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Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
Technological development of PACS installations in Italy Paolo ...
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Technological development of PACS installations in Italy Paolo ...

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  • 1. 1 HOSPITAL NETWORKSHOSPITAL NETWORKS Paolo InchingoloPaolo Inchingolo DEEI - Dipartimento di Elettrotecnica, Elettronica ed Informatica,DEEI - Dipartimento di Elettrotecnica, Elettronica ed Informatica, University of TriesteUniversity of Trieste CRSTBS - Centro Ricerche e Studi Tecnologie Biomediche eCRSTBS - Centro Ricerche e Studi Tecnologie Biomediche e Sanitarie, Area Science Park, TriesteSanitarie, Area Science Park, Trieste 2.nd European Summer School on Telemedicine2.nd European Summer School on Telemedicine TELEIMAGING IN MEDICINETELEIMAGING IN MEDICINE Udine, Italy, 24-28 September 1997Udine, Italy, 24-28 September 1997
  • 2. 2 The development ofThe development of Picture Archiving & CommunicationPicture Archiving & Communication Systems (PACS)Systems (PACS) installations in Italyinstallations in Italy and of their integration withand of their integration with Radiological Information Systems (RIS)Radiological Information Systems (RIS) andand Hospital Information Systems (HIS)Hospital Information Systems (HIS)
  • 3. 3 EARLY PACS INSTALLATIONS INEARLY PACS INSTALLATIONS IN ITALYITALY 1987: the development of PACSs in Italy1987: the development of PACSs in Italy initiated with some delay with respect to otherinitiated with some delay with respect to other countries in Europecountries in Europe in few years Italy became the country inin few years Italy became the country in Europe with the greatest number of commercialEurope with the greatest number of commercial PACS systemsPACS systems 1988: the first system - an AT&T CommView1988: the first system - an AT&T CommView PACS - was installed by Philips at the LocalPACS - was installed by Philips at the Local Health Unit of Trieste, in the Istituto diHealth Unit of Trieste, in the Istituto di Radiologia of the University of Trieste.Radiologia of the University of Trieste.
  • 4. 4 Trieste: the first ItalianTrieste: the first Italian PACS installationPACS installation main system located in themain system located in the Radiology Department ofRadiology Department of the University of Triestethe University of Trieste at the Cattinara Hospitalat the Cattinara Hospital a second, slave system,a second, slave system, installed at the Radiologyinstalled at the Radiology Service of Maggiore Hospital.Service of Maggiore Hospital. 1990: the two sub-systems1990: the two sub-systems inter-operated correctly byinter-operated correctly by means of a protocol-dedicatedmeans of a protocol-dedicated 2 Mb/s leased line, by using a2 Mb/s leased line, by using a proprietary At&Tproprietary At&T communication protocolcommunication protocol Frame Grabber AT&T CommView internal network Frame Grabber 2 Mb/s leased line Istituto di Radiologia Univ. of Trieste Cattinara Hospital Service of Radiology USL 1 Triestina Maggiore Hospital
  • 5. 5 the EC AIM project onthe EC AIM project on PACS EvaluationPACS Evaluation 1989: the EC promoted the AIM Project1989: the EC promoted the AIM Project «Operational Evaluation and Basic«Operational Evaluation and Basic Requirements for Prospective Evaluation ofRequirements for Prospective Evaluation of PACS Technology»PACS Technology» – main contractor:main contractor: PhilipsPhilips – Italian partners:Italian partners: Research Park of TriesteResearch Park of Trieste University of FlorenceUniversity of Florence University of L'AquilaUniversity of L'Aquila ItalsielItalsiel
  • 6. 6 growing of commercial PACSgrowing of commercial PACS installations in Italyinstallations in Italy The AIM projectThe AIM project andand the positive results coming fromthe positive results coming from the evaluation of the first PACSthe evaluation of the first PACS installation of Triesteinstallation of Trieste stimulated and supported the rapidstimulated and supported the rapid growth of other sevengrowth of other seven Philips/AT&T CommviewPhilips/AT&T Commview installations in Italyinstallations in Italy AT&T CommView
