Evolvability of Medical Imaging Networking to the Hospital by mercy2beans115

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									                                                                            Evolvability of Medical Imaging Networking to the Hospital Information System



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   Evolvability of Medical Imaging Networking
       to the Hospital Information System
                                           Ennio Amori, Paride Lambertini, Matteo Berghenti
                                               Parma University Hospital, Parma, Italy




SUMMARY. ˜ÊœÀ`iÀÊ̜ʓ>˜>}iÊ`ˆ}ˆÌ>Êˆ“>}iÃÊ
>˜`ÊVˆ˜ˆV>Ê`>Ì>ʈ˜vœÀ“>̈œ˜Ê*>À“>Ê1˜ˆÛiÀÈÌÞÊ
i˜iÀ>ÊœÃ«ˆÌ>Ê…>ÃÊÀiVi˜ÌÞÊ>VVœ“«ˆÃ…i`Ê>Ê
>À}iʈ˜ÛiÃ̓i˜ÌÊvœÀÊ>Ê̜Ì>ÊÀi˜iÜ>Êœvʈ“>}ˆ˜}Ê
`ˆ>}˜œÃ̈VÊÃÞÃÌi“Ã]ʘiÌܜÀŽÊˆ˜vÀ>ÃÌÀÕVÌÕÀiÊ
>˜`ÊÜvÌÜ>Àiʈ˜vœÀ“>̈œ˜ÊÃÞÃÌi“ÊL>Ãi`ʜ˜Ê
º`iÊ v>V̜»Ê >˜`Ê º`iÊ ÕÀi»Ê Vœ““Õ˜ˆV>̈œ˜ÃÊ
ÃÌ>˜`>À`ðÊ/…iÊwÀÃÌÊÃÌ>}iʅ>ÃÊLii˜Ê̅iʈ˜ÃÌ>-
>̈œ˜ÊœvÊÀ>`ˆœœ}ÞÊÃÞÃÌi“Ê̜ʓ>˜>}iÊ`>Ì>Ê>˜`Ê
`ˆ}ˆÌ>Êˆ“>}iÃ]Ê̅i˜Ê̅iÊ}œL>Ê“i`ˆV>Êˆ“>}ˆ˜}Ê
˜iÌܜÀŽÊ…>ÃÊLii˜ÊiÝÌi˜`i`Ê܈̅ÊV>À`ˆœœ}ÞÊ
>««ˆV>̈œ˜°Ê/…iÊ>ÃÃiÌʅ>ÃÊLii˜Ê“iÀ}ˆ˜}Ê>˜`Ê
Å>Àˆ˜}Ê>ÊVœ““œ˜Ê“>˜>}i“i˜ÌÊ«À>V̈ViÊvœÀÊ
LœÌ…ʈ˜vœÀ“>̈œ˜ÊÃÞÃÌi“Ã]ʈ˜ÊÃÕV…ÊÜ>ÞʈÌÊ܈Ê
LiÊ «œÃÈLiÊ ÌœÊ i˜ÃÕÀiÊ >Ê vՏÊ >˜`Ê v՘V̈œ˜>Ê
ˆ˜Ìi}À>̈œ˜Ê>“œ˜}Ê`ˆvviÀi˜ÌÊ>««ˆV>̈œ˜ÃÊvÀœ“Ê
`ˆvviÀi˜ÌÊÛi˜`œÀðÊ/…iÊ՘ˆwV>̈œ˜Ê>˜`ÊÃÌ>˜-           Figure 1. Global G-PACS Logical diagram and data flow
`>À`ˆâ>̈œ˜ÊœvÊܓiÊv՘`>“i˜Ì>ÊÃÞÃÌi“ÃÊ>˜`Ê
v՘V̈œ˜ÃʏˆŽiÊ`ˆÃ>ÃÌiÀÊÀiVœÛiÀÞÊ«>˜]ÊL>VŽÊÕ«Ê       HL7 standards. At this time all ra-       well as dynamic electrophysiologi-
«œˆVÞ]ÊÃ̜À>}i]Ê܈Ê}Õ>À>˜ÌiiÊ>ÊÈ}˜ˆwV>˜ÌÊ         diological systems are working in to-     cal data. e nal goal is to guaran-
Ã>ۈ˜}]ʓœÀiÊLÕȘiÃÃÊ>˜`ÊÃiÀۈViÊVœ˜Ìˆ˜ÕˆÌÞÊ         tal direct digital mode supported by      tee a quick, safe and well-structured
>ÃÊÜiÊ>Ãʈ˜VÀi>Ãi`ÊÃ>viÌÞʈ˜ÊÌÀi>̓i˜ÌÊ>˜`Ê         an image and information sys-
Ã̜À>}iʜvÊ«>̈i˜ÌÊ`>Ì>°ÊÌÊ̅ˆÃÊÃÌ>}i]Ê̅iʈ“>}iÊ    tem (PACS/RIS) operational- PACS/RIS ARCHITECTURE
“>˜>}i“i˜ÌÊ ÃÞÃÌi“ÃÊ VœÕ`Ê LiÊ Vœ˜Ãˆ`iÀi`Ê           ly integrated with a Cardiolo- "1	
Ê,
"/
Ê,
1  /Ê-
,6
,Ê«ÀœÛˆ`iÃ\
“>ÌÕÀiÊ̜ÊvՏÊˆ˜Ìi}À>̈œ˜Ê܈̅ʫ>̈i˜ÌÊVi˜ÌÀi`Ê      gy PACS/CVIIS that receives UÊ "«Ìˆ“>ÊˆÃ>ÃÌiÀÊ,iVœÛiÀÞÊ*>˜]Ê	ÕȘiÃÃÊ
i*,°Êey words:                                       data and images from the fol-         
œ˜Ìˆ˜ÕˆÌÞ]Ê-iÀۈViÊ
œ˜Ìˆ˜ÕˆÌÞÊ>˜`Ê6œÕ“iÊ
                                                      lowing systems:                       Mirroring
                                                      J two direct digital sys- UÊ "˜Êˆ˜iÊÃ̜À>}iÊ­`œÕLiÊ- ʈ˜ÊwLiÀÊV…>˜-
£°Ê THE GLOBAL MEDICAL IMAGING                            tems for interventional           ˜i®ÊvœÀÊ£ÊÞi>ÀʜvÊ«Àœ`ÕV̈œ˜Ê­{Ê/	ÊÝÊÓ®
     
