My Final CIS project.doc

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My Final CIS project.doc

  1. 1. The PAC System Andi Sherman CIS Spring 2004
  2. 2. Table Of Contents THE PAC SYSTEM................................................................................................1 A QUICK INTRO TO RADIOLOGY........................................................................1 WHAT IS A PACS?................................................................................................2 COMPONENTS OF THE PACS.............................................................................4 ADVANTAGES TO PACS......................................................................................6 PROBLEMS WITH THE PACS..............................................................................6 DOES PACS REALLY MAKE A DIFFERENCE?..................................................7 BIBLIOGRAPHY.....................................................................................................9 INDEX...................................................................................................................10
  3. 3. The PAC System The PACS system is used in the radiology and nuclear medicine departments of hospitals more and more today in place of regular radiology films. The PACS is a system of computers spread out through the departments of a hospital or other medical facility that uses radiology and is connected through a LAN or WAN. The images taken in radiology and nuclear medicine are stored on the Control Computer and then accessed throughout the facility. When radiologists are done using the images, they are archived for later access. PACS have both advantages and disadvantages to being installed in the radiology workspace. Both of these will be discussed along with the other previously mentioned topics in the following article about the PAC System. The PAC System A Quick Intro to Radiology
  4. 4. Page 2 Radiology is a fast growing area of the health profession in most hospitals and private clinics all over the US. With the ability to quickly diagnose such health issues as broken bones, cancer, and abnormalities of the soft tissues of the body, along with being able to use sonography to see a fetus in the womb and other tasks, radiology will soon be able to diagnose any health issue that a patient brings to a physician. As shown in the table above on the left, a total of 223,507 certified professionals hold 316,345 certificates in the many diverse fields of radiology. (Some professionals, such as my RS professor William Hennessey, hold more than one title and certificate) One of the newest technological advances in the radiology field is the introduction of the PACS. This new system has opened new doors for both technologists and the hospitals and clinics that employ them. What is a PACS? The PAC System was originally used for a radiology image management and display system but has now expanded and is used by other medical disciplines such as pathology, endoscopy, and many others. The PACS stands for Picture Archival and Number of Technologists certified by the ARRT in 2002 Radiography 212,72 0 Nuclear Medicine 10,746 Radiation Therapy 12,476 Cardiovascular-Interventional Technology 4,020 Mammography 43,720 Magnetic Resonance Imaging 11,854 Computed Tomography 19,545 Quality Management 1,252 Sonography 12
  5. 5. Page 3 Communication System. These technology systems allow medical images to be stored on compact optical disks rather than in large, costly, file rooms. It is also less costly in the long run than spending money on radiology films and all of the chemicals needed to develop the films. Also the space normally taken up by the development room can be replaced by the PACS computer system.The major components of a PACS system are: 1. Image acquisition system 2. Control Computer 3. Image Display work Stations 4. Image Archiving system 5. Computer network (LAN = local area network, WAN = wide area networks). Systems in the radiology department can take the needed radiograph, MRI, CT etc. and the information is immediately stored on the PACS optical disks to be accessed later. The different radiology systems that can utilize and access the PACS system are - MR scanner - CT scanner - Computed Radiography unit - Nuclear Medicine Cameras - PET scanner All of these imaging systems collect the images and then send their images to a control computer. From the control computer, the images can be accessed in the radiology department, in the ER or in any other department in the hospital that has a PACS computer.
  6. 6. Page 4 Components of the PACS The main component of the PACS is the control computer. The control computer is used to store the images taken during procedures and distribute them around the hospital when needed. The images can also be printed on film if a hard copy is needed for another facility or for reference in a facility outside the hospital (such as a private clinic). A good control computer should interface with the Radiology Information System (RIS) and the Hospital Information System (HIS). The control computer can be found in any of the departments of a hospital, but it will most likely be found in the radiology or nuclear medicine departments. All images can be accessed and viewed from the image display network stations like the one pictured below. The purpose of the image display work stations are to enable radiologists to make diagnoses on these images while viewing them on a computer screen. The monitors needed for these stations must be of a very high resolution. The minimum size of these monitors is 2048x2048 pixels. Sometimes one will find two monitors together in one workspace. This allows the radiologist to compare the two images, the most recent to the last image taken at a previous visit and shows any improvements that the patient may have made.
