John Justine Jay E.

Hernandez
T2A

Module 1

Fundamental Medical Imaging Informatics

also known as radiology informatics or medical imaging informatics, is a subspecialty of
biomedical informatics that aims to improve the efficiency, accuracy, usability and reliability of
medical imaging services within the healthcare enterprise. Imaging informatics is part of the
larger field of clinical informatics which is in turn part of biomedical informatics. Radiology
informatics has some overlap with specific parts of the fields of medical physics, computer
science, data science, and cognitive science.

Computer aided diagnosis (CAD) the use of a computer generated output as an assisting tool
for a clinician to make a diagnosis. It is different from automated computer diagnosis, in which
the end diagnosis is based on a computer algorithm only.

Computer-aided detection (CADe): marks specific areas of images that may seem abnormal,
designed to reduce the risk of missing pathologies of interest

Computer-aided diagnosis (CADx): helps a practitioner assess and classify pathology in

medical images

Radiomics (as applied to radiology) is a field of medical study that aims to extract a large
number of quantitative features from medical images using data characterization algorithms.
The data is assessed for improved decision support. It has the potential to uncover disease
characteristics that are difficult to identify by human vision alone. Radiomics can be applied to
most imaging modalities including radiographs, ultrasound, CT, MRI and PET studies. It can be
used to increase the precision in the diagnosis, assessment of prognosis, and prediction of
therapy response, particularly in combination with clinical, biochemical, and genetic data

Artificial intelligence (AI) has been defined by some as the "branch of computer science
dealing with the simulation of intelligent behavior in computers, however the precise definition is
actually a matter of debate among experts. An alternative definition is the branch of computer
science dedicated to creating algorithms that can solve problems without being explicitly
programmed for all the specificities of the problems. AI algorithms and in particular deep
learning (part of machine learning) aim to either assist humans with solving a problem or solve
the problem without human input. The term artificial intelligence is credited to John McCarthy, a
mathematician (and the creator of the LISP programming language) who proposed and
organized a summer research conference that happened in 1956 at Dartmouth on artificial
Intelligence, who used the term.
Computer Science is the study of computation and information. Computer science deals with
theory of computation, algorithms, computational problems and the design of computer systems
hardware, software and applications. Computer science addresses both human-made and
natural information processes, such as communication, control, perception, learning and
intelligence especially in human-made computing systems and machines.

Computer Technology It combines the hardware of computers and computer-controlled

devices with software—operating systems, authoring tools, expert systems, and courseware—to
support training technology

Information Technology (IT) is the use of computers to store, retrieve, transmit, and
manipulate data or information. IT is typically used within the context of business operations as
opposed to personal or entertainment technologies. IT is considered to be a subset of
information and communications technology (ICT). An information technology system (IT
system) is generally an information system, a communications system or, more specifically
speaking, a computer system – including all hardware, software and peripheral equipment –
operated by a limited group of users

Information Science (also known as information studies) is an academic field which is primarily
concerned with analysis, collection, classification, manipulation, storage, retrieval, movement,
dissemination, and protection of information. Practitioners within and outside the field study the
application and the usage of knowledge in organizations along with the interaction between
people, organizations, and any existing information systems with the aim of creating, replacing,
improving, or understanding information systems. Historically, information science is associated
with computer science, psychology, technology and intelligence agencies. However, information
science also incorporates aspects of diverse fields such as archival science, cognitive science,
commerce, law, linguistics, museology, management, mathematics, philosophy, public policy,
and social sciences

Digital Biomedicine/Medicine and Healthcare Information Technology

Biomedicine
(also referred to as Western medicine, mainstream medicine or conventional medicine) is a
branch of medical science that applies biological and physiological principles to clinical practice.
Biomedicine stresses standardized, evidence-based treatment validated through biological
research, with treatment administered via formally trained doctors, nurses, and other such
licensed practitioners. Biomedicine also can relate to many other categories in health and
biological related fields. It has been the dominant system of medicine in the Western world for
more than a century

Health Information Technology (HIT)

Is health technology, particularly information technology, applied to health and health care. It
supports health information management across computerized systems and the secure
exchange of health information between consumers, providers, payers, and quality monitors.

Advantages - Improve health care quality or effectiveness - Increase health care productivity or
efficiency - Prevent medical errors and increase health care accuracy and procedural
correctness - Reduce health care costs - Increase administrative efficiencies and healthcare
work processes - Decrease paperwork and unproductive or idle work time - Extend real-time
communications of health informatics among health care professionals - Expand access to
affordable care
Informatics
Applies the principles of information science to solve problems using data. It involves the
practice of information processing and the engineering of information systems

Biomedical technology is the application of engineering and technology principles to the

domain of living or biological systems, with an emphasis on human health and diseases,
Biomedical engineering and Biotechnology alike are often loosely called Biomedical Technology
or Bioengineering

Health Information Technology (HIT) is health technology, particularly information technology,

applied to health and health care. It supports health information management across
computerized systems and the secure exchange of health information between consumers,
providers, payers, and quality monitors.

Broad and consistent utilization of HIT

- improve health care quality or effectiveness
- increase health care productivity or efficiency
- prevent medical errors and increase health care accuracy and procedural correctness
- reduce health care costs
- increase administrative efficiencies and healthcare work processes
- decrease paperwork and unproductive or idle work time
- extend real-time communications of health informatics among health care professionals
- expand access to affordable care

1. also known as radiology informatics or medical imaging informatics.

A. Fundamental Medical Imaging Informatics

B. Biomedicine
C. Health Information Technology

2. the use of a computer generated output as an assisting tool for a clinician to make a diagnosis. It is
different from automated computer diagnosis, in which the end diagnosis is based on a computer
algorithm only

A. Computer-aided detection
B. Computer aided diagnosis
C. Computer-aided diagnosis

3. is a field of medical study that aims to extract a large number of quantitative features from medical
images using data characterization algorithms.

A. Computer-aided diagnosis
B. Fundamental Medical Imaging Informatics
C. Radiomics
4. has been defined by some as the "branch of computer science dealing with the simulation of intelligent
behavior in computers, however the precise definition is actually a matter of debate among experts.
 A. Computer Science
B. Artificial intelligence
C. Biomedical technology

5. is the study of computation and information

A. Computer Science
B. Information Technology
C. Computer Technology

6. health technology, particularly information technology, applied to health and health care.

A. Health Information Technology

B. Informatics
C. Computer-aided diagnosis

7. is the application of engineering and technology principles to the domain of living or biological systems,
with an emphasis on human health and diseases.

A. Computer Technology
B. Biomedical technology
C. Informatics

8. is an academic field which is primarily concerned with analysis, collection, classification, manipulation,
storage, retrieval, movement, dissemination, and protection of information.

A. Information Science
B. Informatics
C. Information technology

9. Applies the principles of information science to solve problems using data. It involves the practice of
information processing and the engineering of information systems

A. Information technology
B. Informatics
C. Artificial intelligence

10. helps a practitioner assess and classify pathology in medical images

A. Computer-aided diagnosis
B. Artificial intelligence
C. Computer-aided
MODULE 2 Medical Image Data

The data, on which medical visualization methods and applications are based, are acquired with
scanning devices, such as computed tomography (CT) and magnetic resonance imaging (MRI)

Medical Image Is the technique and process of creating visual representations of the interior of
a body for clinical analysis and medical intervention, as well as visual representation of the
function of some organs or tissues (physiology). Medical imaging seeks to reveal internal
structures hidden by the skin and bones, as well as to diagnose and treat disease. Medical
imaging also establishes a database of normal anatomy and physiology to make it possible to
identify abnormalities.
As a discipline and in its widest sense, it is part of biological imaging and incorporates radiology,
which uses the imaging technologies of X-ray radiography, magnetic resonance imaging,
ultrasound, endoscopy, elastography, tactile imaging, thermography, medical photography, and
nuclear medicine functional imaging techniques as positron emission tomography (PET) and
single-photon emission computed tomography (SPECT)

Image Quality The quality of a medical image is determined by the imaging method, the
characteristics of the equipment, and the imaging variables selected by the operator. Image
quality is not a single factor but is a composite of at least five factors: contrast, blur, noise,
artifacts, and distortion.

Image file formats are standardized means of organizing and storing digital images. An image
file format may store data in an uncompressed format, a compressed format (which may be
lossless or lossy), or a vector format. Image files are composed of digital data in one of these
formats so that the data can be rasterized for use on a computer display or printer. Rasterization
converts the image data into a grid of pixels. Each pixel has a number of bits to designate its
color (and in some formats, its transparency).

