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Modality Worklist - An introduction to this ever important service.Modality Worklist – aka MWL, DICOM MWL, or just worklist. Intro and Basics When imaging devices first began storing images to PACS the process of entering patient information such as in CT and Ultrasound, it had to be done by hand. This frequently resulted in errors and inconsistent data being stored in PACS. The need to have correct patient and study demographics quickly became apparent and the Modality Worklist was developed. The MWL is a server that receives radiology orders from the HIS/RIS and stores all the study and patient information for that order. When a technologist begins a procedure, he or she searches the MWL server from the imaging device they are going to be using for that procedure. When the worklist on the imaging device is populated, the technologists simply select the study that is going to be performed is selected and the procedure is begun. That selection process fills in all the patient and study fields that normally were entered by the technologist. This increases the efficiency of the process. Additionally, there is an increased level of patient safety because there is no chance of incorrect patient information. What was ordered in the system is what passes through MWL and is attached to the images. One note worth mentioning; even though MWL prevents errors on patient information, it does not prevent the technologist from imaging the wrong patient, so correct patient identification steps must continue. MWL services can be provided by different devices. Some RIS systems have the ability to provide MWL services where the imaging devices will query the RIS for MWL orders. Other system configurations require the HIS/RIS to send orders through an interface server where HL7 messages are converted to DICOM worklist entries. Some PACS can even provide the MWL services, receiving the orders directly from the HIS/RIS. The MWL is one of the methods a study can obtain its SUID (Study Unique ID). The SUID is the number under which a study is stored in the PACS Archive. A detailed discussion of the SUID can be found in the DICOM Overview pages. It is important to use the MWL produced SUID because the radiology report for that particular study will have the MWL produced UID. Have the matching SUID’s will allow the report and the images to match in PACS if you are storing reports in the PACS.
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