isite 3.5: exceptions handling (ris version). confidential trn-0035-14 rev 06/23/06 2 table of...
TRANSCRIPT
![Page 1: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/1.jpg)
iSite 3.5: Exceptions Handling (RIS Version)
![Page 2: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/2.jpg)
CONFIDENTIAL 2TRN-0035-14 Rev 06/23/06
Table of Contents
• Objectives
• Terminology
• Exception Definition
• Exceptions Handler
• Resolve Exception
• Verify Resolution
![Page 3: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/3.jpg)
CONFIDENTIAL 3TRN-0035-14 Rev 06/23/06
Learning Objectives
• Understand the purpose and performance of:
– Exception Occurrence
– Exceptions Handler
– Building Exceptions List
– Resolving Exceptions
– Verifying Exceptions
![Page 4: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/4.jpg)
CONFIDENTIAL 4TRN-0035-14 Rev 06/23/06
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
![Page 5: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/5.jpg)
CONFIDENTIAL 5TRN-0035-14 Rev 06/23/06
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
![Page 6: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/6.jpg)
CONFIDENTIAL 6TRN-0035-14 Rev 06/23/06
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
![Page 7: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/7.jpg)
CONFIDENTIAL 7TRN-0035-14 Rev 06/23/06
Exception Resolution
1. Identify Exception1. Worklist Module2. Exceptions Handler Option
2. View Exception Images1. Click on ID hyperlink2. Click View
3. iSite will present matches based on MRN and Accession Number or the user may enter a known ACC (from RIS) and apply1. Additional searches may be performed by clicking find pt/exam button2. Click on the radio button next to patient’s record
4. Locate the Exam1. Click on the MRN hyperlink 2. Verify Exam information and apply
5. Verify Resolution of Exception1. Check patient folder2. Check inactive/active lists
![Page 8: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/8.jpg)
CONFIDENTIAL 8TRN-0035-14 Rev 06/23/06
“Gold Standard” Patient Record
• In a RIS integrated environment, the iSite database is populated with patient records and exams by HL7 messages
• The record from the RIS is the record that iSite will consider the Gold Standard
![Page 9: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/9.jpg)
CONFIDENTIAL 9TRN-0035-14 Rev 06/23/06
Definition of an Exception
• An exception is a study that contains patient or exam information from the modality which does not match patient demographic information residing within the iSite database for this patient or exam
• DICOM Metadata, including MRN and/or Accession number, do not match the iSite database Gold Standard
![Page 10: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/10.jpg)
CONFIDENTIAL 10TRN-0035-14 Rev 06/23/06
Image Validation
• All studies from modalities need to be validated prior to registration into the iSite database
• Exceptions are studies that fail the automatic validation process and are
identified with (!) an exclamation point in the Patient Directory
• Exception studies require a MANUAL process to validate them into the database
![Page 11: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/11.jpg)
CONFIDENTIAL 11TRN-0035-14 Rev 06/23/06
ACC … SUID
Image Validation
• iSite uses an interface (ConnectR) to automatically validate studies into the database
• ConnectR looks at DICOM Metadata for images and validates the images with the corresponding exam ordered by the RIS
HL7 Order Study (DICOM Metadata)
iSite Database
![Page 12: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/12.jpg)
CONFIDENTIAL 12TRN-0035-14 Rev 06/23/06
Image Header Information
• The Image DICOM Metadata information that ConnectR uses for validation in a RIS integrated environment are:
• Medical Record Number• Accession Number
![Page 13: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/13.jpg)
CONFIDENTIAL 13TRN-0035-14 Rev 06/23/06
Image Header Information
Modality (scanner)
Diagnostic viewing
workstation
iSite Server
NAMEMRNACC #
NAMEMRNACC #
![Page 14: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/14.jpg)
CONFIDENTIAL 14TRN-0035-14 Rev 06/23/06
Exception Occurrence in RIS Environment
• DMWL (Dicom Modality Work List) was not used for some reason
– HIS/RIS was down• Network or Connectivity Issue• Power Outage• System Reset• Periodic System Maintenance
– Lack of full DICOM support at the modalities • Technologists must manually enter patient information• ACC not entered or entered incorrectly• Modality allows manual entry of MRN or ACC number, but it does not
insert it into the DICOM Metadata
![Page 15: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/15.jpg)
CONFIDENTIAL 15TRN-0035-14 Rev 06/23/06
Exception Occurrence in RIS Environment
• DMWL (Dicom Modality Work List) was not used for some reason
– ER• Did not have time to order exam in RIS• No ACC number assigned when exam started
– Workflow Error• ACC or Exam was cancelled while exam was in progress
![Page 16: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/16.jpg)
CONFIDENTIAL 16TRN-0035-14 Rev 06/23/06
Identifying Exceptions
• In iSite Enterprise
– Patient Directory (identify exceptions with an ‘!’ next to the patient’s name)
– Worklist Filters
– Exceptions Handler Folder
• In iSuite
– Exceptions Handler tab within the Worklist tab
