Within radiology departments, image management based on the DICOM Standard is already an integral part of most hospitals. However, the non-radiological modalities are generally decentralized and distributed throughout the hospital campus with records being located locally at the point of creation. Each local system has its own viewer and a separate archive. To make matters worse, it is often that case that the results cannot be exported or imported digitally with the result that complete information is not available campus-wide.
Modern image management is extremely comprehensive and complex. Today, in addition to image data and bio signals, photographs and videos need to be integrated, irrespective of whether they are in DICOM or NON-DICOM format. As well as Radiology, this includes other clinical departments, such as Endoscopy, Sonography, ECG and Wound Documentation. In those fields, data is generated in image or document formats such as
PDF or JPEG. In order to allow the integration of all data sources into the clinical routine, a unified basis is required. Here, standard PACS systems reach their limits as they are optimized for the radiological workflow. For example, display functions are missing for Videos, ECGs and PDFs. VISUS bridge exactly this gap by offering JiveX Integrated Imaging and so combines all modalities in the hospital-wide workflow.
The basis of this high performance solution is the consistent use of the DICOM standard and the implementation of IHE profiles. For more than twelve years, VISUS has supported cross-image-based processes in the hospital and thus has a great expertise in their integration into clinical workflow.
With JiveX Integrated Imaging, VISUS focuses on image, video and bio signal data without constraints imposed by department boundaries. This is how the system offers users the opportunity to optimize campus-wide workflows. The efficiency potentials are found primarily in the management and optimization of workflows in the context of reading/reporting and image distribution. JiveX Integrated Imaging offers, among other things, workflow profiles (Hanging Protocols) thus allowing the physician to arrange his exams automatically to his own specific needs. This saves a lot of time in a standardized diagnostic workflow and therefore also saves money. To enable smooth workflows across the campus, JiveX Integrated Imaging is integrated into the processes of special diagnostic systems including the Hospital Information System (HIS). The communication is based on known and established standards such as DICOM or HL7. Thus, JiveX Integrated Imaging provides one hospital-wide DICOM worklist for all departments and functional areas outside Radiology.
By integrating JiveX Integrated Imaging, all image management for an entire healthcare organization is covered. In this context, it is of no importance whether the data is available in DICOM format or not. JiveX Integrated Imaging is able to take data from any source and save them consistently in the DICOM format. A unified viewer that can be accessed via the HIS allows the system-wide representation. This makes JiveX Integrated Imaging a central access point to all image data in the clinical workflow. The unified viewer offers ergonomic operation and allows secure portal solutions to be built with ease.
Effectiveness results from the interplay of all relevant information systems in a healthcare organization. A ward may, e.g., create an order “resting ECG” in the HIS. This procedure can be applied to any order types. However, for an investigation, an order is not always given. Both processes are outlined below.
In order to ensure processing in compliance with standards, the order is communicated as an HL7 Order Entry (ORM) message, and JiveX will create, via the DICOM Worklist Broker, a worklist for the ECG device. Simultaneously, the order is scheduled in the service facility management of the HIS.
Subsequent to the exam, the service rendered is entered automatically and the ECG data is handed over as bio signals to JiveX.
Through the acquisition of bio signals from ECG machines it is now possible, to display the presentation and reporting of electrical signals from the heart on a computer screen whereas previously this could only be done on paper.
During reading/reporting, the physician can retrieve and view the images from the HIS or the electronic medical record (EMR). The linking of the patient and the images is safeguarded via the unique order number or patient number. Thanks to the viewer displaying all images, the physician can access directly any existing information from the patient record – e.g. Sonography, Endoscopy, CT and others – and consult that information for the definition of the subsequent treatment strategy. When reading/reporting or writing the physician’s letter, the physician simply copies the relevant images from the viewer directly into his report. An HL7 message sent to the HIS safeguards that access to the exam information remains possible from the electronic medical record even after diagnostics. The integration of JiveX into the order process was, among others, realized in the following systems: Agfa (Orbis), iSOFT (ClinicCentre), Meierhofer (MCC), Siemens (medico, ish-med), Systema (fd-klinika/highdent-plus) and Tieto (iMedOne).
JiveX Integrated Imaging does not only integrate modalities and image data in a vendor-neutral manner; it also carries out central archiving of all the above-mentioned data in DICOM format. Over the decades DICOM has established itself as the standard in medical image data communication and archiving. It has been defined for a variety of modalities and formats and is being extended continuously. On this basis, images from image sources such as slit lamps – one of the most important devices in ophthalmology – can be integrated into the campus-wide workflow.
Using JiveX Integrated Imaging, the hospital no longer needs to concern itself with storing data from various dedicated systems in multiple locations; this is carried out in a consolidated way. This results in legal, organizational and financial benefits. The archive is flexible and entirely adapted to the requirements of the individual customer. The options for storing and archiving data include online storage, storage area networks (SAN), network-attached storage (NAS), and directly attached hard disk systems (RAID, DAS). Of course, offline storage is also supported on DVDs, BluRay discs or magnetic tapes. Whatever the technical realization may be, the user is informed in a transparent manner via status notifications about the archiving status.
Thanks to the approach of matching data with order confirmations from the coordinating information system, process quality is ensured at all levels of the image processing cycle.
As a separate product for long-term archiving, VISUS offers JiveX Storage Service for PACS (SSP). This service enables the customer to store data in an external archive operated by a service provider who has been contracted by VISUS. This type of data storage enables cost-optimized operation for the user. Fees are based on a pay-per-use model. No additional investment is required. There is no long-term tying-up of capital. Costs can be planned because there are no additional expenditures for migration, administration, or maintenance.