Title: iSite 3.5: Hanging Protocols I
1iSite 3.5 Hanging Protocols I
2Table of Contents
- Objectives
- Terminology
- Introduction
- Hanging Protocol Hierarchy
- Presentation States
- Hanging Protocol Configuration
- Additional Information
3Learning Objectives
Understand the purpose and configuration of
- Hanging Protocols
- Hanging Protocol Hierarchy
- Presentation States
4Terminology
- PACS (Picture Archive and Communications System)
- Information Systems designed to manage, store and
distribute medical images and related information
throughout the healthcare enterprise - HIS (Hospital Information System)
- Information Systems designed to manage patient
records, including patient registration, billing,
order entry - RIS (Radiology Information System)
- Information Systems designed to manage exams
(orders), including filling orders and scheduling
5Terminology
- MRN (Medical Record Number)
- A unique patient identifier (also known as
Patient ID) used for auditing of billing and
scheduling for patients - Accession Number (ACCession Number)
- A unique exam identifier (also known as an order
number or requisition number) used for auditing
of billing and scheduling of scheduled procedures - SUID (Study Instance Unique IDentifier)
- A unique study identifier used for auditing of
performed imaging service requests
6Terminology
- DICOM (Digital Imaging COmmunication in Medicine)
- DICOM is the predominant communication standard
between imaging equipment throughout the
Healthcare Enterprise - HL7 (Health Level 7)
- HL7 is the predominant messaging standard for
exchanging key sets of administrative and
clinical data in the healthcare enterprise
7Introduction
8Introduction
- iSite Radiology Hanging Protocols are an
important part of an efficient reading workflow - iSite Radiology has User and System Level Hanging
Protocols - All iSite Radiology users will be able to select
and utilize any User and System Level Hanging
Protocols that have been created - Hanging Protocols may be configured according to
User Preferences for viewing exams on the
Diagnostic Monitors based upon Modality Type,
Modality Type and Body Part, and Hanging Protocol
Groups
9Introduction
- User Hanging Protocols are created by and
assigned to an individual user log-in, and are
only available to the user log-in for which the
Hanging Protocol was created - In order to create, edit or delete User Hanging
Protocols the user must be assigned to an Access
Group that has the Security Code ISTUSRHP enabled
10Introduction
- System Hanging Protocols are created by the iSite
Administration team and are available to all
users - In order to create, edit or delete System Hanging
Protocols the user must be assigned to an Access
Group that has the Security Code ISTSYSHP enabled
11Introduction
- iSite Radiology offers the ability to create
multiple Hanging Protocols for the same Exam Type - Both User and System Hanging Protocols can be
defined as Default Hanging Protocols or Alternate
Hanging Protocols - There can only be one User or System Default
Hanging Protocol for each Identifier key - There can be up to ten User or System Alternate
Hanging Protocols for each Hanging Protocol
Identifier key - For example A Radiologist who primarily reads
CR EXAM exams may want to define a few alternate
Hanging Protocols to switch to instead of
re-hanging the entire exam
12Hanging Protocol Hierarchy
13Hanging Protocol Hierarchy
- iSite Radiology Hanging Protocols may be created
with varying levels of specificity based upon
values associated with each individual Exam Code
in the Exam Code Dictionary, including the
following
Hanging Protocol Identifier Keys Level
Modality Type Very Generic
Modality Type Body Part Specific
Hanging Protocol Group Very Specific
14Hanging Protocol Hierarchy
- This configuration level is specified in the
Hanging Protocol Wizard
15Hanging Protocol Hierarchy
- User and System Default Hanging Protocols are
identified in the popup menu as default
16Hanging Protocol Hierarchy
- User and System Alternate Hanging Protocols are
never automatically applied to the Main Exam when
loaded in the Canvas Page - Alternate Hanging Protocols are not identified in
the popup menu as alternate Hanging Protocols - However, Alternate User and System Hanging
Protocols can be selected from the popup menu and
are applied to an exam on the fly
17Hanging Protocol Hierarchy
- iSite Radiology applies the highest ranked
Hanging Protocol available for a given exam - The system will automatically select the most
specific Hanging Protocol to load the Main Exam
based on the exam Hanging Protocol Identifier Key - If both User Default User Hanging Protocol and
System Default Hanging Protocol are defined for
the same Hanging Protocol identifier key, the
Main Exam will be loaded with the User Default
Hanging Protocol
18Hanging Protocol Hierarchy
- If only the Default System Hanging Protocol is
defined for the same Hanging Protocol Identifier
key, the Main Exam will be loaded with that
Default System Hanging Protocol - If no User Default Hanging Protocol or System
Default Hanging Protocol is defined, the Main
Exam will be loaded with the Default hard-coded
Hanging Protocol
19Hanging Protocol Hierarchy
- The Main Exam is loaded in the Canvas Page with
the Hanging Protocol automatically applied in the
following order and hierarchy - User Default Hanging Protocol Group Hanging
Protocol. This is the highest ranked Hanging
Protocol. If defined for the Main Exam, this will
be automatically applied. Otherwise, the System
Default Hanging Protocol Group will be applied,
if configured. - System Default Hanging Protocol Group Hanging
Protocol is automatically applied if no User
Default Hanging Protocol Group is defined for
this exam. - User Default Modality and Body Part Hanging
Protocol. If defined for the Main Exam, this will
be automatically applied. Otherwise, the System
Default Modality and Body Part Hanging Protocol
will be applied, if defined.