  • 7. 7 PACS installations in ItalyPACS installations in Italy during early 1990’sduring early 1990’s CITY SITE SUPPLIER YEAR Trieste Cattinara Hospital Univ. of Trieste Philips/AT&T Commview 1988 Bologna Maggiore Hospital Philips/AT&T Commview 1990 Ferrara Sant'Anna Hospital Philips/AT&T Commview 1990 L'Aquila Collemaggio Hospital Univ. of L'Aquila not commercial 1990 Trieste Maggiore Hospital Philips/AT&T Commview 1990 Messina Messina Hospital Philips/AT&T Commview 1991 Bari Mater Dei Clinic Philips/AT&T Commview 1992 Castelfranco Castelfranco Hospital Philips/AT&T Commview 1992 Milano S. Paolo Hospital Philips/AT&T Commview 1992 Monza S. Gerardo Hospital Philips/AT&T Commview 1992
  • 8. 8 The non-commercial PACS at L’AquilaThe non-commercial PACS at L’Aquila 1987-1990: a non-commercial PACS/RIS1987-1990: a non-commercial PACS/RIS system was developed by thesystem was developed by the Istituto diIstituto di Radiologia of the University of L'AquilaRadiologia of the University of L'Aquila 1990: the PACS system was made operative1990: the PACS system was made operative at the Collemaggio Hospital of L'Aquila.at the Collemaggio Hospital of L'Aquila. differently from the commercialdifferently from the commercial systems, this system used standardsystems, this system used standard protocols at all levels:protocols at all levels: EthernetEthernet DECNETDECNET ACR-NEMAACR-NEMA
  • 9. 9 PACS CommviewPACS Commview external communicationsexternal communications in Italian installationsin Italian installations Most of the Commview PACSMost of the Commview PACS Italian installations worked (andItalian installations worked (and till work today) essentiallytill work today) essentially inside the protocol-proprietaryinside the protocol-proprietary optical-fiber network in theoptical-fiber network in the radiology departmentsradiology departments Sometimes they operated alsoSometimes they operated also on anon an external but dedicated Ethernet network, by using:Ethernet network, by using: – an AT&T Gateway andan AT&T Gateway and – quite expensive AT&T Resultsquite expensive AT&T Results Viewing Stations (RVS).Viewing Stations (RVS). AT&T CommView internal network AT&T RVS private Ethernet AT&T RVS AT&T CommView PACS Gateway
  • 10. 10 PACS Commview externalPACS Commview external communications in Italian installationscommunications in Italian installations 1992, at Trieste:1992, at Trieste: a joint research program ofa joint research program of the Unit of Trieste of the National Group ofthe Unit of Trieste of the National Group of Bioengineering at the DEEI - Dipartimento diBioengineering at the DEEI - Dipartimento di Elettrotecnica, Elettronica ed Informatica ofElettrotecnica, Elettronica ed Informatica of the University of Triestethe University of Trieste andand the Centro Ricerche e Studi Tecnologiethe Centro Ricerche e Studi Tecnologie Biomediche e Sanitarie at the Research Park ofBiomediche e Sanitarie at the Research Park of TriesteTrieste the AT&T Commview Gateway at the Istitutothe AT&T Commview Gateway at the Istituto di Radiologia was connected to the Cattinaradi Radiologia was connected to the Cattinara Hospital optical-fiber networkHospital optical-fiber network GNBTS Gruppo Nazionale di Bioingegneria del CNR Unità di Trieste
  • 11. 11 Trieste: Cattinara Hospital RadioloyTrieste: Cattinara Hospital Radioloy services with the "Commview PACS"services with the "Commview PACS" ISO/OSI compliant Remote access to PACSISO/OSI compliant Remote access to PACS Development of Open and Versatile ToolsDevelopment of Open and Versatile Tools for Remote Multi-Platform Workstationsfor Remote Multi-Platform Workstations – 1992:1992: XRISXRIS - X-Window Remote Image Station- X-Window Remote Image Station – 1993:1993: ARISARIS - Autonomous Remote Image Station- Autonomous Remote Image Station – 1994:1994: SRISSRIS - Integration with Stereotactic Neurosurgery- Integration with Stereotactic Neurosurgery – 1995:1995: HRISHRIS - HTML/HTTP browser- HTML/HTTP browser Frame Grabber MS-DOS/Windows PC WorkStation Unix WorkStation X-RIS Image Server AT&T CommView PACS Gateway AT&T CommView internal network Stereotactic Neurosurgery CT MRI USs WSs hospital clinics surgery rooms
