Image management in a multi-hospital environment

The management of images on a full hospital picture archiving and communication system (PACS) is a complex requirement. In order to work efficiently, a "worklist" mechanism is provided to present the radiologist with a simple "view" of his/her work. Worklists are radiologist-specific and consist of unread examinations which are automatically apportioned between radiologists based on local departmental procedures (e.g. body part, modality, etc.). Furthermore, simple "shortcuts", such as a NEXT function and a quick way to know about and to open STAT examinations are mandatory for efficient clinical operation. The presentation of images for new and historical exams on a softcopy workstation should appear similar to the familiar film alternator for speed of operation and ease of use by physicians who are trained on hardcopy film. When the imaging system extends across several medical facilities, the management of images becomes more complex. A radiologist's work may extend across several facilities. Radiologists at several facilities may collectively read exams at all of the facilities. The radiologist worklist must present a view of the new exams anywhere in the system. The worklist must be able to support several radiologists over the system working of the unread examinations simultaneously. This paper describes the concepts for image selection and presentation at PACS workstations both within a medical treatment facility and distributed across several hospitals and clinics.