RSNA 2013 - SSM11 - Image Sharing

The RSNA Image Share Network: 20 Month Follow-up Results from a Pilot Site

An interesting presentation covered automatic rule-based deletion of data in PACS. Based on regulations and actual measurement of the use of older data (retrievel of data >1 yo was less then 5%) they deviced rule based deletion to free up space in PACS and reused the free space. This avoids vast  growth of the PACS database and saves money in the long run.

Strategies for Foreign Study Ingestion by a PACS Interfaced to a XDS Affinity Domain

Quebec (canada) has a regional XDS environment connecting all hospitals and clinics with a single registry for the whole province. There are three repositories with multiple hospitals pushing data to each of the repositories. The repositories take care of the central registration in the registry.

Problem they ran into was the lack of XDS-I consumer support by the PACS providers. Each hospital is fitted by a proxy which queries the registry and get the images from the repository. Subsequently data coercion (pat ID and acc nr correction) is performed and data stored in local PACS.

RSNA 2012 - IHE Image Sharing Demonstration

IHE Image Sharing Demonstration
PURPOSE/AIM
The IHE Image Sharing Demonstration will showcase developments in radiology informatics, standards-based interoperability and image sharing. The demonstration will include: Exchange The IHE Image Sharing Demonstration will showcase developments in radiology informatics, standards-based interoperability and image sharing. The demonstration will include: Exchange of medical images and reports using personal health record (PHR) accounts as in the RSNA Image Share pilot project, funded by the National Institute of Biomedical Imaging and Bioengineering (NIBIB). The image exchange architecture is based on the IHE Cross-enterprise Document Sharing for Imaging (XDS-I) profile.Patient radiation dose monitoring in local and national settings based on DICOM Dose Structure Reports (SRs) and the IHE Radiation Exposure Monitoring (REM) profile.Ordering and scheduling of radiology procedures using procedure names from the RSNA RadLex Playbook.Generation of radiology diagnostic reports using structured templates developed by the RSNA Reporting Committee and including RadLex terminology.Exporting image data exported from PACS using the IHE Teaching File and Clinical Trial Export (TCE) profile and using this data to author teaching files and processing of images for clinical trials using the RSNA MIRC software.

RSNA 2012 - ISP: Informatics (Image Sharing, Management and Display)

ISP: Informatics (Image Sharing, Management and Display)

SSA11-01 • 10:45 AM
Informatics Keynote Speaker: Image Sharing

Network based sharing, probably using cloud services, is mainly the replacement of the sneaker net (CD transfer) and comes with the same challenges. One has to be careful not to use tools that are used daily like Dropbox for patient related data sharing. Standards like XDR and XDM should be used to ensure safe transfer of patient data. Cloud services have to be standards based (IHE XDS.i) as implemented in the RSNA image sharing project. The exchange is based in a money transfer system where the patient gets an eight digit code and password. With these codes the patient can access the data and grant access to healthcare providers.

SSA11-02 • 10:55 AM
The RSNA’s Image Sharing Project: Initial Challenges from the Patients’ Perspective
Yousaf Awan et al

Traditionally patients are not involved in data sharing. The push to patient centered healthcare lead to the implementation of the RSNA image sharing project where the patient has control over his/her own data. Inability to access their images was the biggest issue with the current system looking at the helpdesk calls. In general, not many problems occurred.

SSA11-03 • 11:05 AM
Outcomes of an Automated System of Importation of Outside Imaging Studies into the Radiology Information System
Jonelle Marie Petscavage et al 

Patient data from CDs is uploaded decentrally and recorded in RIS and PACS. Sending AE title is set to 'OUTSIDE CD'. The error rate was less than 1%. interesting report, check our publications by van Ooijen et al in the Journal of Digital Imaging where we demonstrated something similar quite some years ago (free fulltext available)

SSA11-04 • 11:15 AM
Introducing Intuitive Simplicity in a New Type of Browser-based Dicom-Viewer for Non-Radiologists' Daily Clinical Routine
Sebastian Bickelhaupt et al

Many users are presented with non intuitive viewers that either have too much or too little functionality. The new viewer presented by this group is based on the body regions on an anatomic picture of a human. A model of human anatomy is given with colored dots on the model where the color indicates the modality and the datasets are shown next to it. After selecting the dataset of interest the DICOM data is shown and direclt connected to a 3D anatomical atlas. They showed that the new prototype speeds up and simplifies DICOM image viewing.

SSA11-05 • 11:25 AM
Influence of Medical Display System on Productivity and Eye-strain of Radiologists
Mony Weschler et al

This group compared setups with two 3MP screens to one 6MP screen both from Barco. Factors like eyestrain are evaluated using a questionnaire. It is show by this study that 6MP provides significantly less eyestrain and higher reading speeds. Although this is only based on manual registration of findings by the radiologists on a questionnaire.

Health and Technology 2012 - Better care by secure data sharing

Presentation by two employees of NEN, the Dutch normalization institute. Medical technology and data sharing are getting more a joined issue. Legislation for medical technology/ devices is in place or developed, but legislation for medical data sharing are not specified yet. There are multiple standards and legislation relevant for medical devices and data sharing such as standards and legislation for ICT, quality and risk management, EU legislation, information exchange, apps and social media. Currently, projects are ongoing nationally and internationally to provide an overview of the available standards (e.g. By Nictiz in the Netherlands).

An important issue is that software is regarded to be a medical device and should apply to the legislation. The NEN has developed a decision tree to determine whether the software is a medical device or not.

This means that most software used in healthcare should be confirming to the guidelines and thus be tested and validated. To determine if software should be regarded tot be a medical device, the Intended use of the software is an important issue. The risk level of the software will dictate the requirements for approval.

These risk levels are:
1. No injury or damage to health is possible.
2. Non serious injury is possible.
3. Death or serious injury is possible.

Go to www.hat-congres.nl for acces to the presentations of the conference

Cross enterprise data sharing

In radiology the data sharing between healthcare enterprises is a growing challenge and concern. Large amounts of CDs and DVDs are being shipped daily with big problems concerning the handling, viewing, upload, etc. Health Imaging has published a short article about 5 tips for optimizing image sharing. It is worth to read for those involved.

How Secure Is Cloud-based Image Sharing?

Check out this entry on the security of cloud-based image sharing on Diagnostic Imaging.
They state that interest in cloud-based image sharing has swelled in recent months. The topic has appeared on national conference agendas, and a growing number of vendors now offer clients the ability to transfer images anywhere worldwide. But the rising popularity of sending images via the Internet doesn’t mean everyone in the radiology industry is comfortable with the idea.
I a poll Diagnostic imaging did they found that 70% of respondents are concerned about the security of cloud-based image sharing. Two major concerns are: Will images viewed through the cloud be of high enough quality to render a diagnosis, and will a cloud sharing system protect the large number of patient images effectively?
In this article they discuss these issues with some of the vendors that have cloud-based image sharing on the market today.

RSNA: IHE Image Sharing Demo

During RSNA, the IHE has an image sharing demo demonstrating the application of IHE profiles with a large number of different vendors that connect to each other and RSNA software.

In this demonstration they show how IHE can be employed to enhance clincal care by sharing information under patient control using personal health records. Doing this improves radiation safety and facilitates radiological research and aducation by appropriate sharing of images and related data.

Implementing the IHE profiles should also reduce costs by eliminating the need of publishing paper and CDs or DVDs both for patient care and clinical research.

For links to the documentation related to this demonstration see my earlier, pre-RSNA post on this topic.