iSite 3.5: Dictionary Administration

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Table of Contents

• Objectives

• Terminology

• Dictionaries

• Dictionary Maintenance

• Translation Tables

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Learning Objectives

• Understand the purpose of dictionaries

• Understand how to maintain dictionaries

• Understand the purpose of translation tables

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Terminology

• 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

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Terminology

• 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

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Terminology

• 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

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Dictionaries

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Dictionaries

• Dictionaries are files that store definitions of predefined codes, whether these codes originate in external information systems or are exclusive to Philips iSite to ensure advanced workflow functionality is available

• Dictionaries store the data in a uniform manner which can be reused over and over again without the need to re-enter the data

• Dictionaries provide the capability for iSite to automatically associate key data with predefined, unique values transmitted by integrated information systems

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Dictionaries

• Philips iSite PACS has several dictionaries which are a key to proper functioning of the system, including the following system dictionaries

– Anatomy– Document Type– Equipment– Exam Dictionary– Hanging Protocol Groups– Provider– Reason– Subspecialty

• The Exam Dictionary is the primary dictionary which ensures the proper association with pre-defined descriptions, body sites, or modality types with exams to ensure advanced workflow functionality

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Dictionaries

• iSite uses the Exam Dictionary to automatically associate a pre-defined description, body site, or modality type with exams to ensure advanced workflow functionality

• Certain features in iSite depend upon the maintenance of a clean Exam Dictionary

– For example: Worklist Filtering, Hanging Protocols, Patient History Timelines, Exception Handler

* Dictionary Administration is a primary responsibility of iSite Administration and requires extensive planning and on-going maintenance for proper implementation

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Dictionaries

• Each imaging study should be associated with the following four pieces of data for correct functionalities

• Exam Description displayed on worklist

• Modality displayed on timeline and worklist

• Body Site displayed on the timeline

• Subspecialty used in Worklist Filters

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• In the RIS Integrated environment, Exam Dictionaries are pre-loaded

• Most RIS will have, within their repertoire, a file representing the various types of imaging procedures that a customer site uses

• RIS administrators at a customer site extract this file and fill in associated body parts, modality type, description, or subspecialty for each procedure

• Philips Integration Engineers then pre-load the Exam Dictionary which will remain the “Gold Standard” of categorizing studies regardless of what is entered at the modalities

Dictionary Creation

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• Dictionaries at RIS integrated customer sites

• A pre-loaded Exam Dictionary with procedural codes and associated study descriptions, body sites, and modality types will be available

Dictionary Creation

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• Dictionaries at RIS integrated customer sites

• A pre-loaded Exam Dictionary with procedural codes and associated study descriptions, body sites, and modality types will be available

Dictionary Creation

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• In the non-RIS Integrated environment, dictionaries are auto-populated

• The term “auto-populated” indicates that any new unique entry at the modality will auto-populate the Exam Dictionary

• Any unique study description entered at the modality will generate an Exam Code within the Exam Dictionary

Dictionary Creation

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• Dictionaries at non-RIS customer sites

• The auto-populated dictionaries tend to reflect the randomness and missing data entries at the modalities

Dictionary Creation

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Dictionary Maintenance

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Dictionary Maintenance

• The Exam Code Dictionary requires periodic reviews to ensure that exam-specific information is accurate for Worklist Filters and Hanging Protocols

• New Exam Codes may be sent via the HL7 interface in “John Doe” orders to create new entries in the Exam Code Dictionary

• New Exam Codes may then be edited to ensure that each new Exam Code includes the associated

– Exam Description– Modality Type– Body Site– Subspecialty

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Dictionary Maintenance

• In iSuite

1. Click Sys Admin Tab

2. Click Dictionaries

3. Select All in the Entries Filter drop-down box

Step 3

Step 2

Step 1

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Dictionary Maintenance

• To update the Exam Dictionary

1. Click Exam

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Dictionary Maintenance

2. On the next screen, select the box next to the Exam Code and click edit

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Dictionary Maintenance

3. Select the appropriate Modality, Body Site, and Subspecialty to link to the Exam Code

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Dictionary Maintenance

4. Select ‘Save’

• Once you have established the association, any study validated in iSite with the same code will be automatically associated with the appropriate data

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Translation Tables

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Translation Tables

• Translation Tables are files that store definitions, similar to dictionaries

• Translation Tables store predefined values that may be transmitted by external information systems and “translate” data received from external information systems into values which provide context, use and meaning in Philips iSite PACS

• Translation Tables provide the capability for iSite to automatically associate key data with predefined, unique values transmitted by integrated information systems

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Translation Tables

• Philips iSite PACS has several translation tables which are key to proper functioning of the system, including the following:

– Patient Status (or Patient Type)– Patient Sex– Exam Status– Exam Priority

• Translation tables ensure the proper association with predefined values which provide context, use and meaning in Philips iSite PACS

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Patient Status Support

Code Description

C Clinic

D Discharged

E Emergency

I Inpatient

O Outpatient

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Exam Status Support

Code Description Meaning/CommentS Scheduled • exam has been scheduled but not yet

begun• default code when none is received in

an order (ORM) message

I In Progress • patient has arrived and the exam has begun

C Completed • exam is complete and is pending a diagnostic report

D Dictated • report has been dictated for the exam through a dictation system

• has not been transcribed

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Exam Status Support (continued)

Code Description Meaning/CommentP Preliminary • diagnostic report has been

transcribed for the exam• default code when none is received in

a results (ORU) message

F Finalized • diagnostic report has been signed

A Addendum • addendum has been received and the report needs to be finalized again

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Sex Code Support

Code Type Code Description

Sex M Male

Sex F Female

Sex U Unknown

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Translation Tables

• The implementation of Philips iSite PACS may require the development of translation tables beyond the examples provided as a reference

• Philips Global PACS Business Unit personnel will assist in the evaluation of workflow to ensure that necessary translation tables are implemented for the effective use of Philips iSite PACS

* The translation tables require periodic review to ensure that data provided by external information systems is properly interpreted by Philips iSite PACS

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For assistance, please call customer support at

1-877-328-2808 or 1-877-328-2809