iSite 3.5: Hanging Protocols II

Table of Contents

• Objectives • Terminology • Configuration of Series Matching Rules • Hanging Protocol Groups • Body Part Dictionary CONFIDENTIAL TRN-0035-07 Rev 07/13/06 2

Learning Objectives

Understand the purpose and configuration of: • Series Matching Rules • Hanging Protocol Groups • Body Part Dictionary CONFIDENTIAL TRN-0035-07 Rev 07/13/06 3

Terminology

•

PACS

(

P

icture

A

rchive and

C

ommunications

S

ystem) – Information Systems designed to manage, store and distribute medical images and related information throughout the healthcare enterprise •

HIS

(

H

ospital

I

nformation

S

ystem) – Information Systems designed to manage patient records, including patient registration, billing, and order entry •

RIS

(

R

adiology

I

nformation

S

ystem) – Information Systems designed to manage exams (orders), including filling orders and scheduling CONFIDENTIAL TRN-0035-07 Rev 07/13/06 4

Terminology

•

MRN

(

M

edical

R

ecord

N

umber) – A unique patient identifier (also known as Patient ID) used for auditing of billing and scheduling for patients •

Accession Number

(

ACC

ession Number) – A unique exam identifier (also known as an order number or requisition number) used for auditing of billing and scheduling of scheduled procedures •

SUID

(

S

tudy Instance

U

nique

ID

entifier) – A unique study identifier used for auditing of performed imaging service requests CONFIDENTIAL TRN-0035-07 Rev 07/13/06 5

Terminology

•

DICOM

(

D

igital

I

maging

CO

mmunication in

M

edicine) – DICOM is the predominant communication standard between imaging equipment throughout the Healthcare Enterprise •

HL7

(

H

ealth

L

evel

7

) – HL7 is the predominant messaging standard for exchanging key sets of administrative and clinical data in the healthcare enterprise CONFIDENTIAL TRN-0035-07 Rev 07/13/06 6

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Configuration of Series Matching Rules

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Series Matching Rules

• Series Matching Rules are sub-features of Hanging Protocols • The advantage of using Series Matching Rules as part of Hanging Protocols: – Automatic sorting of series – Automatic application of features to specific series • Multi-Image Mode • Window Width/Level Presets • Scout Mode • Localizer Mode • Image Invert CONFIDENTIAL TRN-0035-07 Rev 07/13/06 8

‘Add’ Series Matching Rules

• To add a Series Matching Rule for a series: – Select the series or image you would like to use to define a Series Matching Rule – Select the

‘Matching Series Rule’

option from the Context Menu CONFIDENTIAL 9 TRN-0035-07 Rev 07/13/06

Hanging Protocol Series Matching Rules Dialog

• The Hanging Protocol Series Matching Rules Dialog will open • In this example, several Series Matching Rules have already been created and are listed under

‘Rule Name’

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Hanging Protocol Series Matching Rules Dialog

• To access the Series Matching Rules Dialog, users must be members of an Access Group with the Security Code

ISTHPSTD

• This Dialog allows users to the add, edit or delete Series Matching Rules CONFIDENTIAL TRN-0035-07 Rev 07/13/06 11

Create Series Matching Rules Dialog

• When the

‘Add Rule’

button is selected, the

‘Create Series Matching Rules Dialog’

opens (as shown in this example) • The

‘Define Series’

list displays the selected Series predefined DICOM tags/attributes CONFIDENTIAL TRN-0035-07 Rev 07/13/06 12

Predefined DICOM Tags

• The following are the predefined DICOM tags that can be displayed for series which are applicable or for which there is a value in the meta data: (0x00200011) (0x0008103e) (0x00200037) (0x00180015) (0x00185101) (0x00080008) (0x00180022) (0x00181210) (0x00180010) (0x00180081) (0x00180086) (0x00200012) (0x00180020) (0x00180021) (0x00180080) Series Number Series Description Image Orientation (Patient) Body Part Examined View Position Image Type Scan Options Convolution Kernel Contrast/Bolus Agent Echo Time Echo Number Acquisition Number Scanning Sequence Sequence Variant Repetition Time CONFIDENTIAL TRN-0035-07 Rev 07/13/06 13

