Medical Records on a Huge Scale

displaystorage

Image Processing

RadiologyRadiology

Clinic/Hospital <-> Radiology

• Connect patient data

• What do we need to connect?

Clinic/Hospital <-> Radiology

• Connect patient data• What do we need to connect?

– History– Physicians– Test results– Interpretations

Clinic/Hospital <-> Radiology

• Connect patient data• What do we need to connect?

– History - Text– Physicians - Network– Test results - Text & Images– Interpretations - Text

History• A 54 yr old woman has a head & chest

injury from an automobile accident. She is confused and complains of dizziness, partial blindness & headache.

• At ED registration she is entered into the Hospital Information System (HIS) and assigned a medical record number.

• ED takes her vital signs and sends her to Radiology.

History• First she goes to x-ray, where she

has a chest x-ray, (2 4096x4096 images)

X-ray

ADC Compact Digitizer

• Small footprint• Cassette buffers: 10 in, 10

out• Automated reading, hands

free• High productivity, no

waiting• High res option• Full 12bit raw data

delivered to processor

ADC Compact Digitizer

• Standard resolution (2x2.5K matrix):– 6 pixels/mm on 35x43cm, 35x35cm– 9 pixels/mm on 18x24cm, 24x30cm

• Optional high resolution (3x4K matrix):– 9 pixels/mm on 35x43cm, 35x35cm

• Grayscale resolution 12bit/pixel

ADC image plates

• Available sizes:– 35x43cm (14x17”)– 35x35cm (14x14”)– 24x30cm– 18x24cm– 8x10”– 10x12”– 15x30cm dental

(in development)

ID software• Records patient and exam data

(“menu”) onto cassette memory• Menu drives subsequent

autoprocessing of image• Runs on PC or Sun• Customizable data fields• ID and Preview software can run

in synergy on same PC or Sun

Connecting software

• Rislink Toolkit: demographic data input from RIS systems

• Autorouting software: linking destinations to exam menus

• Softcopy Toolkit: image output to non-DICOM PACS systems

• DICOM store connection

Quality monitoring tools

• Test phantom set: geometrical and contrast test objects

• Auto QC Software: automatic measuring and report generating from test phantom exposures

Diagnostic applications

• All plain x-ray exams:thorax bucky/bedside, skeleton, abdomen, contrast, uro/tomo, pediatric, etc...

• Special exams:dental panoramic, full leg/full spine

• Not yet supported:mammography

CT scan• Then she goes to CT, where she

gets a head scan (20x2 512x512 images)

• and a chest scan (40x2 512x512 images).

CT Chest

History• The x-ray and CT are normal.

• How much data has she accumulated so far and how many people have looked at her studies?

US- Blood flow• Now to ultrasound where she has a

carotid Doppler study performed (4 64x64 color images).

US

Doppler US

MRI• And then an MRI of her head ( 8 x

20 256x256 images)

MRI

History• By now she is asleep. Her last report

shows a history of stroke so although the MRI is negative the neurologists want to start TPA therapy…

• At this point she regains consciousness and it is revealed that she has been misidentified. What went wrong?

What does the system look like?

• HISCommunicate by HL7

• RISCommunicate by DICOM

• PACS