Digitalization Digital Transformation (DT or DX) is the use of new, fast and frequently changing
digital technology to solve problems. It is about transforming processes that were non digital or
manual to digital processes.
A digital image is a representation of a real image as a set of numbers that can be stored and
handled by a digital computer. In order to translate the image into numbers, it is divided into
small areas called pixels (picture elements). One is the type of the image.

Image Acquisition is the creation of a digitally encoded representation of the visual

characteristics of an object,such as a physical scene or the interior structure of an object. The
term is often assumed to imply or include the processing, compression, storage, printing, and
display of such images. A key advantage of a digital image, versus an analog image such as a
film photograph, is the ability to make copies and copies of copies digitally indefinitely without
any loss of image quality.

1-5. Enumerate Image quality five factors

 ●
●
●
●
●
Answer: contrast, blur, noise, artifacts, and distortion.

6. Is the technique and process of creating visual representations of the interior of a body for
clinical analysis and medical intervention, as well as visual representation of the function of
some organs or tissues

A. Image Acquisition
B. Medical Image
C. Image Quality

7. is the creation of a digitally encoded representation of the visual characteristics of an

object,such as a physical scene or the interior structure of an object

A. Image Acquisition
B. Digitalization
C. Medical Image Data

8. is the use of new, fast and frequently changing digital technology to solve problems.

A. Medical Image Data

B. Digitalization
C. Image Acquisition

9. The quality of a medical image is determined by the imaging method, the characteristics of
the equipment, and the imaging variables selected by the operator.

A. mage Acquisition
B. Medical Image Data
C. Image Quality

10. are standardized means of organizing and storing digital images. An image file format may
store data in an uncompressed format, a compressed format.

A. Image file formats

B. Image Acquisition
C. Medical Image Data
MODULE 3: Workflow in Radiology

Radiology Workflow The goal of healthcare IT is to ensure all systems and applications within
a healthcare system work smoothly together for organized, seamless data flow. The first step to
achieving such a goal is to understand your current workflow

The technology used in imaging centers and radiology practices, in particular, is rapidly
evolving, and the technology changes affect both the front-end and back-end radiology
workflows. The front-end workflows are affected by ever changing imaging and modality
technology advancements while the back-end workflows are affected by advancements in
information technology. Keeping up with the changes can be a challenge

In the back-end of an imaging center the workflow might resemble the following:
- Schedulers manually enter orders on the radiology information system (RIS) or orders move
into the RIS electronically from external referring physicians or hospital systems.
- Those orders flow to various internal systems such as the picture archiving and
communication systems (PACS) and a voice recognition (VR) application.
- The images are acquired:
- Modalities query the modality work list manager.
- Once the procedure is completed, images are returned to PACS.
- A radiologist reads the images and dictates the results into a VR application.
- A radiologist self-corrects and approves the reports.
- The reports are distributed to RIS, PACS, Billing and the applicable referring locations.

Radiology analysis Radiologists rely principally on visual inspection to detect, describe, and
classify findings in medical images. As most interpretive errors in radiology are perceptual in
nature, understanding the path to radiologic expertise during image analysis is essential to
educate future generations of radiologists. We review the perceptual tasks and challenges in
radiologic diagnosis, discuss models of radiologic image perception, consider the application of
perceptual learning methods in medical training, and suggest a new approach to understanding
perceptional expertise. Specific principled enhancements to educational practices in radiology
promise to deepen perceptual expertise among radiologists with the goal of improving training
and reducing medical error

Integration challenge is the task of reconciling a plausible account of what is involved in the
truth of statements of a given kind with a credible account of how we can know those
statements, when we do know them. Reconciliation in a given domain may be achieved by
re‐conceiving the metaphysics of that domain, or its epistemology, or both. More radically,
reconciliation may involve offering slimmed‐down truth conditions, or abandoning the notion of
truth conditions altogether for the domain. Options that reject the possibility of integration are
scepticism and the denial that an apparent domain involves any genuine subject matter at all.
Illustrations of these strategies are given in the cases of necessity, the past, self‐knowledge,
and freedom of the will.

Computers in radiology Computers are an integral part of modern radiology practice and are
used by different radiology modalities to acquire, process, and postprocess imaging data. They
help in composing radiology reports, with text and images from different modalities and
specialties.

What is pacs
PACS stands for picture archiving and communication system. On the most basic level, PACS
integrates image acquisition modalities, workstation displays, the image archiving system, and
the underlying network
How are PACS images stored
The PACS archive traditionally has been composed of short-term and long-term storage.
Short-term storage usually is composed of a redundant array of inexpensive (or identical) discs
(RAID) arrays that provide quick access to image data. After a certain amount of time (which
depends on the size of the short-term archive, but can be 3 to 30 days), images from the
short-term archive are moved to the long-term archive, which is usually composed of magnetic
tape or magnetooptical media.

What is a RAID
Image compression is the process of reducing image file size using various mathematical
algorithms. Compression is usually expressed as a ratio. A 10-megabyte (MB) file that is
compressed at a ratio of 10:1 would have a final size of 1 MB. Generally, as compression ratios
increase, file sizes decrease; however, a price is inevitably paid in decreased image fidelity

What is the difference between “lossy” and “lossless” compression

Encoding an image is a process that converts a raw image into a more compact coded file.

Decoding converts the coded file to a decoded image. If the raw image and the decoded image
are the same, the compression method is considered lossless. If there is a difference between
the raw image and the decoded image, the method of encoding and decoding is considered
lossy. Lossless compression can usually achieve ratios of 2:1 or 3:1.

Lossy compression can achieve much higher compression ratios; however, overcompression
may destroy fine detail, making the image unacceptable for diagnostic purposes

What is RIS
RIS stands for radiology information system. RIS is a system responsible for the workflow within
a radiology department. These tasks include patient scheduling and tracking, billing, and
handling of radiology reports

What is HIS
HIS stands for hospital information system. HIS manages patient demographics; insurance and
billing; and often other clinical information systems, including laboratory results, physician
orders, and electronic medical records

What is DICOM
DICOM stands for Digital Imaging and Communications in Medicine. DICOM is a standard that
establishes rules that allow medical images and associated information to be exchanged
between imaging equipment from different vendors, computers, and hospitals.

A computed tomography (CT) scanner produced by vendor A and a magnetic resonance

imaging (MRI) scanner produced by vendor B can send images to a PACS from vendor C using
DICOM as a common language. In addition to storing image information, other DICOM standard
services include query/retrieve, print management, scheduling of acquisition and notification of
completion, and security profiles.

1. Image compression is the process of reducing image file size using various mathematical algorithms

A. RAID
B. HIS
C. DICOM

2. Radiologists rely principally on visual inspection to detect, describe, and classify findings in medical
images.

A. DICOM
B. Radiology analysis
C. RAID

3. The goal of healthcare IT is to ensure all systems and applications within a healthcare system work
smoothly together for organized, seamless data flow.

A. Radiology Workflow
B. pacs
C. Radiology

4. is a standard that establishes rules that allow medical images and associated information to be
exchanged between imaging equipment from different vendors, computers, and hospitals.

A. DICOM
 B. HIS
C. RIS

5. manages patient demographics; insurance and billing; and often other clinical information systems,
including laboratory results, physician orders, and electronic medical records

A. HIS
B. DICOM
C. RIS

6. integrates image acquisition modalities, workstation displays, the image archiving system, and the
underlying network

A. Pacs
B. DICOM
C. RIS

7. are an integral part of modern radiology practice and are used by different radiology modalities to
acquire, process, and postprocess imaging data.

A. Radiology Workflow
B. Radiology analysis
C. Computers in radiology

8. PACS images stored

A. short-term and long-term storage

B. usb
C. Long term storage only

9. is the task of reconciling a plausible account of what is involved in the truth of statements of a given
kind with a credible account of how we can know those statements, when we do know them.