Configuration of Series Matching Rules

• To define a Matching Series Rule, type the Matching Series Name in the

‘Matching Series Rule Name’

field • Select any of the predefined DICOM tags listed under the

‘Define Series’

list • Click the

‘Add >>’

button CONFIDENTIAL 14 TRN-0035-07 Rev 07/13/06

Create Series Matching Rules Dialog

• The DICOM tag

‘Series Description’

(0x0008103e) can be used in most instances as the key defining attribute for most series • Providing consistent and predictable values in the

‘Series Description’

DICOM tags will alleviate the necessity of redefining Series Matching Rules and Hanging Protocols within iSite as new modalities are added 15 TRN-0035-07 Rev 07/13/06 CONFIDENTIAL

Add Series Attribute Dialog

• New Series Attributes (beyond the predefined attributes) may be defined using the

‘Add Series Attribute Dialog’

• For assistance in creating new series attributes please contact customer care CONFIDENTIAL 16 TRN-0035-07 Rev 07/13/06

DICOM MetaData

• To access the DICOM MetaData from iSite: – From the canvas page, hold down the

‘Ctrl’

and

‘Alt’

keys while double-left clicking on the series – Click

‘MetaData’ ‘Image Dialog’

from the TRN-0035-07 Rev 07/13/06 17 CONFIDENTIAL

DICOM MetaData

• Collect the pertinent information from the

‘MetaData Dialog’

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Add Series Attribute Dialog

• Complete the

‘Add Series Attribute Dialog’

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Add Matching Values Dialog

• To define multiple values for a single DICOM tag, highlight the tag in the

‘Define Matching Value’ Value’

box and click

‘Add

20 CONFIDENTIAL TRN-0035-07 Rev 07/13/06

Add Matching Values Dialog

• In the

‘Add Matching Value’

dialog, enter the matching value • Click

‘ok’

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Add Matching Values Dialog

• If the

Matching Value

is numerical, the

Operator

may be selected to include a value range CONFIDENTIAL TRN-0035-07 Rev 07/13/06 22

Configuration of Series Matching Rules

• Each Series Matching Rule will only match one Series/Image in an exam • If the Series Matching Rule matches more than one Series in an exam, the rule will only apply to the first Series • Only one Series Matching Rule can be defined per Series/Image type • No overlapping rules or duplicate rules are allowed • Creating a new Series Matching Rule with a DICOM tag and Matching Value combination that is already in use by another Series Matching Rule is

not allowed

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Defining Attributes for Series Matching Rules

• As most iSite Radiology users currently use the Modality Type and Body Part as the Hanging Protocol Identifier for Hanging Protocols, these attributes are already defined for most series in most exams • Therefore, the body part is already defined and may be discounted in most instances when creating Series Matching Rules • In most instances, using the

“Body Part Examined”

DICOM attribute as a defining attribute for Series Matching Rules would require the creation of an excessive number of unnecessary Series Matching Rules because many exams from the same Modality Type may share many other common attributes such as a Computed Tomography “topogram” or various view positions in Computed Radiography CONFIDENTIAL 24 TRN-0035-07 Rev 07/13/06

Recommendations for Series Matching Rules

• CR and DX (DR) – View Position (0018,5101) • CT – Series Description (0008,103e) – or – Image Orientation (0020,0037) – Slice Thickness (0018,0050) – Contrast/Bolus Agent (0018,0010) – Convolution Kernel (0018,1210) CONFIDENTIAL TRN-0035-07 Rev 07/13/06 25

Recommendations for Series Matching Rules

• MR – Series Description (0008,103e) – or – Image Orientation (0020,0037) – Contrast/Bolus Agent (0018,0010) – Scanning Sequence (0018,0020) – Scan Variant (0018,0021) – Scan Options (0018,0022) – Repetition Time (0018,0080) – Echo Time (0018,0081) – Echo Train Length (0018,0091) CONFIDENTIAL TRN-0035-07 Rev 07/13/06 26

