Vol.2 No.2 (June 2012)
Real-World Applications of SR-Based Laboratory Information Rendering System within Filmless Web-Based PACS Environment——Integration of Labs Data in PACS
检验信息系统； 整合型医疗照护体系； 检索信息显示； 影像传输管理系统； LIS: Laboratory Information System； IHE: Integrating the Healthcare Enterprise； RID: Retrieve Information for Display； PACS: Picture Archiving and Communication System
Laboratory examinations and imaging studies are essential for clinical decisions logically. Nowadays PACS is getting prevalent in modern medical institutes to provide physicians and medical staff easy ways for efficient images retrieval and utilization. With this beneficial factor of PACS wide spreading, we could make the best of the infrastruc-ture of secure imaging network without adding much cost on it to head for the era of electronic medical records solidly and precisely. The purpose of this article is to introduce a real world implementation of a brand new container within PACS for laboratory information (LI), being converted from traditional database records into standard DICOM struc-tured report (SR) objects, under the guidance of IHE framework, as well as the web page results rendering using re-trieve information for display (RID) profile for enormous laboratory results. Aside from the easy perception of labora-tory data on web pages, we also use online processing and analysis (OLAP) tools to have trend statistics of system utilization. Latest data, mined from OLAP cube, revealed that totally we have 9,293,784 stored SR objects from 336,152 active patients in recent five years with the maximal utilization frequency of RID profile near 10,067 per month, 280 on a daily basis. The interesting features of IHE RD profile introduce the usage of graph and trend curves, making the interpretation of medical data more easily, especially in our study, from LIS. With this new integration of web-based PACS and LIS, users could easily browse all the necessary information on web pages simultaneously in-cluding images, reports and laboratory results without hustling to other applications or reading on paper-based charts to fulfill the goals of paperlessness and medical error reduction. The success of our study consolidates the concepts of IHE to be able to integrate different legacy systems on a common platform for unified and standard data communication. Our experience might be helpful for other medical institutes wishing for web-based medical information integration.
杨宗龙 , 陈为忠 , 黄哲勋 , 梁慧隆 , 潘慧本 (2012) 检验信息在网基无片PACS环境中之实体应用——无片环境之检验信息整合。 临床医学进展， 2， 17-24. doi: 10.12677/acm.2012.22004
 B. Olsovsky. How is your EMR communicating with radiology? Integrating radiology data into the electronic medical record. Healthcare Informatics, 2010, 27(11): 20-22.
 A. Lin, M. Harris and M. Zalis. Initial observations of electronic medical record usage during CT and MRI interpretation: Frequency of use and impact on workflow. American Journal of Roentgenology, 2010, 195(1): 188-193.
 S. G. Silverman, B. F. Coughlin, S. E. Seltzer, et al. Current use of screening laboratory tests before abdominal interventions: A survey of 603 radiologists. Radiology, 1991, 181(3): 669-673.
 R. Hussein, U. Engelmann, A. Schroeter, et al. DICOM struc- tured reporting: Part 2. Problems and challenges in implementation for PACS workstations. RadioGraphics, 2004, 24(3): 897- 909.
 R. Hussein, U. Engelmann, A. Schroeter, et al. DICOM struc- tured reporting: Part 1. Overview and characteristics. Radio- Graphics, 2004, 24(3): 891-896.
 R. Noumeir. Benefits of the DICOM structured report. Journal of Digital Imaging, 2006, 19(4): 295-306.
 K. P. Lee, J. Hu. XML schema representation of DICOM structured reporting. Journal of the American Medical Informatics Association, 2003, 10(2): 213-223.
 C. D. Carr, S. M. Moore. IHE: A model for driving adoption of standards. Computerized Medical Imaging and Graphics, 2003, 27(2-3): 137-46.
 ACC/HIMSS/RSNA. IHE IT infrastructure technical framework volume 1: Integration profiles. Pensacola: Setac Foundation, 2008.
 NEMA. Digital imaging and communications in medicine (DI- COM) Part 18: Web access to DICOM persistent objects (WADO): National Electrical Manufacturers Association, PS 3.18-2009.
 L. M. Haas, R. J. Miller, B. Niswonger, et al. Transforming heterogeneous data with database middleware: Beyond integration. IEEE Data Engineering Bulletin, 1999, 22(1): 31-36.
 N. Wirsz, G. Oyntzen, E. Motzkus, et al. IHE is reality at siemens medical solutions. Electromedica, 2002, 70(2): 92-99.
 W3C. Scalable Vector Graphics (SVG), 2008. http://www.w3.org/Graphics/SVG
 E. Ammenwerth, S. Gräber, G. Herrmann, et al. Evaluation of health information systems-problems and challenges. International Journal of Medical Informatics, 2003, 71(2-3): 125-235.
 I. Vessey. Cognitive fit: A theory-based analysis of the graphs versus tables literature. Decision Sciences, 1991, 22(2): 219- 240.
 S. J. Wang, B. Middleton, L. A. Prosser, et al. A cost-benefit analysis of electronic medical records in primary care. American Journal of Medicine, 2003, 114(5): 397-403.
 O. Ratib, M. Swiernik and J. M. McCoy. From PACS to integrated EMR. Computerized Medical Imaging and Graphics, 2003, 27(2-3): 207-215.
 G. Gardarin, A. Mensch, T. Dang-Ngoc, et al. Integrating heterogeneous data sources with XML and XQuery. Proceedings of 13th International Workshop on Database and Expert Systems Applications, 2002: 839-846.
 D. A. Clunie. DICOM structured reporting: An object model as an implementation boundary. Bangor: PixelMed Publishing, 2000.
 M. L. Müller, F. Uckert, T. Bürkle, et al. Cross-institutional data exchange using the clinical document architecture (CDA). International Journal of Medical Informatics, 2005, 74(2-4): 245- 256.