PACS And The Technologist Gen Rad/CR - Workflow 1 GEN RAD/CR - Workflow CR Processing RIS Arrival - Patient Arrived Order Request Prints *** [! - 1 ] *** Verify -Verify Exam and Resource (Correct if needed) *** [! - 2 ] *** Technologist Worklist - Begin Exam - Using Technologist Worklist required *** [! - 3 ] *** *** [! - 4 ] *** Perform Exam Patient Retrival Modality Worklist - Use Modality Worklist to Pull Patient and Exam Data *** [! - 5 ] *** Tech ID - Enter User Tech ID *** [! - 6 ] *** Submit - Submit Data *** [! - 7 ] *** Scan Cassette(s) - Assign Anatomy To Each Cassette *** [! - 8 ] *** Process - Load Cassette on CR Post Exam Processing - Check: Images Match Anatomy Marker(s) Technique Orientation Distance Time Accept - Accept To Push Images MIA Long Term Storage FIC Local Archive Image On CID Provider PC Viewer Image On DxW Radiologists Diagnostic Workstation RIS Complete -Complete exam on RIS *** [! - 9 ] *** QA CID -Verify Images are on CID without exceptions DxW -Verify Images are on CID without exceptions *** [! - 10 ] *** See Stentor Technologist Image Confirmation Document For Help ***! - 1 The Order Request contains vital information that can be visually identified on the form. Information includes patient name, MRN, accession, and resource. ***! - 2 Selecting the correct resource triggers message to PACS with patients demographic information, failure to do this will cause exam to be in exception status on PACS. ***! - 3 Using Technologist Worklist on RIS allows for changing resource in one step at exam begin ***! - 4 Beginning exam on RIS triggers Modality Worklist on CR. Users are required to begin exam prior to performing exam. ***! - 5 Using Modality Worklist to pull patients demographics and exam data will eliminate the need to type patient information manually, and will ensure data is accurate. ***! - 6 Enter Tech ID using barcode provided by your RIS Admin, if user does not have barcode enter name or tech initials depending on facilities protocol. ***! - 7 Verify patient demographics again and press SUBMIT button on CR Screen to save data on screen and to open cassette window. Opening cassette window is important to allow for visual matching of cassette ID and projection when scanning cassettes. ***! - 8 When assigning cassette to virtual cassette on screen, verify that the virtual cassette matches projection that was taken, (i.e.. PA vs. AP, Grid vs. Non Grid) User should select a different projection for every cassette scanned, unless they repeated the same projection twice. ***! - 9 Completing an exam on RIS is important because this triggers a completion or C flag to the PACS indicating to the radiologist that there are no more images 2 to follow. ***!-10 QA is the most important step in this workflow because it allows one last opportunity to ensure data and image integrity. QA is required and technologist will perform visual confirmation of data and image integrity on Stentor application. RIS Arrival/Order Request/Verify 3 1
RIS - Arrival Why is arrival on RIS important? The order request prints. 4! - 1 RIS - Order Request/Verify Vital fields on request Patient Name MRN ACC Resource Procedure Fields vital to PACS Fields can be used for manual entry The order request contains vital information that can be visually verified 5! - 1 RIS - Order Request/Verify What should I be verifying on the Order Request Form? Verify Resource on form and change if necessary during RIS Exam Begin Why is Resource so important? Only certain resources are setup on RIS to trigger the RIS HL7 message to PACS Selecting the correct resource triggers message to PACS with patients demographic information Failure to select the correct resource will cause RIS HL7 message to PACS to not be sent IF RIS HL7 message to PACS is not on PACS images will not pass validation and study flagged as an exception NOTE: Slides number 19 & 20 will explain this in full detail. 6! - 2 2
RIS Technologist Worklist 7 RIS - Technologist Worklist Workflow Manager - Technologist Worklist Click Here Note: If you have not used it you will need to set it up. 8! - 3! - 4 RIS - Technologist Worklist Technologist Worklist - One Time Setup Start The Wizard Click Select RM 2 ButtonClick Next Click OK Repeat until all available resources added 9! - 3! - 4 3