A. Radiology analysis
B. Integration challenge
C. Radiology Workflow

10. DICOM stand for

A. Digital Imaging and Communications in Medicine
B. Digital image and communications in medicine
C. Digital imaging and communication in mars
MODULE 4: Basic Medical Image Processing and Analysis

Quality Evaluation
- is easy to read and understand and has clear advice on what needs to be sustained or changed for a
program to improve.
- emphasizes the importance of evaluations providing information useful for decision-making.
- “A high quality evaluation helps agencies and stakeholders identify successful programs to expand or
pitfalls to avoid

statistical Analysis
- is the science of collecting data and uncovering patterns and trends. It’s really just another way of saying
“statistics.” After collecting data you can analyze it to.
- Summarize the data. For example, make a pie chart.
- is used extensively in science, from physics to the social sciences. As well as testing hypotheses,
statistics can provide an approximation for an unknown that is difficult or impossible to measure.

Information Entropy
In information theory, the entropy of a random variable is the average level of "information", "surprise", or
"uncertainty" inherent in the variable's possible outcomes.

The concept of information entropy was introduced by Claude Shannon in his 1948 paper "A
Mathematical Theory of Communication"

CODING-DECODING is an important part of Logical reasoning section in all aptitude related

examinations. Coding is a process used to encrypt a word, a number in a particular code or pattern based
on some set of rules. Decoding is a process to decrypt the pattern into its original form from the given
codes.

Letter Coding In this type of questions, alphabets of a word are replaced by some other alphabets
according to specific rule to form code.

Number Coding In this type of questions, a word is replaced by certain numbers according to some
specific rule.

Signal processing is an electrical engineering subfield that focuses on analyzing, modifying, and
synthesizing signals such as sound, images, and scientific measurements. Signal processing techniques
can be used to improve transmission, storage efficiency and subjective quality and to also emphasize or
detect components of interest in a measured signal.
Categories

1. Analog signal processing - is for signals that have not been digitized, as in most 20th-century radio,
telephone, radar, and television systems. This involves linear electronic circuits as well as nonlinear ones.
The former are, for instance, passive filters, active filters, additive mixers, integrators, and delay lines.
.
3. Discrete-time signal processing - is for sampled signals, defined only at discrete points in time, and
as such are quantized in time, but not in magnitude. Analog discrete-time signal processing is a
technology based on electronic devices such as sample and hold circuits,

4. Digital signal processing - is the processing of digitized discrete-time sampled signals. Processing is
done by general-purpose computers or by digital circuits such as ASICs, field-programmable gate arrays
or specialized digital signal processors (DSP chips). Examples of algorithms are the fast Fourier
transform (FFT), finite impulse response (FIR) filter

5. Nonlinear signal processing involves the analysis and processing of signals produced from nonlinear
systems and can be in the time, frequency, or spatio-temporal domains Nonlinear systems can produce
highly complex behaviors including bifurcations, chaos, harmonics, and subharmonics which cannot be
produced or analyzed using linear methods.

6. Statistical signal processing - is an approach which treats signals as stochastic processes, utilizing
their statistical properties to perform signal processing tasks.[Statistical techniques are widely used in
signal processing applications. For example, one can model the probability distribution of noise incurred
when photographing an image, and construct techniques based on this model to reduce the noise in the
resulting image.

Pre-Medical Image Processing

Essential environments of a medical imaging system

● Image processing may be a post-imaging or pre-analysis operator.

● Functions of Image processing and Image analysis may overlap each other.

A Goals of medical image analysis techniques:

Quantification: Measuring the features on medical images, eg..
helping radiologist obtain measurements from medical images (e.g., area or volume).
To make the features measurable, it is necessary to extract objects from images by segmentation.

• Computer Aided Diagnosis (CAD): given measurements and features make a diagnosis. Help
radiologists on their diagnosis procedure for accuracy and efficiency.

General image analysis encompasses:

incorporation of prior knowledge

classification of features
matching of model to sub-images • description of shape

many other problems and approaches of AI....

About Digital Image Processing

What is an Image?

Formal definition: A digital image is a multi-dimensional signal that is sampled in

space and/or time and quantized in amplitude.

Looser definition: An image is a "picture."

The brightness values in the picture may represent distance reflectivity density temperature etc

The image may be 2d, 3d or N-D

Image elements: An image may be composed of:

• 2-D: pixels = picture elements

• 3-D: voxels = volume elements
•4-D and higher: hypervoxels = hypervolume elements

What do images represent?

For medical images, pixels may represent parameters such as:

- X-ray attenuation (density)

- Water (proton) density

- Acoustic impedance (distribution) Optical reflectivity (or impedance)

- Electrical activity, etc.

• How are images processed?

- Manual analysis: processed by human

- Semi-automatic analysis: human and computer work together to process image

- Automatic analysis: computer processes image, human reviews the results

For example: Heart chamber volumes, Heart wall motion, Brain activity,

Fetus size/gender, Lesion size and extent

- Visualize: For example: Surgical/Therapy planning, Image-guided surgery

Processing verse Analysis

• Medical image processing

- Deals with the development of problem specific approaches to enhance the raw medical data for the
purposes of selective visualisation as well as further analysis.

• Medical image analysis

- Concentrates on the development of techniques to supplement the usually qualitative and frequently
subjective assessment of medical images by human experts.

- Provides quantitative, objective and reproducible information extracted from the medical images

Why Image Enhancement? Can't distinguish between tissues

The nature of the physiological system under investigation and the procedures used in imaging may
diminish the contrast and the visibility of details.

Data is too noisy for computer algorithm to perform well

Medical images are often deteriorated by noise due to various sources of interference and other
phenomena that affect the measurement processes in

imaging and data acquisition systems.

linaging artifacts interfere with visualization or computer processing

How to Enhance Image? By operations to

Increase contrast

Remove noise

Emphasize edges: Edge boost, Unsharp masking

Modify shapes.

Image reconstruction Image reconstruction in CT is a mathematical process that generates tomographic

images from X-ray projection data acquired at many different angles around the patient. Image
reconstruction has fundamental impacts on image quality and therefore on radiation dose. For a given
radiation dose it is desirable to reconstruct images with the lowest possible noise without sacrificing
image accuracy and spatial resolution. Reconstructions that improve image quality can be translated into
a reduction of radiation dose because images of the same quality can be reconstructed at lower dose.

Background Removal A novel method to automatically recognize and remove background signals in
computed radiography (CR) images caused by X-ray collimation during projection radiographic
examinations is presented. There are three major steps in this method. In the first step, a statistical curve
is derived based on many hierarchical CR sample images as a first approximation to loosely separate
image and background pixels. Second, signal processing methods, including specific sampling, filtering,
and angle recognition, are used to determine edges between image and background pixels. Third,
adaptive parameter adjustments and consistent and reliable estimation rules are used to finalize the
location of edges and remove the background. In addition, this step also evaluates the reliability of the
complete background removal operation. With this novel method implemented in a clinical picture
archiving and communication system (PACS) at the University of California at San Francisco, we
achieved 99% correct recognition of CR image background, and 91% full background removal without
removing any valid image information.

1. is easy to read and understand and has clear advice on what needs to be sustained or changed for a
program to improve

A. Quality Evaluation
B. statistical Analysis
C. CODING-DECODING

2. is the science of collecting data and uncovering patterns and trends. It’s really just another way of
saying “statistics.” After collecting data you can analyze it to.

A. CODING-DECODING
B. statistical Analysis
C. Quality Evaluation

3. the entropy of a random variable is the average level of "information", "surprise", or "uncertainty"
inherent in the variable's possible outcomes

A. statistical Analysis
B. Quality Evaluation
C. Information Entropy

4. is an important part of Logical reasoning section in all aptitude related examinations. Coding is a
process used to encrypt a word, a number in a particular code or pattern based on some set of rules

A. Information Entropy
B. statistical Analysis
C. CODING-DECODING

5. In this type of questions, alphabets of a word are replaced by some other alphabets according to
specific rule to form code.

A. Letter Coding
B. Number Coding
C. A and B

6. this type of questions, a word is replaced by certain numbers according to some specific rule.
A. Letter Coding
B. Number Coding
C. A and B
7. processing is an electrical engineering subfield that focuses on analyzing, modifying, and synthesizing
signals such as sound, images, and scientific measurements.

A. Signal processing
B. Information Entropy
C. CODING-DECODING

8. is for signals that have not been digitized, as in most 20th-century radio, telephone, radar, and
television systems.

A. Discrete-time signal processing

B. Analog signal processing
C. Digital signal processing

9. is for sampled signals, defined only at discrete points in time, and as such are quantized in time, but
not in magnitude.

