GENERIC PACS WORKFLOW, IHE

• 1. New patient arrives at hospital for radiological examination (exam).

  first step for generic workflow without PACS in Radiology
• 2. Patient registers in Radiology area. If the patient is new, patient is registered in the Hospital Information System (HIS).


  second step for generic workflow without PACS in Radiology
• 3. Exam ordered at Radiology Information System (RIS) upon arrival at Radiology registration desk. Exam accession number is automatically assigned, and a requisition is printed.


  third step for generic workflow without PACS in Radiology
• 4. Technologist receives information from clerk and calls the patient in the waiting area for exam.

  fourth step for generic workflow without PACS in Radiology
• 5. Patient escorted into the modality room.

  fifth step for generic workflow without PACS in Radiology
• 6. Examination is performed by a technologist.

  sixth step for generic workflow without PACS in Radiology
• 7. Examination is completed.

  seventh step for generic workflow without PACS in Radiology
• 8. Clerk pulls out old films. [In the absence of a clerk, the RT does it.]


  eigth step for generic workflow without PACS in Radiology
• 9. Clerk prepares all necessary papers and films for radiologist. [In the absence of a clerk, the RT does it.]

  ninth step for generic workflow without PACS in Radiology
• 10. Films are hanged for radiologist's review

  tenth step for generic workflow without PACS in Radiology
• 11. Radiologist reviews films (images), check examination record and dictates reports.


  eleventh step for generic workflow without PACS in Radiology
• 12.Transcriptionist types the draft report from the dictation. [In the absence of a transcriptionist, the RT does it.]

  twelfth step for generic workflow without PACS in Radiology
• 13. Radiologist reviews the report and signs it off.

  thirteenth step for generic workflow without PACS in Radiology
• 14. Final reports are input into RIS for clinician viewing

  fourteenth step for generic workflow without PACS in Radiology
• 1. Patient registers in HIS, with radiology exam ordered in RIS, and exam accession number automatically assigned.

  first step for PACS workflow
• 2. RIS outputs HL7 messages of HIS and RIS demographic data to PACS broker/ interface engine.


  second step for PACS workflow
• 3. PACS broker notifies the archive server of the scheduled exam for the patient.

  third step for PACS workflow
• 4. Following on prefetching rules, historical PACS exams of the scheduled patient are prefetched from the archive server and sent to the radiologist reading workstation (WS).

  fourth step for PACS workflow
• 5. Patient arrives at modality. Modality queries the PACS broker/interface engine for the DICOM worklist.

  fifth step for PACS workflow
• 6. Technologist acquires images and sends the PACS exam of images acquired by the modality and patient demographic data to quality control (QC) WS in a DICOM format.

  sixth step for PACS workflow
• 7. Technologist prepares the PACS exam and sends to the radiologist the diagnostic WS as the prepared status.

  seventh step for PACS workflow
• 8. On its arrival at the radiologist reading WS, the PACS exam is immediately sent automatically to the archive server. Archive server database is updated with the PACS exam as the prepared status.


  eigth step for PACS workflow
• 9. Archive server automatically distributes the PACS exam to the review WSs in the wards based on patient location as received from the HIS/RIS HL7 message

  ninth step for PACS workflow
• 10. Reading radiologist dictates a report with the exam accession number on the dictation system. The radiologist signs off on the PACS exam with any changes. The archive database is updated with changes and marks the PACS exam as signed-off.

  tenth step for PACS workflow
• 11.Transcriptionist fetches the dictation and types a report that corresponds to the exam accession number within RIS


  eleventh step for PACS workflow
• Hospital Information System


  HIS stands for
• electronic medical record


  EMR stands for
• Hospital Information Exchange


  HIE stands for
• Picture Archiving and Communication System

  PACS stands for
• Pathology information system


  PIS stands for
• Radiology information system


  RIS stands for
• health level seven


  HL7 stands for
• Digital Imaging and Communications in Medicine

  DICOM stands for
• HL7


  pathway for EMR to engine interface
• HL7


  pathway for HIE to engine interface
• HL7


  pathway for PIS to engine interface
• DICOM


  pathway for PACS to engine interface
• HL7 and DICOM


  pathway for RIS to engine interface
• DICOM


  pathway for PACS to Modality
• DICOM


  pathway for PACS to Radiologist