20Hanging Protocol Hierarchy
- System Default Modality and Body Part Hanging
Protocol is automatically applied if no User
Default Modality and Body Part Hanging Protocol
is defined for this exam. - User Default Modality Hanging Protocol. If
defined for the Main Exam, this will be
automatically applied. Otherwise, the System
Default Modality Hanging Protocol will be
applied, if defined. - System Default Modality Hanging Protocol is
automatically applied if no User Default
Modality Hanging Protocol is defined for this
exam. - Default Hard-Coded Hanging Protocol. If no User
Default or System Default Hanging Protocols are
defined, the Main Exam is loaded with a Default
hard-coded Hanging Protocol.
21Presentation States
22Presentation States
- Presentation States over-ride Hanging Protocols
- When the user opens an exam, the Presentation
State with the highest priority will be presented - The most recent Presentation State for the
highest priority Presentation State will be
applied to the exam
23Presentation States Hierarchy
- Mark Read Presentation State is the highest
priority Presentation State. If a Mark Read
Presentation State has been defined this will
automatically be applied. - Pre-Read Presentation State is the second
highest priority Presentation State. The
Pre-Read Presentation State enables a
radiologist to save image presentation
modifications without requiring the exam be Mark
Read, so the radiologist may later return to the
exam. - Technologist Presentation State enables the
radiologic technologist to modify image
presentation prior to the radiologist viewing and
interpreting the exam. - Original DICOM Image Presentation is
automatically applied if no Presentation States
have been defined for this exam. - User Presentation State enables specialists to
modify image presentation prior to and following
radiologist interpretation without effecting
other users.
24Presentation States
- When the user selects a Presentation State any
modifications based upon the following features
are displayed - Window Width and Window Level
- Measurements, excluding Point Value
- Annotations
- Invert Image
- Key Image
- Clone
- Key Images
- Flip
- Rotate
- Sort
- Split
25Delete Presentation State
26Hanging Protocol Configuration
27Hanging Protocol Configuration
- Hanging Protocol configuration is specified in
the Hanging Protocol Wizard found in the pop up
menu in the Shelf Bar of the Exam Rack
28Create User Hanging Protocol
- The Use Current Exam Layout option allows the
ability to auto-populate the Hanging Protocol
Dialog (WYSIWYG concept) when the Hanging
Protocol is edited by the user - The Use Current Exam Layout option is only
available if Series Matching Rules have been
defined
29Create User Hanging Protocol
- Series Matching Rules are created and
configured by the site PACS System Administrator - To create Series Matching Rules, the user must be
assigned to an Access Group with the Security
Code ISTHPSTD
30Hanging Protocols Configuration
- Page Two of the Hanging Protocol Wizard displays
the following configuration options - Multi-Image Mode
- Window/Level Preset
- Scout Lines
- Show Localizer
- Invert Image
- Clones
31Hanging Protocols Configuration
- To configure the Display settings that will be
applied to all Stacked Image Windows, click on
the Stack Window(s) listing in the Series list
control, then select the desired settings - All options are available for Single Image
Window(s) and Stack Window(s) with the exception
of Multi Image Mode - Multi Image Mode options are only available for
Stack Windows
32Hanging Protocols Configuration
- To configure the Display settings that will be
applied to all Single Image Windows, click on the
Single Image Window(s) listing in the Series
window, then select the desired settings - To configure the Display settings for Clones,
select each clone and make your selections
33Hanging Protocols Configuration
- Series Matching Rules are sub-features of Hanging
Protocols - The advantage of using Series Matching Rules as
part of Hanging Protocols is - Automatic sorting of series
- Automatic application of features to specific
series - Multi-Image Mode
- Window Width/Level Presets
- Scout Mode
- Localizer Mode