Recommendations for Series Matching Rules

• NM – Image Type (0008,0008) may be used to discriminate series • RF – Images are typically stacked; therefore images are usually displayed as a single series • US – Images are typically stacked; therefore images are usually displayed as a single series • XA – Images are typically stacked; therefore images are usually displayed as a single series CONFIDENTIAL TRN-0035-07 Rev 07/13/06 27

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Hanging Protocol Groups

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Hanging Protocol Groups

• In some cases, the combination of Modality and Body Part is not specific enough for Hanging Protocols • For those cases, it is necessary to create a Hanging Protocol based on specific Exam Procedure Codes • Hanging Protocol Groups are defined by grouping together different Exam Procedure Codes under the umbrella of one User or System Hanging Protocol Group •

Example: The Radiologist would like all ‘2 View Chest’ exams to reference a different Hanging Protocol than ‘Portable Chest’ exams

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Hanging Protocol Group Dictionary

• To create a Hanging Protocol Group: – Log into iSuite – Select the ‘Sys Admin’ tab – Select the ‘Dictionaries’ tab – From the Dictionary List, select the ‘Hanging Protocol Group’ link CONFIDENTIAL 30 TRN-0035-07 Rev 07/13/06

Dictionary Entries

• Click ‘add new’ • Type the name of the Hanging Protocol Group in the ‘Code’ field and ‘Description’ field 31 CONFIDENTIAL TRN-0035-07 Rev 07/13/06

Dictionary Lookup

TRN-0035-07 Rev 07/13/06 • To associate an Exam Code to the Hanging Protocol Group: • Select the ellipsis button

“(…)”

to access the Exam Code Look-up Table • Select the exam code from the list 32 CONFIDENTIAL

Add Exams to Hanging Protocol Groups

• Click the ‘+’ button to associate the exam code to the Hanging Protocol Group CONFIDENTIAL TRN-0035-07 Rev 07/13/06 33

Hanging Protocol Groups in the Exam Dictionary

• To associate an Exam Code to a Hanging Protocol Group from within the Exam Dictionary: – Click the ellipses

(…)

button – Select the Hanging Protocol Group from the Dictionary CONFIDENTIAL 34 TRN-0035-07 Rev 07/13/06

Create New Hanging Protocol

• The Hanging Protocol Group will be the default Hanging Protocol Identifier for any exam associated with the Hanging Protocol Group CONFIDENTIAL TRN-0035-07 Rev 07/13/06 35

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Body Part Dictionary

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Body Part Dictionary

• The Body Part Dictionary enables the iSite Administration team to associate related anatomy for the purpose of defining prior exams for comparison in Hanging Protocols • The Body Part Dictionary is associated with the Security Code ISTSYSPREF CONFIDENTIAL TRN-0035-07 Rev 07/13/06 37

Preferences Dialog

CONFIDENTIAL TRN-0035-07 Rev 07/13/06 • The Body Part Dictionary can be accessed by selecting the ‘P’ icon in the upper-right corner of the iSite Control Strip 38

Body Part Dictionary

TRN-0035-07 Rev 07/13/06 • Select ‘Body Part Dictionary’ from the ‘System Preferences’ list – Select ‘Add’ to create a new entry in the dictionary, or – Select ‘Properties’ to edit an existing entry 39 CONFIDENTIAL

Edit Body Part Dictionary Dialog

• As illustrated at left, the body part “head” is equivalent “brain,” “iac,” “orbits,” “sinus,” and “skull” • Additionally, the body parts listed in the ‘Equivalents’ frame, are equivalent to the body part “Name” as well as all other equivalents •

For example: “head” is not only equivalent to “brain” but also equivalent to “iac”

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CONFIDENTIAL For assistance, please call customer support at 1-877-328-2808 or 1-877-328-2809 TRN-0035-07 Rev 07/13/06 41

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