  7. 7. Page 5 For the Image Archiving system a PACS utilizes two different types of archive: short term and long term. The media chosen for the archive should reflect the speed with which the image data needs to be accessed. For short term archives, the type of media needed to archive the information would be RAIDs or redundant arrays of inexpensive disks. This is because short term archiving is rapid access, in which the information needs to be accessed quickly and has to be on hand whenever necessary. This would be used for patients that are repeatedly coming to the hospital to be scanned, such as patients going on chemotherapy. On the other hand, long term archives need not have such rapid access. This type of archiving is for images that can be stored over long periods of time and do not need to be accessed right away. The types of medias used for long term archiving are optical disks or a magnetic tape. The architecture of different PACS installations differs with respect to the archiving arrangements. These can be either centralised or local servers, or a combination of the two. All computers within the PAC system are connected to a network. This computer network facilitates the transmission of images to various areas within the radiology or nuclear medicine department. This network can be set up in other departments of the hospital and the images can then be transferred to the various parts of the hospital that would need to facilitate them in their studies on the patient. If other facilities outside of the hospital are connected to a network that is shared by the hospital’s PACS the images can then be transferred to the locations outside the department and also outside the
  8. 8. Page 6 hospital. Sometimes the images can be transferred over a large distance such as state to state. The term for the transmission of images over a distance is “teleradiology”. Advantages to PACS The implementation of PACS in the radiology workspace can provide many advantages for hospitals and clinics. PACS can offset expenses of film and related labor, reduce file room clerical FTEs (or File Transfer Errors), and eliminate the problem of lost film that results in lost revenue and repeat exams. Another advantage to having a PACS is the amount of space saved. Existing file rooms will decrease in size and new projects will require smaller file management areas when images are stored on file instead of on film. Having a PACS can also improve staff productivity because they will be better able to access images to diagnose results. Finally PACS will be able to simplify the operational workflow in diagnostic imaging services by automatically allowing access to images and reports which with then be simultaneously accessible to radiology and clinical staff. PACS will also improve the productivity of imaging devices because there is less time spent filming and processing studies – time which is then available to do additional procedures. Problems with the PACS One of the largest problems that arose with the PACS system is that there are many vendors providing medical imaging devices with different means of communication between the stations such as the ones pictured below. Because of the
  9. 9. Page 7 possibility of hospitals being unable to communicate with one another, a system of standards was developed in order to allow the different systems to communicate with each other and share the same images. “This problem was debated among the radiology community through the American College of Radiology (ACR) and in industry through the National Electrical Manufacturers Association (NEMA) In early 1983 the ACR-NEMA Digital Imaging and Communication Standards Committee was founded.”1 From this committee, a system called DICOM was created. DICOM stands for Digital Imaging and Communications in Medicine. This is now the industry standard for transferring medical images and information between electronic devices. Does PACS Really Make A Difference? According to the graph below, Consumer Trends research about the factors that are most important to patients when they select a hospital show that the highest percentage was the hospital having the latest and most high-tech equipment and technology. Not only is the PACS the most up-to-date and accommodating electronic system in the radiology and nuclear medicine departments today, it is also faster, easier and more efficient, both in cost and time management. The amount of money and space saved in using PACS instead of films and a developing room, could equal more money 1 From Picture Archiving Capture Systems PDF
  10. 10. Healthcare Consumer Trends Survey 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% LatestTechnology Courtesy ofHospitalStaff Variety ofSpecialists Physician Recom m endation CostofServices Close to Hom e Friend/Fam ily Recom m endation Religious Affiliation Factors Important to Selection of Hospital PercentofImportance Series1 Page 8 being spent on the radiology department as a whole and updating other technology and equipment.
  11. 11. Page 9 Bibliography www.uab.edu/radiography/Nmt421/picture_archiving_capture_systems.pdf www.raleighrad.com/pdf/pacs.pdf www.bshsi.com/tews/docs/TEWS.PACS%20Overview.pdf http://aicip.ece.utk.edu/publication/99scar.pdf http://www.gwhospital.com/p5581.html http://www.amershamhealth.com/medcyclopaedia/medical/Volume%20I/PACS.asp Picture_Archiving_Capture_Systems PDF
  12. 12. Page 10 Index A archive........................................................................5 C Computer................................................................1, 3 D data.............................................................................5 diagnostic....................................................................6 E equipment...................................................................7 F film.........................................................................4, 6 H hospital........................................................1, 3, 4, 5, 7 I images.....................................................1, 3, 4, 5, 6, 7 N network...............................................................3, 4, 5 P PACS...............................................1, 2, 3, 4, 5, 6, 7, 9 R radiology.............................................1, 2, 3, 4, 5, 6, 7 S system.....................................................1, 2, 3, 5, 6, 7
  13. 13. Page 10 Index A archive........................................................................5 C Computer................................................................1, 3 D data.............................................................................5 diagnostic....................................................................6 E equipment...................................................................7 F film.........................................................................4, 6 H hospital........................................................1, 3, 4, 5, 7 I images.....................................................1, 3, 4, 5, 6, 7 N network...............................................................3, 4, 5 P PACS...............................................1, 2, 3, 4, 5, 6, 7, 9 R radiology.............................................1, 2, 3, 4, 5, 6, 7 S system.....................................................1, 2, 3, 5, 6, 7

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