Incorporating Radiological Patient Data Acquired at Other Hospitals into the Local Workflow

Incorporating Radiological Patient Data Acquired at Other Hospitals into the Local Workflow

P.M.A. van Ooijen (University Medical Center Groningen, The Netherlands) and A. Broekema (University Medical Center Groningen, The Netherlands)
DOI: 10.4018/978-1-60566-266-4.ch009
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Patient data are increasingly distributed between hospitals using CDs instead of physical films. This introduces problems because different viewers from different vendors are provided, and sometimes viewers are unusable because local software installation is not allowed. In 2004, we started to facilitate the incorporation of image data from CDs into the normal workflow of the hospital by using commercially available software to perform patient reconciliation based on the DICOM modality work list. In the years after the first introduction, a more comprehensive software system was developed which allows for the fast upload of large amounts of patient image data into the normal workflow. Although direct network connection between institutions is currently being developed and deployed, in the next decade CDs will remain to be used and the integration of the data into the normal workflow is a must. Literature shows that other institutions also started to handle the CDs similarly.
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In the majority of the hospitals the handling of the CDs is a major concern. Large amounts of CDs are shipped on a daily basis and they all have to be read by the receiving physician. Recently, Onken et al. reported on the situation concerning the exchange of radiological images on DICOM CD in Germany (Onken, 2007). In their paper they describe the test protocol they used to determine whether DICOM CDs provided by German radiologists comply to the DICOM and IHE rules or not. To achieve this they devised a three-stage testing protocol which can be found on the website of the initiative ( Using their, very restrictive, testing scheme they showed in a study of 65 CDs from 27 different vendors and 44 different products and versions that 74% presented with a violation of the specifications and 5% was defective or did not contain any DICOM files at all. Only 9% complied with all requirements, and 12% was usable but not fully compliant. Although the requirements set forth by this initiative are very restrictive and maybe not representative for the situation or requirements outside Germany, the study does show that the usability of CDs with radiological images can be a major problem. Especially since the results state that of the 80% of CDs failing the tests, the majority did not fail a test requirement, but failed to conform to the DICOM standard.

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