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User Success Story

User Success Story. Johannes Gutenberg-University Department of Radiology, Mainz, Germany. prepared by Peter Mildenberger, MD. Topics. Infrastructure ( Hospital / Radiology) IT - responsibilities IHE Integration Profiles used Further developments Conclusions.

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User Success Story

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  1. User Success Story Johannes Gutenberg-University Department of Radiology, Mainz, Germany prepared by Peter Mildenberger, MD

  2. Topics • Infrastructure (Hospital / Radiology) • IT - responsibilities • IHE Integration Profiles used • Further developments • Conclusions

  3. University Hospital Mainz and Department of Radiology • 1500 beds, ~100 wards • 53.000 inpatients/year, 190.000 outpatients • >30 examination rooms • ~ 500 exams / d • ~ 15 clinical conferences / d • RIS since 1988 • PACS since 1996(Rad, Neurorad, NUK, Endo, Dent..) • >30 modalities (e.g. 5 CTs, 5 MRs, 5 CRs, 3 DRs..) • 15 - 20 GB / d as new data • ~ 25 TB online (>40 million images)

  4. Internal 210 Orthopedics503 Surgery 505 Internal701 Radiotherapy Ward 401-2b Departmental Structure Dept. of Radiology Angiogr. Skeletal R Angiogr. CT Radiotherapy Ward CT CT DL DL DL DL MRT MRT Neuroradiology MRT Thorax Mammography Thorax Angiogr. Skelett Thorax Skeletal R CT ICU Skelett ICU DL Ward US Chest US Skeletal R Archive/ Workstation

  5. HIS (Administration) IT Depart in Administration SAP/R3 and IS-H* productive General IT Concept • PACS • Radiology • all DICOM - Objects • central server , RAID + long term storage • DICOM-Viewer • separated workgroup-servers with on demand access • productive HL7 Digital Archive for paperbased files Medical Informatics Microfiche plus Web-Access not available yet! EPR IT Department in Administration SAP based (IS-H*MED) first pilots (2 of 30 dept)

  6. The IHE Radiology Workflow X Modified according to N. Wisrz, PhD, Siemens

  7. Modality Worklist / Performed Procedure Step Name, Date of Birth Accession number UIDs et al. MWL: RIS (gap it!, iSoft) Acq. modality (Integris, PMS) Exposure Time Total dose Exposure dose Fluoro dose Number frames Fluoro time Number series MPPS with auto- matic transfer of:

  8. Pitfalls in conventional documentation • Exposure data *10-100 • incomplete document • Diff. in Fluorotime >20%

  9. Consistency and Completeness of Image Archiving RESULT: • ~ 25000 images / d • ~ 500 studies / d • manual control takes 5 - 15 min / modality • ~ 3h/d for the complete department

  10. Storage Commitment – Push Model Please take responsibility for safekeeping of data O.k., commitment for archiving images permanently PACS (ImageDevices) P A C S DVD Acq modality

  11. Ophthalmology Gastroenterology Urology Cardiology Onkology Dermatology Dental Imaging ... Total (outside Radiology) 300 GB / year 300 GB / year 250 GB / year 900 GB / year 400 GB / year 750 GB / year 700 GB / year ... 5 TB / year Survey in different Departments (est.)

  12. Conclusions • flexible implementation, less independant from a vendor • MWL, MPPS, StComm improve clinical workflow, data consistency, quality of documentation,... • IHE is a pragmatic model for the clinical scenarios • IHE profiles should become regular part of RFPs • IHE Process fit also outside Radiology (e.g. Lab., Card.) • IHE is NOT a standard, it is beyond !!! • IHE solves daily-life problems by Integration Profiles

  13. Using IHE there will be less work for „Consultants“ like this one....

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