teleradiology
TRANSCRIPT
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Tele-Radiology
Eng. Juman Ghazi Presented by:
6/6/2011
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Definition:
-is the transmission of radiological patient
images, such as X-rays, CT and MRI, from one
location to another for the purposes of
interpretation and/or consultation.
-15% annually growth against an increase of
2% in the Radiologist.6/6/2011
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Goals of Tele-radiology
1- Providing timely consultative and
interpretative radiologic services.
2- Making radiologic consultations available
without on-site radiologic support.
3- Facilitating radiologic interpretations in on-
call situations.
4- Supporting telemedicine.6/6/2011
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Goals of Tele-radiology
5- Enhancing educational opportunities for
practicing radiologists.
6- Promoting efficiency and quality
improvement.
7- Providing interpreted images to referring
providers.
8- Providing supervision of off-site imaging
studies.6/6/2011
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Digital Imaging and Communications in Medicine
- international standard for handling, storing, printing, and transmitting information in medical imaging.
- Includes a file format definition and a network communications protocol (TCP/IP).
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DICOM file contains:
1- Header: stores information about the patient
(Name, Birthdate, and ID number), the modality
(device parameter, Calibration, X-ray dosis and
Contrast media).
2- Image data: in compressed (bitmap) or
uncompressed form (jpeg, gif...)6/6/2011
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Health Level 7 (HL7):
- a standard for exchanging information
between medical applications.
- Defines a format for the transmission of
health-related information.
- is an interface between Healthcare
provider organization.6/6/2011
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Health Insurance Portability and Accountability Act (HIPAA):
- addresses the security and privacy of
health data.
- improve the efficiency and effectiveness
of the nation's health care system by
encouraging the widespread use of
electronic data interchange in the health
care system. 6/6/2011
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Integrating the Healthcare Enterprise
- Ensure that in the care of patients all required information for medical decisions is both correct and available to healthcare professionals.
- Defines a technical framework for the implementation of established messaging standards to achieve specific clinical goals.
- The approach employed in the IHE initiative is not to define new integration standards, but rather to support the use of existing standards (HL7, DICOM). 6/6/2011
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Hospital Information System
- Comprehensive and integrated information system designed to
manage the administrative, financial and clinical aspects of
a hospital.
- Encompasses paper-based information processing as well as
data processing machines.
- Easy Access to Patient Data, including classification based on
demographic, gender, age... It is especially beneficial at ambulatory (out-patient) point, hence enhancing continuity of care.
- Improved monitoring of drug usage, and study of effectiveness.6/6/2011
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Radiology Information System
1- Computerized database used by Radiology departments to store, manipulate and distribute patient radiological data and imagery.
2- Patient tracking and scheduling, result reporting and image tracking capabilities.
3- RIS complements HIS and are critical to efficient workflow to radiology practices.
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What is PACS?
P: Picture, videos, ECG, Reports
A: Archive, Online, Offline
C: Communication, Networking, Transfer
Protocols
S: System, Architecture.
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Picture Archiving and Communication System
- Computerized system for the storage,
retrieval and display of diagnostic
images in a networked environment.
- Provides remote access to patient images and
report information, to authorized users, no matter
where they are located.
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Reasons for PACS:
1- More Efficient Workflow:a. RTs spend up to 50% of time “handling” film.b. Reader cannot effectively interpret exams on film.
2- Faster Medical Care Delivery:a. Images available to reader at exam completion.b. Clinical consults possible via remote access.
3- Potential Cost Savings:a. Eliminate lost film.b. Improved productivity.c. Eliminate lost film preventing lost revenue.
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PACS
PACS components:
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PACSPicture Archival & Communication System
Radiology
Dept.
CardiacCentre
GyneLab/
Pathology
ICU/ICCUWards/Clinics
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HIS & RIS & PACS workflow
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Tele-radiology Concepts
1- Classic concept: two DICOM nodes are
connected, and communication takes place
via secured connections in a VPN tunnel
(Virtual Private Network).
2- DICOM e-mail.
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Virtual Private Network
- Remote reading across geographic boundaries with greater control.
- Collects digital imaging studies from multiple, geographically-dispersed locations and delivers them securely, reliably and efficiently to physicians over the Web.
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How VPN works?
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VPN solutions are :
1- Security: all data is encrypted, making it extremely secure.
2- Cost: replacing private circuits can save a considerable amount of money on an annual basis. 3- Flexibility: almost all IP traffic and hence applications can be routed through a VPN.
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DICOM e-mail:
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- is a flexible and powerful protocol that can be used for a variety of Tele-radiology applications.
- Its use is cost effective, setup is simple and a wide range of software applications compatible to the standard is available, including Open Source solutions.
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DICOM e-mail application:
1- Expert Emergency consultations (neurosurgery,
neurology……).
2- Tele-guided examinations without a radiologist
at the location of examination.
3- Cooperative work.
4- Image and report distribution.
5- Integration of images and reports into an EPR.
6- Demonstration of image data and online-
conferences.
7- External archiving services.6/6/2011
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Speed of transfer by DICOM e-mail
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How Teleradiology systems work?
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Image acquisition and display
Image transmission (compression techniques)
Image interpretation
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1- Image acquisition and display: from the modality.
2- Image transmission: Compression techniques:
lossless image compression-lossless tecniques: DPCM, HINT, DP, BPE, MAR.-compression ratios: 1.5:1 - 3:1
lossy image compression- JPEG.- subband coding: wavelets.
Through network: Internet, ISDN, ATM...... 6/6/2011
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Tele-radiology Equipment:
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PACS Components
Data Base Server
CR/ DR QAWorkstation
ComputedRadiographyor DR
Gateway orFrame Grabber
FilmDigitizer
Archive
DICOMModality
Web Server
RIS
JiveX Diagnostic Workstations
Image Server(RAID)
JiveX Review
Workstations
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Medical Diagnostic display
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- Important Parameter:1- The number of heads.
2- The resolution of display (2MP, 3MP, 5MP).
3- Active screen diagonal (21", 19“..) 4- Color or Grayscale.
- Manufactures in world:
BARCO, EIZO, NEC, and
Tokoto……
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Servers: in Tele-radiology network we need:
1-PACS server 2- RIS server 3- web server.
type of processor, memory, display controller…
Manufactures: HP, Dell and Toshiba….
Network backbone: the speed of data
transmission speed is 1 GBPS.
Cicso is the leading company in the world in Networking.
VPN routers:Cisco VPN Router is the leader.
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How we prevent stopping?
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Thanks for your attention
6/6/2011