- Image Invert
- Clones
34Hanging Protocols Configuration
- Add Clone and Remove Clone options are
available for Stack Window(s), Single
Window(s) and Matching Series series options - iSite Radiology provides the ability to create
and configure clone settings automatically as
part of a Hanging Protocol - In the Series list control, clones can be created
and removed for Stack Window(s) and Single
Window(s) - Up to 6 clones can be created for each series
option
35Hanging Protocols Configuration
- Multi Image Mode allows you to display stack
image windows in Multi-Image modes in the
diagnostic monitor - This option is not available for single images
36Hanging Protocols Configuration
- Default Window/Level Hanging Protocols support
applying the default Window Width/Window Level to
the Stack, Single Image Windows or Matching
Series - If the checkbox Default Window/Level is
selected, the User and System Default Window
Width and Level are applied to the selected
Stack, Single Image Windows or Matching Series - Window/Level Preset The Window Width/Level
Presets allow applying quickly a specific Window
Width/Level in order to view particular anatomy
37Hanging Protocols Configuration
- Additional presets are displayed, if configured
- Presets may be configured for all modality images
- Important Notes
- Configured User and System Presets will be merged
under Window/Level Presets list control - If both User and System Window Width/Level
Presets are configured for the same modality
image and have the same Preset Name, then User
Window Width/Level Presets/ Value takes
precedence and User Presets will be displayed
38Localizer, Scout Lines and Invert Image
- Show Localizer This option allows the display of
Localizer tool on images. When selected, images
will display the localizer on all images from the
same frame of reference with the image selected.
Localizer is displayed only on MR, CT and PT
series. - Show Scout Lines This option allows the
automatic display of scout lines on single images
or on stack series. Scout lines are displayed
only on MR, CT and PT series. - Invert Image This feature is only available for
grayscale images. When this option is selected
for a Single or Stack Series, the images will be
displayed in Invert mode.
39Monitor Control
- Page Three of the Hanging Protocol wizard opens
with the Monitor Control group box - In this Hanging Protocol Wizard Page, the
available Matching Series are listed in the
Matching Series list control, whereas the rack
series are listed under the Other Series list
control
40Matching Series
- Under Series Matching list control, there are
two buttons Move Up and Move Down - These are used to change the matching series
order to place them on a specific monitor - When a matching series is selected and Move Up
or Move Down are clicked on the matching series
will be moved up or down on a specific pane in
Monitor 1 or Monitor 2
41Monitor Control
- Monitor Mode options can be selected for
Diagnostic Monitor 1 and 2 - Monitor 1 Mode
- Monitor 2 Mode
- In this window, the diagnostic monitor mode
selection can be previewed for Monitor 1 and
Monitor 2
42Monitor Control
- Hanging Protocol Monitor 1 Mode and Monitor 2
Mode layouts are - M1, M2H, M2V, M3H, M3V, M4, M6P, M6L, M1_2,
M2_1, M1_3, M3_1 - Important Note the monitor configuration loading
differs on one-monitor systems, two-monitor
systems and four-monitor systems
43Main Exam Options
- Page four of the Hanging Protocol Wizard opens
with the following options available only for the
Main Exam configuration - Linking
- Load Relevant Prior based on Matching
- Number of Priors to Load
- Cache Entire Study
- Spine Label Tool on Sagittal
- Split Mode (if enabled)
44Linking Options
- The following are the available Linking options
- Link All Axials
- Link All Sagittals
- Link All Coronals
- Link All Obliques
- Set the Linking options as desired
- You may link all axial, sagittal, coronal or
oblique views of the Main Exam
45Relevant Prior Loading
- The Load Relevant Prior Based on Matching can
be configured to be loaded based on Body Part
Only or on both Modality and Body Part
matching - The Body Part Only option loads the relevant
priors in the Relevant Exam Timeline and the Exam