  • 12. 12 WAN-availability in Trieste ofWAN-availability in Trieste of Pacs Commview imagesPacs Commview images 1990:1990: the Cattinara Hospital network wasthe Cattinara Hospital network was connectedconnected (with access-lists to assure security and privacy)(with access-lists to assure security and privacy) – to the high-speed Metropolitan Area Network of theto the high-speed Metropolitan Area Network of the SIST (Sistema Informatico Scientifico Triestino) andSIST (Sistema Informatico Scientifico Triestino) and – to the SISR (the Regional Health IP WAN of theto the SISR (the Regional Health IP WAN of the Regione Friuli Venezia Giulia)Regione Friuli Venezia Giulia) 1992:1992: The PACS archive was made available toThe PACS archive was made available to all the hospitals of Trieste and also to any otherall the hospitals of Trieste and also to any other site on the network, by means of:site on the network, by means of: – Unix- or PC-based remote client stationsUnix- or PC-based remote client stations (XRIS,ARIS)(XRIS,ARIS) – [1995][1995] a WWW gateway and browsersa WWW gateway and browsers (HRIS)(HRIS)
  • 13. 13 Trieste & Regione FVG: MAN and WANTrieste & Regione FVG: MAN and WAN Radiology services with the "Commview" PACSRadiology services with the "Commview" PACS Cattinara Hospital SIST Metropolitan Area Network Maggiore Hospital County Network Router router PACS WS Hospital Network router router Other SIST’s sites Remote Hospital router County Personal Data Server HTML Browser Hospital Network PACS WS HTML Browser SISR County Health Network IRCCS "Burlo Garofolo" PACS WS Hospital Network HTML Browser Clients WSs: • XRIS • ARIS • HRIS • SRIS
  • 14. 14 NEW PACS PROJECTS, DEVELOPMENTSNEW PACS PROJECTS, DEVELOPMENTS AND INSTALLATIONSAND INSTALLATIONS mid 1990’s:mid 1990’s: with few exceptions, thewith few exceptions, the newnew projects, developments and installationsprojects, developments and installations ofof PACSs in Italy startedPACSs in Italy started in hospital sites andin hospital sites and research centers differentresearch centers different from those of thefrom those of the first PACS installations.first PACS installations. This may be partially due to the inherentThis may be partially due to the inherent difficulty for most of the sites to integratedifficulty for most of the sites to integrate the PACS systems of the first generationthe PACS systems of the first generation with the open and standard environment ofwith the open and standard environment of our days.our days.
  • 15. 15 as in most of the world, a transitionas in most of the world, a transition – from the concept of the (closed) PACS systemfrom the concept of the (closed) PACS system just collecting all the images within a radiologyjust collecting all the images within a radiology departmentdepartment – to the concepts ofto the concepts of » open and standard systemsopen and standard systems » integrated health care environmentsintegrated health care environments » world-wide remote consultation and exchange ofworld-wide remote consultation and exchange of imagesimages » network image processingnetwork image processing » combined processing and integration ofcombined processing and integration of morphological and functional (e.g. EEG maps)morphological and functional (e.g. EEG maps) images.images. there has been also in Italythere has been also in Italy
  • 16. 16 The National Project of TelemedicineThe National Project of Telemedicine 8 themes8 themes 1.st theme:1.st theme: create integrated and integrablecreate integrated and integrable information systems for the hospitalinformation systems for the hospital managementmanagement 3.rd theme:3.rd theme: develop and build-up adevelop and build-up a system for acquisition and processing ofsystem for acquisition and processing of radiological digital images and a system forradiological digital images and a system for the diagnostic support.the diagnostic support. 5.rd theme:5.rd theme: develop a telematic system fordevelop a telematic system for the management of a cardiology departmentthe management of a cardiology department
  • 17. 17 National ProjectNational Project of Telemedicineof Telemedicine 3° Theme3° Theme duration:duration: August 1995 - March 1998August 1995 - March 1998 1.st sub-theme:1.st sub-theme: a system for thea system for the acquisition, management, archiving andacquisition, management, archiving and transmission of radiological imagestransmission of radiological images 2.st sub-theme:2.st sub-theme: > systems for diagnosis support> systems for diagnosis support > systems for reporting support> systems for reporting support
  • 18. 18 development:development: by some Italian industriesby some Italian industries and by some scientific centersand by some scientific centers DIEDIE IROEIROE coordinated bycoordinated by DII CSMNDII CSMN
