1
PACS And The Technologist
Gen Rad/CR - Workflow
2 FIC Local Archive MIA Long Term Storage CR Processing
Modality Worklist - Use
Modality Worklist to Pull Patient and Exam Data
*** [! - 5 ] ***
Tech ID - Enter User
Tech ID
*** [! - 6] ***
Submit - Submit Data
*** [ ! - 7 ] ***
Scan Cassette(s)
-Assign Anatomy To Each Cassette
*** [ ! - 8] ***
Process - Load Cassette
on CR
Post Exam Processing
- Check: Images Match Anatomy Marker(s) Technique Orientation Distance Time
Accept - Accept To Push
Images Patient Retrival Image On DxW Radiologists Diagnostic Workstation Image On CID Provider PC Viewer Perform Exam RIS Arrival - Patient Arrived Order Request – Prints ***[ ! - 1]*** Verify - Verify Exam and Resource (Correct if needed) *** [! - 2] *** Technologist Worklist - Begin Exam - Using Technologist Worklist required *** [! - 3 ] *** *** [! - 4] *** QA CID - Verify
Images are on CID without exceptions
DxW - Verify
Images are on CID without exceptions *** [ ! - 10] *** See Stentor Technologist Image Confirmation Document For Help RIS Complete -Complete exam on RIS *** [ ! - 9] ***
*** ! - 1The Order Request contains vital information that can be visually identified on the form. Information includes patient name, MRN, accession, and resource.
*** ! - 2Selecting the correct resource triggers message to PACS with patients demographic information, failure to do this will cause exam to be in exception status on PACS.
*** ! - 3Using Technologist Worklist on RIS allows for changing resource in one step at exam begin
*** ! - 4Beginning exam on RIS triggers Modality Worklist on CR. Users are required to begin exam prior to performing exam.
*** ! - 5Using Modality Worklist to pull patients demographics and exam data will eliminate the need to type patient information manually, and will ensure data is accurate.
*** ! - 6 Enter Tech ID using barcode provided by your RIS Admin, if user does not have barcode enter name or tech initials depending on facilities protocol.
*** ! - 7Verify patient demographics again and press SUBMIT button on CR Screen to save data on screen and to open cassette window. Opening cassette window is important to allow for visual matching of cassette ID and projection when scanning cassettes.
*** ! - 8When assigning cassette to virtual cassette on screen, verify that the virtual cassette matches projection that was taken, (i.e.. PA vs. AP, Grid vs. Non Grid) User should select a different projection for every cassette scanned, unless they repeated the same projection twice.
*** ! - 9Completing an exam on RIS is important because this triggers a completion or “C” flag to the PACS indicating to the radiologist that there are no more images to follow.
*** !-10QA is the most important step in this workflow because it allows one last opportunity to ensure data and image integrity. QA is required and technologist will perform visual confirmation of data and image integrity on Stentor application.
GEN RAD/CR - Workflow
3
RIS
4
RIS - Arrival
The order request prints.
Why is arrival on RIS important?
! - 1
5
RIS - Order Request/Verify
The order request contains vital information that can be visually verified
Vital fields on request
Patient Name
MRN
ACC
Resource
Procedure
Fields vital to PACS
! - 1
Fields can be used for
manual entry
6
RIS - Order Request/Verify
What should I be verifying on the Order Request Form?
! - 2
•Verify Resource on form and change if necessary during RIS Exam Begin
Why is Resource so important?
•Only certain resources are setup on RIS to trigger the “RIS HL7 message to PACS” •Selecting the correct resource triggers message to PACS with patients demographic information
•Failure to select the correct resource will cause “RIS HL7 message to PACS” to not be sent •IF “RIS HL7 message to PACS” is not on PACS images will not pass validation and study flagged
as an exception
7
RIS
Technologist Worklist
8
RIS -
Technologist Worklist
Workflow Manager - Technologist Worklist
Click Here
Note: If you have not used it you will need to set it up.
! - 3
! - 4
9
RIS -
Technologist Worklist
! - 3
! - 4
Technologist Worklist - One Time Setup
Start The Wizard
Click Next Click Button
Select RM 2
Click OK
10
RIS -
Technologist Worklist - Begin Exam
Select Patient Click BEGIN
Select Resource
That’s it! The exam was begun!
