Transcript Outside of North America, GE should be added to monogram

MEDT8002
Digital image storage
Patient workflow
1
Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
Ditgital image storage – information
Standard image storage format: DICOM
> What does that mean?
– Raw Data, Raw DICOM, Pure DICOM?
– DICOM SR?
2
Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
DICOM
DICOM:
Digital Imaging and Communication in Medicine
> Global tandard for exchange of medical information between
medical devices
> Continuously developed, organized by NEMA
(http://medical.nema.org/)
> Four dimensions of DICOM:
–
–
–
–
DICOM for Image Management
DICOM for Network Image Transfer
DICOM for Network Printing
DICOM for Media Interchange/Archiving
> Covers all modalities (CT, MR, US, PET, X-Ray, …)
3
Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
DICOM (cont.)
GE Ultrasound uses DICOM as a file format when
storing images.
DICOM images are stored as pixel-data (i.e. what
is displayed on screen)
> Still flexibility related to encoding
– Color: Monochrome, Monocrhome2, Pallette,
RGB and YBR
– Compression: none, RLE or JPEG
> Cardiac u/s images uses JPEG/YBR
4
Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
DICOM (cont.)
Measurements/reporting is not a part of the
DICOM file format.
> Has not been stored earlier
> New standard: DICOM SR. Supported for
export by GE systems. No systems support
import yet.
5
Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
Raw data
Data that are processed trough different calculation steps
in order to generate the image on screen.
> not part of the DICOM standard,
> stored as private data elements in the DICOM file.
> DICOM file with raw data: “Raw DICOM”
> DICOM File without raw data: “Pure DICOM”
> Non-GE systems will ignore the raw data section.
6
Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
Raw data – features with Pure DICOM
• Basic measurements
• Run/stop loop
• Adjust replay framerate
• Step frame by frame
• Brightness / Contrast
• Re-size
• Annotations
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Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
Raw data – features with RawDICOM
• Color on/off
• High-quality zoom
• Change colormap (flow and tissue)
• TVI -> Strain -> Strain Rate Imaging ->
Tracking
• Variance on/off
• Angle correct
• Hor. Sweep (Doppler spectr. & M-Mode)
• Baseline shift
• Phys. Trace manipulation
• Persistance
• Velocity traces (from TVI)
Data size
• Significant reduction of data size with raw data vs. bitmaps
• Must use lossy compression for bitmaps, with some degradation of IQ
• Even more significant for 3D/4D
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Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
Dataflows
9
Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
Dataflows – overview
Hospital IT
• Patient data
• Images/ PACS
• Billing
• Connection to other Hospitals,
Image Centers, Clinics,
Insurance, Suppliers
• HL7 interface
U/S Workflow
CIS/RIS/PACS
Enterprise Image Mgt
U/S
Workflow
Connect to GE
& non-GE
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Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
• Patient record
• Findings
• Images
• Volume sweep – 3D
• Referrals
• Billing
• Mostly DICOM in Rad/ OB
• No Standard in Card/ Raw Data
• Server, MiniPACS
Hospital
HIS
HL7
Dicom Server
Department
HL7*
Dicom Worklist
Echo
V7
* Export excel file + report to HIS
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Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
Hospital
HIS
Dicom Server
Department
HL7
Query/
Retrieve
Storage*
Echo
V7
* Images + SR(~60% of M&A)
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Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
Hospital
HIS
HL7
Dicom Server
Department
HL7*
Dicom Worklist
Echo
V7
* EchoServer7, ImageVault3, ImageVault4
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Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
GE Server*
Department
EPPC
Server*
Server*
Server*
Server*
Echo Adult
V7
EchoServer
Echo
Children
V7
* Server containing one or more image shares
14
Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
Hospital
EnterpriseServer
Workstation
Department
EPPC
ImageVault4
Echo Adult
V7
Echo
Children
15
V7
* Server containing one or more image shares
Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
Department
EPPC, DICOM
share
EPPC
Echo
V7
Other
Sacnner
* Server containing one or more image shares
16
Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
Connectivity Product Overview
Vivid 7
HIS
High-End
EchoPAC PC
Multi-Modality
Hosp. Network
Vivid HL7 Gateway
PACS
XA, CT, MR, NM
AI1000 + DMS
ImageVault 3.0
Vivid 3
EchoPAC PC
Vivid 4
Mid-Range
Vivid 7
Echo only
WEB Browser
Non-GE scanner
ImageVault 4.0
EchoServer
Low-End
Small office /
Dept.
EchoPAC PC Share
17
Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
EchoPAC PC
SW-Only
EchoPAC PC
Workstation
Workflows
18
Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
End-user workflows
In-exam (V7)
> Protocol based, observations and measurement
requirements
> Track observations (“notepad” with checkboxes)
> Guiding based on normal measurements
“Sonographers don’t want to report, but they make
observations that directly creates statements.”
19
Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
End-user workflows
Reading (EPPC, EPPC swo)
> Efficiency: “Minimize clicking, maximize overview”
– See images and report/statements at the same time
– Automate processes: “Stack of unread”, done reading
signoff (eg. HL7 export), patient locking
– Easy access to trending data (images, measurements,
observations
– Suggested statements based on
observations/measurements.
-> Taylor as reading station
20
Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004
End-user workflows
Back-end/admin (EPPC, EPPC swo)
> Secondary reports based on statements in
report
– Billing codes (ICD-9)
– Accreditation (CPT)
> General data mining
21
Jens Lien, GE Vingmed Ultrasound
Nov 11, 2004