PACS (eBook)

PREFACE 8
CONTENTS 10
CONTRIBUTORS 14
INTRODUCTION 20
ORGANIZATION 22
INTRODUCTION TO RIS AND PACS 26
THE RADIOLOGY INFORMATION SYSTEM 30
THE PICTURE ARCHIVING AND COMMUNICATION SYSTEM 32
CONCLUSION 42
PACS STRATEGIC PLAN AND NEEDS ASSESSMENT 44
WHY DO YOU NEED A PACS STRATEGIC PLAN? 44
WHAT IS IN THE PACS STRATEGIC PLAN? 45
PACS STRATEGIC PLANNING: OPERATIONS 46
PACS STRATEGIC PLANNING: TECHNICAL 58
FINANCIAL ANALYSIS 60
CONCLUSION 61
CREATING THE PACS REQUEST FOR PROPOSAL AND SELECTING A VENDOR 62
RFP CONTENT 64
DISTRIBUTING THE RFP 82
VENDOR EVALUATION AND SELECTION PROCESS 82
NEGOTIATE THE CONTRACT 87
CONCLUSION 88
REFERENCE 88
REENGINEERING WORKFLOW: A FOCUS ON PERSONNEL AND PROCESS 90
ANALYZING WORKFLOW FROM THE PERSONNEL PERSPECTIVE 93
ANALYZING WORKFLOW FROM THE QUEUING PERSPECTIVE 102
THE ROLE OF QUALITY ASSURANCE IN WORKFLOW AND PRODUCTIVITY 106
CONCLUSION 108
REFERENCES 109
REENGINEERING WORKFLOW: THE RADIOLOGIST’S PERSPECTIVE 114
BACKGROUND 116
PREPARING FOR INTERPRETATION: WORKLISTS, ARCHIVE ACCESS, AND INITIAL DISPLAY 116
THE INTERPRETATION PROCESS 123
CHANGING THE REPORTING PARADIGM 127
THE EFFECT OF CHANGED RADIOLOGIST WORKFLOW ON ENTERPRISE INTERACTIONS 129
THE READING ROOM ENVIRONMENT AND WORKFLOW 133
AUDITING THE RADIOLOGIST WORKFLOW PROCESS 134
CONCLUSION 135
REFERENCES 136
FINANCIAL MODELING 142
ANALYSIS METHODS 142
RISKS OF PACS IMPLEMENTATION 148
INTERNAL RATE OF RETURN 150
BREAKEVEN ANALYSIS AND FIXED AND VARIABLE COSTS 152
COSTS 154
COST REDUCTION AND REVENUE ENHANCEMENT 155
COMPETITIVE IMPACT 160
REFERENCES 160
LEGAL ISSUES AND FORMAL POLICIES 162
THE CURRENT SITUATION 163
STANDARDS AND POLICIES OF PROFESSIONAL ORGANIZATIONS 165
GOVERNMENT REGULATIONS 171
RELATED LEGAL CONSIDERATIONS 180
CONCLUSION 184
REFERENCES 184
COMPUTER FUNDAMENTALS 190
INPUT 191
OUTPUT 192
MEMORY 192
PROCESSING 193
THE BUS 194
OPERATING SYSTEMS 195
COMPUTER LANGUAGES 196
APPLICATION PROGRAMS 197
CONCLUSION 198
DIGITAL IMAGING FUNDAMENTALS 200
WHY IMAGING? 201
DIGITAL IMAGES 201
SHADES OF GRAY 202
IMAGE PROCESSING 203
IMAGE ANALYSIS 204
IMAGE UNDERSTANDING 204
CONCLUSION 204
IMAGE ACQUISITION 206
INTRODUCTION TO IMAGE ACQUISITION 207
ACQUISITION OF THE NATIVE DIGITAL CROSS- SECTIONAL MODALITIES 211
ACQUISITION OF PROJECTION RADIOGRAPHY 213
QUALITY ASSURANCE AND QUALITY CONTROL FOR ACQUISITION 234
FUTURE TRENDS IN IMAGE ACQUISITION 237
CONCLUSION 239
REFERENCES 242
IMAGE COMPRESSION 246
IMAGE COMPRESSION TECHNOLOGIES 248
APPLICATION TO MEDICAL IMAGING 252
THE FUTURE 259
REFERENCES 262
PACS ARCHITECTURE 266
WHAT IS PACS ARCHITECTURE? 267
COMPARISON OF PACS ARCHITECTURES 274
MEDICAL- LEGAL ARCHIVE 279
SOLUTION REQUIREMENTS 283
NETWORKING FUNDAMENTALS 286
FOR REFERENCE: THE INTERNATIONAL ORGANIZATION FOR STANDARDIZATION MODEL 287
A SIMPLE NETWORK 288
FACTORS TO CONSIDER IN BUILDING A NETWORK 304
A REAL- WORLD EXAMPLE 306
PACS NETWORKS 308
FUTURE TRENDS 316
SERVERS AND OPERATING SYSTEMS 320
THE PACS CORE ( SERVERS) 321
DISASTER RECOVERY 327
OPERATING SYSTEM SECURITY AND POLICIES 329
PASSWORD CONSTRUCTION GUIDELINES 331
VIRUSES, TROJANS, AND WORMS 333
EDUCATION AND TRAINING 334
GLOSSARY 334
STORAGE AND ENTERPRISE ARCHIVING 336
