IntelliSpace PACS 4.4. Image Enabled EMR Workflow and Enterprise Overview. Learning Objectives

Transcription

1 IntelliSpace PACS 4.4 Image Enabled EMR Workflow and Enterprise Overview Learning Objectives Use the Cerner EMR to view images and reports via IntelliSpace PACS: Image Launch Workflow (SUBI Image Viewer) View Images View Reports 1

2 IntelliSpace PACS Enterprise Web-based medical image distribution solution that delivers diagnosticquality images to clinicians anytime, any place in the healthcare environment Used by: Clinicians (Referring Physicians, Nurses, Surgeons, Techs) For: viewing, analyzing, qualify images EMR Image Launch Workflow 2

3 Cerner EMR: Results Page Step One: Select Radiology Results Cerner EMR: Results Page Step Two: Select Report/Results that you would like to view 3

4 Cerner EMR: Results Page Step Three: The Report Will Display Cerner EMR: Results Page Step Four: Select the View Image Icon to launch the study for viewing 4

5 Cerner EMR: Results Page Step Five: the SUBI Image Viewer will launch If the image button is not enabled in PowerChart, You can also launch the SUBI Image viewer from Citrix. Cerner EMR: Results Page Step Six: the exam will open for viewing 5

6 Viewing Images Canvas Page 1. Patient Information Area: 1 Patient s name, DOB, sex, MRN, Referring Physician and Patient Class Patient Timeline: History of and navigation menu to all of a patient s studies in IntelliSpace PACS 4 3. Exam notes: When icon is present, indicates diagnostic report is available for the exam. Click to open the diagnostic report. 4. Exam Margin: Access point to exam specific menu and information 6

7 Canvas Page (continued) 8 5. Thumbnail: Thumbnail view of image 6. Exam Rack: Set of images that make up the exam 7. Image/ Series Information: Image specific information (for example; description, number of images, slice thickness, etc.) Image/ Series date and time: Exam accession number, Date and Time image was acquired 7 Patient History Timeline Left-click to open exam Hover mouse to view exam information History of and navigation menu to patient s exams in IntelliSpace PACS Colors and symbols in timeline Green Blue No diagnostic report Diagnostic report available Image available X A No images Exams on 3 rd party digital archive not on IntelliSpace PACS server 7

8 Patient History Timeline (continued) Right-click for menu Timeline Sub menu: 1. Open Exam: Open exam and return to main Patient Directory 2. Close Exam: Close exam and return to main Patient Directory 3. Show Report: View diagnostic report Navigation within the Exam Rack Exam Rack: the set of images in an study Reorder series by dragging and dropping on grey image header or footer Navigating through stacked series 1. Mouse wheel 2. Select C on keyboard 3. Select Cine Loop from context menu Double-click to open in pop-up window 8

9 Screen Overlay Used to display the DICOM overlays on the image from the modalities Different Screen Overlays for each modality type F6 key toggles screen overlay on/off Preparing Images 9

10 Context Menu Right-click on series for context-menu Single Image Series Menu Stacked Series Menu Note: Additional menu items may be present depending upon API integrations and use of Philips Clinical Applications Window Width/ Level WW/WL menu Default WWL: Applies IntelliSpace PACS WWL values Modality default: Applies modality WWL values Histogram Calculation: Uses histogram calculation to set WWL Customer WW/L set by admin: Applies WWL values set by admin Changing Window Width and Level Mapped to 1 10 keyboard number keys for CT (for example; 1=Abdominal) Mouse: While holding down Left button, move mouse horizontally/ vertically Image Menu 10

11 Measurement Tools to measure specific areas of an image Measurement menu: Ruler: Linear measurements (pixel or mm) Angle: Degree measurement for specified region ROI Circle: Average data value for a circular region of an image ROI Ellipse: Average data value for an elliptical region ROI Freehand: Similar to ROI but allows free hand selection of ROI Point Value: The value of data points at a specific point on the image pixel Measurement Palette: Floating measurement palette Calibrate Image: Calibrate to a certain known measurement Image enhancement tools Image Processing Process images (excepted inverted) are marked with P icon in the lower right corner of image Image Processing settings are editable in User and System Preferences Image Processing menu: Invert Image: Reverses the black and white coloration of an image Edge Enhance: Increases image edge visibility Edge Detect: Uses Sobel operator to increase image edge visibility Median Filter: Common filtering method to reduce noise in the image 11

