Basic PACS Administration and Management

Transcription

Basic PACS Administration and Management
Basic PACS Administration
and Management
Edward Wong
1 March 2008
Contents
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Basic PACS components
Real PACS vs Mini PACS
Broker
Printing
QC / Diagnostic workstations
Presentation state
Image flow plans
Queues audit
Contingency plan
Department of Radiology, NTWC
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Basic PACS components
Database
Server
Archive
Server
Application
Server
Processing
Server
PACS
Naming is different for different PACS Vendors!
Department of Radiology, NTWC
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Basic PACS components
ƒ DB Server
ƒ Patient Demo, RIS Reports, Exam Status, DICOM
info of images, Study info, Image pointers
ƒ Application Server
ƒ PACS performance
ƒ User information and configuration
ƒ Archive Server
ƒ Synchronize archives
ƒ Compression and decompression
ƒ Processing Server
ƒ Computing support to Advanced application like 3D,
volume rendering etc
Department of Radiology, NTWC
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Archive System
ƒ Local Hard Disk for each modalities (1 week)
ƒ On Line Data Storage
ƒ Redundant Array Independent Disk (RAID)
ƒ Near Line Data Storage
ƒ Juke Box (Plasmon) - Giga Bytes
ƒ Tape Library - Tera Bytes
ƒ Off Line Data Storage
ƒ ATL / DVD / High Capacity Optical Disk 5.2 Gbytes
Department of Radiology, NTWC
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Archive System (past)
Online: SCSI RAID disk (1-2sec)
SCSI
connection
PACS Server
2 Tier (past)
Offline: MOD jukebox (>30sec)
Department of Radiology, NTWC
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Archive System (present)
Online: SCSI / SAN RAID
disk (1-2sec)
Expand
Nearline: Harddisk (<10sec)
PACS Server
3 Tier (present)
Offline/offsite: MOD jukebox
(>60sec) or Tape (mins.)
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Real PACS vs Mini PACS
Archive
Server
Application
Server
CT Scanner
Mini PACS
CT Workstations
Department of Radiology, NTWC
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Real PACS vs Mini PACS
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No Patient Demo update
No RIS reports
Limited user configurations
Limited worklists on that modality only
Hard to assess images from other modalities
Advantages:
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Full data sets (CT thin cuts, Angio raw data)
Dedicated processing workstations
Tendering process
Department of Radiology, NTWC
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Broker
HL7
HA
HIS
ADT
CR
HA
RIS
HA
CMS
DR
Mitra
PACS
Broker
interface
Appt.,
X-ray
request
Clinical visit
US
RF
PACS
Modalities: Get worklists
PACS: Update report, info etc
Department of Radiology, NTWC
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Broker
ƒ Modality DICOM worklists
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AET: AEDDR
IP: 160.8.12.130
Port: 104
Firewall setting if cross hospital
ƒ Resource
ƒ RIS room name
ƒ Constraints like: today, AET etc
ƒ Multiple rooms/ CR characteristics
ƒ Worklists removal: capture RIS out time
Department of Radiology, NTWC
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Broker
NTWC
RIS server
POH Broker
TMH Broker
Department of Radiology, NTWC
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Broker
NTWC
RIS server
M, N: status
for event table
M
N
POH Broker
N
TMH Broker
Primary
Secondary
Department of Radiology, NTWC
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Printing
Kodak DryView
8700 with 8800
GE ADW
Review
Kodak
KELP 2180
with 180LP
GE PC3
GE PACS
PacsLink
9410
DPS
GE PCS
GE PCS
DICOM
DPS
FUJI FL IMD
Laser Printer
MFL-300
Multiformator
VOXEL Q
Kodak
KELP 2180
with 180LP
KELP XLP
GE MRI
Picker CT
Connection with Digital
Connection with Analog
Inter-connection with two printers
DICOM Connection
Ultra-sound
GE Rm.6
GE Rm.8
Remarks :
•Existing PIU upgraded to DPS.
•U/S direct connect to exist KELP 2180 with
analogofinterface.
Department
Radiology, NTWC
GE PC2
GE PC1
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Printing
ƒ PCS incorporated
ƒ Number of connection
ƒ Origin configuration
ƒ Film sorting
ƒ Speed
ƒ Daylight operation
ƒ Reliability
Department of Radiology, NTWC
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Printing
ƒ Standardization of item locations
ƒ Essential items (name, ID, Sex/Age, Acc #,
Date & Time, Equipment ID etc)
ƒ Date Style (UK / US)
ƒ Printable area
ƒ True size printing (print review)
ƒ Window level / bit depth support
ƒ GSDF
Department of Radiology, NTWC
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? True Size Printing
L
L
Department of Radiology, NTWC
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Printing
ƒ Standardization of item locations
ƒ Essential items (name, ID, Sex/Age, Acc #,
Date & Time, Equipment ID etc)
ƒ Date Style (UK / US)
ƒ Printable area
ƒ True size printing (print review)
ƒ Window level / bit depth support
ƒ GSDF
Department of Radiology, NTWC
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Consistent Printing
ƒ To achieve consistency in image printing
ƒ Creating hardcopy output using DICOM basic print
with Presentation LUT Support
ƒ Calibrate the hardcopy output devices (printers) using
DICOM Grayscale Standard Display Function
ƒ Apply Grayscale Softcopy Presentation State to
control the consistent appearance of images on
softcopy display
Department of Radiology, NTWC
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QC workstations
ƒ Versatile Printing
ƒ Multiple Destinations transmission (status
change)
ƒ Demographic modification
ƒ Media Backup Storage
ƒ DVD burner with DICOM viewer
Department of Radiology, NTWC
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How to apply a marker
Department of Radiology, NTWC
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A little test, what’s wrong?
