http://www.pacs-admin.com/PACS-Administrator-Training-blog.html Tips, tricks, thoughts and anecdotes from the front lines of a PACS Administrator. en-us PACS Administrator Training Tue, 19 Aug 2008 22:22:39 GMT Tue, 19 Aug 2008 22:22:39 GMT pacs-admin.com http://www.pacs-admin.com/outside-studies-loaded-from-cd-into-pacs-as-needed.html Exams are loaded as needed for comparison to a current (similar) study or at the specific request of the provider. Resources to do this are scarce and Tue, 19 Aug 2008 22:22:36 GMT http://www.pacs-admin.com/the-radiologists-determine-whether-a-cd-is-imported-or-not.html I am the Chief PACS Administrator for a health system comprising of 3 hospitals, 6 imaging centers, and 3 orthopedic clinics. We have set a Sat, 16 Aug 2008 12:57:30 GMT http://www.pacs-admin.com/a-maximum-of-three-prior-studies-unless-otherwise-agreed.html We have made it policy to import a maximum of three prior studies unless otherwise agreed. we were getting in the situation where a dr would bring Thu, 14 Aug 2008 19:39:34 GMT http://www.pacs-admin.com/DICOM_Training.html DICOM Training - Essential DICOM Tools for PACS Administrators Sun, 20 Jul 2008 22:07:45 GMT http://www.pacs-admin.com/import-only-active-patient-images-into-pacs.html We only import outside CD's if the patient is active in our RIS. We created an outside film exam study in our RIS, it has a zero dollar amount Wed, 11 Jun 2008 12:05:24 GMT http://www.pacs-admin.com/importing-cdsfor-now.html We are currently importing images into our PACS We use a work station to modify patient information prior to sending to PACS ie PACS id # We have Wed, 11 Jun 2008 00:36:26 GMT http://www.pacs-admin.com/no-cd-importing-at-all.html We have a non-networked computer that is used for viewing all outside Mon, 09 Jun 2008 04:36:36 GMT http://www.pacs-admin.com/import-cds-only-when-requested-by-the-doctors.html We import CD's only when requested by the doc, and then mark them Reference Only, which insures we are not saving these into our deep archive. We Wed, 04 Jun 2008 14:57:27 GMT http://www.pacs-admin.com/a-14-day-limit-for-images-on-a-cd-to-be-stored-in-pacs.html When requested by physician (only when requested though) I will import a study onto the PACS in which it is stored for 14 days. After 14 days, I go Sat, 31 May 2008 04:50:44 GMT http://www.pacs-admin.com/unknown-pacs-administrator.html We currently import all CD's that are received into our outpatient imaging facility. We store these images on the PACS just like all the other digital Thu, 29 May 2008 23:33:56 GMT http://www.pacs-admin.com/leslie-from-ohio.html The current process is to import outside CDs when requested. The CD is identified as outside studies. These studies are not stored in the long term Wed, 28 May 2008 16:21:54 GMT http://www.pacs-admin.com/Imaging_CDs.html What are you doing with your medical imaging CDs? Tell the PACS Administrator community your process. Tue, 27 May 2008 19:02:19 GMT http://www.pacs-admin.com/PACS_Training.html PACS Training - options for the begining PACS Administrator Sat, 24 May 2008 03:50:58 GMT http://www.pacs-admin.com/SIIM_2008_Day_3.html Summary of SIIM 2008 Day 3 Sun, 18 May 2008 06:45:27 GMT http://www.pacs-admin.com/SIIM_2008_Day_2.html Summary of SIIM 2008 Day 2 Sat, 17 May 2008 06:54:55 GMT http://www.pacs-admin.com/SIIM_2008_Day_1.html Summary of SIIM 2008 Day 1 Thu, 15 May 2008 22:40:23 GMT http://www.pacs-admin.com/Suspect_PACS_Websites.html A comment about Suspect PACS Websites. Original Content Please! Sat, 10 May 2008 04:53:13 GMT http://www.pacs-admin.com/PACS_Administrator_Forum.html The PACS Administrator Forum Fri, 09 May 2008 16:07:43 GMT http://www.pacs-admin.com/radiology-image-QA.html Basics of a radiology image QA program. Fri, 18 Apr 2008 22:14:49 GMT http://www.pacs-admin.com/pacs_certification.html A discussion of the two types of PACS certification available today. Sat, 12 Apr 2008 02:55:26 GMT http://www.pacs-admin.com/Radiology_Workflow.html Radiology Workflow - Learn what the PACS Administrator needs to know about about it. Wed, 02 Jan 2008 04:08:11 GMT http://www.pacs-admin.com/Prefetching.html Description of prefetching in PACS workflow Wed, 02 Jan 2008 03:48:15 GMT http://www.pacs-admin.com/PACS-Administrator-Training-blog.html#Developing-a-cost-effective-image-QA-workflow-with-PACS Here is a