management And Communication System)
This has come to mean more than PACS. It includes not only radiology images, but other  images of patients as well: histopathology, endoscopes, dermatology photographs etc. The images are labeled (have a header file) which follows the DICOM standard to allow seamless dissemination to hospital computers and printers or even to other hospitals.

5. Why PACS? Filmless﹝無片化﹞ Optimal Workflow﹝工作流程最佳化﹞ 節省時間﹝流程電腦化﹞
降低費用﹝藥水、膠片、空間及人工﹞
增高空間利用率﹝儲片空間﹞
Optimal Workflow﹝工作流程最佳化﹞
Prefetch
Autorouting

6. From this….
….to this

7. From this…..

8. X-Ray Exam without PACS
Patient
Registered
Previous Exams
hung in Reading
Room
Patient Data
Re-Entered
at Acq Device
Exam Performed
Develop
Film
Quality
Assurance
Hang
Films
Radiologist Read
Dictate & Approve
Un-Hang Films
& Attach Report
Re-assemble
Film Jacket
Send Films &
Report to Referring
Physician
Retrieve Films &
Report to Referring
Physician
Return Films
to File Room

9. …..to this

10. X-Ray Exam with PACS Patient Registered Exam Performed
Radiologist Read
Dictate & Approve
Referring Physician
Accesses Report
and Films

11. PACS Workflow(GE) ─集中式
Exam Ordered
Exam Sched.
Patient Exam Performed
Web Distribution to Referring Physicians
Modality Worklist Demographics Downloaded
Images Transferred in STS
RIS
Images Copied on Web Server
Order Event
Prefetch Exams from Storage
Images/ Prior Reports
PACS Worklist Updated
IMS/Archive
Exam Read
Dictated Status
Preliminary Status
Final Report Available
Report Verified
Exam Transcribed
Within Radiology
Outside Radiology

12. PACS Workflow(GE) ─集中式
Exam Ordered
Exam Sched.
Patient Exam Performed
Web Distribution to Referring Physicians
Modality Worklist Demographics Downloaded
Images Transferred in STS
RIS
Images Copied on Web Server
Order Event
Prefetch Exams from Storage
Images/ Prior Reports
PACS Worklist Updated
IMS/Archive
Exam Read
Dictated Status
Preliminary Status
Final Report Available
Report Verified
Exam Transcribed
Within Radiology
Outside Radiology

13. PACS Workflow(GE) ─集中式
Exam Ordered
Exam Sched.
Patient Exam Performed
Web Distribution to Referring Physicians
Modality Worklist Demographics Downloaded
Images Transferred in STS
RIS
Images Copied on Web Server
Order Event
Prefetch Exams from Storage
Images/ Prior Reports
PACS Worklist Updated
IMS/Archive
Exam Read
Dictated Status
Preliminary Status
Final Report Available
Report Verified
Exam Transcribed
Within Radiology
Outside Radiology

14. PACS Workflow(GE) ─集中式
Exam Ordered
Exam Sched.
Patient Exam Performed
Web Distribution to Referring Physicians
Modality Worklist Demographics Downloaded
Images Transferred in STS
RIS
Images Copied on Web Server
Order Event
Prefetch Exams from Storage
Images/ Prior Reports
PACS Worklist Updated
IMS/Archive
Exam Read
Dictated Status
Preliminary Status
Final Report Available
Report Verified
Exam Transcribed
Within Radiology
Outside Radiology

15. PACS Workflow(GE) ─集中式
Exam Ordered
Exam Sched.
Patient Exam Performed
Web Distribution to Referring Physicians
Modality Worklist Demographics Downloaded
Images Transferred in STS
RIS
Images Copied on Web Server
Order Event
Prefetch Exams from Storage
Images/ Prior Reports
PACS Worklist Updated
IMS/Archive
Exam Read
Dictated Status
Preliminary Status
Final Report Available
Report Verified
Exam Transcribed
Within Radiology
Outside Radiology

16. PACS Workflow(GE) ─集中式
Exam Ordered
Exam Sched
Patient Exam Performed
Web Distribution to Referring Physicians
Modality Worklist Demographics Downloaded
Images Transferred in STS
RIS
Images Copied on Web Server
Order Event
Prefetch Exams from Storage
Images/ Prior Reports
PACS Worklist Updated
IMS/Archive
Exam Read
Dictated Status
Preliminary Status
Final Report Available
Report Verified
Exam Transcribed
Within Radiology
Outside Radiology

17. PACS Workflow(SIEMENS)
分散式
HIS Terminal
RIS
PACS Data Management & Storage
Archive & Secondary Archive
ADT
Bidirectional Communication
Archiving
Prefetch of Images & Reports
DICOM Worklist
Report & Sign Off
Image transfer to RAID
Modality
Image distribution (2)
Image Transfer to Reporting
Reporting Workstation
Image distribution (1)
Viewing Workstation
System Monitoring

18. What’s PACS? 儲存系統(Archiving system) 傳輸系統(Communication system) 集中式或分散式
容量的規劃
影像壓縮的大小
傳輸系統(Communication system)
網路頻寬
網路協定
Prefetch
Autorouting

19. PACS 規 劃 策 略 圖 PACS Strategy 產品 (Product) 市場 (Marketing) 知識
(Knowledge) 客戶
(Customer)
MagicView 300
MagicView 1000
MagicView Mondo
MagicStore
MagicWeb
MagicLink
MagicWatch
MagicSAS
ACOM,INTURIS,LANTIS...
SIENET 網路
(TCP/IP,Protocol,Physic...)
影像規格
(DICOM,JPEG,TIFF,BMP,MPEG... )
作業系統
(WIN NT,UNIX,LINUX...)
PACS
(Scale,Product Character...)
DICOM
(Modality,Workstation,Server...)
HL7
(Connection with RIS & HIS)
專案管理
競爭廠商產品及規模
中文化需求
市場預估
各醫院之專責單位 對象
﹝醫師，醫工，資訊，放射科
... ﹞
協力廠商
教育訓練
﹝網路，協定，專案管理
互信及合作
PACS 規 劃 策 略 圖 軟體
(XML,Java,Database...)

20. What knowledge you should know
建立網路概念
了解何謂DICOM/HL7
DICOM(Digital Imaging and COmunications in Medicine)
HL7(Health Level 7)
IHE(Integrated Healthcare Enterprise)
徹底了解各科的工作流程
了解何謂HIPAA
HIPAA(Health Insurance Portability and Accountability Act)
如何做專案管理