Integrating a radiology information system with a picture archiving and communications system

Abstract

Images stored in the central database of a picture archiving and communications system (PACS) must be identified and described with textual information such as patient name, exam procedures, and diagnostic reports. Most radiology departments already use a radiology information system (RIS) for departmental administrative functions, such as exam scheduling, film tracking, billing etc., so this information is readily available. Ideally, the PACS and the RIS should be combined into one complete system, which is not easily achievable due to costly investment of replacing the current RIS and slow clinical acceptance of the PACS. Alternatively, for a successful PACS operation using the existing RIS, the two systems should be linked together so that the PACS can freely retrieve the RIS information whenever the need arises. As a part of the PACS evaluation project, an interface system to link our RIS (DECrad) to our PACS (AT&T CommView) has been implemented using an external microcomputer system running UNIX. The interface system handles proprietary communication protocols on each side, translating the information from one format to the other. Although the interface system translated the RIS transactions and transferred them to the PACS, they were not always associated with the image data at the PACS. This paper presents the design concept and the implementation details of the interface system we have developed. The performance and the problem areas of the interface system are also investigated, as well as suggesting future directions for a better implementation.