RIS - Technologist Worklist - Begin Exam Select Resource Select Patient Click BEGIN That s it! The exam was begun! 10! - 3! - 4 RIS Technologist Worklist Why is it important to begin exam using the Technologist Woklist? The most important thing to take from this step is that beginning the exam on RIS is what triggers the RIS HL7 demography data message to be available to query/ pull from the scanners Secondly Technologist Worklist allows you to change resource prior to beginning exam and with only one simple click Selecting the correct resource is vital because once you are at a scanner the it will have a resource name like R2 so if you selected a different resource on the RIS the RIS HL7 message demography data will not be available at the R2 scanner Remember is very important to understand the RIS-Scanner resource relationship! NOTE: Slides number 19 & 20 will explain this in full detail. 11! - 3! - 4 Patient Retrieval/Perform Exam 12 4
CR - Main Menu From CR ROP Or Main Console Main Menu - Select Study Data 13 CR - Worklist/Study Data Patient Data Menu - Put Cursor On Accession Number From CR ROP Or Main Console - Use Scanner Gun to Scan RIS Form ACC 14 CR - Worklist/Study Data 12345678 Patient Data Menu - Accession Number Should Populate NOTE - If RIS Form Not Available ACC Can Be Manually Typed 15 5
CR - Worklist/Study Data 12345678 Patient Data Menu - Once The Accession Number Is Present Press Find Remote To Activate Modality Worklist Interface 16 If Data not found it can be added manually! - 5 CR - Study Data You Will See A Waiting For Response 17 Modality Worklist Interface Integrated Medical Imaging Solutions 18! - 5 6
Modality Worklist Interface What is Modality Worklist Interface? It Is An Interface Between The Modality/Scanner And RIS Only It Is On Demand Modality/Scanner Queries RIS for HL7 Demography Data Message 19! - 5 Modality Worklist Interface Why is Modality Worklist Interface Not Working? The RIS Does Not Respond Because No Patient Is Being Done On R2 20! - 5 Importance of Using the Modality Worklist Interface Patient information is retrieved from RIS no need to enter manually into the scanner Patient information is retrieved from RIS Data is accurate, less chance for errors. Patient information is retrieved from RIS no need to enter manually into the scanner Being able to retrieve information to Modality/Scanner using the Modality Worklist Interface is a good indication that the Technologist has done everything correct up to this point. Patient information is retrieved from RIS no need to enter manually into the scanner Remember is very important to understand the RIS-Scanner resource relationship! 21! - 5 7
CR - Tech ID/Study Data Patient Data Menu Verify That Cursor Is On Tech ID - Scan Badge From CR ROP Or Main Console - Use Scanner Gun to Scan Badge 22! - 6 CR - Submit/Study Data Patient Data Menu - Once The Tech ID Is Present Press Submit 23! - 7 CR - Study Data You Will See A Waiting For Response 24 8
CR - Images - Scan Cassette The Virtual Cassettes Will Now Show Up/Select Anatomy (Like PA) From CR ROP Or Main Console - Use Scanner Gun to Scan Cassette (s) 25! - 8 CR - Images - Scan Cassette The Cassette Will Now Show The Scanned Cassette ID Repeat This Step for all positions taken 26! - 8 CR - Images - Processing Place Cassette (s) On Kodak 975 For Processing 27 9
CR - Images Post Process The Virtual Cassettes Will Now Show Display Images Verify Anatomy Matches / Performs Post-Processing If Required Select Accept All Images To Push Images 28 Complete Exam RIS Continue To Complete Exams As Usual CID/DxW - Image Confirmation See Stentor Technologist Image Confirmation For Help On This Step 29! - 9! - 10 CR101 Tips & Trouble Shooting 30 10
IMAGE VALIDATED 31 INPROGRESS 32 IMAGE NOT VALIDATED 33 11
ACC NOT ENTERED 34 ACC ENTERED INCORRECT 35 MRN & ACC NOT ENTERED 36 12
MRN ENTERED INCORRECT 37 INVALID MRN ACC PAIR 38 NAME ENTERED INCORRECT 39 13
CANCEL UNCOMPLETE 40 NOT COMPLETED 41 CR101 What have we learned? Why is it important to arrive on RIS? Why is the Order Request important tool? Why is using the Technologist Worklist on RIS an important tool? Why is Beginning an Exam on RIS important? Why is using the Modality Worklist Interface an important tool? Why is it important to get a barcode with your name? Why is it important to Submit once you have entered Study Data and Tech ID? Why is it important to verify that the anatomy matches virtual cassette? Why is Completing an Exam on RIS important? Why is QA the most important step? 42 14