Rack based on matching of the same Body Part - For example Body Part CHEST
46Relevant Prior Loading
- The Modality and Body Part option loads the
relevant priors in the Relevant Exam Timeline and
the Exam Rack based on matching of the same
Modality and Body Part - For example Modality CR and Body Part CHEST
47Hanging Protocols Configuration
- The Number of Priors to Load option allows up
to 10 Relevant Priors to be loaded automatically
in the Hanging Protocol Wizard - The Cache Entire Study option allows caching of
the entire Main Exam into iSite Radiology
workstation memory - If the Show Spine Label Tool on Sagittal box is
checked, the Spine Label Tool will be displayed
on all Sagittal windows
48Additional Information
49F2 Hotkey
- iSite Radiology is designed to work with one, two
or four diagnostic monitor displays - However, iSite Radiology only supports the
configuration of two-monitor Hanging Protocols - Only two monitors can be configured (i.e. Monitor
1 and Monitor 2) in the Hanging Protocol Wizard
50F2 Hotkey
- The hotkey F2 is designed to toggle between
what is visible (i.e. Monitor 1) and what might
not be visible (i.e. Monitor 2) on a two-monitor
system configuration - On a one-monitor system, the F2 key toggles
between the first and second series - Monitor 2 is considered virtual monitor on a
two-monitor system - On a four-monitor system, F2 key does not have
any functionality
51F2 Hotkey
Number of monitors Relevant Prior Found? Monitor 1 Monitor 2 Monitor 3 Monitor 4
1 No New Exam General PA gtgt New Exam General LAT N/A N/A N/A
1 Yes New Exam General PA gtgt New Exam General LAT N/A N/A N/A
2 No New Exam General PA gtgt N/A New Exam General LAT gtgt N/A N/A N/A
2 Yes New Exam General PA gtgt New Exam General LAT Prior Exam General PA gtgt Prior Exam General LAT N/A N/A
4 No New Exam General PA gtgt N/A New Exam General LAT gtgt N/A Empty Empty
4 Yes New Exam General PA gtgt N/A New Exam General LAT gtgt N/A Prior Exam General PA gtgt N/A Prior Exam General LAT gtgt N/A
52F2 Hotkey
- Two-Monitor System loading for the Main Exam
without prior will display red and blue
rectangles around the first and second rack
series, unless otherwise specified in the loaded
Hanging Protocol - The images will be displayed on both Monitor 1
and Monitor 2 - In this configuration, F2 key does not have any
functionality
53F2 Hotkey
- Two-Monitor System with prior the red rectangle
will represent Monitor 1 the Main Exam will load
on Monitor 1 - The blue navigation rectangle represents Monitor
2, on which the prior exam will load - F2 key toggles between the first series
displaying for the Main Exam and Prior and the
second series displaying on the virtual Monitor
2 for the Main Exam and Prior
54F2 Hotkey
The image on the left represents the display
prior to selecting F2, while the image on the
right displays the series following selection of
the F2 hotkey
55Main Exam Monitor Layout
- Users can configure how the Hanging Protocol
loads a Two-monitor system or a Four-monitor
system in the User General Preferences Main Exam
Monitor Layout control box
56Main Exam Monitor Layout
- 2-Monitor System Main Exam Monitor Layout
- Left Main Exam on left monitor (1), prior on
right monitor (2) (this is the default selection) - Right Main Exam on right monitor (2), prior exam
on left monitor (1) - Four-Monitor System Main Exam Monitor Layout
- Left Main Exam on left monitor (1), prior on
right monitor (2) (this is the default selection) - Middle Main Exam on inside 2 monitors (2,3),
prior on outside 2 monitors (1, 4) - Right Main Exam on right monitors (3,4), prior
on left monitors (1,2)
57Import and Export Hanging Protocols
- In iSite Radiology configured User and System
Hanging Protocols may be imported and exported - To accomplish this Import and Export buttons
are provided in both User and System Hanging
Protocol Pages
58Import and Export Hanging Protocols
- No more than 10 User or System Hanging Protocols
can be imported for the same Hanging Protocol
Identifier Key - All imported Hanging Protocols will be set as
Alternate Hanging Protocols
59For assistance, please call customer support at
1-877-328-2808 or 1-877-328-2809
60(No Transcript)