RSNA 2006 MIRC

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RSNA 2006 Educational exhibit R Stramare , MD, A Castellini, G Feltrin, MD, P Inchingolo*, C Saccavini, PhD, G Vaccari University of Padova *University of Trieste Open Three (O3) Consortium Experience: Open Source+Open Standard (IHE)+Open Knowledge (MIRC)

Transcript of RSNA 2006 MIRC

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RSNA 2006Educational exhibit

R Stramare, MD, A Castellini, G Feltrin,MD, P Inchingolo*, C Saccavini, PhD, GVaccari

University of Padova

*University of Trieste

Open Three (O3) ConsortiumExperience:

Open Source+Open Standard(IHE)+Open Knowledge (MIRC)

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Exhibit Outline

The goal is to realize an open source solution based onOpen Source technology, Open Standard, such asIHE, and Open Knowledge such us MIRC.

We have developed a solution that is formed by IHEactors into a four packages: O3-MARiS, that is a RISsystem based on php/Apache/MySQL, O3-DPACS,that is a PACS based on Jboss/PostgreSQL, O3-RWS. that is a reporting workstation based on Java,and O3-FatBrother, that is an Audit Record RepositoryATNA.

 

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Exhibit Outline

It is very important to notice that all the packages canexport/import radiologial data in MIRC format, and anO3-MIRC site has active since October 2005 inPadova University

The goal of the Open Three (O3) Consortium is topromote an Integrated Healthcare Environment for archiving, transmission, exchange, retrieval andvisualization of data, signals, images and reports, in

which the three dimensions of the Health Policies -Hospitals, Territory / RHIOs and Home Care / AmbientAssisting Living (AAL)) are linked together.

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Open Source

The basic idea behind open source is very simple:when programmers can read, redistribute, and modifythe source code for a piece of software, the softwareevolves. People improve it, people adapt it, people fixbugs. And this can happen at a speed that, if one isused to the slow pace of conventional softwaredevelopment, seems astonishing.

Some consider it as a philosophy, and others

consider it as a pragmatic methodology.

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Creative Commons

The Creative Commons (CC) enables copyright

holders to grant some of their rights to the public whileretaining others through a variety of licensing andcontract schemes including dedication to the publicdomain or open content licensing terms. The intentionis to avoid the problems current copyright laws createfor the sharing of information.

The CC is a non-profit organization devoted to

expanding the range of creative work available for 

others legally to build upon and share.

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Open Standards

Open standards are publicly available and

implementable standards. By allowing anyone to

obtain and implement the standard, they can increase

compatibility between various hardware and software

components, since anyone with the necessary

technical know-how and resources can build products

that work together with those of the other vendors that

base their designs on the standard.

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Open Standards: IHE

IHE is an initiative by healthcare professionals and

industry to improve the way computer systems in

healthcare share information.

Systems that support IHE Integration Profiles

communicate better, are easier to implement, and

enable care providers to use information more

effectively. The goal is efficient delivery of optimal

patient care.

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Open Knowledge: MIRC

The MIRC project was initiated by the RSNA

Radiology Informatics Committee to construct a

library of medical information, globally accessible to

the imaging community through the Internet. The

project has evolved to support communities of 

cooperating libraries, individually managed by

healthcare and educational institutions, whose content

can be accessed by a user as if it were a single

library.

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Our Project

We try to insert in a real-world radiology the Open

Source metodology, the Open Standard approach

and the Open Knowledge Management to realize a

simple radiological report workplace in which there

are:

RIS

PACS archive

Workstation

MIRC Server 

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Dpt. Medical and Diagnostic Sciences Layout

O3-DPACS DCM4CHEE v

v

General HospitalPadova

University HospitalPadova

Public MIRC

Server

Private

MIRC Server

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MARiS-OF: the OSS RIS

The MARiS-OF is a RIS developed using IHE

architecture. It is based on Apache/PHP server and

the GUI is realized using CSS approach. The

dababase can be MySQL, PostgreSQL or Oracle. All

DICOM and HL7 services are developed using

dcm4chee libraries.

The website is maris.sourceforge.net

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MARiS technical architecture

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O3-DPACS: the OSS Image Manager 

The O3-DPACS open-source DPACS is an image-

data manager/archiver. It’s a Java J2EE (Java 2Enterprise Edition) Application developed on JBOSS,an open source application server, but it runs onnearly every application server as the concept of platform independence states. It has been realized asa modular collection of services.This server is implemented in the Padova GeneralHospital

The website is www.o3consortium.eu

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O3-DPACS technical architecture

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DCM4CHEE: the OSS Image Manager 

dcm4chee is an Image Manager/Image Archive

(according to IHE). The application contains theDICOM, HL7 services and interfaces that are requiredto provide storage, retrieval, and workflow to ahealthcare environment. By taking advantage of manyJBoss features , and assuming the role of several IHEactors for the sake of interoperability, the applicationprovides many robust and scalable servicesThis server is implemented in the Padova UniversityHospital.

The website is www.dcm4che.org

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RWS: the OSS Image Display

This workstation has been developed thinking upon

radiology department needs, with strong feedbackfrom radiologists. It gives the support for theintegration with the open source RIS (MARIS-OF).IHE profiles that was be tested at IHE EuropeConnectathon 2006:

SWF Scheduled Workflow

CPI Consistent Presentation of Images

KIN Key Image Notes

The website is www.o3consortium.eu

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RWS: the OSS Image Display

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RSNA MIRC software: the OSS MIRC server 

There are several ways for an individual or an

institution to establish a system that can participate ina MIRC community:

The RSNA MIRC software provides both a query serviceand a storage service as well as support for the MIRC-defined authoring format.

An existing teaching file system can be modified to useits internal database to provide an index of its documents,requiring only the construction of the software layer necessary to respond to a MIRC query.

Some commercial teaching file systems also support the

MIRC query mechanism, allowing them to participate in aMIRC community.

The website is mirc.rsna.org

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MIRC case Workflow

The Modality produces imagesand store to PACS server 

The resident or junior radiologistprepare the report

The senior radiologist validatethe report and decide if it is

interesting for MIRC publication

The editorial board of  postgraduated School of 

Radiodiagnostic decide if to publish the case on public MIRC

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MIRC case consumer during reporting

The Modality produces imagesand store to PACS server 

The resident or junior radiologistretrive image on workstation

He queries MIRC servers to findsimilar images or interesting

teaching files

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Private MIRC site: simple resident case

P i t MIRC it

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Private MIRC site:example of Resident’s vs Fellow’s Report

Private MIRC site:

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Private MIRC site:example of Resident’s vs Fellow’s Report

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Public MIRC site

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Public MIRC site: clinical case

Public MIRC site: historical clinical case

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Public MIRC site: historical clinical case(PaleoRadiology)

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Conclusions

The Knowledge Management in Radiodiagnostic

using Open Source + Open Standard + OpenKnowledge are very interesting especially inUniversity Hospitals, because:

Present and future Residents will benefit of their historical errors.

Resident’s reading error trackingTeaching quality control

Training effectiveness.

The flexibility of Open technologies will open new

approaches in Diagnostic Imaging Management, inparticular with the image comparison not only withprevious examinations, but also with “similar” ones