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ISite 3.5: Demographic Mismatches. CONFIDENTIAL TRN-0035-15 Rev 06/23/06 2 Table of Contents Objectives Terminology Demographics Mismatch Overview Hide.

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Presentation on theme: "ISite 3.5: Demographic Mismatches. CONFIDENTIAL TRN-0035-15 Rev 06/23/06 2 Table of Contents Objectives Terminology Demographics Mismatch Overview Hide."— Presentation transcript:

1 iSite 3.5: Demographic Mismatches

2 CONFIDENTIAL TRN Rev 06/23/06 2 Table of Contents Objectives Terminology Demographics Mismatch Overview Hide Demographics Mismatch Remove Demographics Mismatch Assign New Study Instance Unique Identifier Detach Images from an Order Delete Image(s)

3 CONFIDENTIAL TRN Rev 06/23/06 3 Objectives Understand Demographic Mismatches (Duplicate Study Instance Unique Identifiers or Dup UIDs) Understand the use of Remove Demographics Mismatch Understand the use of Assign New Study Instance Unique Identifier Understand the use of Delete Image(s)

4 CONFIDENTIAL TRN Rev 06/23/06 4 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, and order entry RIS (Radiology Information System) –Information Systems designed to manage exams (orders), including filling orders and scheduling

5 CONFIDENTIAL TRN Rev 06/23/06 5 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

6 CONFIDENTIAL TRN Rev 06/23/06 6 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

7 CONFIDENTIAL TRN Rev 06/23/06 7 Demographics Mismatch Overview

8 CONFIDENTIAL TRN Rev 06/23/06 8 Demographics Mismatch A Demographics Mismatch (Duplicate Study Instance Unique Identifier or Dup UID) is an event where a single study (as identified by a single Study Instance Unique Identifier) has more than one set of associated patient demographics A Demographics Mismatch is a study which contains images with patient demographic discrepancies but contains the same study unique identifiers (SUID) Upon detection of this error, notification is presented to the iSite PACS Administration team for action

9 CONFIDENTIAL TRN Rev 06/23/06 9 Demographics Mismatch iSite offers a set of tools to allow an iSite Administrator to resolve Demographic Mismatches These tools can also be used to resolve workflow errors that may not necessarily generate a Demographics Mismatch scenario It is not uncommon due to noncompliant modalities or technologists’ workflow errors that two studies with different patient demographic information are assigned the same SUID When this happens the images are merged into a single study

10 CONFIDENTIAL TRN Rev 06/23/06 10 Demographics Mismatch Occurrence Noncompliant Modalities: –When certain modalities are upgraded, the SUID counter may be reset –Any “new” SUID will be a duplicate of a previous one prior to the upgrade Technologist Workflow Errors: –A technologist scanned in a patient with the wrong patient demographics and sends the study to iSite with a specific SUID –The technologist realizes the mistake and corrects the patient demographics on the modality console prior to resending the study which maintains its previous SUID

11 CONFIDENTIAL TRN Rev 06/23/06 11 NO Study received by server. Detection level? Name or DOB different as well as ID? Level 1 YES Level 2 NO No Dup Case. Study merged with existing patient. AutoGenerate enabled? YES Any AE Titles specified? YES Sending AE Title on list? New study UID generated from SUID + MRN, regardless of dup status. Uses demographics from incoming study. NO Dup Case in System. sent to PACS admin. Study hung w/ existing study. All series in study display warning msg. YES Important Note: At this point the study will either have the original UID or the generated UID. If a new UID was generated, it will be used for all dup UID comparisons, not the original UID. This ensures that generated study UIDs will never have a dup UID condition. Does Patient ID match existing study patient ID? YES Continue with rest of consolidation process. NO Does Study UID already exist on server? YES Demographics Mismatch Detection

12 CONFIDENTIAL TRN Rev 06/23/06 12 Demographics Mismatch Notification An automatic will be sent from the iSite server directly to the main iSite PACS Administrator at the customer site when a Demographics Mismatch is detected

13 CONFIDENTIAL TRN Rev 06/23/06 13 DUPUID Case Folder The DUPUID Cases Folder provides a historical reference of Demographic Mismatches for the iSite PACS Administrator

