Management of Radiological Images - from Distribution and Digital Reporting to Audit-Proof Long-Term Archiving

Radiology is at the core of diagnostic imaging in hospitals. For most inpatients in this department, an exam is carried out at least once during their stay; care for outpatients is of similar importance. For both groups, the procedure is as follows: images need to be acquired, to be distributed for reporting, reported on, sent back to the referring physician with the report included, and finally, they need to be archived for a duration of up to 30 years in an audit-proof manner. This requires precise logistics in the process of image management. The PACS solution JiveX Radiology covers these logistics in a safe and reliable way. The system provides straightforward and efficient support for the workflows of all users - radiologists, radiology technologists, and physicians in the wards as well as medical specialists.

Seamless Integration into HIS and RIS

In order to be able to provide safe support for all processes around the digital X-ray image in hospitals and doctor’s offices, JiveX Radiology is linked seamlessly with the radiology and hospital information systems of the leading vendors. It inherits the patient and job information which is made available automatically for each modality via a DICOM worklist. The acquired images can be distributed automatically based on a set of rules which can be configured freely. Reporting is carried out at the integrated RIS/PACS workplace.

Third-party images acquired beforehand can be imported into the PACS without any problems - regardless whether they are on a CD, DVD, or removable disk, whether they come in via a DICOM e-mail, as a scan of a conventional X-ray film, or from some other image source. Positive attribution to a defined patient allows for the safe integration of the images into the reporting process.

Providing Support for Reporting, a Core Process

The main focus of the processes in radiology is on reporting. What may sound simple is linked to a multitude of individual steps. With JiveX Radiology, the user continuously has full control of all work processes. The system supports him in his work, assuring a smooth workflow.

The digital X-ray images are transferred, depending on each customer-specific configuration, to individual worklists for each workplace and user. In the reporting process, JiveX Radiology supports the radiologist by providing a multitude of tools. They include, e.g., the function 'Capture and Continue' which the user applies to store certain steps of the process in the PACS, and to restore the current status of the workplace automatically at a later moment in time. This helps facilitate significantly, e.g., the preparation of demonstrations or case collections for educational purposes. The reporting physician organizes his patient exams automatically through 'hanging protocols'; 'reading protocols' automatically provide links with process steps.

In order to support reporting, the 3D function MPR/MIP (Multiplanar Reconstruction / Maximum Intensity Projection) is integrated into every reporting workplace. Further special applications for analysis and postprocessing can be integrated, as desired, without any problem via open interfaces. Applications include, e.g., various systems for volume rendering or computer-aided diagnosis.

Thanks to the seamless integration into the HIS, images as well as reports are available to all users in the hospital immediately after approval.

Clinical demonstrations are an important routine task in radiologists' day-to-day work. The challenge is to prepare and conduct these demonstrations in an effective and time-saving manner. JiveX Radiology helps carry out the preparations without any effort: during reporting, the radiologist stores workplace statuses through "Capture and Continue", or transfers marked images to be used for demonstration into a demo list. He can also create various lists in parallel for a multitude of demonstrations.An additional monitor allows him to keep track of things at any time, and he is provided with a complete overview of patient information, reports, demo lists, as well as stored "captures".

Radiology is a classic service discipline; therefore, teleradiology consultations are integrated into the PACS solution. This allows hospitals, e.g., to offer their expert opinion for specific problems, or to provide radiology services to smaller-size caregivers outside normal working hours as well as during weekends and holidays. Furthermore, it permits the hospital in question to organize stand-by duty from home offices.

Options for Communication with Referring Physicians

In today´s patient care, cross-sector and integrated treatment schemes are a key aspect. In these schemes, fast and seamless communication of image and report data plays a major role in the efficiency and quality of patient care. JiveX Radiology offers hospitals and physician practices a multitude of options to implement efficient communication between the various caregivers in the treatment chain. The simplest approach is paper or film print; creating patient CDs is far more efficient and cost-effective. This process is fully integrated into the departmental workflow and is operated by the click of a button.

In addition, there is the option of making available, for access by referring physicians secured by password, the exam studies and approved reports for their patients on a separate web server. Physicians log in and can then download this information via an encrypted communication path. Alternatively, a web application or a special DICOM viewer made available by the web server can be used for this purpose. 


An alternative solution is provided by sending secure DICOM e-mails. Use of common e-mail technology allows to easily create connections with referrers or other healthcare organizations. This technology enables caregivers to link in without any significant technical or financial effort involved. In order to receive image data, all that is required is a connection to the Internet as well as a DICOM e-mail-enabled application. Caregivers profit from savings of time and increased efficiency, whereas patients benefit from increased quality in diagnostics and therapy. 



If a multitude of sites is to be integrated, JiveX Radiology can create an independent DICOM network across various sites. The communication platform used for this purpose allows for highly efficient image distribution via secured data connections. 



All processes carried out with JiveX Radiology - whether within the campus or in off-campus communication - can be protocolled and tracked. This creates effective quality management which safeguards the quality of every step in the process, and of the overall results.

Flexible archiving, fast access

For archiving, the user selects the relevant images and sequences. Data can be stored online, in a Storage Area Network (SAN), on shared hard disk systems in a network (Network Attached Storage, NAS), or on a direct attached hard disk system (RAID). Offline storage is done on DVDs, BluRay discs, or magnetic tapes which are handled either manually or by robots. Before archiving of image data, feedback is given to the leading information system. The reconciliation with the order communication ensures process quality.

A further option for long-term archiving is JiveX Storage Service for PACS (SSP). This service enables the customer to store his data in an external archive operated by a service provider. This type of data storage enables cost-optimized operation for the user. With the full orientation of fees towards use, the customer is not required to make investments and tie up capital. Cost can be planned because there are no additional expenditures for migration, administration, or maintenance.