VISTA IMAGING. Catherine Moore, IHS Vista Imaging Coordinator

Transcription

1 VISTA IMAGING Catherine Moore, IHS Vista Imaging Coordinator

2 WHAT IS VISTA IMAGING VistA Imaging is the multi-media component of the IHS-EHR. It captures clinical images both DICOM and non-dicom, gray scale and color images, scanned documents, and other nontextual data files and makes them part of the patient's electronic medical record. VistA Imaging enables EHR users to view scanned documents and clinical images (photos, radiographs, etc.) that are linked to a patient's electronic record. It also provides Picture Archiving and Communication System (PACS) capabilities for the longterm storage of radiographic images. VistA Imaging provides clinicians with access to all images and text data in an integrated manner that facilitates the clinician's ability to make patient care decisions in a timely and accurate way.

3 VISTA IMAGING COMPONENTS Clinical Capture Clinical Display DICOM Gateways (Text and Image) VistARad Diagnostic Reading Software Background Processor (VIX, Telereader, AWIV) Tier 1 Storage Clustered RAID Tier 2 Storage Optical Archive

4 VISTA IMAGING VS COMMERCIAL PACS What is a Picture Archiving and Communication System (PACS)? A PACS is a medical imaging technology which provides storage and convenient access to electronic images from multiple modalities. The universal format for PACS image storage and transfer is DICOM (Digital Imaging and Communications in Medicine). A PACS consists of 4 major components: Imaging modality such as CR, CT, or MRI A secure network for transmission of patient information Diagnostic workstations for interpreting and reviewing images Archive for the storage and retrieval of images How is VistA Imaging different from a Commercial PACS VistA Imaging is an RPMS application and integrated into the EHR VistA Imaging provides diagnostic quality reading software at no additional cost IHS has contracts with the VA and HP to support VistA Imaging

5 VISTA IMAGING Class 1 Medical Device The Food and Drug Administration (FDA) classifies this software as a medical device. As such, it may not be changed in any way. Modifications to this software may result in an adulterated medical device under 21CFR820, the use of which is considered to be a violation of US Federal Statutes.

6 Image Storage Flow DICOM Modality Background Processor Archive Appliance Cache RPMS HIS DICOM Gateway Clinical Capture/Display Tier 1 RAID Image Primary Storage Cluster (IMAGE1$ share) The Background same Clinical process Capture Here Processor applies are writes the continuously to players images images to captured Tier 1 storage through AA monitors software Clinical DICOM and Capture moves processes Gateways files sets queues from VistA AA Imaging cache queue to (in WORM Background RPMS) media to have Processor files copied copies to images tier 2 from storage Tier 1 storage to Archive Appliance (Tier 2) Tier 2 Archive Image Archive Storage (IMAGEJB1$ share)

7 VISTA IMAGING Clinician Benefits Availability of PT Data Integrated into EHR Increased Productivity Future Applications- remote viewing

8 VISTA IMAGING TERMS aka Clinical Workstations Runs parallel with EHR. View scanned documents and Radiology studies FDA Controlled Medical Device Diagnostic Quality Imagery

9 Standard VistA Imaging Hardware Configuration 2 Clustered servers 1 SAN Management Server 2 DL360 gateway servers 1 EVA 4400 Storage subsystem 1 MSL 2024 LTO4 tape library HP 3-year support 1 backup Exec 5 MS W2008 SRV HP Installation and Integration Services 3 smaller hardware configurations available for small facilities 2 approved vendors- HP and Dell

10 VistA Imaging Display

11 VISTA IMAGING IS INTEGRATED INTO IHS-EHR FOR RADIOLOGY IMAGES AND REPORTS

12 VistA Rad

13 IMPLEMENTATION SEQUENCE Functionality Hardware Software Phase 1: Document Scanning Scanners, PCs, Clinical Capture & Display Workstations **************** Background Processor / RAID & LTA EHR V.I. KIDS & Client Software RPC Broker Scanner Drivers Phase 2: Capture & View Radiology Images via DICOM Capture & Display Workstations Radiology Pkg updates Modality Worklist Objects Level 3: Capture & View Radiology Images via DICOM and VistA Rad Diagnostic Workstations VistARad Workstations VistaRad Software

14 Status of VistA Imaging across IHS VistA Imaging Sites as of 12/12/2012 Federal Hospital 29 Federal Health Ctr/Stn 70 Tribal Hospital 9 Tribal Health Ctr/Stn 50