! - 3
! - 4
11
RIS – Technologist Worklist
Why is it important to begin exam using the Technologist Woklist?
•Remember is very important to understand the RIS-Scanner resource relationship! •NOTE: Slides number 19 & 20 will explain this in full detail. •The most important thing to take from this step is that beginning the exam on RIS is what triggers
the RIS HL7 demography data message to be available to query/”pull” from the scanners •Secondly Technologist Worklist allows you to change resource prior to beginning exam … and
with only one simple click
•Selecting the correct resource is vital because once you are at a scanner the it will have a resource name like “R2” … so if you selected a different resource on the RIS the RIS HL7 message
demography data will not be available at the “R2” scanner
! - 3
! - 4
12
13
CR - Main Menu
From CR ROP Or Main Console Main Menu - Select “Study Data”
14
CR - Worklist/Study Data
Patient Data Menu - Put Cursor On “Accession Number”
From CR ROP Or Main Console - Use Scanner Gun to Scan RIS Form“ACC”
15
CR - Worklist/Study Data
Patient Data Menu - “Accession Number” Should Populate
12345678
16
CR - Worklist/Study Data
Patient Data Menu - Once The Accession Number Is Present
12345678
Press “Find Remote” To Activate Modality Worklist Interface
If Data not found it can be added manually
! - 5
17
CR - Study Data
You Will See A “Waiting For Response …”
18
Modality Worklist Interface
Integrated
Medical
Imaging
Solutions
19
Modality Worklist Interface
What is Modality Worklist Interface?
It Is An Interface Between The Modality/Scanner And RIS Only
It Is “On Demand”
Modality/Scanner Queries RIS for HL7 Demography Data Message
! - 5
20
Modality Worklist Interface
Why is Modality Worklist Interface Not Working?
The RIS Does Not Respond Because No Patient Is Being Done On “R2”
! - 5
21
Importance of Using the
Modality Worklist Interface
•Remember is very important to understand the RIS-Scanner resource relationship! •Patient information is retrieved from RIS – no need to enter manually into the scanner
•Patient information is retrieved from RIS – Data is accurate, less chance for errors.
•Being able to retrieve information to Modality/Scanner using the Modality Worklist Interface is a good indication that the Technologist has done everything correct up to this point. •Patient information is retrieved from RIS – no need to enter manually into the scanner
•Patient information is retrieved from RIS – no need to enter manually into the scanner
22
CR - Tech ID/Study Data
Patient Data Menu – Verify That Cursor Is On “Tech ID” - Scan Badge
From CR ROP Or Main Console - Use Scanner Gun to Scan Badge
! - 6
23
CR - Submit/Study Data
Patient Data Menu - Once The “Tech ID Is Present
Press “Submit”
! - 7
24
CR - Study Data
25
CR - Images - Scan Cassette
The “Virtual Cassettes” Will Now Show Up/Select Anatomy (Like PA)
From CR ROP Or Main Console - Use Scanner Gun to Scan Cassette (s)
! - 8
26
CR - Images - Scan Cassette
The “Cassette” Will Now Show The Scanned Cassette ID
Repeat This Step for all positions taken
! - 8
27
CR - Images - Processing
28
CR - Images Post Process
Verify Anatomy Matches / Performs Post-Processing If Required
The “Virtual Cassettes” Will Now Show Display Images
Select “Accept All Images” To Push Images
29
Complete Exam RIS
CID/DxW - Image Confirmation
See “Stentor Technologist Image Confirmation” For Help On This Step
Continue To Complete Exams As Usual
! - 9
! - 10
30
CR101
31
IMAGE VALIDATED
32
INPROGRESS
33
34
ACC NOT ENTERED
35
ACC ENTERED INCORRECT
36
37
MRN ENTERED INCORRECT
38
INVALID MRN ACC PAIR
39
40
CANCEL UNCOMPLETE
41NOT COMPLETED
42CR101
What have we learned?
•Why is it important to arrive on RIS? •Why is the Order Request important tool? •Why is using the Technologist Worklist on RIS an important tool?
•Why is Beginning an Exam on RIS important? •Why is using the Modality Worklist Interface an important tool?
•Why is it important to get a barcode with your name? •Why is it important to “Submit” once you have entered Study Data and Tech ID?
•Why is it important to verify that the anatomy matches virtual cassette? •Why is Completing an Exam on RIS important?
