Enterprise Imaging Blog

How to Build a Better Workflow with Advanced Functionality PACS
Alternate text Posted by Mark Bronkalla on 2/2/2015 11:15:45 AM

How to Build a Better Workflow with Advanced Functionality PACS
Remember the days when all you could do with a telephone was call people—and only then from home, work, or a public phone booth?
 
Thanks to the power of innovation, today we can not only make and receive calls, but we can also buy, spend, read, watch TV, turn on the lights, and carry out any number of other functions from our smartphones.
 
Take a look around and you’ll see that much the same thing is happening with picture archiving and communication systems (PACS) technology. The days of limited cache sizes, having to pre-fetch imaging studies in order to work with them, bouncing around from one work list to another, and time-consuming, labor-intensive manual entry of users’ privileges and preference settings are swiftly coming to a close. In their place, a new era has ushered in advanced functionalities.

PACS as a Plug-in to the VNA – iConnect® Enterprise Archive
With this combination you can have your cake and eat it too. The iConnect Enterprise Archive (VNA) delivers the most flexible and widely deployed VNA on the market. The iConnect Enterprise Archive “future proofs” your images and provides a unified archive—not just for Merge PACS™ , but also for the other existing PACS in your enterprise or those you may add in the future. With Merge PACS “plugged into” the iConnect Enterprise Archive, the need for a separate PACS cache disappears, eliminating the need to pre-fetch studies contained within the VNA because they are all immediately accessible with full fidelity. Better yet, most deployments now use the Enterprise Archive RCM (Replicated Content Management) functionality for a full second copy on the second VNA. The second VNA then hosts the Merge PACS contingency server. This configuration provides a fully redundant PACS architecture with no need for separate cache or any concern about how to access all of the prior comparisons during what would otherwise be a PACS “downtime” workflow. Supported by a contingency server, you keep running at full speed and functionality whether the cut over was caused due to hardware failure, software upgrade, or other events.

Composite Common Worklists
As a centralized workflow engine, the Merge PACS  worklist covers the breadth of your enterprise. However with hundreds or thousands of studies traversing the system that need to be read in a timely manner each day, getting the “right study” to the “right readers” is increasingly important. Remember: in a system covering 1.5 million studies per year there are 6000 studies to be read each day. Simply having a list that everyone pulls from or attempting to do “traffic cop” style worklist assignment it is not sufficient. Each of your readers has multiple, important tasks they need to accomplish in a given day. And those responsibilities often require readers to juggle too many simultaneous tasks—without adequate tools for success. They may have site-specific work such as interventions, sub-specialty reading such as neuro, studies that are assigned to them due to consultations, interventions, or simply referrer preference as well as sharing in the pool of general “body” reading. Composite worklist capabilities give your enterprise the ability to tune worklists to match the multiple concurrent roles of any given reading physician, eliminating the need to flip back and forth among three or four worklists. Instead, each user can combine the filters for these multiple roles into one comprehensive worklist that covers multiple roles, locations, and other criteria whether for reading radiologists, ER physicians, specialists, or other staff.

Templated User Management
Imagine sitting down as a new user of a PACS system completely ready to go, without any need for intervention by the system administrator or having to consult a startup configuration “cheat sheet.” Merge PACS Templated User Management enables new users to do just that.  In addition, the long-term user management is significantly easier for administrators. With Merge PACS template user management administrators can not only see the preference and privilege configuration of every user and group, but can also centrally manage them. The admin no longer has to rely on users actually following their recommendations for changes (which they often do not). The “dirty little secret” of the industry is that an admin might be tempted to login as that user, which would be a HIPAA and general security violation. With the central management of Merge PACS Templated User Management, administrators can securely make changes to individuals or thousands of users in one fell swoop. Of course before committing the changes the system does ask, “Are you sure?” This saves administrators countless hours and the risk of violating security protocols to make changes.

Enhanced Breast Tomosynthesis Viewing
3D breast imaging (Tomosynthesis) is a hot topic; it was recently highlighted by Time Magazine as the major medical advance of 2014. Most PACS cannot handle breast tomosynthesis images. Merge PACS can, and the viewing capabilities have been improved—adding thick slice/slab stack scroll viewing and a new stack position indicator. We are seeing a huge growth in tomosynthesis capable modality system deployments from both Hologic and GE among our customers. With Merge PACS you can use the same PACS workstation for everything including breast tomosynthesis reading. Using one PACS workstation simplifies workflow by putting all of the comparison studies immediately at your fingertips including conventional mammo, ultrasound, MR, and more. Tomosynthesis deployment plans are easier to deploy because you no longer have to weigh the cost and benefits of dedicated mammo reading workstations vs adding a few more tomosynthesis-capable modality devices.

While the breast tomosynthesis studies are on average 10 times larger than conventional mammo studies, Merge PACS takes this in stride with the Workflow Accelerator. It has the advantage of pre-caching the studies automatically to your workstation and—in the case of ad hoc viewing—the images are available to view as soon as the first one is downloaded; there is no need to wait for the entire study. With the lossless images cached locally on the workstation you can stack scroll though the slices at will even with a slow network connection.

Macros and DIY Desktop Integration Capabilities
Merge PACS 7.0 includes the ability to devise macros, this means implementing a string of tasks that otherwise would take multiple keystrokes or mouse clicks to accomplish. By leveraging macros and DIY desktop integration administrators can provide enhanced workflows and new application integration without having to budget for thousands of additional dollars in professional services configuration fees.  

You may read this post and think that capabilities like these go well beyond anything available in the marketplace today—or even in the next one to two years. In fact, however, these functionalities are available with Merge PACS 7.0, the latest iteration of Merge’s industry-leading PACS and iConnect Enterprise Archive, part of the iConnect solution suite.

 
Filed under: 7.0, PACS, Tomosynthesis, VNA

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