link to an article I wrote for AuntMinnie.com. It is how you can develop a QA workflow for a low price. IT includes a discussion of what type of equipment is needed to ensure that the technologists can see images like the radiologists so that images can be check for quality prior to the radiologist viewing them. You will have to join auntminnie.com to view the article. If you are a PACS Administrator, you should join if you are not yet a member. Thu, 22 Nov 2007 00:46:25 GMT http://www.pacs-admin.com/PACS-Administrator-Training-blog.html#Importing-CDs-into-PACS:-Follow-Up. A hot topic among PACS administrators these days is the handling of images from outside facilities. The debate arises from questions about the responsibility to maintain images received from a referring facility vs. the legal ramifications in assimilating those images into your own PACS. Wanting to adapt a policy within my own organization that we import all CDs into our PACS. I was very interested in this debate. To ensure that I was making the correct decision, I brought the topic to my organizations Privacy and Security Committee for a recommendation. One difficulty the committee had to grapple with is the actual definition of the EMR. Some felt that the radiology images were not part of the EMR and the others felt the opposite. Currently, there is no precedent or case law that refers to how this should be implemented. Other areas of consideration involve a risk management perspective which includes the validation of the chain of custody and identification of the correct study, assurance that the image is of diagnostic quality, and adequate defense in the event of a lawsuit in which one interpretation differs from another. As it stands, on recommendation from the committee, I am going to document the process of importing outside studies into our PACS and review the policy and procedure regularly with the PSC committee. The committee, noting a lack of precedence of any cases similar to this, felt that documentation of policies and procedures was the most crucial task. To other PACS Administrators struggling with the same issues, consider the recommendations from a committee whose responsibility it is to ensure that we adhere to regulations regarding privacy and security and perhaps you too can take a step closer to confidently importing studies from outside facilities. Wed, 21 Nov 2007 04:02:44 GMT http://www.pacs-admin.com/how_to_ping.html How to Ping - A Radiology PACS Administrator's introduction on performing a PING Mon, 19 Nov 2007 00:32:43 GMT http://www.pacs-admin.com/paperless_radiology_workflow.html Paperless Radiology Workflow: What the PACS administrator needs to know about chosing a paperless workflow solution. Sun, 18 Nov 2007 18:44:22 GMT http://www.pacs-admin.com/Free_DICOM_Viewers.html Free DICOM Viewers - PACS Software for the PACS Administrator Sun, 11 Nov 2007 23:11:35 GMT http://www.pacs-admin.com/DICOM_Analysis.html DICOM Analysis, an intro to DICOM troubleshooting when a device cannot send to PACS. Sun, 11 Nov 2007 21:44:36 GMT http://www.pacs-admin.com/Routers_and_Switches.html Routers and switches and how they differ. An explanation for the Radiology PACS Administrator. Sun, 11 Nov 2007 06:06:49 GMT http://www.pacs-admin.com/The_OSI_Model.html A brief description of the OSI Model for new PACS Administrators. Fri, 09 Nov 2007 23:10:53 GMT http://www.pacs-admin.com/PACS-Administrator-Training-blog.html#CDs---To-import-or-not-to-import?-That-is-the-question. To import or not to import, that is the question. One of the hot button topics that always causes a run on comments is the question of how to handle outside studies that come into your facility on CD. On one side of the argument, import the CDs into your PACS, is based on the need for continuity of care. You want the radiologist to make current study comparisons with studies from outside institutions on the quality workstations you have built for them rather than use the less than optimal CD viewers that typically accompany discs. Other cases for importing CDs include; a central location for all physicians to access the complete patient record, to prevent CDs from floating all around the facility and record keeping. On the flip side of the argument, there are also a few reasons not to import outside CDs into your PACS. The biggest argument