3. PACS Flashcards

1
Q

what does PACS stand for

A

picture archiving & communications system

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2
Q

what were the benefits of digitising medical data and waht are some examples

A
  • manage surge in patients
  • interoperability
  • continuity of care
  • efficiency of care

examples = medical imaging, OCR, voice recognition for dictation, lab reports etc

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3
Q

does a gamma camera work on a dead patient

A

no

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4
Q

what is DICOM

A

standard for handling, storing & printing info in medical imaging

also a file format def & network communications protocol

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5
Q

what are the PACs levels

A

dept, hospital, state

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6
Q

what is CMRGlu

A

cerebral metabolic rate of glucose consumption - used for dementia

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7
Q

what is EIR

A

enterprise imaging repository where patients can be searched and their imaging viewed

central repository across state-wide public hospitals

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8
Q

why do we need digitisation of medical data

A
  • manage the surge of patients
  • collect massive amounts of data
  • use data to improve standard of care
    -ageing population
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9
Q

what are some structural medical images

A

xray, OCT (optical coherence tomography), US

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10
Q

what are functional medical images,with examples

A

any medical image that examines changes in metabolism, blood flow, chemical consumption & absorption

cardiac MRI, functional MRI, dynamic PET

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11
Q

what is the diff between PET and CT

A

CT shows the anatomical structure while PET shows the physiology of a metabolic structure e.g. the blood supply of a tumour

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12
Q

what is an issue with all of the advancements in imaging

A

data explosion = multiple scans = more data
more sophisticated imaging * more patients =
PETs generate > 40TB of data a day (imagine the cost)

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13
Q

what is PACS purpose

A

storage & communication of imaging data

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14
Q

what does PACs integrate with

A

EMR (institute level/hospital)
also follows HL7

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15
Q

what are PACS features

A
  • standardisation (DICOM, HL7)
  • cost-effectiveness
  • fault tolerance
  • connectivity (multi-disciplinary teams can access their respective modalities)
  • architecture
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16
Q

what are the 4 levels of dicom data

A
  • patient
  • study
  • series (PET, CT)
  • image (CT has 128 slices)
17
Q

what is PMS

A

pharmacy management system

18
Q

why are big PACS vendors less popular

A

they have restrictive software, that makes data heterogeneous, whereas smaller companies are more open source so the imaging data can be more homogenous

19
Q

why are DICOM web-based viewers popular now

A

different images require different types of visualisations e.g. there are more greys in a radiologists visualisation, which may be different to a histologist, who needs more colours

20
Q

what is a PACS thick client model

A
  • stand-alone
  • images automatically sent to designated diagnostic & review WS
  • short term cache
21
Q

what is a PACS thin client model

A
  • client server
  • images centrally archived in PACS server
  • each client WS can access imaging from PACS
  • no local storage, images flushed after reading
22
Q

what is a PACS web based model

A
  • similar to client side but only a web browser is needed
  • hardware can be platform independent
  • viewed anywhere
  • limited functionality & performance
23
Q

describe the interaction between PACS & PHR

A
  • PHR can have links to the full PACS archive
  • image compression is lossless
  • includes diagnostic report with key images
24
Q

what is DICOM-SR & it’s purpose

A
  • DICOM structured reporting
  • rules for encoding, transmitting & storing imaging diagnostic reports
  • structured doc containing text and links to waveforms (ECG), spatial & temporal coordinates (pathology location), images
  • purpose is for it’s coding to enable integration with EHR
25
Q

image of DICOM-SR

A
26
Q

what is PACS customisation

A

the same software, with tuned features for a specific specialty. based on:
- patient volume
- number of interpretation areas
- diagnostic locations
- cost

27
Q

what is a major paradigm shift in PACS

A

vendor neutral archives (VNA):
- simplifies data migration issues
- inter-departmental data exchange
- long term enterprise wide storage

28
Q

Questions for Review

  1. A hospital has an existing EHR system and several other HISes. They wish to
    establish an on-site PACS for their radiology department that integrates
    with the existing infrastructure. Explain how this establishment and
    integration can be achieved?
  2. With the use of an example provide two benefits of Cloud PACS.
  3. You have been asked to design a new PACS solution for your hospital.
    Select your preferred solution (standalone or cloud), justifying your
    selection by contrasting the limitations of standalone PACS and Cloud
    PACS.
A