The National Institutes of Health Clinical Center digital imaging network, picture archival and communication system, and radiology information system

Abstract

In this work, we describe the digital imaging network (DIN), picture archival and communication system (PACS), and radiology information system (RIS) currently being implemented at the Clinical Center, National Institutes of Health (NIH). These systems are presently in clinical operation. The DIN is a redundant meshed network designed to address gigabit density and expected high bandwidth requirements for image transfer and server aggregation. The PACS projected workload is 5. IN THIS WORK, we describe the digital imaging network (DIN), picture archival and communication system (PACS), and radiology information system (RIS) currently being deployed at the Clinical Center, National Institutes of Health (NIH). The first phase of the NIH Clinical Center DINIPACSIRIS solution was implemented within a to-month period and followed a master plan that started with the issuance of a PACS Request for Proposal (RFP).l During this initial phase, all systems were brought into "live state," ie, into clinical operation.Historically, the deployment of a modern RIS and implementation of a fast DIN at the NIH Clinical Center were driven by needs created by a PACS environment. In fact, we consider a RIS and a properly sized DIN mandatory prerequisites for an enterprise-wide PACS. The RIS, in turn, has its own prerequisites that are related to the existence of a bidirectional messaging mechanism with the hospital information system (HIS), preferably using electronic data sharing standards such as Health Level 7 (HL-7),2 Once the RISIHIS and associated interfaces are in place, as well as a network capable of handling imaging density, then one is ready to start a successful deployment of an enterprise-wide PACS. This statement does not imply that the physical implementation of these systems should happen in a serial fashion. Actually, in our case, all of these systems were implemented in parallel, yielding greater economies of scale and resource optimization. RADIOLOGY INFORMATION SYSTEMThe RIS follows a client-server model and provides tools to order examinations, schedule resources, retrieve and review results (including images, as an option), chart clinical data, and generate management reports. The RIS also offers interesting possibilities related to increased research support. The benefits yielded by a well-design, welldeployed RIS are associated with enhancements in the quality of radiologic services, improvements in data access, potential cost reductions, and improvements in operational processes. Ultimately, the goal of our DINIPACSIRIS project is to improve workflow within the enterprise.In order to allow interoperability across the enterprise, the RIS must be integrated or, at least, interfaced to other medical information systems and mission-critical legacy systems. Our RIS interfaces include a PACSIRIS broker engine, a bidirectional interface to the digital dictation system, and several bidirectional interfaces to the HIS including incoming/outgoing admissions, discharges, and transfers (ATDs/demographics), orders (with ...

A Review of Medical Imaging Informatics

“…However, from an informatics perspective we consider PACS to belong to the area of traditional data processing and information systems. For this field, we refer readers to recent excellent reviews on PACS research and development 4–6. Medical image processing and analysis is again a broad subject with several research areas of intense activity.…”