Information relevant to radiological applications is commonly managed by several autonomous medical information systems including hospital information systems (HIS), radiological information systems (RIS), and picture archiving and communications systems (PACS). In this report, we expiain the need to coordinate these systems and to provide some framework in which they can exchange information. In the first half of this report, we describe the integration of a PACS system into a hospital operation. Next, we present the interfacing methods between the HIS and the RIS, and between the RIS and the PACS. Two methods are further detailed for the communication between the RIS and the PACS (1) the triggered database to database transfer, and (21 the query protocol. The implementation of the first method successfully allows RIS reports, procedure and patient demographic information to be displayed at the request of the user along with the associated images at a PACS workstation. The query protocol allows a PACS to dynamically query RIS information. It will be eventually integrated into the design of a scientific multimedia distributed medical database system built on top of the HIS, the RIS, and the PACS.
Copyright ~ 1993 by W.B. Saunders Company
KEY WORDS: PACS, HIS-RIS-PACS interfacing, HIS, RIS, Medical Information Systems.
ARIOUS information systems in hospitalenvironments independently address the management of certain subsets of medical and administrative information using conventional database management methods. Radiological picture archiving and communication systems (PACS) allow image data from once autonomous imaging systems to be sent to general purpose networked computers and provide efficient communication, retrieval, and display of radiological images. Radiological information Lately, it has become increasingly important to consider some framework to unify the coordination of HIS, RIS, and PACS, to consider their interrelationships, and to allow these systems to exchange information. For radiological applications, there is currently no framework to integrate and to process multimedia data stored in several distributed medical information systems. This clearly limits the querying power for the radiology department's clinical usage which is concerned in particular with correlating radiographic features stored in PACS, HIS, and RIS. The diagnostic process requires the search for corresponding radiological images in the PACS, the retrieval of patient and examination information from the RIS and the HIS, and the gathering of the results for further processing (le, determining the diagnosis of the patient). PACS, RIS, and HIS are likr to forma set of heterogeneous database systems, in which each database may use a different quevy language, data model, and access technique. Therefore, retrieving the data to answer high level clinical and research questions is no simple matter.
INFORMATION SYSTEM ACCESS DEStGNRecent advances in network communication technology make it feasible to efficiently and reliably interconn...