PACS / Image Management Systems

Question 1

PACS

Answer 1

Picture Archiving and Communications System

Question 2

What are the primary functions of PACS?

Answer 2

to store, distribute, and display digital medical images

Question 3

How does a good PACS system add value to a facility?

Answer 3

It adds improvements to diagnostic capability and operational efficiency

Question 4

When and by whom was PACS first conceptualized?

Answer 4

1972

Dr. Richard Steckel

Question 5

When and where was the first large-scale PACS system implemented?

Answer 5

University of Kansas in 1982

Question 6

NEMA

Answer 6

National Electrical Manufacturers Association

Question 7

ACR

Answer 7

American College of Radiology

Question 8

DICOM

Answer 8

Digital Imaging and Communications in Medicine

Question 9

Who created an interoperability standard across imaging platforms in 1980?

What was this standard called?

Answer 9

1. ACR (American College of Radiology) and NEMA (National Electrical Manufacturers Association)
2. DICOM (Digital Imaging and
   Communications in Medicine)

Question 10

Specialized Workstations

Answer 10

image post-processing systems

may be part of a modality, a stand-alone computer, or the radiologist reading stations

Question 11

What can be done on specialized workstations?

Answer 11

Additional image post-processing

(3D Recons, image annotations by Rad, etc.)

Question 12

VLAN

Answer 12

Virtual Local Area Network

May be segregated from other enterprise data traffic

Question 13

Where is PACS traffic configured within the network and why is it set up this way?

Answer 13

1. On a VLAN
2. This increases performance, through-put, and creates high reliability. Additionally, this improves information security

Question 14

Archive

Answer 14

refers to data storage

Question 15

Synonyms for Short-term Storage

Answer 15

Online, near-line, hot, and active

Question 16

Synonyms for Long-term Storage

Answer 16

Offline, passive, and cold

Question 17

What is short-term storage?

Answer 17

A type of data storage designed to make data quickly accessible

Question 18

Why is short-term storage generally smaller in size?

Answer 18

Because of the the higher costs associated with specified fast-performing storage media

Question 19

What is long-term storage?

Answer 19

A type of data storage that is generally inactive or infrequently used

Question 20

Gateways

Answer 20

the point of entry for devices external to a defined network

Question 21

What is the role of a Gateway?

Answer 21

they act as the protocol convertor which allows data to flow between networks

(the gateway acts as a crucial point of enforcement for NAC policies)

Question 22

Switches

Answer 22

devices that connect multiple devices on the network
using packet switching to receive
and forward data to network destinations

Question 23

Packet Switching

Answer 23

a method where data is broken down into smaller units called packets, which are then transmitted independently across the network

Question 24

Routers

Answer 24

e devices that analyze the contents of packets transmitted within the network and determine the best route for information to travel

Question 25

What is the "heart" of PACS?

Answer 25

The database

Question 26

What is the PACS database responsible for?

Answer 26

the organization and management of images and their associated information within the system

Question 27

How are routers and gateways used within a PACS system?

Answer 27

They help to evenly distribute image ingestion and archive exportation. They also assist in balancing the workload of the database

Question 28

What are the two main models of image viewing software?

Answer 28

1. Web-based and thin client viewers often called "clinical" viewers 2. Web-deployable or designated workstation thick clients called "diagnostic" viewers

Question 29

How do web-based and thin client (clinical) viewers work?

Answer 29

They utilize existing web technologies to render image data for display

Question 30

How do web-deployable or designated workstation thick clients (diagnostic) viewers work?

Answer 30

They have direct licensing and increased hardware dependencies

Question 31

In terms of system management how web-based image viewers compare to web-deployable image viewers?

Answer 31

Web based (thin-client) are easy to access and manage Web-deployable (thick-client) require more overall support

Question 32

What is used to track exams in PACS?

Answer 32

unique exam accession numbers

Question 33

RIS

Answer 33

Radiology Information System

Question 34

HIS

Answer 34

Health Information System

Question 35

EMR/EHR

Answer 35

Electronic Medical Record / Electronic Health Record

Question 36

HL7

Answer 36

Health Level 7

Question 37

What protocol does RIS use for communicating with other systems?

Answer 37

HL7

Question 38

What is the role of the PACS Broker?

Answer 38

It is responsible for processing messaging between PACS and other connected systems (RIS, HIS, EMR, EHR, and VR)

Question 39

What is another term for PACS Broker?

Answer 39

Interface Engine

Question 40

How does the Interface Engine process messaging between PACS and other connected systems?

Answer 40

It converts HL7 messages in DICOM format and vice versa

Question 41

What is EMR/EHR integrated storage?

Answer 41

A form of image storage within the EMR/EHR itself

Question 42

What is another term for EMR/EHR integrated storage?

Answer 42

Enterprise Content Management (ECM)

Question 43

What is EMR/EHR integrated storage primarily used for?

Answer 43

medical document management, but can also be used for storing photos like those captured in dermatology or surgical wound care

Question 44

What is HL7?

Answer 44

a comprehensive framework/standard for the exchange, integration, sharing, and retrieval of electronic health information

Question 45

Departmental/ specialty image storage can also be referred to as what?

Answer 45

mini-PACS

Question 46

What is mini-PACS and what do they offer?

Answer 46

PACS systems used by specialty departments (derm, cardiology, etc.) They offer targeted image review tools, typically with limited capabilities for integrating with the HIS, EMR, or EHR

Question 47

Do specialties have to use a mini-PACS?

Answer 47

Not necessarily, in some instances they may piggyback off of the full radiology PACS system for their image storage

Question 48

POCUS

Answer 48

Point-of-care Ultrasound

Question 49

What is point-of-care ultrasound?

Answer 49

small inexpensive US machines that can be used by healthcare providers outside of the radiology department

Question 50

Does POCUS used traditional PACS?

Answer 50

No, POCUS vendors offer focused application software with associated storage configurations for use with their devices. The workflow for such devices varies greatly from the PACS workflow

Question 51

VNA

Answer 51

Vendor Neutral Archive

Question 52

Why are VNAs and enterprise archives popular?

Answer 52

These repositories are capable of ingesting and storing data objects in both DICOM and non-DICOM formats This allows for integrated image storage at the enterprise level

Question 53

In what decade were the first PACS systems put into place?

Answer 53

the 1990s

Question 54

The primary functions of PACS are storage, _________, and display of images. A. Integration B. Distribution C. Quality assurance D. Interpretation

Answer 54

B

Question 55

The PACS database is responsible for managing which pertinent data elements? Select all that apply: A. Patient demographics B. Associated reports C. Where the images are stored in the archive D. Where the images should be sent

Answer 55

ABC

Question 56

Which of the following advances, when part of PACS or other image management systems, gives attending radiologists the ability to share important or interesting cases with residents for future review? A. Integrated programmed peer review B. Digital teaching fles C. Incorporated advanced visualization technologies D. Teleradiology

Answer 56

B