Data processing: financial – business practice – management – or co – Automated electrical financial or business practice or... – Health care management
Reexamination Certificate
1998-06-12
2001-07-10
Voeltz, Emanuel Todd (Department: 2761)
Data processing: financial, business practice, management, or co
Automated electrical financial or business practice or...
Health care management
C705S003000, C705S001100, C709S241000, C707S793000
Reexamination Certificate
active
06260021
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates to a computer system and method for enabling uniform access to and ready distribution of medical images and associated records in electronic form via a network, such as an intranet or the Internet, from multiple heterogenous and incompatible existing server systems.
2. Description of the Related Art
Handling of medical images, and of associated medical information, has been profoundly changed by the impact of digital and computer technologies. But in the current state of the art, these technologies have not resulted in uniform system by which a user can readily access medical image information from multiple and incompatible existing server systems.
Picture Archiving and Communication and Radiology Information Systems
Medical images are currently acquired by diverse imaging technologies and methods, including, for example, such methods as X-ray imaging, computed X-ray tomography, radioisotope emission imaging, computed emission tomography, magnetic resonance imaging, ultrasound imaging, and so forth. With increasing prevalence, medical images acquired by these and other methods are being directly acquired in or converted into digital form for storage and retrieval.
Current computer systems for storage and retrieval of such digital medical images (generically named Picture Archiving and Communication, or “PAC”, systems), typically have large amounts of digital storage, a processor for storing and indexing images, and user workstations attached directly, or across a network, to the PAC systems for image display. These systems have usually been designed with a client-server, or two-tiered, structures. In such structures, the workstations, acting on the second-tier as image clients, run specific software designed for interacting with a specific PAC system, acting on the first tier as an image server, in order to obtain and display images. The specific server software on the PAC system is designed to accept and respond only to the specific requests from the corresponding image-clients.
Therefore, two different PAC systems having different client and server software cannot be expected to be able to exchange image data. A user needing to access multiple different PAC system needs a specific client suited for each PAC server system.
Similarly text interpreting medical image and associated patient information is being transcribed into or captured directly in digital form and stored on server systems (generically named Radiology Information, or “RI”, systems). RI systems, like PAC systems, are also usually designed as client-server, or two-tiered, systems with user workstations running specific client software that interacts only with specific server software on the RI system.
Also like PAC system, two different RI systems cannot be expected to be able to exchange image data, and a user needs multiple specific clients suited for each RI server system of interest. Indeed, a PAC system is even less likely to be able to exchange data in any fashion at all with an RI system.
Other specialized information systems exist in the health-care environment. For example, there are specialized departmental-scale systems, such as those for storing and retrieving diagnostic cardiology images, for interfacing to and reporting results from laboratory instruments, for pharmacy management, and so forth. There are also institution-scale Hospital Information (“HI”) systems, such as those for patient financial and billing, or for patient admissions, discharge, and transfer (“ADT”).
All of these systems, like PAC and RI systems, comprise specialized software designed for the particular application and also often structured in a client-sever, two-tiered, architecture. And like PAC and RI systems, these departmental- or institution-scale information systems (e.g., HI systems) present in the health-care environment cannot be expected to exchange data or to interoperate. Users typically require a separate client to interface each of these systems.
Incompatibility Problems Associated with Current Standard Efforts
One approach to solving these incompatibilities is standardization of messages or interfaces. However, standardization alone is at best only a partial solution to solving system incompatibilities and to providing uniform data access. For example, the Digital Imaging and Communications in Medicine (“DICOM”) is one standard relevant to medical image distribution. DICOM has been developed and promoted by the American College of Radiology/National Equipment Manufacturers Association (ACR/NEMA), and aims to standardize formats for exchange of image data in PAC systems by defining a standard set of basic and composite data types along with a standard set of requests involving those data types, all of which are representative of the imaging activities in a radiology department. Accordingly, a single workstation with a DICOM-conforming client can expect some success in accessing multiple PAC systems, also DICOM-conforming, and the multiple DICOM-conforming PAC systems can themselves expect some success in exchanging image data. Individual variations in the details of DICOM-conformance may defeat interoperability or data interchange.
A similar standard applicable to RI systems is HL7, a standard that aims to define formats for electronic data interchange in health-care environments, In particular, HL7 defines message formats for exchange of information relating to a broad range of health-care activities, including patient admissions, discharges, transfers, patient queries, billing, clinical observations, and orders, and eventually patient medical records generally. Because of such broad goals, HL7 is even less of a true “plug-and-play” standard than is DICOM. In other words, two systems, although conforming to HL7, are likely, nevertheless, not be able to exchange requests and data. Therefore, a single user may still require multiple clients in order to access multiple RI systems, even though they are all HL7 conforming.
Yet a further problem is due to the multiple standards, such as DICOM and HL7 in radiology, present in the health-care environment. Even if they individually achieve plug-and-play interoperability, and not all do, the various standards do not interoperate for data interchange among themselves. For example, even within one radiology department, a DICOM-conforming PAC system cannot exchange requests or data with an HL7-conforming RI system. Although, the multiple health-care data exchange standards may reduce system incompatibilities within their individual scopes, as a collection they do not achieve reduced system incompatibilities outside across their scopes as a whole within a health-care institution generally.
Therefore, the current state of the art in medical image distribution faces daunting problems due to a lack of uniform access to and interchange of medical images stored in various different PAC systems, and also to a lack of uniform access to and interchange of associated medical interpretive text information stored in RI and other health-care systems.
What is needed, therefore, is a method and system by which a user can uniformly and rapidly access medical image data without regard to the boundaries of existing PAC, RI, or other health-care systems. Further, since health-care personal often do not have fixed work locations, needing to respond to health-care problems promptly wherever they happen to be, such uniform and rapid access should allow users to access medical image information from many diverse local or remote workstations. And since patients also move, such uniform access should provide medical image information between separate health-care institutions.
SUMMARY OF THE INVENTION
It is an object of the present invention to provide a solution to the above problems of the incompatibilities of existing PAC and RI systems and of lack of uniformity of access to their stored image data. This object is achieved by novel and innovative application of computer middleware technologies to create a three-tier
Prior Fred
Wong Stephen
Morgan George D.
Philips Electronics North America Corporation
Renfrew, Jr. Dwight H.
Todd Voeltz Emanuel
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