Invited Speech: HIS/RIS/PACS/ePR

This presentation will discuss four topics: "n HIS/RIS/PACS integration"n Medical image and data Standards"n IHE (Integrating the Healthcare Enterprise) Pro-files"n ePR (electronic Patient Record)"nPACS is an imaging management system that requires pertinent data from other medical information systems for an effective operation. Among these systems are hospital information system (HIS), and radiology information system (RIS). A voice recognition (VR) system can also be used to generate a radiology report as a direct output of the RIS which can be considered as a component of RIS. Many functions, for examples, image routing, prefetching, automatic grouping, etc. in the PACS server and display workstations rely on data extracted from both HIS and RIS. This presentation first discusses the infrastructure and functions of HIS, RIS, VR and data which are important to PACS operation, and their interfaces. HIS and RIS follow HL-7 (Health Level 7) data format and TCP/IP communication standards, PACS uses DICOM (Digital Imaging and Communication in Medicine) image format and communication standard. The success of PCAS, HIS, and RIS interface rely on the conformance to these standards of each information system during system operation. "nTo interface HIS and RIS with PACS, certain guidelines are necessary including:"n(1) Each system (HIS, RIS, PACS) remains unchanged in its configuration, data, and functions performed."n(2) Each system's hardware and software are ex-tended to allow for communication among systems."n(3) Only data are shared; original system functions remain local. For example, RIS functions should not be performed at PACS or HIS workstation, or images should not be viewed at RIS workstation. Keeping each system specific and autonomous would simplify the interface process, since a complete database updates is difficult to perform at a global level."nBased on these guidelines, successfully interfacing HIS, RIS, and PACS should follow these steps:"n(1) Identify the subset data that would be shared by other systems. Set up access rights and authorization for each system."n(2) Convert non standard subset textual data to HL 7. This step, composing of designing a high level presentation, solving data inconsistencies, and naming conventions, can be accomplished by using a common data model and data language for all systems, and by defining rules of correspondence between various data definitions among systems."n(3) Define communication protocol of data transfer, i.e., TCP/IP or DICOM."nIn general, medical imaging industry conforms to the aforementioned