A. Discrete-time signal processing

B. Digital signal processing
C. Analog signal processing

10. is the processing of digitized discrete-time sampled signals. Processing is done by general-purpose
computers or by digital circuits such as ASICs

A. Digital signal processing

B. Discrete-time signal processing
C. Analog signal processing
Module 5: Medical image distribution network and communication

Network architecture topology and protocols

NETWORK- the study of the association or mapping of the elements (hyperlinks, nodes, and so on.) of a
network. The Network Architecture focuses on how the data flow within the network

Network topology - the layout of verbal exchange network. (answers query on how records flows in a
network whereas Network Topology talks about the arrangement of workstations

Network Protocol - a not unusual set of regulations and alerts that governs the conversation among
computers on a network.

PACS
picture archiving and communication system is a medical imaging technology used primarily in healthcare
organizations to securely store and digitally transmit electronic images and clinically-relevant reports.

4 major components of pacs

1 hardware imaging machine
2 secure for the distribution and exchange of patient images
3 workstation or mobile device for viewing, processing and interpreting images
4 electronic archives for storing and retrieving images and related documentation

Medical image data transfer

Is the electronic exchange of medical images between hospital physicians and patients

Primary format for images is DICOM

Internet services

The use of World Wide Web technologies in radiology is not new.

These technologies have been used in radiology teaching files, to access information in multimedia
integrated picture archiving and communication systems (PACS) and for teleradiology parposes

Web technology has also been used to access the images stored in a Digital Imaging and
Communications in Medicine (DICOM) archive in PACS environments

Enterprise computing for medical imaging informatics

Effective understandings even with progressively huge and complex imaging contemplates and to convey
this data rapidly and in the most valuable way"

Medical imaging informatics (MII) incorporates large numbers of the process radiologists need to arrive at
these objectives.

The issue of dealing with this load of activities for clinical data has become important.
Network Architecture - The design of a communication network and it also detail the allocation between
the tasks of computer in a network

Network Topology - The study of elements, arrangement or mapping. It is also the layout of a network.
There are two part the physical and logical. The physical part detail that physical layout and the logical
part is the detail how the data flow in the network

Network Protocols - The set out of rules that establish how the data is transmitted between different
device in the alike network. Signal that controls the communication between the computer networks.

Internet service
The internet services offers a way for data to be sent to your computer from internet servers

In clinical settings, the Internet enables care providers to gain rapid access to information that can aid in
the diagnosis of health conditions or the development of suitable treatment plans. It can make patient
records, test results, and practice guidelines accessible from the examination room. It can also allow care
providers to consult with each other electronically to discuss treatment plans or operative procedures. At
the same time, the Internet supports a shift toward more patient-centered care, enabling consumers to
gather health-related information themselves; to communicate with care providers, health plan
administrators, and other consumers electronically; and even to receive care in the home.

Medical image data transfer

Medical image sharing is the electronic exchange of medical images between hospitals, physicians and
patients. Rather than using traditional media, such as a CD or DVD, and either shipping it out or having
patients carry it with them, technology now allows for the sharing of these images using the cloud. The
primary format for images is DICOM (Digital Imaging and Communications in Medicine). Typically,
non-image data such as reports may be attached in standard formats like PDF (Portable Document
Format) during the sending process Additionally, there are standards in the industry, such as IHE Cross
Enterprise Document Sharing for Imaging (XDS-I), for managing the sharing of documents between
healthcare enterprises A typical architecture involved in setup is a locally installed server, which sits
behind the firewall, allowing secure transmissions with outside facilities. In 2009, the Radiological Society
of North America launched the "Image Share" project, with the goal of giving patients control of their
imaging histories (reports and images) by allowing them to manage these records as they would online
banking or shopping

uses
Care Facilities Institutions use medical image sharing to facilitate transfers between other facilities that
may or may not be on the same network. They are also able to instantly send results to referning
physicians in the community, as well as directly to patients [2] Physicians. Doctors use the technology to
have immediate access to images, as opposed to waiting for physical media to arrive. Having access to a
patient's medical history improves the
point of care service [3]
Patients: In conjunction with recent US government initiatives, patients are able to receive their
imaging exams electronically, without needing to carry and store physical media. It allows for the
ability to see physicians in multiple locations and have their imaging at the ready
Digital Imaging and Communication in Medicine (DICOM) network protocols are widely used for reviewing
images and performing primary diagnosis within radiology and other imaging departments, by means of
Picture Archiving and Communication System (PACS) DICOM, which is the communication standard for
medical imaging, is also applied in teleradiology cases, where the transfer of patient radiological images
from one location to another for the purposes of interpretation and/or consultation is performed

DICOM View Service

It displays and processes DICOM single-frame and multiframe images stored inside the DICOM sub
domain and acquired from various modalities (e.g., X-ray, CT, MRI, CR, angio, US, etc). It allows the use
of 2D image processing functions (eg, zoom in/out, magnifier, window level, smooth/sharp, annotations,
pseudo color, etc.) to enhance the client diagnostic capability. The activation of this service requires
additional functionality from the user web browser, downloaded from the WPServer after the request for
this service. This service offers facilitations related to the viewing or processing of "native" DICOM
medical images

This service provides users with web interfaces to employ DICOM communication for sending within the
whole DICOM hierarchy. It is required in order to send the whole set of images belonging to one IE
instance to another user of the system or to send processed evidence images to the PACS

Network structure and system components

We have four important parts to our system that are Image Modalities, Communication Networks, Archive
and Servers.

Image Modalities are obviously important because these are the devices we used to capture the human
anatomy. Image Modalities include MRI, CT scan, and many others. The various Image Modalities are
connected to our servers by using the computer that the medical facilities possess.

Communication Networks is an important component to our systems because it is in charge of

transferring medical information to the servers and to other systems in various locations

The Archives and Servers are important because all our medical information is being stored there for
further use in the future. Medical Informations are being sent to our servers by using hospital computers.

Web application, web services and client server distributed computing

Web application is an application software that runs on a web server, unlike computer-based software
programs. The web application requires a web server to manage requests from the client, an application
server to perform the tasks requested and sometimes a database to store the information. This are
accessed by the user through a web browser with an active internet

Web services are part of an applications that can be still communicated by exchanging data with each
other through a web service between clients and servers. Web services fulfill a specific task or a set of
tasks that provides all of the details necessary to interact with the service, including message formats,
transport protocols, and location. The client-server model is a distributed application structure that is
divided into tasks or workloads between providers of a resource or service, called servers, and service
requesters, called clients.
Enterprise computing for medical imaging informatics

Enterprise imaging has been defined as a set of strategies, initiatives, and workflows implemented
across a healthcare enterprise to consistently and optimally capture, index, manage, store, distribute,
view, exchange, and analyze all clinical imaging and multimedia content to enhance the electronic health
record The concepts of enterprise imaging are elucidated in a series of papers by members of the
HIMSS-SIIM Enterprise Imaging Workgroup.

The use of the term enterprise imaging in this manner is relatively new, having previously been used to
describe expanding access to radiology images throughout an enterprise. The concept of expanding
PACS to include visible light imaging and other modalities beyond radiology and cardiology dates back to
the relatively early days of PACS

1-4 4 major components of pacs

●
●
●
●
Answer: 1 hardware imaging machine
2 secure for the distribution and exchange of patient images
3 workstation or mobile device for viewing, processing and interpreting images
4 electronic archives for storing and retrieving images and related documentation

5. the study of the association or mapping of the elements of a network.

A. Network topology
B. Network
C. Network Protocol

6. The study of elements, arrangement or mapping. It is also the layout of a network.

A. Network topology
B. Network
C. Network Protocol

7.The set out of rules that establish how the data is transmitted between different device in the alike
network.

A. Network topology
B. Network
C. Network Protocol

8. is an application software that runs on a web server, unlike computer-based software programs

A. Network topology
B. Network
C. Web application
9. are part of an applications that can be still communicated by exchanging data with each other through
a web service between clients and servers

A. Web application
B. Web services
C. Web

10. offers a way for data to be sent to your computer from internet servers

A. Web application
B. Web services
C. Internet service

Module 6: PRACTICAL AND CLINICAL MEDICAL IMAGING INFORMATICS

X-ray Scanner
An X-ray scanner, also called radiography, is a diagnostic imaging technique that produces images of our
bones, providing a clear detail of our bony structure. The way that is works is that the X-ray machine
shoots an X-ray beam through the body and the beam will passed through soft tissues but not through
bones, due to their density. It can be used to diagnose fractures, tumors, and more. X-ray scanners are
commonly used and considered relatively safe.