/7",                                             cardiology                   UÊ "˜Êˆ˜iÊÃ̜À>}iÊ­- ʈ˜Ê/ÊÌiV…˜œœ}Þ®ÊvœÀÊ{Ê
   In order to manage digital images                  J electrophysiology digital           Þi>ÀÃʜvÊ«Àœ`ÕV̈œ˜Ê­£ÈÊ/	®
and clinical data information Parma                       system                       UÊ "vvʏˆ˜iÊÃ̜À>}iʜ˜Ê`œÕLiÊ6ÊVœ«Þ
University General Hospital has re-                   J echocardiography imaging UÊ 	>VŽÊիʜ˜ÊÌ>«iʏˆLÀ>ÀÞ\Ê`>Ì>L>ÃiÃÊ>˜`Ê>«-
cently accomplished an investment of                      network.                          «ˆV>̈œ˜Ã
about US$15 million for a total re-                      As mentioned above all sys- UÊ Õ̜“>̈VÊ>˜`ÊÌÀ>˜Ã«>Ài˜ÌÊ`>Ì>Ê>˜`ʈ“>}-
newal of radiology and cardiology                     tems are logically linked and         iÃÊ>ˆ}˜“i˜ÌÊ>“œ˜}Ê̅iÊ`ˆvviÀi˜ÌÊÃ̜À>}iÊ
   diagnostic systems, network in-                    integrated, over DICOM and            ÃÞÃÌi“Ã
frastructure and software informa-                    HL7 standard, to share digital 

