Hybrid Nature on the PACS Architecture - Assignment Example

Imaging Informatics Number Question This PACS’ architecture varies and is a mixture of the web-based kind and the client-server seeing as the idea demands that the software offer that the license of the user have no limits therefore suggesting an architecture kind of the client-server class. To denote web centered architecture, the software offers in every 1,000 cases of study, reports of diagnosis and review of the websites. In essence therefore, the PACS’ architecture is of the hybrid nature as it boasts two architectures that come with roles that are complimentary to each other. Advantages For one, readings of films that are redundant is non-existent as PACS test’s primary copy is found in the archive of the server of the PACS and is common in all stations of work. The main PACS list of images allows users to determine at once if they are looking at a similar study/ exam and this therefore prevents repeated readings. Secondly, study distribution/ pre-fetching is not needed as the information of the chosen pictures are loaded for display directly onto the station of work’s memory from the PACS due to the absence of storage in the station of work. Thirdly, there is no need for query/ retrieve functions as the radiologist simply chooses from the client workstation work-list the test and then the pictures are automatically brought up. Contrasted with the architecture of the singular kind, this hybrid type is simpler to use. Also, the retrieval, reading and reviewing of pictures by the user is made easier since every station of work receives similar central pictures at all times compared to single architecture kinds where various stations of work may poses various lists of pictures and additionally lack some pictures altogether. In addition, in the hybrid system, there is ubiquitous service due to the connections with the internet as the web centered component is totally movable and can be accessed anywhere even in homes that have internet service and this is very convenient as the user does not have to reach the office premises to access and report on exams – they can do it from anywhere. Lastly, in this format, the hardware of the workstation of the client can independently serve as a platform if there is support for the browser of the web. Disadvantages There is lack of service in case the servers are down because the server of the PACS is the only image origin and if it fails, the whole PACS go with it therefore. Consequently, radiologists are unable to access tests on any of the stations of work of the clients and any test that is currently needed must wait from the storage at the modalities archive till the time that the server comes back on. This is tedious and equally time consuming. In addition, because of the increase in the number of operations, there is the tendency for more mistakes of the transactions of the database seeing as there is the lack of archiving so that each time of operation there is the need to check the database and review the pictures. This limitation makes the hybrid architecture less efficient compared to the single type where there are always available previous pictures in the stations of work. Thirdly, the system, since it has no storage, is very much reliant on the performance of networks particularly when the WAN (wide area network) is in session. For operations of tele-radiology, slow performances of the WNS can be troubling. In addition, it is impossible until the picture is stored to enhance the header of the DICOM in the control section of picture quality and lastly, the hybrid set up may be disadvantaged in the quantity of browser (web-centered) performance and functionality. Question 2 In PACS, the oracle is the system of managing/ handling the database. This database can be based on a tested system of the database that is commercial that is the oracle contrasted with the Microsoft. The oracle archives information physically in information documents and logically as table space which can come with a number of segments of memory like the index and information segments. To support and oversee the stations of work’s query/ retrieve functions, the database offers study or client data handling and the function of picture indexing and additionally manages client data from the RIS/ HIS. Basically, the gateway conveys the DICOM picture and header upon receiving the picture, onto the archiving information. The oracle/ manager of the database creates the image of the DICOM upon retrieval and transmittance while at the same time making a similar copy the operation but not the picture in the event of a disc crash of failure of the system. In this case therefore, there is no loss/ interruption of operations as radiologists do not have to endure downtime. Question 3 The gateway of the database’s build is the brokerless interface of the RIS. In this case, there is demonstration of no involvement of the broker of the PACS by the brokerless while the software of the interface shows presence of build in the gateway of the database. The gateway of the database serves as an interface between the PACS and the RIS and there exist minimal direct link between the PACS and the RIS since the RIS is only able to yield exam results in a format that the PACS are unable to receive and read – the HL7 system format. The gateway of the database performs the role of the interface as it works on the HL7 information from various systems of RIS and maps the information into a table of the database that is easy to customize. It can thereby work on the requests elicited by different components of the PACS and avail the correct format of information. These encompass aspects such as the work-list of the DICOM for modality of acquisition, arranging for pre-fetching tests, the location of clients for default conveyance of PACS tests to stations of work in the ward regions of the medical center and user feedback (reports of radiology) for workstation for PACS observation. Question 4 The size of the medical center that this PACS system can serve well would be a small medical center with approximately 20-30 radiology cases daily and most often than not, it would preferably be a rural set up government center/ hospital since the number of tests of the software has a maximum of only 10,000. In addition, for the station of work that reports diagnoses, the monitors are only two and therefore this system would suit the government medical institution as the costs is friendlier to them unlike their private sector counterparts. There are a number of merits that this PACS system offers the hospital in which it is utilized. First of all, there are significant reductions in the number of cases that are unread as they are easily located by the HIS/ RIS system and then availed for reading and re-reading using the PACS. Also, the system minimizes the amount of exam repeats as a result of wanting tests using the capability of picture modification at the stations of work and CR’s expanse of dynamic range which collectively reduces the cases of retakes. This