14 CONFIDENTIAL TRN Rev 06/23/06 14 Demographics Mismatch Warning Message The merged studies will be displayed in iSite with a Warning Message overlaying the images to warn users of the possibility of viewing a study with images/series from different patients

15 CONFIDENTIAL TRN Rev 06/23/06 15 DUP UID Toolset iSite PACS Administrators to perform the following whenever there are merged studies with patient demographic discrepancies due to Demographic Mismatches: –Delete any series which do not belong to the study –Assign New Unique Study UID to the specific series which do not belong with the rest of the study. These images can later be validated with another patient’s exam –Remove Demographics Mismatch is a resolution measure which will accept existing study’s patient demographics and merge the duplicate UID series –Hide Demographics Mismatch option is for end users to temporary turn off the warning message while navigating the study

16 CONFIDENTIAL TRN Rev 06/23/06 16 Hide Demographics Mismatch

17 CONFIDENTIAL TRN Rev 06/23/06 17 This feature is accessed by right clicking on a series thumbnail within a study rack or on a pop up window The option to “Hide Demographics Mismatch” will only be available if the study contains multiple varying patient demographics This feature is only available if the user DOES NOT have the Security Code: ISTRDUPID Hide Demographics Mismatch

18 CONFIDENTIAL TRN Rev 06/23/06 18 Remove Demographics Mismatch

19 CONFIDENTIAL TRN Rev 06/23/06 19 Remove Demographics Mismatch Demographics Mismatch Case: –A radiologic technologist acquired images and discussed additional views or sequences with the radiologist –Upon review, the radiologist requests additional views –The radiologic technologist then inadvertently mistypes the patient demographics Resolution: –Use the “Remove Demographics Mismatch” feature on the additional views to resolve the demographics mismatch and keep the demographics provided by the first set of images

20 CONFIDENTIAL TRN Rev 06/23/06 20 This feature is accessed by right clicking on a series thumbnail within a study rack or on a pop up window The option to “Remove Demographics Mismatch” will only be available if the study contains multiple varying patient demographics This feature is only available if the user has the Security Code: ISTRDUPID Remove Demographics Mismatch

21 CONFIDENTIAL TRN Rev 06/23/06 21 Assign New Unique Study UID

22 CONFIDENTIAL TRN Rev 06/23/06 22 Assign New Unique Study UID This feature is accessed by right clicking on a series thumbnail within a study rack The option to “Assign New Unique Study UID” will only be available if there is more than one series in any particular study This feature is only available if the user has the Security Code: ISTRDUPID

23 CONFIDENTIAL TRN Rev 06/23/06 23 Assign New Unique Study UID Demographics Mismatch Case: –A radiologic technologist acquired images for multiple patients –The radiologic technologist mistakenly identifies all image cassettes as images for one specific patient’s demographics (Patient A) into the console –This is not a Demographics Mismatch because all images will have the same demographics (Patient A) Resolution: –Use the “Assign New Unique Study UID” to have iSite generate a new SUID for the series (Patient B) that should be assigned to Patient B –Use Digital Image Management to disassociate the series (Patient B) from the rest of the exam –Resolve exception images to the Patient B record

24 CONFIDENTIAL TRN Rev 06/23/06 24 Assign New Unique Study UID Demographics Mismatch Case: –A radiologic technologist acquired images for a patient –The radiologic technologist did not “complete” the study on the modality –The radiologic technologist enters new patient demographics for the next patient and begins acquiring images –The modality did not assign a new Study Instance Unique Identifier; therefore, the studies will have the same SUID –This is a Demographics Mismatch Resolution: –Use the “Assign New Unique Study UID” to have iSite generate a new SUID for the series (Patient B) that should be assigned to Patient B –The Assign New Unique Study UID feature will attempt to validate and resolve the images with a corresponding record or the images will not resolve and will be exceptions –Resolve exception images to Patient B’s record

