1. Iguana
Interface Engine
Synapse PACS
Synapse RIS PowerScribe 360
NextGen EHR
Clinicas Modality
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Palms Imaging Center and Clinicas
HL7 Interfaces and Workflow
1 - A Patient is registered in the NextGen EHR and then
an Order is created. An ORM (Order) message is sent
from NextGen via the Rosetta Interface to the Iguana
Interface Engine.
2 - Iguana forwards the ORM (Order) message to the
Synapse RIS. The RIS uses the data from the ORM
(Order) message to either Create or Update the Patient
and to Create or Cancel the Order. The RIS interfaces
also prepend the leading characters “CLI” to the
PatientID, to indicate the Patient is from Clinicas.
3 - The RIS sends ADT (Patient Demographic) and ORM
(Order) messages to Iguana.
4 - Iguana forwards the ADT (Patient Demographic) and
ORM (Order) messages to both the Synapse PACS and
PowerScribe 360. The ADT (Patient Demographic)
messages either Create or Update the Patient and the
ORM (Order) messages either Create or Cancel the
Study in the PACS or the Order in PowerScribe.
5 - The Clinicas Modality sends Images to the PACS.
The Images match to the PACS Study based on
Accession Number sent via the Images DICOM Header.
The Clinicas Radiology Technician has to enter the
PatientID (i.e. “123456"), the Patient Name and the
Accession Number (i.e. “PALM123”) prior to sending the
Images. A Custom DICOM Script has been applied on
the PACS that adds the leading “CLI” to the PatientID
before the Images attempt to store in the PACS.
6 - The PACS sends an ORM (Image Status Notification)
message to Iguana.
7 - Iguana forwards the ORM (Image Status Notification)
message to the RIS.
8 – The Reading Radiologist interprets the Images and
creates a Report in PowerScribe. Then an ORU (Report)
message is sent to Iguana.
9 - Iguana forwards the ORU (Report) message to the
RIS.
10 - The RIS sends an ORU (Report) message to
Iguana.
11 - Iguana forwards the ORU (Report) message to the
PACS and the NextGen EHR via the Rosetta Interface.
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