eRAD PACS

Feature #20387 - Display Cache progress of Current Study and Priors

Radiologists sometimes want to start reading a current study even if priors are going to take some additional time to load. To do this efficiently, they need to know that the current study has been fully cached and a separate indication of the caching progress for the priors.

The Pending Dictation WL has been updated to make this information available to the radiologist. The previously existing Study Rate column has been renamed Study Cache Progress. A new column has been added called Priors Cache Progress. The columns will show a whole number (decimals are rounded) with a % sign to indicate the percentage that has been cached. The Study Cache Progress column shows the percentage cached for the current study and the Priors Cache Progress column shows the percentage cached for all priors that are configured to cache (combined).

This feature did not change the order in which studies are cached. However, if the priors were already on the workstation, the Priors Cache Progress may be greater than for the current study. In the example above, the 3^rd study’s priors were pre-fetched to the workstation in anticipation of the scheduled appointment. Therefore, the Priors Cache Progress is at 100% while the Study Cache Progress is only at 85%.

These columns can be sorted individually or together using composite sorts. For example, sort first on the Study Cache Progress column to get the current studies that have been cached to the top, then hold the shift key to add a secondary sort to the Priors Cache Progress column to further sort so that studies with the highest percentage cached, and whose priors have the highest percentage cached, will rise to the top. Keep in mind that the sort for these columns should be a descending sort (high number -> low number) to work effectively. These sorts can of course be combined with sorts on other columns as well (most radiologists have a primary sort set to bring STAT cases to the top, for example).

Notes on Conditional Formatting: It is possible to use the Conditional Formatting worklist feature to set a different cell color to represent caching progress. For example, show 75% - 99% as green.

Configuration:

If desired, update the System Configuration value for PACSCachingDelayInSeconds, which controls the delay before the caching mechanism kicks off on the Pending Dictation WL and the delay that takes place after a sort or filter is applied to the worklist. Once this delay expires, caching will commence (without refresh) on the top X rows (where X is the Studies to Cache user preference). The default is 30 seconds. Keep in mind that low values will cause the caching mechanism to start up faster which could be problematic if the user is applying a new sort or filter.

If desired, update the System Configuration value for PACSCachingActivePollingIntervalInSeconds, which controls the number of seconds between each call to get caching status from PACS when the worklist is actively caching studies. The default is 5 seconds.

If desired, update the System Configuration value for PACSCachingStandbyPollingIntervalInSeconds, which controls the interval in which the RIS will continue to call out to PACS via the getcachinfo requests after the active portion of caching has concluded and there have been sparse or no updates in the last few responses. This will be the fallback for cases that have not entirely cached. The default is 60 seconds.

eRAD PACS v7.2 (non-EVO):

In the PACSServer editor, the following configuration should be used (note the bold section):

<UseOtherRelevantPriors>False</UseOtherRelevantPriors>

<UseWMICacheManager>False</UseWMICacheManager>

<UseWMICacheInfo>True</UseWMICacheInfo>

<GetCacheInfoSendsServer>False</GetCacheInfoSendsServer>

<UseCitrixWMICacheManager>False</UseCitrixWMICacheManager>

<UseStudyOpenInfo>False</UseStudyOpenInfo>

<UseExtendedGetState>False</UseExtendedGetState>

<UseModify>False</UseModify>

<LaunchV8>False</LaunchV8>

</config>

Also, ensure that this PACSServer row has a Y in the Caching Enabled Flag column. You will need to log out / back in to apply changes before using this PACSServer entry.

eRAD PACS v7.2 (EVO):

In the PACSServer editor, the following configuration should be used (note the bold section):

<UseOtherRelevantPriors>False</UseOtherRelevantPriors>

<UseWMICacheManager>True</UseWMICacheManager>

<UseWMICacheInfo>True</UseWMICacheInfo>

<GetCacheInfoSendsServer>True</GetCacheInfoSendsServer>

<UseCitrixWMICacheManager>False</UseCitrixWMICacheManager>

<UseStudyOpenInfo>False</UseStudyOpenInfo>

<UseExtendedGetState>False</UseExtendedGetState>

<UseModify>False</UseModify>

<LaunchV8>False</LaunchV8>

</config>

Also, ensure that this PACSServer row has a Y in the Caching Enabled Flag column. You will need to log out / back in to apply changes before using this PACSServer entry.

eRAD PACS v8:

In the PACSServer editor, the following configuration should be used (note the bold section):

<UseWMICacheInfo>True</UseWMICacheInfo>

<GetCacheInfoSendsServer>True</GetCacheInfoSendsServer>

<UseWMICacheManager>True</UseWMICacheManager>

<UseCitrixWMICacheManager>False</UseCitrixWMICacheManager>

<UseExtendedGetState>False</UseExtendedGetState>

<UseModify>False</UseModify>

<eRAD_V8>True</eRAD_V8>

</config>

Also, ensure that this PACSServer row has a Y in the Caching Enabled Flag column. You will need to log out / back in to apply changes before using this PACSServer entry.

Feature #20386 – Ability to sort “Minutes Since Cache Request” column so that seconds are taken into account

When manually caching, it is common that a user will select several studies to cache within the same minute. The Minutes Since Cache Request column previously stored values rounded to the nearest minute, so if the user made 5 requests in the same minute, all 5 rows would show the same value in the column. This made sorting those values pointless because the value was the same for all rows. Because PACS caches studies in the order the requests were received, radiologists want to be able to properly sort so that the study requested first is at the top and so forth.