Department of Radiology, NTWC
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The picture is flipped…
Department of Radiology, NTWC
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Diagnostic workstations
ƒ CPU counts
ƒ Image quality
depends on monitor/
graphic card combo
ƒ Pixel to pixel viewing
ƒ Size of images
ƒ CT: 512 x 512
ƒ US: 256 x 256
ƒ DX: 2048 x 2048
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Diagnostic workstations
Portrait vs landscape ?
Color vs mono ?
5MP
1 vs 4 config. ?
4 monitor for MRI
6 MP
Department of Radiology, NTWC
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Correct Presentation
Acquire
Print
Department of Radiology, NTWC
Display
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Presentation state
Area Of
Interest
Presentation State
Annotate
Area Of
Interest
Consistent Presentation
Zoom
Flip
Without
Consistent Presentation
Window Level
Original Image
Department of Radiology, NTWC
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Image flow plans (examples)
AED General and
portable
CR + DR
General in Dept.
CR + DR
Contingency only
AED General
Use RIS/web
client for VNC
verification
General Rm1
Use RIS/web
client for VNC
verification
Impax 3 for QC,
review and local
storage
Manual send
Web
Server
Auto send
POH PACS
Auto send
Department of Radiology, NTWC
IT ePR
gateway
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Image flow plans (examples)
Ultrasound
IU22 in
RB
DRePR
ePR
Auto route
VF4 (QC
& review)
Manual send
after QC,
TMHAERW2
routing
Easy Access
(US)
General
CR console after
QC, auto send out
images
Auto route
TMHAERW1
(VNC to verified)
Department of Radiology, NTWC
1. TMHAEEA
2. ePR
3. AED web server
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Image flow plans (examples)
IP table
Common name
IP
AET
hostname
port
MAC
Remarks
Ultrasound TMH:.RB.3.029.D01-04 & TMH.RB.3.030.D01-04; GATEWAY 160.8.48.254 MASK 255.255.255.0
IU22
160.8.48.101
IU22
104
00-D0-68-06-77-73
PHILIPS IU-22 IN RB
VF4
160.8.48.102
VF4
3010
00-1A-A0-A9-EF-19
View Forum
Easy Access (US) 181.8.7.111
EA_US
7818
Easy Access (store only)
DRePR
160.8.12.64
DRePR
104
GATEWAY 160.8.12.253
TMHAERW2
160.8.12.142
TMHAERW2
104
GATEWAY 160.8.12.253
FUJI DPX7
160.8.48.109
TMHDPX7R1
Kodak
KELP2180
160.8.12.58
MIM200
tmhdpx7r1
104
00-00-74-C7-27-B0
Fuji Printer
5040
8x10, 14x17
Backup printer in ACC
Department of Radiology, NTWC
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Queues audit
1st QC
2nd QC
QC workstation
in AED
DX console
Matching
ePR
LDGW
Review by
web
Clinician
reading via
ePR
HA ePR
Server
Department of Radiology, NTWC
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High availability
ƒ In information technology, high availability
refers to a system or component that is
continuously operational for a desirably
long length of time. Availability can be
measured relative to "100% operational“.
A widely-held but difficult-to-achieve
standard of availability for a system or
product is known as "five 9s" (99.999
percent) availability.
Department of Radiology, NTWC
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99.999% uptime
ƒ By calculation
ƒ 24hr x 60min x 356days = 525600 mins
ƒ 0.001% downtime = 0.001% x 525600 =
5.256 mins
ƒ So if 99.999% availability is required, the only
downtime per year is ~ 5 mins
ƒ More reasonable downtime is 52.5 mins
which means 99.99% availability
Department of Radiology, NTWC
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Contingency plan
AED X-ray Contingency Plan for break down of machine (including DR X-ray and CR system)
1. Call respective vendors for service (GE/Agfa/Philips/Fuji etc)
2. Hotline for Services
Agfa 28739335 (Mon-Fri 09:00-18:00) 77780378 (Sat, after office hours and PH)
GE 21006288 (24 hours)
Philips 28215473 (24 hours)
Fuji 61130089 (24 hours)
3. We have enough numbers of CR readers backup, just relocate them after power off and power on again
4. If DR X-ray is down, go to Trauma room 1 for backup
5. If DR Erect detector is down, may continue to use the room, Chest stand and CR is used for Erect Projections
6. If TMHAERW1 is down, shift to TMHAERW2
7. If Broker is down, manual input of Patient name and ID and accession #, verified in TMHAERW1 as usual.
8. If RIS is down, manual input of Patient name and ID and manually sent to Web Server only, do not verified in
TMHAERW1 until all patient demographics are edited afterwards.
9. If Web Server is down, revert to film printing for AED
10.If CMS for AED is down, shift to another workstations as there are total 15 workstations for them to use
11.If the whole CMS system is down, revert to film printing for AED
12.If CS5000 in C2 or AED is down, relocate the backup CS5000 for them (park in Trauma room Control)
13.If AED Network is down, depends on which switch or port is down, may need to continue services in the Main
Department. Please refer to next page for details
Please inform Administrator and mark down the incidents afterwards in the log!
Department of Radiology, NTWC
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Thank you
www.pacs.hk