  • 19. 19 experimentation:experimentation: by five clinic centers:by five clinic centers: – Dip. di Fisiopatologia Clinica - Univ. of FlorenceDip. di Fisiopatologia Clinica - Univ. of Florence – Ist. di Radiologia - Univ. of PisaIst. di Radiologia - Univ. of Pisa – Ist. di Radiologia - Univ. "La Sapienza" of RomIst. di Radiologia - Univ. "La Sapienza" of Rom – Centro di Medicina Nucleare - CNR of NapleCentro di Medicina Nucleare - CNR of Naple – Servizio di Radiodiagnostica - Ist. Naz. deiServizio di Radiodiagnostica - Ist. Naz. dei Tumori of MilanTumori of Milan
  • 20. 20 Telemed networkTelemed network TUSCANA MAN The five clinic centersThe five clinic centers are connected:are connected: to the Tuscanato the Tuscana MANMAN oror to the GARRto the GARR Italian NetworkItalian Network GARR GARR
  • 21. 21 Metropolitan & Regional tele-Metropolitan & Regional tele- radiology at the Dipartimento diradiology at the Dipartimento di Radiologia of PisaRadiologia of Pisa metropolitan tele-radiology betweenmetropolitan tele-radiology between the hospitals Santa Chiara and Cisanello in Pisathe hospitals Santa Chiara and Cisanello in Pisa regional tele-radiology between theregional tele-radiology between the – dept. of Cardiology of the Santa Chiara Hospital indept. of Cardiology of the Santa Chiara Hospital in Pisa andPisa and – dept. of Radiology of the Careggi Hospital atdept. of Radiology of the Careggi Hospital at FlorenceFlorence Geographical communications are made by usingGeographical communications are made by using the Metropolitan Area Network linking Pisa andthe Metropolitan Area Network linking Pisa and FlorenceFlorence
  • 22. 22 Metropolitan & Regional tele-radiologyMetropolitan & Regional tele-radiology at Pisa and Florenceat Pisa and Florence Images are essentially stored on a "modular" PACSImages are essentially stored on a "modular" PACS simply made by an Ethernet interconnection of thesimply made by an Ethernet interconnection of the imaging modalities, using DICOM or other proprietaryimaging modalities, using DICOM or other proprietary protocols.protocols. PISA MAN FLORENCE MAN 34 MB/s 140 MB/s 140 MB/s S. Chiara Hospital Cisanello Hospital Careggi Hospital IFC CNR
  • 23. 23 The SPERIGEST ProjectThe SPERIGEST Project at the IFC-CNR of Pisaat the IFC-CNR of Pisa oct. 1996: the IFC of CNR at Pisa, as Aziendaoct. 1996: the IFC of CNR at Pisa, as Azienda Ospedaliera CREAS-IFC, startsOspedaliera CREAS-IFC, starts SPERIGESTSPERIGEST a ”special program” of the Ministry of Healtha ”special program” of the Ministry of Health with the collaboration of ItalTBS - Research Parkwith the collaboration of ItalTBS - Research Park of Triesteof Trieste duration: 24 monthsduration: 24 months the project utilizes the connection facilities of thethe project utilizes the connection facilities of the Tuscana MANTuscana MAN
  • 24. 24 The SPERIGEST ProjectThe SPERIGEST Project at the IFC-CNR of Pisaat the IFC-CNR of Pisa the aim of the projectthe aim of the project is an integrated systemis an integrated system collectingcollecting – clinical componentsclinical components – administrativeadministrative componentscomponents – governmentgovernment componentscomponents within a Health localwithin a Health local unit.unit. integrated clinic card: • data and signals from labs of CREA-IFC • data and signals from clinics of CREA-IFC • clinical chemistry • hemodynamics • ecography • nuclear medicine • PET • holter • ECG • ergonometry • etc.
  • 25. 25 The PACS/RIS system at the Dep. of RadiologyThe PACS/RIS system at the Dep. of Radiology II of the University "La Sapienza" of RomII of the University "La Sapienza" of Rom A PC-based PACS/RIS system with hypermediaA PC-based PACS/RIS system with hypermedia capabilities has been recently developed,capabilities has been recently developed, installed and evaluated.installed and evaluated. The PACS section is being upgradedThe PACS section is being upgraded to a Unix-based system from Imationto a Unix-based system from Imation The system supportsThe system supports – schedulingscheduling – recordingrecording – examinationexamination – reportingreporting – statisticsstatistics – system administrationsystem administration – image archiving of secondaryimage archiving of secondary caption images from video orcaption images from video or scanning.scanning.
