The field of orthopedics has been experiencing a significant change for some time: whereas, only a few years ago, physicians used to plan their interventions and implants by way of contour templates placed on X-ray films, digital technology is now also increasingly being introduced also to this discipline. This is leading to a fundamental paradigm shift, with modifications occurring to habitual processes. As a consequence, not only is work made easier for orthopedists, but quality of care of patients is improving - from planning to intervention and post-operative treatment.
For the purpose of diagnostics, orthopedists use X-ray images from a variety of modalities. More often than not, images from referring physicians - on CD or scans from conventional images - are integrated into the planning of interventions. In order to allow for a smooth workflow, availability of all these images in the PACS is indispensable. For an efficient treatment, the integration into leading systems for patient administration, in particular hospital information management and GP office solutions, is beneficial. This allows for rapid retrieval of all relevant information in the context of the patient.
Software also facilitates the work of orthopedists with regard to the reporting process. Routine work steps are automated, e.g. by highly specialized hanging protocols. These have been programmed on the basis of know-how from expert reporting physicians. However, the hanging protocols can be adapted to the individual work habits of the respective physician at any time. Their use safeguards rapid and efficient reporting. In order to make sure that the physician "feels at ease" with the reporting environment, the graphic user interface can be adapted to the individual needs.
For the consistent realization of a digital image workflow, it is an essential requirement to make available the images in digital format, anywhere on the hospital campus, and in a manner which is tailored to the needs of the respective user. It is obvious that intervention planning is among the target user environments. JiveX is designed to support the orthopedist as best as possible in the pre-operative planning. Integrated special software facilitates these tasks. This software includes, among other features, digital templates and orthopedic measuring functions.
The complete intervention plan based on these tools can be stored with all notes, and retrieved anytime for modification. For the subsequent tasks in the operating room, the orthopedist can arrange a selection of images, and save them in a dedicated directory. The same holds true for the pre-intervention ward round. The resulting collections of images are then displayed during the intervention exactly in the way defined pre-operatively by the physician. Of course, all other exams can also be accessed in the PACS if the intra-operative situation makes this retrieval necessary.
In the orthopedic OR, images are typically acquired from a variety of sources: endoscopic or sonographic images, images from X-ray devices and the C-arm, or videos from OR cameras, partly also including sound. All these different captures can be integrated selectively or comprehensively into the PACS, and are available for retrieval from that moment onwards anywhere on the hospital campus.
For post-operative image processing, JiveX offers physicians an integrated video cutting workplace with export functions. There, video DVDs can be produced easily. For subsequent processing, there is the option of passing on the native video sequences downstream to dedicated video processing applications. This helps to keep all options open for the user. This approach allows creating and integrating even extensive archives, for use in teaching or for publication purposes, into the workflow.
Archiving images and reports is done in a flexible manner, adapted completely to the needs of the individual customer. As soon as they are stored in the PACS, both, images and reports, are available to all authorized users anywhere on the hospital campus. This facilitates interdisciplinary communication and safeguards optimal patient care.
Even post-operative checks are no longer an issue because the images acquired during the intervention are available to the reporting orthopedist or radiologist by way of the PACS. This fulfils a key requirement for accurate evaluation of post-operative checks.