IHE - multiple orders - one exam - how to act as PACS/RIS? - DICOM

This is a discussion on IHE - multiple orders - one exam - how to act as PACS/RIS? - DICOM ; Dear All, RIS order two exams for same patient - CT Chest and CT abdomen - so we have one PATIENT_ID and t wo ACCESSION_NUMBERS. But technician will make one exam - full scan...so we have one MPPS, one completed ...

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Thread: IHE - multiple orders - one exam - how to act as PACS/RIS?

  1. IHE - multiple orders - one exam - how to act as PACS/RIS?

    Dear All,

    RIS order two exams for same patient - CT Chest and CT abdomen - so we
    have one PATIENT_ID and t wo ACCESSION_NUMBERS. But technician will
    make one exam - full scan...so we have one MPPS, one completed study?
    That is irrational - how that should be done according to IHE standard
    + DICOM + HL7?

  2. Re: IHE - multiple orders - one exam - how to act as PACS/RIS?

    On Oct 2, 10:03*am, M1nd0nF1r3 wrote:
    > Dear All,
    >
    > RIS order two exams for same patient - CT Chest and CT abdomen - so we
    > have one PATIENT_ID and t wo ACCESSION_NUMBERS. But technician will
    > make one exam - full scan...so we have one MPPS, one completed study?
    > That is irrational - how that should be done according to IHE standard
    > + DICOM + HL7?


    This is the classic "group case" documented in IHE Radiology Technical
    Framework. Basically, in this case the modality is supposed to leave
    the Accession Number attribute of the acquired images empty/blank and
    instead document to attributes of the multiple requested procedures
    which were performed/satified by the acquisition of the images as
    separate items in the Request Attributes Sequence.

    Also, it should be noted - the values generated by the RIS are not
    Accession Numbers. They are Request Procedure Ids (which may have
    been included in the Accession Number attribute on the MWL). I don't
    have the rad tech framework at my finger tips, so don't recall the
    exact name (Performed Steps Sequence?) but there is also a sequence
    which can contain multiple items, where each "item" is itself a
    sequence, in the MPPS IOD. Just as the attributes of the requested
    procedures are included the request attribute sequence in the images,
    most of the same attributes are included in the performed steps
    sequence.

    As a PACS receiving the images from a properly acquired group case
    image, your trigger to record the images as acquired for multiple
    procedures is the fact that the Accession Number of the received
    images is empty. You should be checking for a request attribute
    sequence containing multiple items anyway (because somebody might put
    one requested procedure Id into the Accession Number attribute, but
    document the other procedures in the sequence) -- but I digress --
    when you get an image with the accession number value missing, it is
    your trigger to definitely go look for multiple requested procedure
    items in the request attributes sequence.

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