ABSTRACT
The aim of this study was to develop wireless
Picture Archiving and Communication System (PACS) device and to analyze its
effect on image transfer from portable imaging modalities to the main PACS
server. Many hospitals have adopted the Picture Archiving and Communication
System (PACS) for effective handling of medical images. With the advent of PACS
in a filmless hospital environment, there is an increasing demand for rapid or
immediate access to patient images. In most hospitals, clinicians and
radiologists can only retrieve relevant images and patient information via
workstations with fixed locations using restricted local networks. Many
hospitals now have access points for wireless communications. In the wireless
local area network (LAN) environment, the need for interface between PACS and
the wireless network has increased.
However, past studies have mainly focused on
retrieving PACS images using the wireless network. If the wireless network is
used in the transfer of images to PACS, it could help shorten the time interval
for image transport.
The aim of this study was to develop a
wireless PACS device for rapid delivery of DICOM modality worklist from the
PACS server and images to the PACS server and to analyze its effect on image
transfer from portable imaging modalities to the main PACS server.
TABLE OF CONTENTS
CHAPTER
ONE
1.0 Introduction
1.1 Background
to study
1.2 Statement
of problem
1.3 Objectives
of study
1.4 Significance
of study
1.5 Scope/limitation
of study
1.6 Methodology
1.7 Definition
of Terms
CHAPTER
TWO: LITERATURE REVIEW
2.0 Introduction
2.1 Historical
Background of Radmed Diagnostic Clinics,
2.2 Telemedicine
2.2.1 Setbacks
in Telemedicine Practice
2.3 The
Transition to Digital Imaging in Medicine
2.4 Benefits
of Digital Imaging
2.5 The
Impact of PACS on Radiologists’ Work Practice
2.6 Avoiding
a Common Pitfall in the Transition to Digital
2.7 Teleradiology
2.8 Conclusion
CHAPTER
THREE
SYSTEM
ANALYSIS AND IMPLEMENTATION
3.0 INTRODUCTION
3.1 Development
Phases
3.1.1 Preliminary
Investigation and Analysis Phase
3.1.2 Understanding
the Existing System.
3.1.3 Determining
True Nature of the Problem
3.1.4 Objectives
/ Advantages of the Proposed System
3.1.5 Determining
the System Requirements
3.2 Implementation
Phase
3.2.1a Software Requirements
3.2.1b
Hardware Requirements
3.2.1c
Network Requirements
CHAPTER
FOUR
IMPLEMENTATION
4.1
System Implementation
4.1.1 Network
Design
4.2 Software
Configuration
4.3 Routers
Configuration
CHAPTER
FIVE
SUMMARY,
CONCLUSION AND RECOMMENDATION
5.1
Summary
5.2
Conclusion
5.3
Recommendation for Future Study
References
Appendix A
Appendix B
Appendix C
CHAPTER ONE
INTRODUCTION
1.0 INTRODUCTION
Radiology is a branch or specialty of medicine
that deals with the study and application of imaging technology like x-ray and
radiation to diagnosing and treating disease. Radiology also uses imaging
technology such as Radiography, Magnetic Resonance Imaging (MRI), Nuclear
medicine, ultrasound, computed tomography (CT), and positron emission
tomography (PET) to see within the human body in order to diagnose diseases and
abnormalities.
Radiology is sometimes referred to as
radioscopy or clinical radiology. Clinical radiology refers to the use of
radiology to diagnose or treat injury.
Radiology is a key part of clinical practice
across a wide range of medical disciplines. It is usually the best, minimal
invasive way of diagnosing, treating or monitoring disease and injury.
Radiological information System (RIS) is a networked
software suite for managing medical imagery and associated data. An RIS is especially
useful for managing radiological records and associated data in a multiple
locations and often used in conjunction with a picture achieving and
communication system (PACS) to manage workflow and billing. An RIS has several
basic functions:
Patient management: An RIS can track a patient’s entire
workflow within the radiology department, images and reports can be added to
and retrieved from electronic medical records (EMRs) and viewed by authorized
radiology staff.
Scheduling: Appointments can be made for both in and out
patients with specific radiology staff. Patient tracking: A patient’s entire
radiology history can be tracked from admission to discharge. The history can
be coordinated with past, present and future appointments. Results reporting:
An RIS can generate statistical reports for a single patient, group of patients
or particular procedure. Film tracking: An RIS can track individual films and
their associate data. Billing: An RIS
facilitate detailed financial record-keeping electronic payments and automated
claims submission.
PACS (Picture Archiving and Communication System) is a
computer-based system used to transfer, store, display and manage medical
images and associated text data. A PACS presumes the use of softcopy/digital
medical images, typically but not always in DICOM format.
In the early 1970s
at the University of Arizona, Dr. M. Paul Capp and Sol Nudelman, PhD,
Organize a digital imaging group that works to develop the first digital
subtraction angiography (DSA) device –
the first clinical application of digitally derived images. In Mid 1970s
Professor Jean-Raoul Schrrer pioneers a medical information display system at
the Geneva University Hospitals in Switzerland, which would have broad
implication for later PACS development. The system, called DIOGENE, collects
and display patient information on computer monitors. A bank of telephone
operators would type in information that would show up on the screens.
At a minimum, a PACS consist of an archive device for
image storage, database and workflow management software, and diagnostic
display stations for interpreting physicians. A PACS can also incorporate
brokers (also called gateways) that are used to communicate with other systems
(such as modalities or a HIS/RIS), display stations for non-diagnostic images
review, and dictation/report management software. Some image-producing modalities such CR
(Computed Radiology) and DR (Direct Radiology) devices are considered to be
PACS components as well. Film digitizers may be used to converts film-based
images into digital images for storage in a PACS, and printers can be used to produce
hardcopy for situations where softcopy access is not convenient.
