PACS - A Guide to the Digital Revolution

PREFACE

CONTENTS

CONTRIBUTORS

INTRODUCTION

ORGANIZATION

INTRODUCTION TO RIS AND PACS

THE RADIOLOGY INFORMATION SYSTEM

THE PICTURE ARCHIVING AND COMMUNICATION SYSTEM

CONCLUSION

PACS STRATEGIC PLAN AND NEEDS ASSESSMENT

WHY DO YOU NEED A PACS STRATEGIC PLAN?

WHAT IS IN THE PACS STRATEGIC PLAN?

PACS STRATEGIC PLANNING: OPERATIONS

PACS STRATEGIC PLANNING: TECHNICAL

FINANCIAL ANALYSIS

CONCLUSION

CREATING THE PACS REQUEST FOR PROPOSAL AND SELECTING A VENDOR

RFP CONTENT

DISTRIBUTING THE RFP

VENDOR EVALUATION AND SELECTION PROCESS

NEGOTIATE THE CONTRACT

CONCLUSION

REFERENCE

REENGINEERING WORKFLOW: A FOCUS ON PERSONNEL AND PROCESS

ANALYZING WORKFLOW FROM THE PERSONNEL PERSPECTIVE

ANALYZING WORKFLOW FROM THE QUEUING PERSPECTIVE

THE ROLE OF QUALITY ASSURANCE IN WORKFLOW AND PRODUCTIVITY

CONCLUSION

REFERENCES

REENGINEERING WORKFLOW: THE RADIOLOGIST’S PERSPECTIVE

BACKGROUND

PREPARING FOR INTERPRETATION: WORKLISTS, ARCHIVE ACCESS, AND INITIAL DISPLAY

THE INTERPRETATION PROCESS

CHANGING THE REPORTING PARADIGM

THE EFFECT OF CHANGED RADIOLOGIST WORKFLOW ON ENTERPRISE INTERACTIONS

THE READING ROOM ENVIRONMENT AND WORKFLOW

AUDITING THE RADIOLOGIST WORKFLOW PROCESS

CONCLUSION

REFERENCES

FINANCIAL MODELING

ANALYSIS METHODS

RISKS OF PACS IMPLEMENTATION

INTERNAL RATE OF RETURN

BREAKEVEN ANALYSIS AND FIXED AND VARIABLE COSTS

COSTS

COST REDUCTION AND REVENUE ENHANCEMENT

COMPETITIVE IMPACT

REFERENCES

LEGAL ISSUES AND FORMAL POLICIES

THE CURRENT SITUATION

STANDARDS AND POLICIES OF PROFESSIONAL ORGANIZATIONS

GOVERNMENT REGULATIONS

RELATED LEGAL CONSIDERATIONS

CONCLUSION

REFERENCES

COMPUTER FUNDAMENTALS

INPUT

OUTPUT

MEMORY

PROCESSING

THE BUS

OPERATING SYSTEMS

COMPUTER LANGUAGES

APPLICATION PROGRAMS

CONCLUSION

DIGITAL IMAGING FUNDAMENTALS

WHY IMAGING?

DIGITAL IMAGES

SHADES OF GRAY

IMAGE PROCESSING

IMAGE ANALYSIS

IMAGE UNDERSTANDING

CONCLUSION

IMAGE ACQUISITION

INTRODUCTION TO IMAGE ACQUISITION

ACQUISITION OF THE NATIVE DIGITAL CROSS- SECTIONAL MODALITIES

ACQUISITION OF PROJECTION RADIOGRAPHY

QUALITY ASSURANCE AND QUALITY CONTROL FOR ACQUISITION

FUTURE TRENDS IN IMAGE ACQUISITION

CONCLUSION

REFERENCES

IMAGE COMPRESSION

IMAGE COMPRESSION TECHNOLOGIES

APPLICATION TO MEDICAL IMAGING

THE FUTURE

REFERENCES

PACS ARCHITECTURE

WHAT IS PACS ARCHITECTURE?

COMPARISON OF PACS ARCHITECTURES

MEDICAL- LEGAL ARCHIVE

SOLUTION REQUIREMENTS

NETWORKING FUNDAMENTALS

FOR REFERENCE: THE INTERNATIONAL ORGANIZATION FOR STANDARDIZATION MODEL

A SIMPLE NETWORK

FACTORS TO CONSIDER IN BUILDING A NETWORK

A REAL- WORLD EXAMPLE

PACS NETWORKS

FUTURE TRENDS

SERVERS AND OPERATING SYSTEMS

THE PACS CORE ( SERVERS)