12 Image Viewing Options Scout Line (series only): Reference line inserted to help visualize and navigate to same location in multiple series with different orientations (2D) Localizer (series only): crosshair (+) reference mark to help visualize and navigate to a location in multiple series with different orientations (3D) Create Pop up: Inserts selected series into floating pop up window Clone Window With Preset: Creates a copy of the selected series with a Window Width/Level preset Key Image: Marks specific images as notable in the study and puts it into Key Image window Play Cine Loop (stacked series only): Cycles through images in series in a continuous loop Linking Options (Series Only) Synchronizes images or series with a designated master image to: View through multiple images at the same location simultaneously Have same navigation as the master, like Zoom or Pan Linked Series denoted by icon Link Sub menu: New Link: Link images within or across studies Link All Axials/ Sagittals/ Coronals/ Obliques (series only): Links all series in exam rack with the same orientation 12

13 Save & Print Options Window to Clipboard: Copies the entire window with measurements, annotations, and overlays to the clipboard Window to File: Saves window as either a JPEG, TIFF, GIF, PNG or BMP format file with measurements, annotations, and overlays to the clipboard Image to Clipboard: Saves only the images, without measurements, annotations and overlays Image to File: Saves images as either a JPEG, TIFF, GIF, PNG or BMP format file without measurements, annotations and overlays Image Orientation and Sorting Flip: Horizontal: Right to left (x axis) Vertical: Top to bottom (y axis) Rotate: Clock wise, counter clock wise Rotate 90 CW: Rotate 90 CCW: Sort (series only) Image Number Ascending (1, 2, 3, etc.) Image Number Descending (3, 2, 1) Table Position Ascending Table Position Descending 13

14 Zoom Presets: Used to apply a zoom factor to a series Fit to Window: Adjusting zoom factor applied so that the entire image is visible on the screen True Size: Approximates the actual size of the anatomical structure on screen 100 % Original Size: Also known as pixel to pixel where a single pixel in the image corresponds to a single image on the screen 200%, 300%, and 400%: Additional zoom factor options Zoom Presets Key Image Key images stack must be enabled in User Preferences to be visible Images that are marked as key images are saved when a Presentation State is saved regardless of whether Key Image Window is enabled Images can be marked as key images by: Pressing [Space Bar] when image is selected Key Image option in context Menu 14

15 Exam Margin Right-click for Exam Margin menu Exam Margin: Grey bar to the left of the exam rack with additional exam menu and information Closing the Image Viewer 15

16 Closing Options There are two options to close out of the study or the viewer all together. Option #1: If you are completely done reviewing images/studies at this time, will want to close out of the image viewer window. Option #2: If you plan to review additional images/studies and results during your logged on session, you will want to use the radio button on the control strip to close just the study. Closing Option #1: Closing Out of the Image Viewer Option #1: If you are completely done reviewing images/studies at this time, you will want to close out of the image viewer window. To do this, you will want to use the Windows red X at the top right hand corner of the SUBI Image Viewer window. This will totally close out the viewer. 16

17 Closing Option #2: Closing Out of the Image Viewer Option #2: If you plan to review additional images/studies and results during your logged on session, you will want to use the radio button on the control strip to close just the study. To do this, you will want to use the radio button on the control strip. This will close just the open study. Closing Option #2: Closing Out of the Image Viewer Closing the study via the radio button will still keep the SUBI Image Viewer window open and will allow for quicker study launching when reviewing additional cases. 17

18 Closing Option #2: Closing Out of the Image Viewer If you close via the radio button, you will still see an open SUBI Image Viewer Window that looks like the below window. 18