With this feature, the Minutes Since Cache Request column will store the values in seconds, so that proper sequential sorting can be done. The values will still be displayed in minutes, but when sorted, the column will take into account the seconds and order the items appropriately.

This change enables radiologists to take advantage of a composite sort that incorporates the Minutes Since Cache Request column, along with the Study Cache Progress and the Priors Cache Progress columns described in the feature above. A beneficial sort on these columns would include a primary sort on Study Cache Progress, a secondary sort on Priors Cache Progress, and a tertiary sort on Minutes Since Cache Request.

Feature #16807 – Alternate viewer options for technologists or other users who do not require the Full Viewer (eRAD PACS v7)

For many technologists, it is not necessary to use the full viewer to carefully review images in PACS, which they have already reviewed on their modality. Often, the purpose of launching the images in the viewer is simply to ensure that all of the images successfully transferred to PACS. It is now possible for users to open images using a lighter version of the viewer: either the Quick Viewer or the Web Viewer.

This feature is an extension of the functionality already available for eRAD PACS version 8, so that eRAD RIS can also support for eRAD PACS versions 7.2 and 7.3.

To take advantage of this option, the User Preference will need to be adjusted for technologists or other users who would benefit from using either the Quick Viewer or Web Viewer. The Default PACS Viewer on the Integration tab of the User Preference screen should be set to the desired viewer.

This preference will be automatically applied when clicking the View Images button from Perform Exam and View/Edit screens, as well as from Radiologist Reporting screens. Note that it is not yet available for the right-click View Images option from the main Patient Folder. This functionality will be coming in a future build (#25542 in 2018.5.2 and #20388 in 2019.1).

If the user wishes to use a viewer option that is different from their default for a particular study, they can dynamically launch one of the other viewers if they occasionally need a different viewer. For example, on the technologist Perform Exam screen, the View Images button is now a split button. Hitting the down arrow will show the available eRAD viewers, and the user can select an alternate.

The user preference can be saved from this dropdown by pressing the Control key on the keyboard, and clicking the alternate viewer. The default user preference is indicated by the gray checkmark.

There is a known limitation when using non-EVO (eRAD PACS Version 8) viewers. The limitation prevents the RIS from using the same authentication token with the Quick and Web Viewers and the Full Viewer. Because of this limitation, it is strongly recommended that users are working in either the Full viewer or the Quick/Web Viewers, instead of switching back and forth. It is possible to use both viewer types at the same time, however the user will receive notifications in the full viewer that the study is locked by another user. For this reason, it is not recommended for radiologists to use the alternate viewer options until they have upgraded to using an EVO (version 8) viewer. If they are doing so, they can access the functionality as shown below.

For radiologists, there are two places on the reporting screen where they can access alternate viewers. As with technologists, the View Images button (represented by a chest x-ray image on the reporting screen) has a new split button option. Clicking the arrow will give options to open the images using an alternate viewer.

In addition, the new viewer options are also enabled on the Patient History worklist (mini-Patient Folder) for any reporting screens as a context menu item.

As before, double clicking the row will continue to launch the images in the Full Viewer.

Configuration Notes:

The integration is enabled for all systems which have the following eRAD configuration settings in the PACSServer configuration table:

Feature #22402 - Option for using “as is” compression for CD Burning

In RIS version 3.2017.2 (Features #9368, #12240), functionality was added to allow the user to choose from several types of compression when burning CDs, along with the ability to set a compression preference for referring physicians. Three options for compression existed previously: Uncompressed, Compressed-JPEG, and Compressed-JPEG 2000.

While these changes allowed customers to choose the appropriate mode of compression for recipients who could only accept certain compression types, it did not have the most efficient default for the majority of CDs where the recipient doesn’t require a particular compression type.

PACS can store images in a variety of compression formats. If the RIS requests a CD to be burned in a format that is different from the current compression that exists in PACS, PACS has to uncompress and recompress the images, which has a significant performance impact. This is acceptable if the recipient truly requires a certain format, but it is often unnecessary if the recipient can accept any compression type.

For improved performance, the compression type will now default to the compression type in which the images are currently stored in PACS. When requesting DICOM media from eRAD PACS, there is an existing parameter for compression mode, which is how we request the currently available modes. RIS will now use a fourth option for this parameter, known as “as is”—meaning that the images should be burned using the current compression mode, whatever it happens to be.

A new option has been added to the Compression dropdown in the Burn CD and Image Request dialogs, as well as the Compression Preference option in the Personnel editor.

The label for the option in the dropdown is “Use current compression mode (as is)”. Going forward after the upgrade to version 3.2018.5, this will be the default compression setting for CD Burning and Image Request, as well as the default Compression Preference for any referring physicians added to the Personnel table from that point forward. The user or administrator has the option to change the default to any of the three pre-existing options when desired.

At the time that the Compression Preference field was first implemented, the preference for all existing referring physicians was defaulted to Compressed – JPEG to maintain existing functionality. After upgrading to version 3.2018.5, a script can be implemented to change the Preferred Compression setting to the new “as is” option for any referring physician whose preference has not yet been updated from the previous default of Compressed – JPEG (assuming that if a change was made to the default, the referring physician expressed a preference and those should be left intact).