25 CONFIDENTIAL TRN Rev 06/23/06 25 Assign New Unique Study UID Ultrasound Demographics Mismatch Case: –A sonographer acquired images for a patient –The sonographer did not “complete” the study on the modality –The sonographer enters new patient demographics for the next patient and begins acquiring images –The modality did not assign a new Study Instance Unique Identifier; therefore, the studies will have the same SUID –This is a Demographics Mismatch; however, the images must be separated (split) before a new Study Instance Unique Identifier may be assigned Resolution: –Use the “split exam” feature to un-stack the images –Use the “Assign New Unique Study UID” to have iSite generate a new SUID for the series (Patient B) that should be assigned to Patient B –The Assign New Unique Study UID feature will attempt to validate and resolve the images with a corresponding record or the images will not resolve and will be exceptions –Resolve exception images to Patient B’s record

26 CONFIDENTIAL TRN Rev 06/23/06 26 Digital Image Management: Detaching Images from an Order

27 CONFIDENTIAL TRN Rev 06/23/06 27 At times, it may be necessary to detach a study from an exam For example, if images belonging to one patient’s record are accidentally assigned to another patient’s exam, you will have to detach the images from the incorrect exam and reassign them to the correct patient’s exam This involves detaching a study or studies from a patient’s exam record, thereby creating an exception, and then resolving the resulting exception by assigning it to the correct patient’s exam Detaching Images from an Order

28 CONFIDENTIAL TRN Rev 06/23/06 28 Log into iSuite (the administrative application of iSite) and follow these steps to detach images from a patient’s record Detaching Images from an Order

29 CONFIDENTIAL TRN Rev 06/23/06 29 Sys Admin Module Click the Sys Admin module Step 1

30 CONFIDENTIAL TRN Rev 06/23/06 30 Sys Admin Module Click the Digital Img Mgmt option Step 2

31 CONFIDENTIAL TRN Rev 06/23/06 31 Sys Admin Module Search for the exam by Accession Number, MRN or patient name, etc. Step 3

32 CONFIDENTIAL TRN Rev 06/23/06 32 Sys Admin Module The images may be viewed by clicking the view button

33 CONFIDENTIAL TRN Rev 06/23/06 33 Sys Admin Module Deselect the check box next to the Study Instance Unique Identifier Step 4

34 CONFIDENTIAL TRN Rev 06/23/06 34 Sys Admin Module Click the detach button to detach the study from the exam Step 5

35 CONFIDENTIAL TRN Rev 06/23/06 35 Sys Admin Module A verification dialog is presented The selected study will become an exception

36 CONFIDENTIAL TRN Rev 06/23/06 36 Delete Image(s)

37 CONFIDENTIAL TRN Rev 06/23/06 37 Delete Image(s) Images may be deleted by “right clicking” on an image and selecting ‘Delete’ from the Context Menu

38 CONFIDENTIAL TRN Rev 06/23/06 38 Delete Image(s) A Reason must be selected from the list presented

39 CONFIDENTIAL TRN Rev 06/23/06 39 Delete Image(s) The “Delete Image” feature is available only if the user has the Security Code: ISTIMGDEL The “Delete Image” feature is accessed by right clicking on an image thumbnail on the Exam Rack The “Delete Image” feature does not allow all in an exam to be deleted The “Delete Image” feature will not allow images to be accepted, in most cases, if resent from the modality

40 CONFIDENTIAL TRN Rev 06/23/06 40 Recover Deleted Images Deleted Images may be recovered by “right clicking” the Exam Rack Shelf Bar and selecting “Recover Deleted Images”

41 CONFIDENTIAL TRN Rev 06/23/06 41 Recover Deleted Images The “Recover Deleted Images” option is available only if the user has the Security Code: ISTIMGDEL Images may be recovered by “right clicking” the Exam Rack Shelf Bar All deleted images for the exam are recovered

42 CONFIDENTIAL TRN Rev 06/23/06 42 Delete Image(s) The “Delete Image” feature may be used to delete images which were sent in error, if the images will not be resent to Philips iSite PACS

43 CONFIDENTIAL TRN Rev 06/23/06 43 For assistance, please call customer support at or

44 CONFIDENTIAL TRN Rev 06/23/06 44


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