Installation of a clinic-wide system for distribution of radiological data

Problem: This report describes the problems that can occur in the represent ation of the radiological workplace in a digital environment. On one hand t he radiologist can sometimes access good equipment in "stand-alone" surroun dings (CT, laser printer, workstations,...); on the other hand,the existing insufficient communication between different components is only rarely qua lified to support the radiological workflow. This unsatisfactory framework handicaps the required clinic-wide distribution of radiological information . Methods: From the beginning we defined user groups requiring different radi ological data closely associated with specific hard- and software: The radiological workstation in the department for reporting and image proc essing The demonstration workstation in wards/ outpatient departments for clinicia ns involved in treatment Standard PCs with access to the digital medical document for clinicians inv olved in treatment At all workstations the medical as well as the legal unity of digital radio logical images and the corresponding report is ensured. Results: Only the first two user groups have unrestricted access to the RIS database and to the PACS achive. We have decided that the RIS should be th e master of the RIS/PACS-System. For an effective master/slave relationship between RIS and PACS archive and PACS workstations we suggest to mark imag es and/or series of images. Conclusion: The third user group depends on the information exported by the radiologist from PACS. After the report is written and signed by the radio togist,the digital report is transferred from the RIS to the HIS. The repor t is automatically attached to these images. Authorized personnel at the wa rds and outpatient are able to read the combination of validated report and exported radiological images as part of the digital medical record with an intranet browser on standard PCs.