Integrated architecture dissolves RIS-PACS boundaries

An enterprise-wide information management model developed at Harvard Medical School promises to bridge the disparities becoming apparent as radiology information systems extend their reach beyond the radiology department.

Digital radiology departments increasingly serve not just diagnostic imaging, but also the interventional, therapeutic, and telemedical imaging needs of an institution. One of the first integrated enterprise architectures for image information management systems was described in a recent paper (IEEE Trans Inf Technol Biomed. 2003 Sep).

"The current information management model of radiology is made up of islands of automation, including RIS and PACS. It lacks the proper means for monitoring and tracking progression of jobs and imaging cases," said lead author Stephen T.C. Wong, Ph.D., director of the Center of Bioinformatics at Harvard Medical School.

Cost containment issues and an increasing focus on electronic patient records further expose how inefficient and impractical the current models are in meeting the needs of the digital hospital.

According to Wong, his architecture provides a uniform way to integrate RIS, PACS, and the imaging modalities, while at the same time providing scalability across multiple hospital enterprises.

It also supports automatic activity coordination, configurable business process definition, process statistics collection, and business process reengineering. The design provides a customized working environment for each end-user category to improve productivity, he said.

"With these new supports, the architecture positions next-generation digital radiology information systems as sociotechnical systems tightly integrated with radiology enterprise management and other relevant clinical information systems in digital hospitals," Wong said.

Wong's prototype was demonstrated at the most recent meetings of the RSNA and Healthcare Information and Management Systems Society. The architecture project was originally sponsored by Philips Medical Systems, but the company is no longer involved.

"A metasoftware layer allows configuration to local workflow and routes the right information to the right place at the right time to the right user, bringing medical image management completely to the next level," Wong said.