Is storage commitment a necessary part? - DICOM

This is a discussion on Is storage commitment a necessary part? - DICOM ; Hi all I was told by a technician in a hospital that the modality machine deletes the patient studies saved in it based on First In First Out (FIFO) rule. I understand that the storage commitment is used to ensure ...

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  1. Is storage commitment a necessary part?

    Hi all

    I was told by a technician in a hospital that the modality machine
    deletes the patient studies saved in it based on First In First Out
    (FIFO) rule.

    I understand that the storage commitment is used to ensure the reliable
    storage of the image in PACS.

    So I want to know is it a necessary step in real operation in hospital
    that a modality will send a storage commitment request to PACS before
    it deletes any study? If FIFO rule is applied, can the modality delete
    studies saved in it automatically without any interaction with PACS? Or
    if a study is manually deleted from modality machine, will it send
    storage commitment to PACS?

    Thanks a lot to anybody who knows the answer.


  2. Re: Is storage commitment a necessary part?

    It is unusual for a modality vendor to allow their machine to
    automatically delete patient studies without human intervention. The
    limitation is not technical but is instead driven by medical liability
    and accountability rules. In most modalities a patient is exposed to
    ionizing radiation and/or injected with contrast agents which carry a
    small but measurable (and cummulative) risk to the patient's health. If
    a study were to be acquired on a modality and for some reason was not
    transferred for interpretation before the automatic deletion removed
    the study from the device, the manufacture is potentially liable for
    the unneccessary re-imaging of the patient. The costs of
    services,equipment etc. also come into the picture.

    Countering against the medical liability, risk, etc. are the very real
    costs for the rad techs or biomedical technical staff to manually
    delete studies which have been transferred for interpretation - ie. the
    normal routine workflow. It is a valid argument to question why Storage
    Commit is neccessary if you also track whether a study was transferred
    to some external device. However, since a modality can transfer images
    to multiple different destinations, not all of them resulting in the
    safe, reliable storage of the image (e.g., requesting physicians desk
    top PC), Storage Commitment is associated with the transfer from the
    modality to a storage destination which is "special". In a sense it is
    a sort of network bureacracy/red tape. But through the storage
    commitment transaction, the modality and PACS (or other responding SC
    SCP) agree responsibility for safe storage of the images have been
    transferred - hence giving the modality manufacture cover from any
    liability associated with deleting the studies.

    So - technically storage commitment is not "required". Anybody can
    decide to automate deletion of the studies from the modality; but
    they're taking the tedious, boring, and personnally accountable
    responsibility task away from technical staff. Thus, have potentially
    opened themselves to responsibility for losing critical images. I'm
    not aware of anyone/any company ever having been prosecuted or sued for
    automatic deletion of images. Possibly the risk is so small they felt
    it was not worth worrying about. But, the problem with medical
    liability is the downside of a very low probability risk can bankrupt
    your company if the improbable happens. The risk of such
    prosecution/lawsuit was sufficient to drive vendors to implement
    storage commit interface in the first place.


    miaomiao@gmail.com wrote:
    > Hi all
    >
    > I was told by a technician in a hospital that the modality machine
    > deletes the patient studies saved in it based on First In First Out
    > (FIFO) rule.
    >
    > I understand that the storage commitment is used to ensure the reliable
    > storage of the image in PACS.
    >
    > So I want to know is it a necessary step in real operation in hospital
    > that a modality will send a storage commitment request to PACS before
    > it deletes any study? If FIFO rule is applied, can the modality delete
    > studies saved in it automatically without any interaction with PACS? Or
    > if a study is manually deleted from modality machine, will it send
    > storage commitment to PACS?
    >
    > Thanks a lot to anybody who knows the answer.



  3. Re: Is storage commitment a necessary part?

    Thank you a lot for your answer.

    eric.goodall@gmail.com wrote:
    > It is unusual for a modality vendor to allow their machine to
    > automatically delete patient studies without human intervention. The

    ..


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