Study status consistency and duplicate-read protection in a distributed architecture

This presentation will discuss the benefits and pitfalls of implementing a study status and duplicate-read protection mechanism within a distributed p icture archiving and communication system (PACS) architecture. There are ma ny advantages to a distributed PACS network in which image studies are prea ctively pushed to reading stations before they are required by a radiologis t. The absence of a central server, which serves on demand, makes managing study status and protecting against duplicate reads challenging. The system to manage study status and read access must be efficient, robust, and easy to administer. A system is presented that accomplishes these goals while m aintaining the advantages of a distributed architecture. Methods: The basic workflow of the system is that image studies acquired at a modality device are automatically sent to an archive server. Using a set of advanced routi ng rules, the archive automatically routes studies to diagnostic workstatio ns where studies are candidates for diagnostic read. The workstations displ ay a list of all local studies available for reading. A monitor application running on the workstations coordinates access to studies for diagnostic r ead. Once the status of a study has been changed, the workstations on the n etworks and the archive are notified, which causes the study to be automati cally removed from any list on a workstation where it might be a read candi date. Results: Implementation of this system provides a balanced workflow t hroughout the system while minimizing the need for costly high-speed networ k hardware. Additionally studies are read as soon as they are available by the next available radiologist. This workflow is enabled without the need f or specific interaction by any of the radiologists on the network. By havin g the images available at the workstation in an organized worklist, this me thodology increases the efficiency of the radiologist. Conclusion: The impl ementation of this system enables a radiology department, or even a special ty group within a department, to gain the benefit of a distributed system a s well as the benefits provided by a central-server architecture. This can be done very cost effectively with minimal configuration overhead and hardw are requirements, Copyright (C) 2001 by W.B. Saunders Company.