DISASTER RECOVERY

OPERATING SYSTEM SECURITY AND POLICIES

PASSWORD CONSTRUCTION GUIDELINES

VIRUSES, TROJANS, AND WORMS

EDUCATION AND TRAINING

GLOSSARY

STORAGE AND ENTERPRISE ARCHIVING

HARD DRIVES

DISK ARRAYS AND INTERFACES

RELIABILITY AND CALCULATING MEAN TIME TO FAILURE

REDUNDANT ARRAY OF INEXPENSIVE DISKS

ROLE OF THE FILE SYSTEM

DIRECT ATTACHED STORAGE, STORAGE AREA NETWORKS, AND NETWORK ATTACHED STORAGE

GRID STORAGE

CONTENT ADDRESSABLE STORAGE

FOOD AND DRUG ADMINISTRATION AND STORAGE

NEAR- LINE TECHNOLOGY

ROLE OF THE HIERARCHICAL STORAGE MANAGER BETWEEN ONLINE AND NEAR- LINE STORAGE

CONCLUSION

ABBREVIATIONS

REFERENCES

SUGGESTED READING

IMAGE DISPLAYS

HISTORY

HOW MANY MONITORS?

PHYSICAL SIZE

RESOLUTION AND PIXEL PITCH

LUMINANCE

CALIBRATION

MOUNT

GRAPHICS CARDS

GRAYSCALE VERSUS COLOR AND MEDICAL GRADE VERSUS CONSUMER GRADE

OPERATING ROOM DISPLAYS

DISPLAY ERGONOMICS

DIGITAL MAMMOGRAPHY

IMAGE ACQUISITION

IMAGE RETRIEVAL

IMAGE DISPLAY

WORKSTATION DESIGN

INTERACTION BETWEEN MULTIPLE SYSTEMS

REFERENCES

WEB DISTRIBUTION

THE INTERNET

HOSPITAL- WIDE IMAGE DISTRIBUTION

COSTS

INFRASTRUCTURE

CLIENT

EXAMPLE: THE WEB EXPERIENCE AT MASSACHUSETTS GENERAL HOSPITAL

CONCLUSION

PACS WORKSTATION SOFTWARE

BACKGROUND AND DEFINITIONS

A BRIEF HISTORY

THE ROLES OF THE WORKSTATION

WORKSTATION HARDWARE

WORKSTATION SOFTWARE: SOFTWARE FOR OPERATIONS AND FUNCTIONS

THE USER INTERFACE: HISTORICAL BACKGROUND AND ANALYSIS

SYSTEM DESIGN CONSIDERATIONS

IMPLEMENTATION

WORKSTATION ENVIRONMENTS

CONCLUSION

REFERENCES

BREAST IMAGING, COMPUTER- AIDED DETECTION, AND COMPUTERASSISTED CLASSIFICATION

COMPUTER- AIDED DETECTION AND COMPUTER- ASSISTED CLASSIFICATION

PACS AND BREAST IMAGING

REFERENCES

THREEDIMENSIONAL IMAGING IN RADIOLOGY

CLINICAL THREE- DIMENSIONAL IMAGING SERVICES

THREE- DIMENSIONAL IMAGING SERVICE — STAFFING ISSUES

WHEN AND HOW TO CHARGE FOR THREE- DIMENSIONAL IMAGING

CONCLUSION

REFERENCES

VOICE RECOGNITION

HISTORY

ACCEPTANCE AND CONTINUED INTEREST

RESISTANCE TO ADOPTION

CURRENT OFFERINGS

COST SAVINGS

REPORT TURNAROUND

CONCLUSION

ORDER ENTRY IN RADIOLOGY

PRINCIPLES

DESIGN

ADVANTAGES

PROBLEMS

THE FUTURE

REFERENCES

DIGITAL TEACHING FILES AND EDUCATION

MEDICAL IMAGE RESOURCE CENTER

OTHER TEACHING FILE RESOURCES

SPECIFICATIONS FOR DEVELOPMENT OF TEACHING FILES

INTEGRATING THE HEALTHCARE ENTERPRISE TEACHING FILE INFORMATION EXPORT PROFILE

TYPES OF TEACHING CASES

WORKFLOW INTEGRATION

SHARING CASES WITH COLLEAGUES

MEDICAL IMAGE RESOURCE CENTER COMPATIBILITY

ELECTRONIC MEDICAL RECORD INTEGRATION

PERSISTENCE

ANONYMIZATION

DEPTH

QUALITY ASSURANCE

AUTHORING TOOLS

USER ROLES

POST- PROCESSING

IMAGING INFORMATICS EDUCATION

CONCLUSION

REFERENCES

TELERADIOLOGY

IMAGE ACQUISITION AND IMAGE DIGITIZATION

IMAGE COMPRESSION

IMAGE TRANSMISSION

IMAGE INTERPRETATION

ACCURACY OF TELERADIOLOGY

APPLICATIONS OF TELERADIOLOGY

MEETING THE GOALS OF TELERADIOLOGY

LEGAL AND SOCIOECONOMIC ISSUES

CONCLUSION

ACKNOWLEDGMENT

REFERENCES

APPENDIX

INDEX