  • 26. 26 Center for Biomedical ApplicationsCenter for Biomedical Applications of CRS4 at Cagliariof CRS4 at Cagliari development of WWW-Intranet baseddevelopment of WWW-Intranet based techniques:techniques: W-MED:W-MED: an electronic patient record system thatan electronic patient record system that allows to securely view clinical information including:allows to securely view clinical information including: – medical imagesmedical images – datadata – signals associatedsignals associated with individual patientswith individual patients Wolviz:Wolviz: a medical 3D visualization systems.a medical 3D visualization systems.
  • 27. 27 Trieste - The DPACS projectTrieste - The DPACS project 1996:1996: following the previous experience, a largefollowing the previous experience, a large project called DPACS (Data and Picture Archivingproject called DPACS (Data and Picture Archiving and Communication System) has been startedand Communication System) has been started Aim of the project:Aim of the project: develop andevelop an open systemopen system forfor the archiving and remote consultation ofthe archiving and remote consultation of radiological imagesradiological images as well as of otheras well as of other data anddata and signalssignals.. Final goal:Final goal: offer aoffer a citizen's virtually integratedcitizen's virtually integrated clinical cardclinical card available toavailable to all the populationall the population of theof the Provincia of Trieste, through the networkProvincia of Trieste, through the network at anyat any hospital and private health sitehospital and private health site
  • 28. 28 The DPACS ProjectThe DPACS Project Data & Picture Archiving and Communication SystemData & Picture Archiving and Communication System Replacement of current PACS SystemReplacement of current PACS System Full HIS-RIS-PACS IntegrationFull HIS-RIS-PACS Integration Medical Records Access from any locationMedical Records Access from any location » Intra-Hospital servicesIntra-Hospital services » MAN and WAN interoperabilityMAN and WAN interoperability Support for DICOM andSupport for DICOM and non-DICOM devicesnon-DICOM devices WAN
  • 29. 29 The DPACS ProjectThe DPACS Project Data & Picture Archiving and Communication SystemData & Picture Archiving and Communication System Heterogeneous Medical Data StorageHeterogeneous Medical Data Storage Three-level Hierarchical Data StorageThree-level Hierarchical Data Storage Relational/Distributed DataBase EngineRelational/Distributed DataBase Engine Multi-platform Client-Server architectureMulti-platform Client-Server architecture HTML SQL DICOM
  • 30. 30 DPACS Cattinara Hospital NetworkDPACS Cattinara Hospital Network Cattinara Hospital Hospital Router Other Departments DPACS Server CT MR US DPACS WS HIS/RIS Server switch DICOM WS DPACS WS & Frame Grabber repeater HTTP Server Printer Radiology Department ATM 10 BASE T 100 BASET SIST Metropolitan Area Network SISR FVG County Health Network
  • 31. 31 The DPACSThe DPACS ProjectsProjects GNBTS Gruppo Nazionale di Bioingegneria del CNR Unità di Trieste Azienda Ospedaliera "Ospedali Riuniti" Trieste I.R.C.C.S. Istituto per l'Infanzia «Burlo Garofolo» dDipartimento di Elettrotecnica Elettronica ed Informatica R&D Group Clin.&Econ. Eval. Group Target Institutions
  • 32. 32 the DPACS project: industrial collaborationsthe DPACS project: industrial collaborations INSIEL S.p.A. joined R&D and key production HW support & and wide area telematics experimentation DPACS integration with no-standard environments and DICOM testing transfer to cardiology of DPACS potentialities and functionalities market study and user-matched integration of radiological PACSs with local and geographical HIS systems virtual integrated health card and PACS/RIS/HIS integration in FVG and other Italian counties •integration of legacy-protocol- oriented administrative services with Intranet client/server systems •high performance health networking