Computed Tomography Scanner

A Computerized Tomography Scanner (CT scan) allows us to view the insides of our body to create
cross-sectional images. These images provide more detailed information than normal X-rays. It uses a
computer to process or create cross-sectional images of the bones, blood vessels and soft tissues inside
our bodies.
Magnetic Resonance Imaging

Magnetic Resonance Imaging (MRI) is a test that uses powerful magnets, radio waves, and a computer to
produce or make a detailed images of the inside of our body. This allows us to monitor our patient and
see how well they've responded to a treatment. Unlike X-rays and Computed tomography scanners (CT
Scan) MRI's doesn't use a damaging ionizing radiation of X-rays.

Nuclear Medicine

Nuclear Medicine is a medical specialty that uses radioactive tracers to assess bodily functions and to
diagnose and treat a disease such as Hyperthyroidism, thyroid cancer, lymphomas, and bone pain from
some types of cancers, Therefore helping the Physicians diagnose a disease to make a treatment
effective or more effective.

Ultrasound

An ultrasound scan is a medical test that uses high frequency sound waves to capture live images from
the inside of your body. It is also known as sonography.
Unlike other imaging techniques, ultrasound uses no radiation. For this reason, it's the preferred method
for viewing a developing fetus during pregnancy.

Computer Systems
Workstation is a high-performance computer system that is basically designed for a single user and has
advanced graphics capabilities, large storage capacity, and a powerful central processing unit.

A server(s) is a computer or system that provides resources, data, services, or programs to other
computers, known as clients, over a network.

Open and Commercial software for RIS • The RIS manages the entire workflow of the imaging
department, from the point a patient checks in with the

receptionist, to when the final report is issued to the

referring physician.

Enables convenient interaction with users, and also facilitates the company policy that all employees
attend at least one of the clinical areas to understand how users interact with the existing RIS.

MEDICAL IMAGE COMMUNICATION AND NETWORKING

Network -to be truly effective each of these image - processing nodes must be quick and easy to use.
This requires that each workstation must be microprocessor controlled and must interact with each
imaging system and with the central computer. To provide for such interaction a network is required.

MEDICAL IMAGE COMMUNICATION AND NETWORKING

MEDICAL IMAGE COMMUNICATION - Telemedicine is currently being used to bridge the physical
distance between patients in remote areas and medical specialists around the world. Distributed
client-server applications have become very popular with the explosive growth of the Internet. These
distributed applications provide an inexpensive and fast way to access medical information and also
provide good accessibility a and availability of medical service. Telemedicine applications are a
client/server applications where medical and patient information is stored in a server and the information
is made accessible to doctors and medical personnel at a distant site. In addition, depending on the type
and the needs of the medical application different type of communication protocols and medical devices
are utilized making interoperability and communication over different communication channels quite
difficult.

MEDICAL IMAGE DATA BASE MANAGEMENT SYSTEMS SOLUTION AND DEVELOPMENT

The increasing availability of personal and departmental computers. in radiology departments has led to
increasing interest in data management. Data base management software must be system compatible,
simple, and flexible to insure its acceptance and constant use. Once in place, such a system streamlines
the daily documentation of interesting cases for conference, follow-up, research, and quality assurance.
The authors have developed such a data base program for tracking computed body tomography cases in
their department, which can be run as a portable computer to maximize ease of access and therefore
usage.
A Database Management System is a single or set of computer programs that are responsible for
creating, editing, deleting and generally maintaining a database or collection of data records. The type of
database management system is determined by the database model. A database model is the manner in
which the data collection is stored, managed and administered Codd (1970)
ditionally, medical images are being stored on film but the advances in modern imaging modalities made it
possible to store them electronically. Thus, there is a need for Database Management System for storing,
retrieving and processing the medical images. Nowadays, medical images are generated and stored in
large medical Picture Archive and Communication Systems

We are developing a platform to store, integrate and analyze medical image information, with the option
of safely sharing it (and the data that results from further processing) with other specific authorized users,
if needed. These operations always involve the necessary restrictions to protect the personal information
of patients.

Network Security

Network security is a broad term that covers a multitude of technologies, devices and processes. In its
simplest term, it is a set of rules and configurations designed to protect the integrity, confidentiality and
accessibility of computer networks and data using both software and hardware technologies.

1. also called radiography, is a diagnostic imaging technique that produces images of our bones,
providing a clear detail of our bony structure.
a. X-ray Scanner
b. Computed Tomography Scanner
c. Magnetic Resonance Imaging

2. allows us to view the insides of our body to create cross-sectional images. These images provide more
detailed information than normal X-rays
a. X-ray Scanner
b. Computed Tomography Scanner
c. Magnetic Resonance Imaging

3.is a test that uses powerful magnets, radio waves, and a computer to produce or make a detailed
images of the inside of our body.
a. X-ray Scanner
b. Computed Tomography Scanner
c. Magnetic Resonance Imaging

4. is a medical specialty that uses radioactive tracers to assess bodily functions and to diagnose and treat
a disease such as Hyperthyroidism, thyroid cancer, lymphomas, and bone pain from some types of
cancers, Therefore helping the Physicians diagnose a disease to make a treatment effective or more
effective.
a. Nuclear medicine
b. Ultrasound
c. computer systems

5. is a medical test that uses high frequency sound waves to capture live images from the inside of your
body. It is also known as sonography.
a. Nuclear medicine
b. Ultrasound
c. computer systems
6. Workstation is a high-performance computer system that is basically designed for a single user and
has advanced graphics capabilities, large storage capacity, and a powerful central processing unit.
a. Nuclear medicine
b. Ultrasound
c. computer systems

7. is currently being used to bridge the physical distance between patients in remote areas and medical
specialists around the world
a. Telemedicine
b. Xray
c. computer system

8. This requires that each workstation must be microprocessor controlled and must interact with each
imaging system and with the central computer.
a. artificial intelligence
b. Network
c. none of the above

9. is a broad term that covers a multitude of technologies, devices and processes. In its simplest term, it is
a set of rules and configurations designed to protect the integrity, confidentiality and accessibility of
computer networks and data using both software and hardware technologies.
a. Network security
b. Network topology
C. artificial intelligence

10.pacs stands for

a. picture archiving and communication system
b. picture archive and communication system
c. picture archive and communication source

Module 7: Information Technology Development Team Training in Clinic Knowledge and

Healthcare Workflow

Information systems are being used by organizations of all types to improve their effectiveness
and efficiency. The development and implementation of information systems within an
organization takes a significant amount of time and money.

Hospitals are large institutions with many departments and units that coordinate patient care. A
hospital information systern (HIS) is a large, integrated system that stores, manipulates, and
retrieves administrative and clinical information to support the comprehensive information needs
of hospitals, such as patient, clinical, ancillary, and financial management. Hospitals are relying
increasingly on his skills to help with diagnosis, management, and education in order to provide
better and enhanced services and practices

Hospital Information Services (HIS)

A health information system (HIS) is a data management system for healthcare. This can
include systems that collect, store, maintain, and transmit a patient's electronic medical record
(EMR), as well as technologies that support health care policy choices.

Health Information System Include:

Electronic Medical Record (EMR)- Digitized paper charts that include diagnoses, allergies,
medical history, immunization dates, lab result, medication and physicians notes.

Remote patient monitoring - A method of health care delivery that uses th

latest advances in information technology to gather patient data outside of traditional healthcare
settings.
Master Patient Index - An electronic database that holds demographic information on every
patient who receives healthcare services.

Information technology training for Radiologic Technologist

Working Conditions
Most full-time radiologic technologists work about 40 hours a week, they may have evening,
weekend or on-call hours. Opportunities for part-time and shift work are also available.

Salary Range and Outlook:

According to a recent survey by the American Society of Radiologic Technologists, the average
national wage for radiologic technologists in 2013 was $62,763 per year. Incomes for entry-level
radiologic technologists (those with two years or less experience) averaged $45,878 per year.
Technologists who work in specialty areas such as CT or MRI typically earn more.

Academic Requirements

Radiologic technologists are educated in anatomy, patient positioning, examination techniques,

equipment protocols, radiation safety, radiation protection and basic patient care. Many
radiologic technologists specialize in a particular area of medical imaging, such as
mammography or computed tomography (CT scans).