![Page 17: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/17.jpg)
CONFIDENTIAL 17TRN-0035-14 Rev 06/23/06
• In iSuite or iSite Enterprise from the Folder List
Exceptions Handler
![Page 18: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/18.jpg)
CONFIDENTIAL 18TRN-0035-14 Rev 06/23/06
Exceptions List• Select an Exceptions List
![Page 19: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/19.jpg)
CONFIDENTIAL 19TRN-0035-14 Rev 06/23/06
Exceptions List• A New Exceptions Worklist may be built
![Page 20: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/20.jpg)
CONFIDENTIAL 20TRN-0035-14 Rev 06/23/06
Exceptions List
• Active or Inactive Status
• Reason (e.g. ACC not found)
• Patient Sex
• Performing Resources
![Page 21: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/21.jpg)
CONFIDENTIAL 21TRN-0035-14 Rev 06/23/06
Exceptions List “Best Practices”
• 2 Days is recommended for Date Range
• ACQ and FIND are recommended for Type
• Modality is recommended in most instances
• To select a modality click the (…) button
![Page 22: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/22.jpg)
CONFIDENTIAL 22TRN-0035-14 Rev 06/23/06
Exceptions List
• Select the modality from the pop-up Equipment Dictionary
![Page 23: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/23.jpg)
CONFIDENTIAL 23TRN-0035-14 Rev 06/23/06
Identifying Exceptions• An Additional Search may be made using Patient Name or Accession
Number as well as other identifiers
![Page 24: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/24.jpg)
CONFIDENTIAL 24TRN-0035-14 Rev 06/23/06
Resolve Exceptions• An Exception may be resolved by selecting the ID hyperlink
![Page 25: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/25.jpg)
CONFIDENTIAL 25TRN-0035-14 Rev 06/23/06
Resolve Exceptions• View the image by selecting the ‘View’ button
![Page 26: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/26.jpg)
CONFIDENTIAL 26TRN-0035-14 Rev 06/23/06
Resolve Exceptions• Images of poor quality may be removed by selecting the
‘remove’ button
![Page 27: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/27.jpg)
CONFIDENTIAL 27TRN-0035-14 Rev 06/23/06
Resolve Exceptions• iSuite conducts a Database search for a matching MRN (Patient ID)
and ACC (Accession Number)
![Page 28: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/28.jpg)
CONFIDENTIAL 28TRN-0035-14 Rev 06/23/06
Resolve Exceptions• Locate the Patient’s Record/Exam
![Page 29: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/29.jpg)
CONFIDENTIAL 29TRN-0035-14 Rev 06/23/06
Resolve Exceptions• Select the correct Accession Number to which the images belong
![Page 30: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/30.jpg)
CONFIDENTIAL 30TRN-0035-14 Rev 06/23/06
Resolve Exceptions• If ACC number is known it may be entered in the field
• ACC number entered must represent a valid exam that the RIS ordered or it will be rejected
![Page 31: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/31.jpg)
CONFIDENTIAL 31TRN-0035-14 Rev 06/23/06
Resolve Exceptions• ‘find pt/exam’ may be used to perform additional searches
![Page 32: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/32.jpg)
CONFIDENTIAL 32TRN-0035-14 Rev 06/23/06
Resolve Exceptions• iSuite conducts a Database search for a Name, although additional
searches may be made
![Page 33: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/33.jpg)
CONFIDENTIAL 33TRN-0035-14 Rev 06/23/06
Resolve Exceptions• Select the ‘apply’ button
![Page 34: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/34.jpg)
CONFIDENTIAL 34TRN-0035-14 Rev 06/23/06
Resolve Exceptions• Resolve the Exception by confirming the selection
![Page 35: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/35.jpg)
CONFIDENTIAL 35TRN-0035-14 Rev 06/23/06
Exception Resolution Verification
• Verify the Exception is now in the ‘Inactive’ Exception List and no longer in the ‘Active’ Exception List
![Page 36: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/36.jpg)
CONFIDENTIAL 36TRN-0035-14 Rev 06/23/06
In iSite Enterprise verify:
• Exception with the “!” is no longer there
• Exception’s Images or study are now part of the patient’s original folder
Exception Resolution Verification
![Page 37: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/37.jpg)
CONFIDENTIAL 37TRN-0035-14 Rev 06/23/06
Exception Resolution
1. Identify Exception1. Worklist Module2. Exceptions Handler Option
2. View Exception Images1. Click on ID hyperlink2. Click View
3. iSite will present matches based on MRN and Accession Number or the user may enter a known ACC (from RIS) and apply1. Additional searches may be performed by clicking find pt/exam button2. Click on the radio button next to patient’s record
4. Locate the Exam1. Click on the MRN hyperlink 2. Verify Exam information and apply
5. Verify Resolution of Exception1. Check patient folder2. Check inactive/active lists
![Page 38: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/38.jpg)
CONFIDENTIAL 38TRN-0035-14 Rev 06/23/06
For assistance, please call customer support at
1-877-328-2808 or 1-877-328-2809
![Page 39: ISite 3.5: Exceptions Handling (RIS Version). CONFIDENTIAL TRN-0035-14 Rev 06/23/06 2 Table of Contents Objectives Terminology Exception Definition Exceptions](https://reader035.vdocuments.us/reader035/viewer/2022062718/56649e7c5503460f94b7f04f/html5/thumbnails/39.jpg)