I hear not to import is legality. Having the outside studies in your PACS system now makes you potentially liable for them. For example, what if something was read outside, then imported in and then the internal radiologist makes a different diagnosis. Can the radiologist or hospital be liable for any mis-treatment for acting on that difference? I have been watching this argument for a few years now and one thing that is missing from everybodys discussion, whether pro or con, is a legal basis. We are PACS Administrators, Radiographers and IT specialists, not lawyers! I have yet to hear a lawyer speak to this subject matter. Well, that is about to change. I have secured a meeting with my organizations lawyers and will be presenting the legality question to them and that will be a strong basis for my policy regarding outside CDs. I am going to ask them the same things that I have brought up here. As we meet, I am going to do some documenting of what is said and then I will feel confident that not only will I be making a more informed decision regarding the formal policy but also one that will be backed up legally. Check back after November 12th and Ill post the results of that meeting. Fri, 09 Nov 2007 03:34:41 GMT http://www.pacs-admin.com/The_IP_Address.html The IP address defined at its most basic level. This is for the Radiology based PACS administrator who doesn't know about networking. Mon, 05 Nov 2007 00:11:58 GMT http://www.pacs-admin.com/PACS_IT_Skills.html PACS IT Skills - What you neeed to know as a PACS Administrator Mon, 05 Nov 2007 00:10:42 GMT http://www.pacs-admin.com/PACS-Administrator-Training-blog.html#Troubleshoting-Tips---Episode-1 What a night I had last night. Pretty frustrating but should serve as a good tip for troubleshooting. We have a Radworks PC that acts as an image server, which receives studies from our scanners after hours. This server then sends through a VPN tunnel to our after hours radiology reading service. Last night, the server apparently stopped working. I received a call from the CT techs saying that none of their studies were going over to the after hours reading service. I performed the normal trouble shooting routine and I was able to ping the server and then also perform a successful DICOM echo to the server. The service person on the phone was also able to VPN into our site and see the server so we knew that we had connectivity all around. He said that the issue must be on the CT scanner since we had full connectivity and I agreed. We did have a service engineer in earlier that day and it is not uncommon to have a software update reset the scanner info, so I checked all of the DICOM and network configurations on the scanner and all checked out. The scanner was sending images to PACS so now I was starting to get perplexed. I called the after hours reading company and asked their service tech to look at his server again. He said a few minutes later that everything on his side was fine and that I really needed to look at my end. Needless to say, I was starting to get frustrated, as I knew the issue was on the outside companys image server. After some more frustrating time on the phone I realized this service tech was just not going to answer my questions and I drove into work. When I finally got onto the PC, I found log files for the database and the connection service. The data connection logs were showing failed sends and the database logs showed errors in writing to the database. That made me curious and when I looked at the drive that the database was on I found that there were only 8 Megabytes of space left. After deleting a bunch of studies off of the Radworks study list, images started flying over to the server. I then asked the service tech if hed mind exploring why the auto delete feature wasnt working, he agreed to continue working on it. So, stick to your guns if you know your equipment is working properly and make sure that the vendor does due diligence in troubleshooting their equipment. If they do it as good as the company I dealt with last night, you may want to look at taking over the support yourself. At least youll get the work done faster. Oh yeah, and check that hard-drive! Sat, 03 Nov 2007 01:28:51 GMT http://www.pacs-admin.com/PACS_Workstation.html PACS Workstations - What hardware do you need to create a quailty PACS