Foreign Exam Management in Practice: Seamless Access to Foreign Images and Results in a Regional Environment

Abstract

A challenge for many clinical users is that a patient may receive a diagnostic imaging (DI) service at a number of hospitals or private imaging clinics. The DI services that patients receive at other locations could be clinically relevant to current treatments, but typically, there is no seamless method for a clinical user to access longitudinal DI results for their patient. Radiologists, and other specialists that are intensive users of image data, require seamless ingestion of foreign exams into the picture archiving and communication system (PACS) to achieve full clinical value. Most commonly, a clinical user will depend on the patient to bring in a CD that contains imaging from another location. However, a number of issues can arise when using this type of solution. Firstly, a CD will not provide the clinical user with the full longitudinal record of the patient. Secondly, a CD often will not contain the report associated with the images. Finally, a CD is not seamless, due to the need to manually import the contents of the CD into the local PACS. In order to overcome these limitations, and provide clinical users with a greater benefit related to a patient's longitudinal DI history, the implementation of foreign exam management (FEM) at the local site level is required. This paper presents the experiences of FEM in practice. By leveraging industry standards and edge devices to support FEM, multiple sites with disparate PACS and radiology information system (RIS) vendors are able to seamlessly ingest foreign exams within their local PACS as if they are local exams.

Enterprise imaging and big data: A review from a medical physics perspective

“…Enterprise imaging solutions have an additional layer of complexity when deployed in a single hospital, across a hospital network, or on a regional or national basis. While the principles of image ingestion, indexing, linking to a report, extraction and viewing are similar in all contexts, aspects such as the wider range of imaging modalities, the size and growth of the archive, and in particular, the indexing becomes more complex as the archive extends its coverage [7,8].…”

Image Exchange in Canada: Examples from the Province of Ontario

“…Most recently, in Ontario, CHI funded a Provincial Patient Engagement Platform planning project to provide patients’ access to their health records, which resulted in the development of the Patient Portal Provincial Service Standards. At the provincial level, in Ontario, a provincial government agency, Ontario Health (formerly eHealth Ontario), originally oversaw the creation and implementation of four regional DIRs and now operates the Diagnostic Imaging Common Service that acts as an access point and consolidates data from the DIRs [ 1 ]. Ontario Health also funds the day-to-day onboarding and operation of ClinicalConnect, noting that the DI Common Service is one of four provincial data repositories integrated with ClinicalConnect.…”

Measuring the Benefits of a Regional Imaging Environment

“…Central DIRs and the implementation of foreign exam management (FEM) provide clinical users with the ability to seamlessly access DI exams and reports that originate from an outside location. FEM has been implemented to varying degrees across regional DIRs within Canada [ 1 ]. Historically, measuring the benefits of transitioning from a film-based environment to a PACS environment has been documented as being difficult and poses challenges [ 2 ].…”