|View from the deck of the MedWEB training facility|
Just implementing the IHE scheduled workflow profile alone could result in a significant improvement in efficiency, major reductions in potentially lost images or studies, and reduced turn-around times for procedures. Let’s look at the MPPS or Modality Performed Procedure Step. While most modality vendors have long ago implemented this DICOM service, there are still major PACS and RIS vendors that have not yet implemented MPPS.
The MPPS is an automatically issued transaction from the modality that signals when a procedure has started, completed or canceled, indicates the number of images and other objects such as presentation states or measurements that are generated, and it provides any order changes and updates to both the PACS and RIS. When properly implemented, the modality worklist is automatically updated as soon as the study is started, and the finished procedure is immediately added to the radiologist workstation worklist and changes in the procedure are automatically updated in the RIS. Without MPPS, a technologist might have to complete or “verify” the study at the PACS and RIS, and there is a chance that a radiologist could start reporting on an incomplete procedure or wait unnecessarily to begin reporting.
Another major component of the scheduled workflow profile is the so-called STC or Storage Commitment, which is the hand-shake between a modality and short-term archive. It can also be used as a handshake between a short- and long-term archive, which can be hosted on-site or in a cloud. As more and more systems deploy enterprise archiving solutions and off-site storage, this is a critical transaction.
The best known IHE profile is the PDI or Portable Data for Imaging, which specifies how to store images on a CD so that they can be read by another institution and imported into their PACS. Unfortunately, there are still institutions that create proprietary CD’s, which cause unwarranted charges that “DICOM does not work,” when the real culprits are institutions and PACS vendors that simply do not follow the rules.
These are just two of the most popular profiles, there are many more that can have an impact on daily workflow, or emerge when an archive is migrated to a new version or vendor, and suddenly all of the image overlays have disappeared or when deleted images suddenly re-appear.
|View at lake Donner, a couple of|
miles from the training facility