Preparation for this profession is offered in hospitals, colleges and universities, vocational
technical institutes and the U.S. Armed Forces. (You can search for accredited programs on the
website of the Joint Review Committee on Education in Radiologic Technology or on the
website of the American Registry of Radiologic Technologists) Beginning in 2015, individuals
must have earned a minimum of an associate's degree in order to sit for certification exams
offered by the American Registry

Hospitals, which employ most radiologic technologists, prefer to hire those with formal training
and national certification. The American Registry of Radiologic Technologists has information on
certification.

STEPS TO BECOME A RADIOLOGIC TECHNOLOGIST

Step 1: Graduate from high school (four years): High school (or equivalency) is mandatory for
any radiologic technologist. If you're planning to go into the field as early as high school, it's
essential to pay particular attention to science and mathematics courses. These will be useful
for future educational opportunities. If possible, high school students should also try to work or
volunteer in a healthcare setting to get an idea of what the career will entail.

Step 2: Apply for and attend an accredited undergraduate radiologic technology program (two to
four years): Radiologic technologists may earn either an associate's or bachelor's degree to be
eligible for certification from the ARRT. As of June 2021, all applicants for ARRT certification in
Radiography, Nuclear Medicine Technology, Radiation Therapy, Magnetic Resonance Imaging,
or Sonography must have graduated from a school that is accredited by a body recognized by
the ARRT. A complete list of those accrediting agencies is available from ARRT.
Step 3: Apply for certification and registration with ARRT (timeline varies): As mentioned, there
are no national licensing requirements for radiologic technologists, though many states do have
their own licensing process. To maximize potential employability and establish expertise, most
radiologic technologists choose to pursue certification with the ARRT. This process involves
submitting proof of an acceptable academic record, filling out and submitting an ethics
pre-application, and passing an exam that "assesses the knowledge and cognitive skills
underlying the intelligent performance of the tasks typically required of staff technologists
practicing at entry-level within the discipline." For entry-level positions, a certification in
radiography is the most applicable. After working in this capacity, radiologic technologists may
want to pursue specialty certification with the ARRT in areas such as mammography, bone
densitometry, or cardiac-interventional radiography. Specializations include radiography, nuclear
medicine technology, radiation therapy, MRI, and sonography.

Step 4: Maintain ARRT certification (every two years) Technologists must renew their
certifications every two years, which first requires compliance with all ARRT regulations,
adherence to the ARRT standards of ethics, and completion of the required number of
continuing education hours. Renewing technologists must either earn 24 credit hours each year
to stay current with their certification or be awarded further certifications from the ARRT in other
specialties.

Education Requirements for Radiology Techs

Radiologic tech training program options include:

1-year certificate or diploma
2-year associate's degree
4-year bachelor's degree

Upon completion of an associate degree, opportunities exist to continue education and obtain a
bachelor's degree. A bachelor's or master's degree in one of the radiologic technologies is
desirable for supervisory, administrative, or teaching positions.

Before you begin your research, make sure you look for programs that have been accredited by
either the Joint Review Committee on Education in Radiologic Technology or the Council for
Higher Education Accreditation. This ensures your program has been reviewed by professionals
and given a complete vetting for currency and relevance of curriculum. Accreditation also
ensures your ability to file for federal financial aid to help pay for your education. Both agencies'
websites have searchable databases of schools and programs.

Question
1. are being used by organizations of all types to improve their effectiveness and efficiency. The
development and implementation of information systems within an organization takes a
significant amount of time and money.
a. Information systems
b. Hospital Information Services
c. radiology information system
2. is a data management system for healthcare. This can include systems that collect, store,
maintain, and transmit a patient's electronic medical record
a. Information systems
b. Hospital Information Services
c. radiology information system

3. Digitized paper charts that include diagnoses, allergies, medical history, immunization dates,
lab result, medication and physicians notes.
a .Electronic Medical Record
b. Remote patient monitoring
c. Master Patient Index

4. A method of healthcare delivery that uses th

latest advances in information technology to gather patient data outside of traditional healthcare
setting
a .Electronic Medical Record
b. Remote patient monitoring
c. Master Patient Index

5. An electronic database that holds demographic information on every patient who receives
healthcare services.
a .Electronic Medical Record
b. Remote patient monitoring
c. Master Patient Index

6. How many Steps to Become a Radiologic Technologist

a. 6
b. 5
c. 4

7. What steps is Graduate from high school (four years): High school (or equivalency) is
mandatory for any radiologic technologist.
a. Step 1
b. Step 2
c. step 3

8. What steps is Apply for and attend an accredited undergraduate radiologic technology
program
a. Step 1
b. Step 2
c. step 3

9. Apply for certification and registration with ARRT (timeline varies): As mentioned, there are no
national licensing requirements for radiologic technologists, though many states do have their
own licensing process.
a. Step 1
b. Step 2
c. step 3

10. Maintain ARRT certification Technologists must renew their certifications every two years,
which first requires compliance with all ARRT regulations, adherence to the ARRT standards of
ethics, and completion of the required number of continuing education hours.
a. Step 1
b. Step 2
c. step 4

Module 8: Medical Imaging Informatics System Evaluation and Quality Assurance

Data storage
Data storage refers to the use of recording media to retain data using computers or other
devices. The most prevalent forms of data storage are file storage, block storage, and object
storage, with each being ideal for different purposes.

There are two broad types of data storage

Direct Attached Storage

As the name might suggest, direct attached storage (DAS) includes types of data storage that
are physically connected to your computer. This storage is generally accessible to only a single
machine. Some common devices in this category include:

● Hard Drives
● Solid-State Drives (SSD)
● CD/DVD Drives
● Flash Drives
● And More

Network Attached Storage

Network attached storage (NAS) allows for multiple machines to share storage over a network.
This is accomplished with multiple hard drives or other storage devices in a RAID configuration.
One of the key benefits of NAS is the ability to centralize data and improve collaboration. Data
can be easily shared among connected machines, and permission levels can be set to control
access. While NAS solutions tend to be more costly than DAS solutions, they are still very
affordable as storage technology has advanced significantly.

Disaster Discovery
Imaging department directors and PACS administrators are reviewing their disaster recovery
plans, extending beyond system failure and recovery to encompass the whole hospital and its
day-to-day operations now that they know what they didn't know back then. In the imaging
industry, disaster recovery usually entails restoring access to patient medical data and pictures.
When a hospital's communications system fails, normal workflow (such as admissions, test
scheduling, and payment) comes to a standstill.

Data Back up plan: Simply put, it means making a backup of all data on a regular basis – say,
once a month – and keeping it on an external hard drive in a different place. While this is better
than nothing, it still necessitates adherence to a strict schedule and does not allow for disaster
recovery of data created between planned backups. On the other hand, you may utilize a cloud
platform to create an always-accessible backup copy of your data that is up to date. The
majority of clinics provide something in the middle of these two alternatives.

Reasonable cost: If at all feasible, you should have a data backup plan in place that secures
your data and makes it accessible at all times. Most practices, unfortunately, do not adopt this
type of system because they believe it is either unachievable or prohibitively expensive. This is
no longer the case, thanks to the rise of cloud services; there are several cloud-based solutions
available that will enable you to attain this degree of preparation.

Cyber security: even for those who believe they are safe from invasion Indeed, health-care
institutions have been in the news as victims of ransomware attacks, in which thieves encrypt
data and hold it hostage until the medical facility pays a charge or a ransom.

Unless you're willing to pay up, you should have a disaster recovery plan in place that allows
you to discard the encrypted data and switch to your backup data right away. Even if you pay
up, the harm to your reputation may be irreversible.

Data Flow Fault Tolerance

The PACS system is mission important since it operates 24 hours a day, seven days a week.
The vast computer network and system integration of medical pictures and information require
high levels of operational dependability. The goal of PACS fault-tolerant design is to ensure that
the system remains operational at all times. System fault-tolerance is required for the
development and operation of an enterprise PACS.

Networking Latency
Sometimes called lag, it is the term used to describe delays in communication over a network.
What causes Internet latency? One of the principal causes of network latency is distance,
specifically the distance between client devices making requests and the servers responding to
those requests. When delays in transmission are small, it’s referred to as a low-latency network
and longer delays are called a high-latency network . Long delays that occur in high-latency
networks create bottlenecks in communication. In the worst cases, it’s like traffic on a four-lane
highway trying to merge into a single lane. High latency decreases communication bandwidth,
and can be temporary or permanent, depending on the source of the delays. Latency is
measured in milliseconds, or during speed tests, it’s referred to as a ping rate. Obviously, zero
to low latency in communication is what we all want. However, standard latency for a network is
explained slightly differently in various contexts, and latency issues also vary from one network
to another.
Interoperability

It refers to the basic ability of different computerized products or systems to readily connect and
exchange information with one another, in either implementation or access, without restriction.