Basically a PACS provides the ability to electronically Input
Images and data from (digital) modalities, Distribute images and data to PC’s
and workstations, Read on Computer display (diagnostic and clinical), Store
(Both long and short term) images, Transmit (to other areas or off-site)
1.1 BACKGROUND TO THE STUDY
Over the years, the trend in technology as tremendously
increase workflows in hospitals especially in the radiology departments, but
Radmed Diagnostic Clinic is not fully moving with the trend, this is most seen
as a set-back in the Clinic, which brings about an unsatisfactory state of
affairs in the radiology department of the clinic.
The clinical application of X-rays and the birth of
radiology followed Roentgen’s 1895 discovery in a matter of days. This rapid
transfer of basic scientific knowledge and technology to medicine coincided
with a period of great technological development and social change in the
Western world. As radiology begins its second century, technological progress
combined with social and political upheaval creates a similar environment of
uncertainty and promise. Although the outcome of the changes currently in
progress cannot be predicted, it is clear that the second century of radiology
will be very different, but probably no less exciting, than it’s first,
offering both change and opportunity.
Several factors will contribute and, in many cases,
compete for influence in the changes that will define the second century of
radiology.
Rapid and dramatic progress in imaging and imaging-related
technology will continue, matching and perhaps outpacing the developments of
the 1970’s, 1980’s and 1990’s. Today’s growing trend toward less invasive image
guided intervention will extend well beyond the methods currently available. It
will contribute to improved quality of life and greater productivity, and
provide higher value for its cost. These changes will be moderated and perhaps
compromised by reordered social and economic priorities. Limits will be imposed
by society on the amount of resources that can be allocated for health care. In
this changing environment, radiology will succeed only to the extent that it
can provide patients, clinicians, and bureaucrats with high value in solving
the problems of medicine in the 21st century. In meeting this challenge,
radiology finds many opportunities for success.
1.2 STATEMENT OF PROBLEM
Radiology might be
thought of as a “two-thirds way” diagnostic technology. Advanced imaging now
provides striking images of clinical problems, in many cases far superior to
what can be seen by the naked eye. The steady growth of technical improvements in
these mature technologies has enabled remarkable insight of images from
advanced imaging modalities such as CT and MRI, as well as fusion imagery of metabolic
processes.
Although radiologic
diagnosis has become sufficiently developed to eliminate much exploratory
surgery, it is still not developed sufficiently to avoid triggering costly follow-up
studies. Because imaging cannot determine in many cases how much clinical risk
is embodied in a potentially threatening finding, today’s advanced imaging examinations
still generate excessive cost and patient anxiety.
The recent trends in
technology cannot be overlooked in radiological application. I became
interested in bringing solution to common challenges in the Radiological
departments of Radmed Diagnostic Clinic Victoria Island and its three other
branches outside Victoria Island.
Therefore the following
challenges will be examined;
(i)
Cost of
transporting X-films for reporting from other branches of Radmed Diagnostic
clinic to the Headquarter in Victoria Island
(ii)
Printing of hardcopies of X-ray films even when not necessary,
(iii)
The performances of Radiologist/Radiographers while using manual way of
transporting films compared to using PACS.
(iv)
Cost implication of buying X-ray films,
(v)
Time expended during processing of films
1.3 OBJECTIVES OF STUDY
The objectives of this study are to;
(i)
achieve all Dicom
(Digital Imaging and Communication in Medicine) Images on a central server
(ii)
ease the sending
X-ray Images of patient from the head quarter to all other branches (Agege,
Ikeja, Ipaja)
(iii)
eliminate
hardcopies of X-ray films and digitizing the Hospital
(iv)
implement a
central Server and Network to all consulting doctors’ computer system in Radmed
Diagnostic clinic Victoria Island Lagos with all other consulting doctors’ of
Radmed Diagnostic Clinic computer systems outside Victoria Island.
Therefore this project is about the
implementation of Radiological information System (RIS) in Radmed Diagnostic
Clinic and all its 3 other branches in Lagos, using an application software
platform called Charrua.
1.4 SIGNIFICANCE OF STUDY
This project will help in improving efficiency
by automating radiology workflow, this is achieved by removing barriers between
images and information, which decreases report turnaround time and
significantly refines service to patients and referring physicians
1.5 SCOPE/LIMITATION OF STUDY
The project can be implemented in both
Government and Private Hospitals but it focuses on internetworking of several
locations and transmission of Images and data through wireless and wired means just
within Radmed diagnostic clinics and its three other branches.
1.6 METHODOLOGY
This project will involve the use of Routing
protocols such as OSPF (Open Shortest Path First), wireless devices, Routers,
switches and servers, PCs, and Workstations etc to connect Radmed diagnostic
clinic VI to other 3 branches using an application PACS Software
called Charrua PACS to send DICOM (Digital Imaging and Communication in
Medicine) images and data over the networks.
1.7 DEFINITION OF TERMS
Charrua
PACS: This is an application software
vendor for Managing Radiological Information System and PACS
DICOM: DICOM stands for Digital Imaging and
Communication in Medicine. It was initiated by ACR (America College of
Radiology) to address the need for connectivity between imaging equipment
Telemedicine: Combination of Telecommunication technology
and Medicine
EIGRP: A dynamic routing protocol (Enhanced
Interior Gateway Routing Protocol)
Routers: Routers are wireless network device that can
regenerate signals, concentrate multiple connections, convert data transmission
formats, and manage data transfers. They can also connect to a WAN, which
allows them to connect LANs that are separated by great distances.
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