HARD DRIVES 338
DISK ARRAYS AND INTERFACES 340
RELIABILITY AND CALCULATING MEAN TIME TO FAILURE 341
REDUNDANT ARRAY OF INEXPENSIVE DISKS 342
ROLE OF THE FILE SYSTEM 344
DIRECT ATTACHED STORAGE, STORAGE AREA NETWORKS, AND NETWORK ATTACHED STORAGE 345
GRID STORAGE 351
CONTENT ADDRESSABLE STORAGE 351
FOOD AND DRUG ADMINISTRATION AND STORAGE 353
NEAR- LINE TECHNOLOGY 353
ROLE OF THE HIERARCHICAL STORAGE MANAGER BETWEEN ONLINE AND NEAR- LINE STORAGE 356
CONCLUSION 357
ABBREVIATIONS 357
REFERENCES 359
SUGGESTED READING 360
IMAGE DISPLAYS 364
HISTORY 364
HOW MANY MONITORS? 366
PHYSICAL SIZE 367
RESOLUTION AND PIXEL PITCH 368
LUMINANCE 371
CALIBRATION 372
MOUNT 375
GRAPHICS CARDS 375
GRAYSCALE VERSUS COLOR AND MEDICAL GRADE VERSUS CONSUMER GRADE 378
OPERATING ROOM DISPLAYS 379
DISPLAY ERGONOMICS 379
DIGITAL MAMMOGRAPHY 380
IMAGE ACQUISITION 381
IMAGE RETRIEVAL 384
IMAGE DISPLAY 385
WORKSTATION DESIGN 387
INTERACTION BETWEEN MULTIPLE SYSTEMS 388
REFERENCES 388
WEB DISTRIBUTION 390
THE INTERNET 391
HOSPITAL- WIDE IMAGE DISTRIBUTION 393
COSTS 395
INFRASTRUCTURE 395
CLIENT 396
EXAMPLE: THE WEB EXPERIENCE AT MASSACHUSETTS GENERAL HOSPITAL 397
CONCLUSION 399
PACS WORKSTATION SOFTWARE 402
BACKGROUND AND DEFINITIONS 402
A BRIEF HISTORY 403
THE ROLES OF THE WORKSTATION 405
WORKSTATION HARDWARE 408
WORKSTATION SOFTWARE: SOFTWARE FOR OPERATIONS AND FUNCTIONS 409
THE USER INTERFACE: HISTORICAL BACKGROUND AND ANALYSIS 416
SYSTEM DESIGN CONSIDERATIONS 419
IMPLEMENTATION 424
WORKSTATION ENVIRONMENTS 434
CONCLUSION 443
REFERENCES 443
BREAST IMAGING, COMPUTER- AIDED DETECTION, AND COMPUTERASSISTED CLASSIFICATION 450
COMPUTER- AIDED DETECTION AND COMPUTER- ASSISTED CLASSIFICATION 452
PACS AND BREAST IMAGING 458
REFERENCES 460
THREEDIMENSIONAL IMAGING IN RADIOLOGY 464
CLINICAL THREE- DIMENSIONAL IMAGING SERVICES 468
THREE- DIMENSIONAL IMAGING SERVICE — STAFFING ISSUES 474
WHEN AND HOW TO CHARGE FOR THREE- DIMENSIONAL IMAGING 475
CONCLUSION 480
REFERENCES 480
VOICE RECOGNITION 484
HISTORY 485
ACCEPTANCE AND CONTINUED INTEREST 486
RESISTANCE TO ADOPTION 487
CURRENT OFFERINGS 487
COST SAVINGS 498
REPORT TURNAROUND 499
CONCLUSION 499
ORDER ENTRY IN RADIOLOGY 500
PRINCIPLES 501
DESIGN 502
ADVANTAGES 505
PROBLEMS 508
THE FUTURE 508
REFERENCES 509
DIGITAL TEACHING FILES AND EDUCATION 512
MEDICAL IMAGE RESOURCE CENTER 513
OTHER TEACHING FILE RESOURCES 517
SPECIFICATIONS FOR DEVELOPMENT OF TEACHING FILES 518
INTEGRATING THE HEALTHCARE ENTERPRISE TEACHING FILE INFORMATION EXPORT PROFILE 518
TYPES OF TEACHING CASES 520
WORKFLOW INTEGRATION 520
SHARING CASES WITH COLLEAGUES 520
MEDICAL IMAGE RESOURCE CENTER COMPATIBILITY 521
ELECTRONIC MEDICAL RECORD INTEGRATION 522
PERSISTENCE 523
ANONYMIZATION 523
DEPTH 524
QUALITY ASSURANCE 525
AUTHORING TOOLS 525
USER ROLES 526
POST- PROCESSING 527
IMAGING INFORMATICS EDUCATION 528
CONCLUSION 537
REFERENCES 537
TELERADIOLOGY 540
IMAGE ACQUISITION AND IMAGE DIGITIZATION 541
IMAGE COMPRESSION 543
IMAGE TRANSMISSION 546
IMAGE INTERPRETATION 547
ACCURACY OF TELERADIOLOGY 547
APPLICATIONS OF TELERADIOLOGY 550
MEETING THE GOALS OF TELERADIOLOGY 553
LEGAL AND SOCIOECONOMIC ISSUES 559
CONCLUSION 564
ACKNOWLEDGMENT 564
REFERENCES 564
APPENDIX 567
INDEX 578