reduction essentially means the reduction of client exposure to radiation and also enhances the level of medical service. The system also does away with certain processes in the procedure in which studies for imaging are availed for the reasons of reading by the user/ radiologist in that the previous 59 processes have been considerably reduced by 50 to merely 9 by relocating from the film focused system to the PACS. This inevitably saves time and also reduces the amount of work performed by radiologists allowing them time for more patients or other medical concerns. In addition, there is the cutting of the amount of time from the period the study commences to the point of the exam reports from the previous numerous man-hours to the present duration which is less than half an hour. Furthermore, times for reports have been slashed from a day to below 2 hours with the introduction of reporting performed in real time. This has improved the quality of medical care and eased the time of referring practitioners. Another merit is the medical set ups are now capable of saving on costs concerning things as operation of films, space, and personnel (including radiographers, clerks at the library of films, technician in the dark room, and other radiologists). In the film storage section, there is considerable reduction in the amount of used space since the act of film archiving is no longer necessary and in addition, there has been considerable limitations on supplies that are film concerned like film chemistry, processor and folders. The system also serves to enhance the quality of medical service with the presence of the technique of tele-radiology where client pictures/ results are conveyed to a professional radiologist from the location of test who conducts the diagnosis and the reports are sent to the main doctor for prescription appropriate of treatment service. In this scenario, the number of radiologists required is cut down significantly more so as a professional center can serve numerous departments, centers and so on. In the end, costs incurred by the hospital are reduced. Also, there is the advantage of sound management of pictures due to storage mechanism that is systematic and with criteria for searching that one can use to access softcopy information. Lastly, with quicker turnaround duration, the services of the medical center are effectively enhanced and quality improved hence. In the end clients wait less for their results as even more diagnoses can be done in the consequent hours of the day. In as much as the expenditure is high, it is advisable to have system of PACS and governments are now capable of meeting the overall costs after putting in mind all the merits of installing PACS systems. Apart from generally enhancing the effectiveness and efficiency of work in the medical center, PACS are additionally able to offer service to its clients that are of the high end value and in turn, the patient is left satisfied and at ease with the offered services. Question 5 There is insufficient data for me to arrive at a solid conclusion from the contents of the proposal. In this very vein therefore, there are a number of additional details that I require so that I can make a decision. For instance, the proposal only holds that for clinical reviews, license of user is not limited, with review that is web-based with up to 10, 000 different reports of diagnosis but fails to indicate the costs that will be contended with should this threshold (10, 000) be surpassed. Medical facilities require such data in order to make arrangements for cases that may exceed the value indicated. Also, the proposal fails to offer any data concerning the hardware of the server of the PACS and further falls short of highlighting whether the storage server device is based on windows, UNIX or LINUX. I need to know the kind of operating system in use so that I can, with relative confidence, state the reliability, stability and user friendliness of the system in application. Moreover, the proposal fails to highlight any data regarding the capacity for storage of the archives and their back up information which an essential detail that is useful in determining whether or not the capacity for archiving data is sufficient for the given medical set up. Also, there is no mention on the kind of data archiving in place. It is essential to note the type of form of storage for long term use such as the DVD, SAN, digital linear tape, large scale RAID or whether it is the offside model of ASP. This is important in assisting the medical facility in arranging present and future storage ventures that is equally compatible with the conditions at the hospital. There is equally no data offered concerning the network of communication where crucial network data like technology, speed, standard of network, frequency, kind of internet technique whether bridge or router, expenditure of connection, rate of signal, scale, technique of connection whether wireless or cable, and so on, are left unmentioned. Medical centers require knowledge concerning the speed of transmission from the equipment for picturing modality to the gateway device for acquisition and to and from the station of work and the controller of the PACS. Since the users are often in need of quick access to images, there is the need for quick transmission rates. All these data is crucial in helping the medical center effectively plan the communication and flow of work. Furthermore, the proposal fails to offer information on the station of work for the diagnostic reports. Whether it is an LCD or a CRT monitor is not mentioned and this knowledge is needed to determine the suitability of the type with the hospital situation and whether the center is making good use of their money in this light. I also require data illuminating the monitor’s luminance, ratio of contrast, contrast itself, and resolution which is equally important in producing high image qualities that boast superior luminance, contrast and resolution. This knowledge will help improve the report of the radiologist concerning the diagnosis and the data assists the center of healthcare look at what other manufacturers are offering and at what costs. The proposal only talks about the number of monitors available for the stations of reports of diagnoses with no data whatsoever pertaining the number of monitors for the workstation for printing and those undergoing digitization/ review. The user requires such data so that they can print data if situation warranted such a move, and they cannot do this unfortunately. There is equally no information on the kind of services that are to be provided to professionals and no training durations for the radiologists mentioned too even as it is inevitable in ensuring the center can effectively access PACS. Lastly, the proposal fails to offer data on what inspections of the sites will be available like the device allocation, device location, and so on – a data that is essential for the facility in determining the size of space necessary to be left aside for the installation of the PACS. Read More