workstation. Wed, 24 Oct 2007 03:07:17 GMT http://www.pacs-admin.com/PACS-Administrator-Training-blog.html#PACS-Security It is amazing what kind of information you can happen upon during your day-to-day activities. At my site, the echo group in cardiology had a desire to put their US machines on DHCP. When I caught wind of the project I became concerned that they were heading down a path of wasted money and time. I tried explaining to the group that typically, the host table in the PACS system will tie a device down to one IP address. Moving to DHCP and jumping from subnet to subnet would prevent that device from performing its intended function which would be to allow the echo techs to move from floor to floor performing portables and sending the studies as they go. Bar an expensive wireless solution I asked them for a few days to test some different configurations. To test, I went to an US device in the main radiology department. I removed the device from the Remote AE table in our PACS system and changed the IP address on the US device. I then sent a test study to PACS. I was surprised to see that I did not get an error when sending. I jumped on the nearest PACS workstations and sure enough, there was the study in its entirety. Concerned about the fact that our PACS system is open to the general population I called our vendor. When I explained what I found to the engineer assigned to my issue, the response was that the only requirement needed for a device to send to our PACS system is that they send the information to us in the DICOM format which we use, which matches the DICOM Standard. So, in the matter of an instant, I went from feeling good to a worry that we had a wide-open PACS system. Now, in the matter of two years we have not had an incident where a device was just hooked up and information was maliciously sent however, as any network analyst may say, the system needs to be closed. The moral of the story? You have to work constantly to know your PACS system. Wed, 24 Oct 2007 00:21:25 GMT http://www.pacs-admin.com/PACS_Groups.html PACS Groups and Organizations - Where to go for professional PACS Groups Tue, 23 Oct 2007 03:47:56 GMT http://www.pacs-admin.com/ABII.html ABII - Information regarding the American Board of Imaging Informatics Tue, 23 Oct 2007 03:41:13 GMT http://www.pacs-admin.com/Modality_Worklist.html Modality Worklist - An introduction to the Modality Worklist functionality. Sun, 21 Oct 2007 21:02:15 GMT http://www.pacs-admin.com/PACS_Overview.html PACS Overview - If you are completely new to PACS these pages will introduce you to PACS Sun, 21 Oct 2007 18:30:49 GMT http://www.pacs-admin.com/What_Is_DICOM.html What is DICOM? - The defintiion of DICOM, what it stands from and why it was developed. Sun, 21 Oct 2007 05:59:41 GMT http://www.pacs-admin.com/Operating_Systems.html Operating Systems - An overview for the new PACS Administrator. Sat, 20 Oct 2007 03:40:17 GMT http://www.pacs-admin.com/PACS_Administrator_Toolkit.html PACS Administrator Toolkit - Viewers, editors, servers, storage analysis tool among others. Sat, 20 Oct 2007 02:47:30 GMT http://www.pacs-admin.com/PACS_Acronyms.html PACS Acronyms - What do all those abbreviations in the PACS world mean? Sat, 20 Oct 2007 02:32:19 GMT http://www.pacs-admin.com/Basic_PACS_Architecture.html Basic PACS Architecture - The bare bones of what makes a PACS. Written for the layperson Sat, 20 Oct 2007 02:26:20 GMT http://www.pacs-admin.com/PACS-Administrator-Training-blog.html#Vermont-group-aims-for-Statewide-EHR Vermont Information Technology Leaders (VITL) is a group that is made up of public and private entities to form a non-profit organization. This group has introduced legislation in the Vermont Assembly aimed at creating a statewide electronic health record. To my knowledge, this could be one of the first statewide EHRs in the country. I do know that Deleware began working on a similar initiative in March of 2007 but I ahve yet to see if they have completed the project. The exciting aspect of the news is that I can foresee the need of an informatics manager to manage a system this large, especially if there are images involved. Fri, 19 Oct 2007 20:14:10 GMT http://www.pacs-admin.com/PACS-Admin-Blog_101807.html PACS-Admin Blog - PACS News, events and comments from PACS-Admin.com Thu, 18 Oct 2007 21:40:03 GMT