They must be able to exchange, interpret, and present shared data in a way that is understood
by the other. This is accomplished with the establishment of syntactic interoperability, which
involves adopting a common data format and common data structure protocols, followed by
semantic interoperability, which involves the addition of metadata that links each data element to
a controlled, shared vocabulary. Within this shared vocabulary are associated links to an
ontology, which is a data model that represents a set of concepts within a domain and the
relationships among those concepts.

RIS Assessment

Radiology Information System (RIS)

The software system for storing and managing medical images and data.

Frequently used in conjunction with a PACS to manage picture archives, record-keeping, and
invoicing.

Functions: Patient management, Scheduling, Patient tracking, Image tracking, and Billing

Patient benefits

Keep a copy of any radiographs and documents in a safe place.

This not only helps to prevent errors, but it also helps to keep all patient information safe.

Interactive documents, such as zooming in and out of x-ray pictures and film tracking, can assist
a radiologist in providing a more visual explanation of a test result to a patient.

Radiologic Technologist benefits

Increased productivity and a more pleasant working environment.

With significantly less effort, you can keep track of what stock you have left and what needs to
be ordered.

Saves a significant amount of time when entering data and avoiding errors.

Advantages
-When a PACS and a RIS are combined, pictures and radiological reports may be linked,
substantially enhancing service to patients and referring physicians.

-You may dedicate more time to your patients and deliver better treatment by computerizing and
simplifying paperwork.

-Workers may reduce numerous redundancies in the registration procedure of new patients with
a well-designed radiological information system.

-More accurate diagnoses result from simplified RIS applications.

Disadvantage

-Hackers attempting to break in and steal critical patient information must be taken into account.

-Ransomware is a new form of attack on healthcare IT networks. The perpetrators obtain illegal
access to the network and then hold the data hostage using a variant of malware that prevents
you from accessing patient records.

-When you first establish the RIS, like with any new technology, there may be a time where the
worker is unfamiliar with the program.

HIS Integration Report

Hospital Information System is a comprehensive, integrated information system built for

managing the operations in running health care facilities. It helps gather and analyze health data
to provide prescriptions concerning the patient’s ailment, improves healthcare delivery by
producing medical personnel with better access to the medical records of the patient, and more.

Integration Report is a detailed account of how an organization's strategy, governance,

performance, and prospects, when considered in the context of its external environment,
contribute to the creation of value in the short, medium, and long term.

Decision - Making Assurance

Health planners and decision-makers need different kinds of information including:

• health determinants (socio-economic, environmental behavioural, genetic factors) and the

contextual environments within which the health system operates;

• inputs to the health system and related processes including policy and organization, health
infrastructure, facilities and equipment, costs, human and financial resources, health information
systems;

• the performance or outputs of the health system such as availability, accessibility, quality and
use of health information and services, responsiveness of the system to user needs, and
financial risk protection ;

• health outcomes (mortality, morbidity, disease outbreaks, health status, disability, wellbeing);
and
• health inequities, in terms of determinants, coverage of use of services, and health outcomes,
and including key stratifiers.

Quality assurance
is a program used by management to maintain optimal diagnostic image quality with minimum
hazard and distress to patients. The program includes periodic quality control tests, preventive
maintenance procedures, administrative methods and training.

to maintain the quality of diagnostic images;

to minimize the radiation exposure to patient and staff; and

to be cost effective.

to ensure that all measures are in place to ensure that the diagnostic quality of radiographs
taken provides the clinician with the information required, thus negating the need for repeat
radiographs, which increase the dose of ionising radiation to both patients and the dental team.
In a hospital x-ray facility, the radiology department should establish a formal Quality Assurance
Committee (QAC). It will provide the structure required to plan and evaluate the program and to
resolve quality assurance issues and problems. A QAC will also provide management with
recommendations for direction to those charged with the various aspects of the program.

Questions
1. refers to the use of recording media to retain data using computers or other devices.
a. Data storage
b. Disaster recovery
c. Data Back up plan

2. includes types of data storage that are physically connected to your computer
a. Data storage
b. Direct Attached Storage
c. Data Back up plan

3. allows for multiple machines to share storage over a network.

a. Network attached storage
b. Direct attachment storage
c.Data Back up plan

4.Imaging department directors and PACS administrators are reviewing their disaster recovery
plans, extending beyond system failure and recovery to encompass the whole hospital
a. Data storage
b. Direct Attached Storage
c. Disaster Discovery

5. it means making a backup of all data on a regular basis say, once a month and keeping it on
an external hard drive in a different place.
a. Data Back up plan
b. Direct Attached Storage
c. Disaster Discovery
6.If at all feasible, you should have a data backup plan in place that secures your data and
makes it accessible at all times.
a. Reasonable cost
b. Direct Attached Storage
c. Disaster Discovery

7. Sometimes called lag, it is the term used to describe delays in communication over a network.
a. Networking Latency
b. Direct Attached Storage
c. Disaster Discovery

8.It refers to the basic ability of different computerized products or systems to readily connect
and exchange information with one another, in either implementation or access, without
restriction.
a. Direct Attached Storage
b. Disaster Discovery
c. Interoperability

9. The software system for storing and managing medical images and data
a.Radiology Information System
b.picture archiving and communication system
c health information system

10 RIS stands fpr

a. Radiologist information system
b.Radiology Information System
c.Radiology Information Scout

Module 9: PACS SYSTEM

Picture Archiving and Communication System

a medical imaging technology which provides economical storage, retrieval, management,

distribution and presentation of medical images.

A picture archiving and communication system, or PACS, is a system for storing and
transmitting images. Instead of manually filling, collecting, and transporting film jackets, which
are used to store X-ray film, this system stores images and reports electronically. With the
development of a new professional title, PACS administrator, the necessity for qualified
professionals to administer image archiving and communications systems (PACS) has been
acknowledged. Radiology technologists (RTS), information systems analysts, and radiology
administrators are all needed for this profession.

System components and function

PACS has four major components: hardware imaging machines, a secure network for the
distribution and exchange of patient images, a workstation or mobile device for viewing,
processing and interpreting images, and electronic archives for storing and retrieving images
and related documentation and reports.

In turn, PACS has four main uses. The technology:

1. replaces the need for hard-copy films and management of physical archives.

2. allows for remote access, enabling clinicians in different physical locations to review the same
data simultaneously.

3. offers an electronic platform for images interfacing with other medical automation systems
such as a hospital information system (HIS), electronic health record (EHR), and radiology
information system (RIS).

4. allows radiologists and other radiology and medical personnel to manage the workflow of
patient exams

Imaging information systems like PACS have replaced the need to store and manage hard-copy
films and reports in space-consuming shelving and rooms. Instead, medical images and
non-image data can be securely stored digitally on premises or in the cloud

Cloud based pacs store and backup an organization's medical imaging data to a secure off-site
server. This is required in the U.S. by the HIPAA Security Rule, which governs the privacy of
patient information. A cloud PACS also enables medical staff to view medical imaging data from
any approved devices, such as a smartphone.

Providers often use a hybrid cloud system, in which primary images are stored on-premises and
backups are kept in the cloud. Additional types of storage

architectures may be configured and attached to the PACS server, such as direct-attached
storage (DAS), network-attached storage (NAS) or via a storage area network (SAN), each
allowing for upgradeability, connectivity, improved protection against failure and added security.

Use with other medical imaging technologies Although PACS processes are widely adopted in
healthcare, vendor neutral archive (VNA) technology has replaced PACS in some healthcare
settings and integrates with PACS in others.

PACS vendors employ various syntaxes within DICOM, which makes it hard for data from one
system to work in another system VNAS enable data integration by deconstructing data from an
originating PACS and then migrating the data to the new system with the proper syntax

DICOM
Digital Imaging and Communications in Medicine is a standard protocol for the management
and transmission of medical images and related data and is used in many healthcare facilities.

originally developed by the National Electrical Manufacturers Association (NEMA) and the
American College of Radiology (ACR).