  • 33. 33 The DPACS projectThe DPACS project in the Regione FVGin the Regione FVG The Government of the Regione FriuliThe Government of the Regione Friuli Venezia Giulia, has considered strategicVenezia Giulia, has considered strategic that thethat the model of the DPACS projectmodel of the DPACS project isis extended, with suitable adaptations, to theextended, with suitable adaptations, to the the health integration of all the countythe health integration of all the county Some experimental integrations have beenSome experimental integrations have been programmed by the regional committe ofprogrammed by the regional committe of health care communication:health care communication: – DPACS (Trieste)DPACS (Trieste) – Regional Cardio-NetRegional Cardio-Net – PACS/RIS (Aviano, PN)PACS/RIS (Aviano, PN) – Telepatology-Net (Udine)Telepatology-Net (Udine)
  • 34. 34 SISR -SISR - FVG Regional HealthFVG Regional Health NetworkNetwork WAN Backbone (1996)WAN Backbone (1996) 4500M 40004500M 4500M 4500M AGS+ LAN SISR 193.42.75.0 Rete di ASS 3, ASS 5 e Udinese Rete ass 2 del Goriziano Rete ASS 2 del Monfalconese 64 K 64 K 256 K 128 K Rete della ASS 1 Rete del Pordenonese INSIEL S.p.A. end of 1997: upgrade to a private regional Cisco/Stratacom-based ATM backbone
  • 35. 35 SISR -SISR - FVG Regional Health NetworkFVG Regional Health Network WAN Backbone of Provincia di Pordenone (1996)WAN Backbone of Provincia di Pordenone (1996) INSIEL S.p.A. 2501 4000 4500M 2501 1005 1005 2000 2501 1005 4500M LAN CED Pordnenone SISR 3000 4000 2503 IGS/R Routers di backbone del CED di Pordenone Router di backbone del CED di Trieste Ospedale di S. Vito ASS 4 Pordenone via Vecchia Ceramica Ospedale Spilimbergo Ospedale Maniago 19,2 K 128 K CRO Aviano 19,2 K 64 K Osp. Pn ACT Osp. Pn Amm. 1 Osp. Pn Amm. 2 Osp. Pn Radiologia Pn - v. Interna Radiologia Ospedale di Pordenone router di backbone 64 K int. 64 K int. 19,2 K int. 19,2 K 19,2 K 19,2 K int.
  • 36. 36 Centro Riferimento OncologicoCentro Riferimento Oncologico CRO of Aviano (Pordenone, FVG)CRO of Aviano (Pordenone, FVG) 1995-1996: A large commercial1995-1996: A large commercial PACS of the new generation,PACS of the new generation, developed by Philips has beendeveloped by Philips has been installed at the Department ofinstalled at the Department of Radiology of CRORadiology of CRO The PACS has been integratedThe PACS has been integrated with the Insiel RISwith the Insiel RIS It is connected to the SISR WANIt is connected to the SISR WAN A first experience of radiologicalA first experience of radiological regional cooperation/consultingregional cooperation/consulting with the DPACS Project atwith the DPACS Project at Trieste through the SISRTrieste through the SISR Regional Network is startingRegional Network is starting INTURISINTURIS image andimage and information managementinformation management systemsystem DPACSDPACS INSIEL S.p.A. RIS SISR networkSISR network DICOM SQL
  • 37. 37 The FVG Health Network:The FVG Health Network: a look to a possible near futurea look to a possible near future ISDN o commutata ISDN o commutata PRESIDI SANITARI ENTE PUBBLICO SAN. RETE GARR PERMANENT FVG REGIONAL ATM & ATM-like BACKBONE (health virtual circuits) REGIONE F.V.G. Agenzia Regionale Sanità UNIVERSITA’ di TRIESTE MEDICINA+INGCLIN UNIVERSITA’ di UDINE MEDICINA AZIENDA OSPEDALIERA COMUNE ALTRO ENTE PUBBLICO AMBULATORIO MEDICO CONVENZ. RETI COMMERCIALI AREA DI RICERCA DI TRIESTE CIVAB-CRSTBS AZIENDA SERV. SANIT. IRCCS BURLO GAROFOLO RUPA AZIENDA OSPEDALIERAAZIENDA OSPEDALIERAAZIENDA OSPEDALIERAAZIENDA OSPEDALIERA AZIENDA SERV. SANIT.AZIENDA SERV. SANIT.AZIENDA SERV. SANIT.AZIENDA SERV. SANIT. COMUNE COMUNE COMUNE COMUNE AMBULATORIO MEDICO CONVENZ. PRESIDI SANITARIPRESIDI SANITARIPRESIDI SANITARIPRESIDI SANITARI ISDN SERVIZI (farmacie,ecc)SERVIZI (farmacie,ecc)SERVIZI (farmacie,ecc) 1996: ~200 routers 1997: ~450 routers
