It makes sense that information should be consistent across all of the devices and records within your practice. Primary functions such as scheduling or billing are all headache-free because of the availability of database-enabled software that helps keep related information unique with minimal effort, and it stands to reason that this should apply to patient information as well. Because a variety of advanced technology has become commonplace within hospitals, well maintained and consistent patient records allow you to quickly pull up a patient’s information no matter what device or system you are using and is crucial to ensure that imaging from multiple modalities (ultrasound, X-Ray, CT, etc.) relates to each other, building a picture of a patient’s health record.
This concept of consistency is even more important when medical imaging is transmitted from a modality to a repository such as a PACS (Picture Archiving and Communication System) or VNA (Vendor Neutral Archive). Modern medical imaging devices use the DICOM image format, which became widely adopted as the standard format for imaging in medicine in 1993. One of the most unique features of the DICOM format is that each transmitted images can contain a great deal of metadata about the image and study. Fields, such as those related to the patient information or information about the hospital, that are entered on the imaging device are directly mapped to a series of ‘tags’ that are part of the DICOM standard, which are in turn read by the repository and used to correctly archive the incoming information.
While the DICOM standard has many different metadata tags, chief among those are the tags used for transmission of patient data. The information in these tags is the primary source that the receiving repository uses to store and related studies, most often using a patient's ID, but sometimes a combination of ID, first and last names. Proper transcription of the patient's information at your hospital into relevant fields on the imaging device prior to the study means that all of the studies for that patient, even across multiple modalities, will all belong to the same record, making it incredibly easy to summarize a patient's health. While this blog focuses on the importance of this consistency as it relates to image transmission, it is equally important and helpful to use the same principles within systems in your own hospitals, such as your Practice Information Management software (PIMS). In a world of big data that is only getting bigger, knowing that your data is organized and consistent confers peace of mind.
Because of it's relevance to our business, I will use the Oncura ultrasound system as an example of where to input patient information and what to enter so that your records stay organized.
On the Oncura ultrasound system, the one field that must always be populated for a patient is the patient ID. If left blank, the system will automatically generate and assign a patient ID based on the date and time that the study was initiated. While this ensures that each patient has a unique ID, this causes problems if the same patient has another exam in the future, unless the same generated ID is used again; if left blank and allowed to generate a new ID, the past and present studies are not related and considered different patients by almost all other systems. It is also worth noting that the patient ID cannot be changed once the study has been started, so it is imperative that the correct value is added prior to each study.
It is highly recommended that you enter the patient’s unique ID from your practice information management software (AviMark, Cornerstone, etc.), instead of allowing the patient ID to be generated. Doing so would allow any member of your staff to search your ultrasound system for patient studies based on the ID in the PIMS system.
Figure 1: The exam wizard in the Sonix software is pre-configured to ask for patient identifying information. This information is used to populate the metadata tags during image transmission, correctly archive the study on our VNA and automatically relate the new study to prior studies for the same patient
Similarly, on your other modalities (digital X-Ray, CT, etc), the same patient ID should be used to fill the field for Patient ID prior to image capture. This ensures that no matter what, all imaging for that patient will be related when sent to archives or telemedicine services like our telemedicine portal, and that looking at a patient's record is effortless and headache-free.