KEYWORDS: Radiology, Software development, Data storage, Picture Archiving and Communication System, Open source software, Information technology, Medical physics, Biomedical engineering, Medical imaging, Imaging informatics
In the Vastra Gotaland region (VGR) we use a Radiology Information Infrastructure containing all information produced
within the Radiology departments (1,2,3). All information is stored as Dicom-objects (4). This means that request and
report information is stored as Structured Reports (SR) -objects (5) together with the images if they exist.
At Sahlgrenska University Hospital (SU) in Gothenburg, Sweden we have radiological workstations that can't display
the contents in the SR-objects and have a working RIS-integration at the same time.
We have developed some software in conjunction with the dcmtk-software package (6) developed by the Oldenburg
University to make it possible to display information from SR-objects on the radiological workstations.
The workstations have the ability to use Web-functionality so the solution is based on web-technology.
The following happens when a request is made to display the SR-information:
1. Workstation calls a cgi-script that checks if the archive has any SR-reports for the given study.
2. A c-move request is sent to the archive to send the SR-objects (reports) to a Dicom-receiver on the web-server.
3. The dicom-receiver (storescp) creates html-files with help of a modified version of dsr2html.
4. The cgi-script read the names of the created html-files and returns the names in an javascript-array.
5. The report is displayed on the workstation.
By developing some pieces of software and using open source software we have developed a well functional solution to
display SR-reports stored in a central dicom-archive on workstations that can't show SR-information by themselves.
KEYWORDS: Medicine, Radiology, Databases, Web services, Information technology, Standards development, Information fusion, Open source software, Software development, Java
This paper describes how the integration between one of the RIS-systems (Adapt) in VGR and the infobroker in the
central archive is implemented. The project was presented in 2006 with the title Building an IT Healthcare Enterprise by
taking the standards to the limits and sometimes beyond that. The Adapt RIS is used by the Sahlgrenska University
Hospital (SU) in Gothenburg and handles 8 different radiology departments.
The implementation is based on HL7 version 3 and the message exchange is based on Web Services/SOAP.
The base of the RIS-system was developed in the beginning of the 1990:s by a company that no longer exists. SU has
always been able to modify the system by changing the source code and we have been responsible for the system-development
since late 1990s.
We are using IBM Informix Dynamic Server that is running on a Solaris-based cluster with additional software from
Veritas/Symantec.
The communication is planned to be 2-way. Our RIS-system transfers order promises, various status updates during the
workflow and finally reports with various status levels. Our system will be able to receive requests and reports from the
broker. The broker in turn receives these messages from other hospitals in VGR (Vastra Gotalands Regionen).
We use Axis2 to generate skeleton java-code based on WSDL- and XSD-files that defines the Web Services. Axis2 is an
Open Source software that is developed as a part of the Apache project. Eclipse is a development environment for Java
that we use and it is also open source.
Apache Tomcat is the application server that we use to receive messages from the infobroker.
KEYWORDS: Radiology, Picture Archiving and Communication System, Digital imaging, Data archive systems, Telecommunications, Medical imaging, Databases, Medicine, Software development, Internet
In 1998 three hospitals merged to form the Sahlgrenska University Hospital. The total radiology production became 325 000 examinations per year. Two different PACS and RIS with different and incompatible archiving solutions were used since 1996. One PACS had commercial origin and the other was developed inhouse. Together they managed 1/3 of the total production. Due to differences in standard compliance and system architecture the communication was unsatisfactory. In order to improve efficiency, communication and the service level to our customers the situation was evaluated. It was decided to build a transparent virtual radiology department based on a modular approach. A common RIS and a central DICOM image archive as the central nodes in a star configured system were chosen. Web technique was chosen as the solution for distribution of images and reports. The reasons for the decisions as well as the present status of the installation are described and discussed is this paper.
An Image Management And Communication (IMAC) system adapted to the X-ray department at Sahlgrenska University Hospital has been developed using standard components. Two user demands have been considered primary: Rapid access to (display of) images and an efficient worklist management. To fulfil these demands a connection between the IMAC system and the existing Radiological Information System (RIS) has been implemented. The functional modules are: check of information consistency in data exported from image sources, a (logically) central storage of image data, viewing facility for high speed-, large volume-, clinical work, and an efficient interface to the RIS. Also, an image related database extension has been made to the RIS. The IMAC system has a strictly modular design with a simple structure. The image archive and short term storage are logically the same and acts as a huge disk. Through NFS all image data is available to all the connected workstations. All patient selection for viewing is through worklists, which are created by selection criteria in the RIS, by the use of barcodes, or, in singular cases, by entering the patient ID by hand.
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