  • 38. 38 DPACS <--> SSICDPACS <--> SSIC Italian AgreementsItalian Agreements extensionsextensions integrationintegration collaborationscollaborations of the DPACS project to other Italian sites can beof the DPACS project to other Italian sites can be feasible thanks to the 18 agreements of didacticfeasible thanks to the 18 agreements of didactic and research collaboration signed by the SSIC -and research collaboration signed by the SSIC - the post-graduate School of Clinicalthe post-graduate School of Clinical Engineering of Trieste with hospital, companiesEngineering of Trieste with hospital, companies and institutions in all Italy:and institutions in all Italy:
  • 39. 39 Formal agreementsFormal agreements Area di Ricerca di TriesteArea di Ricerca di Trieste Azienda Ospedaliera «OspedaleAzienda Ospedaliera «Ospedale Niguarda Ca' Grande», MilanoNiguarda Ca' Grande», Milano Azienda Ospedaliera «S. Maria degliAzienda Ospedaliera «S. Maria degli Angeli», PordenoneAngeli», Pordenone Azienda Ospedaliera di BolognaAzienda Ospedaliera di Bologna Azienda Ospedaliera di ForlìAzienda Ospedaliera di Forlì Azienda Ospedaliera di PadovaAzienda Ospedaliera di Padova Azienda Ospedaliera di TriesteAzienda Ospedaliera di Trieste Azienda per i Servizi Sanitari n.1Azienda per i Servizi Sanitari n.1 Triestina, TriesteTriestina, Trieste Azienda per i Servizi Sanitari n.16 diAzienda per i Servizi Sanitari n.16 di ModenaModena Azienda Sanitaria USL Centro-Sud -Azienda Sanitaria USL Centro-Sud - BolzanoBolzano Azienda USL n. 2 di LuccaAzienda USL n. 2 di Lucca CRSTBS, TriesteCRSTBS, Trieste INSIEL S.p.A., Trieste and UdineINSIEL S.p.A., Trieste and Udine IRCCS “Casa Sollievo dellaIRCCS “Casa Sollievo della Sofferenza”, San Giovanni RotondoSofferenza”, San Giovanni Rotondo (Foggia)(Foggia) IRCCS Ospedale Infantile "BurloIRCCS Ospedale Infantile "Burlo Garofolo” , TriesteGarofolo” , Trieste IRCCS «San Raffaele», Milano (to beIRCCS «San Raffaele», Milano (to be signedsigned)) Istituto di Fisiologia Clinica delIstituto di Fisiologia Clinica del C.N.R., PisaC.N.R., Pisa ITALTBS S.p.A., TriesteITALTBS S.p.A., Trieste Unità Locale Socio-Sanitaria n. 7,Unità Locale Socio-Sanitaria n. 7, Pieve di Soligo (Treviso)Pieve di Soligo (Treviso)
  • 40. 40 Other Italian PACS/RIS and teleradiologyOther Italian PACS/RIS and teleradiology new or future installations in depts. of radiologynew or future installations in depts. of radiology Bolzano, Azienda Sanitaria USL Centro-Sud:Bolzano, Azienda Sanitaria USL Centro-Sud: – AGFA Digital Radiology with distributedAGFA Digital Radiology with distributed DICOMDICOM WSsWSs – Siemens PACS system, intra- & inter-hospitalsSiemens PACS system, intra- & inter-hospitals Ravenna+Feanza+Lugo di Romagna (Regione ER), ASS:Ravenna+Feanza+Lugo di Romagna (Regione ER), ASS: – Imation teleradiology systemImation teleradiology system Lodi (Milano), ASS:Lodi (Milano), ASS: – Imation PACS archive manager integrated with RISImation PACS archive manager integrated with RIS Tortona, ASS:Tortona, ASS: – Imation PACS archive manager + digitizerImation PACS archive manager + digitizer Rome, University "La Sapienza":Rome, University "La Sapienza": – Imation PACS archive manager integrated with RISImation PACS archive manager integrated with RIS

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