It is used worldwide to store, exchange and transmit medical images, enabling the integration of
medical imaging devices from multiple manufacturers. Patient data and related images are
exchanged and

stored in a standardized format.

Enterprise PACS System

What is Enterprise Imaging? Enterprise imaging (El) refers to a set of strategies, initiatives, and
workflows implemented across a health care enterprise to consistently and optimally capture,
index, manage, store, distribute, view, exchange, and analyze all clinical imaging and
multimedia content to enhance the electronic health record.

Enterprise imaging brings the data from disparate PACS together, transforming it, and making it
accessible to anyone, anywhere, anytime. This ability to share and access data across an
organization can eliminate barriers associated with the siloed data of PACS systems. Through a
user-customizable interface, an enterprise-level solution addresses the needs of all
departments, allowing healthcare organizations to standardize applications and workflows -
ultimately becoming less department-centric and more patient-centric In addition, with
enterprise-level data access, there are also opportunities for data-based insights that can lead
to business efficiencies.
PACS facilitated Core Workflow In Today's RIS and HIS
Continue with the connection test between the modality emulator and the PACS after deciding
which patients will be processed. Before transmitting pictures to PACS, double check that the
"Image Storage" folder already contains an image. The next step is to verify the modality's
TCP/IP connection and DICOM association with the PACS Emulator. After the link has been
established, pictures and patient data may be sent.

INSTALLATION AND INTEGRATION OF MODALITIES WITH PACS AND RIS

RIS/PACS integration - Better usage of radiology resources enhances productivity when the RIS
and PACS are connected to work as a unified system. PACS allows radiology, hospital clinical
areas, and other remote users near-instant access to pictures and patient data.

Questions
1. a medical imaging technology which provides economical storage, retrieval, management,
distribution and presentation of medical images.
a. Pacs
b. Ris
c . dicom

2. is a standard protocol for the management and transmission of medical images and related
data and is used in many healthcare facilities
a. Pacs
b. Ris
c. dicom

3. Pacs stands for

a. Picture Archiving and Communication System
b. Picture Archive and Communicate System
c. pictorial Archiving and Communication systematic

4.DICOM stand for

a. Digital Imaging and Communications in Machine
b. Digitize Imaging and Communications in Medicine
c. Digital Imaging and Communications in Medicine

5. brings the data from disparate PACS together, transforming it, and making it accessible to
anyone, anywhere, anytime. This ability to share and access data across an organization can
eliminate barriers associated with the siloed data of PACS systems.
a. Pacs
b. Ris
c. Enterprise imaging

6. PACS has ___ major components

a. Two
b. Four
c. three

7. It is used worldwide to store, exchange and transmit medical images, enabling the integration
of medical imaging devices from multiple manufacturers.
a. Pacs
b. Ris
c. dicom

8. Better usage of radiology resources enhances productivity when the ___ and ____ are
connected to work as a unified system
a. Dicom and pacs
b. Ris and dicom
C. RIS and PACS

9. allows for remote access, enabling clinicians in different physical locations to review the same
data simultaneously.
a. Pacs
b. Ris
c. dicom

10. Before transmitting pictures to PACS, double check that the _______ folder already contains
an image.
a. Image Storage
b. Data
c. internet
Module 10: RADIOLOGY INFORMATION SYSTEM

Impatient workflow information and guidance

The Radtech purpose is to improve this process, and to that end we have explored three
possible avenues

2. Help (guide) patients to find their way by using ticketing and digital signage screens 2.
Visualise the occupancy of the different x-ray rooms by making use of digital dashboards

3. The global aim is to render patient throughput and production processes visible to

management.

There is a three stage solution to solve this problem:

1 Digital signage

2. Ticketing

3. Creation of digital dashboards and management statistics.

Radiology started from the patient's point of view. Upon entering the radiology department, the
first step for every out patient is to register for his or her examination(s). After registration, the
patient is then directed towards a specific waiting room depending on the type of scheduled
examination (chest x-ray, CT scan etc.).

At present, stage one is fully operational in our department. Every waiting area is equipped with
a digital signage screen, which displays a video loop containing specific examination related
information for the patient as well as more general information about the radiology department
and the medical staff.

Stage two (ticketing) is partially implemented Upon arrival at the reception desk, patients take a
numbered ticket from a dispenser. They are called in a sequential order for registration in the
RIS (by ticket number). Currently these numbered tickets are thrown away after the patient has
been registered. For the future it is our goal to include the ticket number in the RIS at procedure
level.

Finally, in the third stage of the process, we need to create a waiting room dashboard, which will
provide an overview of the different waiting areas, and allow the staff to evaluate patient
throughput and workflow. This third step will be implemented together with the RIS vendor

Outpatient information system (OIS)

This program was created to address the issue of outpatient records being mishandled. Human
errors in diagnosis and drug prescription, as well as misplaced patient files and delays in
retrieving patient information.

Diagnostics information systems (dis)

-promotes the accuracy and efficiency of patient care and improves

the productivity of physicians, nurses, and others at all points of care by providing instant
access to cumulative patient information in an easy to read and analyze format.

-addresses one of healthcare's most problematic, inefficient, and costly workflow issues
-Specifically designed for immediate use * Provides detailed specifications
-Fast access to patient information

Radiology Information System (ris)

-is a software system that stores and manages medical images and data
-widely used in conjunction with PACS and VNAs to handle picture archives, record-keeping,
and billing, and it is particularly useful for preserving radiological imaging requests and billing
data.

BASIC FUNCTIONS

Patient Management * Scheduling

Patient Tracking

Results Reporting

Image Tracking Billing

PACS Professional development

What is PACS?
Picture Archiving and Communications Systems (PACS)

WHAT IS A PROFESSIONAL DEVELOPMENT?

set of tools, resources, and training sessions for educators

PARCA AND ARRT

As the PACS administrator profession grows, so have the opportunities to obtain certification.
Two organizations currently provide certification for PACS administrators: the American Board of
Imaging Informatics (ABII) and the PACS Administrators Registry and Certification Association
(PARCA).

The ABII offers the Certified Imaging Informatics Professional (CIIP) exam and PARCA offers a
tract of exams that accumulate in the Certified PACS System Manager. I have had the
opportunity to obtain both the CIIP exam from ABII and the CPSA level of certification through
PARCA.

A comparison of these two methods of certification is an ongoing hot topic among PACS
administrators in the field. Regardless of which side you take or which certification method you
prefer, there are unique aspects of each certification method that warrant consideration.

Certification Consists of Three Components

Certified PACS Associate (CPAS) This certification is achieved by passing the 2 exams listed
below.
1. CPAS-Technical: Individuals are able to demonstrate their knowledge of general technical

2. skills related to Imaging Informatics 2 CPAS-Clinical Individuals are able to demonstrate their
knowledge of general clinical skills related to Imaging Informatics.

Certified DICOM Integration Professional (CDIP) Individuals are able to demonstrate their

knowledge about DICOM, including troubleshooting

3 Certified PACS System Analyst (CPSA) Individuals are able to demonstrate their knowledge
about PACS components, system administration and workflow.

Before pacs

After Pacs

Questions
1. This program was created to address the issue of outpatient records being mishandled.
a. Outpatient information system
b. Diagnostics information systems
c. none of the above

2.promotes the accuracy and efficiency of patient care and improves

the productivity of physicians, nurses, and others at all points of care by providing instant
access to cumulative patient information in an easy to read and analyze format.
a. Outpatient information system
b. Diagnostics information systems
c. none of the above

3. OIS stand for

a. Outpatient internet system
b. Over the internet system
c. Outpatient information system

4. Dis stand for

a. Diagnostics information systems
b. Digital information system
c. diagnose information system

5. This certification is achieved by passing the 2 exams

a. Certified PACS Associate
b. Digital information system
c. diagnose information system

6. ABII stand for

a. American best imaging informatics
b. American Board of Imaging Informatics
c. American Board of Imaging Information

7. set of tools, resources, and training sessions for educators

a. Outpatient information system
b. Diagnostics information systems
c. Professional development

8.CPSA stand for

a. certified PACS System Analyst
b. Certified pinoy system analyst
c. certified person System Analyst

9. is a software system that stores and manages medical images and data
a. Pacs
b. Ris
c. his

10. is partially implemented Upon arrival at the reception desk, patients take a numbered ticket
from a dispenser
a. Ticketing
b. Waiting
c. Digital signage