/
Ê 
/7",Ê ÌœÊ À>`ˆœœ}ÞÊ `>Ì>Ê yœÜ\Ê
tion system based on DICOM and                        images and data information as `œÕLiʏˆ˜iÊ܈̅ÊV>«>VˆÌÞÊ£Ê	Êi>V…


AIM 2009; 17(3): 165-167                                                                                            vol 17 no 3 SEPTEMBER 2009 165
Evolvability of Medical Imaging Networking to the Hospital Information System


                                                                                                 age, will guarantee a signi cant sav-
                                                                                                 ing, more business and service con-
                                                                                                 tinuity as well as increased safety in
                                                                                                 treatment and storage of patient data.
                                                                                                 practice, has proofed increased secu-
                                                                                                 rity and network uptime and better
                                                                                                 maintenance policy (Figure 2).
                                                                                                       is integration is DICOM and
                                                                                                 HL7 conformant and compliant.
                                                                                                 Particularly in the IHE framework
                                                                                                 publications (1,2,3) a close depen-
                                                                                                 dency of administrative and proce-
                                                                                                 dural work ow both in cardiology
                                                                                                 and in radiology is shown.
                                                                                                    At the present time radiology
                                                                                                 and cardiology work ows are com-
                                                                                                 pletely computerized and fully inte-
Figure 2. CVIIS –PACS-RIS Disaster Recovery Sharing
                                                                                                 grated with EHR informative sys-
access to patient data, consistent-                         e possibility to merge and share     tems (Hospital Information System
ly with an enterprise-wide language                   the disaster recovery plan, back up        (HIS), Production Analysis System,
and large data distribution. e in-                    devices and policies, CD/DVD pub-          Regional Cath-Lab Database).
tegration and full interoperability of                lishing systems of both applications          Next step will provide an evolu-
di erent medical imaging networks                     into a common management                   tion of the application adopting the
peculiar to specialized clinical needs,                  In such way it will be possible to      same architectural approach im-
should reach important objectives                     ensure a full and functional integra-      plemented in the CVIIS. e proj-
both clinical and economical:                         tion among di erent applications           ect will include all clinical resourc-
J reducing total investment and                       from di erent vendors (Federative          es (Surgery, Endoscopy, Pathology,
    maintenance costs                                 PACS).       e uni cation and stan-        Dermatology, Ophthalmology, etc)
                                                                                                 producing routine digital informa-
                                                                                                 tion such as images and videos lead-
                                                                                                 ing then to an enterprise-wide solu-
                                                                                                 tion: Global PACS (G-PACS).
                                                                                                    Since the beginning of this new
                                                                                                 renewal project the solution adopted
                                                                                                 and implemented has been to man-
                                                                                                 age all images in one common logi-
                                                                                                 cal structural archive, although safe-
                                                 Figure 4. Global PACS One centralized archive   ly redundant and clustered (Figure.
Figure 3. Distributed Archives
                                                                                                 3,4).
J   easing infrastructure networking                  dardization of some fundamental
    complexity                                        systems and functions like disaster        Ó°Ê 
,‡*
-Ê /
,


J improving the set of informa-                       recovery plan, back up policy, stor-         In respect to this process the ac-
    tion in support to the multidisci-
    plinary diagnosis and therapeutic
    capabilities
J increasing the quality and pro-
    ductivity with a dramatic reduc-
    tion of costs
J decreasing of time to access clini-
    cal information
      e rst approach towards an in-
tegrated network: CVIIS
   In gure 1 is shown the logical di-
agram and data ow among the dif-
ferent systems composing CVIIS.
      is architectural solution be-
tween PACS/RIS and CVIIS ensures
elevate business and service continu-
ity and volume mirroring with a well-
developed disaster recovery plan.
                                                      Figure 5. PACS Maturity Model (PMM) [5]


166 vol 17 no 3 SEPTEMBER 2009                                                                                   AIM 2009; 17(3): 165-167
                                                            Evolvability of Medical Imaging Networking to the Hospital Information System


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AIM 2009; 17(3): 165-167                                                                            vol 17 no 3 SEPTEMBER 2009 167

								
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