PACS integration with OpenMRS radiology module

[Pratap Kumar]

Dear implementers,

I'm working on a service that presents both patient EMR and radiology images (stored in DICOM format) on a single website. I'm wondering if anyone else has tried this and what your opinions are.

It's important for me to have a custom interface that pulls EMRs and radiology onto one site. The two options are:

1. Use the OpenMRS radiology module to link DICOM data to the patient record. I'll have to deploy Xebra (which is the PACS the radiology module is built around). I'll still have to use a browser-based DICOM viewer (like Oviyam or Weasis) to view the DICOM data.

Xebra seems to have not been updated since 2009. I might have to get the radiology module to work with another PACS (eg. dcm4chee)

2. Have separate EMR and PACS servers and use the same patient ID to store EMR data in OpenMRS and DICOM data in the PACS (eg. dcm4chee). Here patient EMRs and DICOM data are stored separately and not linked.

Ideas and suggestions welcome!

Pratap

[Mark Goodrich]

Pratap,

We are buillding integration between OpenMRS and a McKesson PACS system at our hospital in Mirebalais.  However, we haven't tackled the problem of actually importing the DICOM images into OpenMRS yet.  We are simply sending orders (with the patient identifier) from OpenMRS to PACS (via HL7) and then we will be receiving the text reports back from PACS (again via HL7) and importing them into OpenMRS. (We are using Mirth as middleware for transporting and queuing the HL7 messages). So we are more or less going for option #2 at this point.  The PACS system does have a web client, so it will hopefully be possible for doctors to view the images and OpenMRS from the same terminal--although the new OpenMRS UI we designed is optimized for Chrome while the McKesson PACS client is an ActiveX app and so it requires IE!

Mark

--
OpenMRS Implementers: http://go.openmrs.org/implementers
Post: implem...@openmrs.org
Unsubscribe: implementers...@openmrs.org
Manage your OpenMRS subscriptions at https://id.openmrs.org/
 
 

[Saptarshi Purkayastha]

Hi Pratap,

You have already looked at Xebra and since you mention that it is somewhat limited for the functionality you needs from a PACS system, dch4chee seems like a good option. Infact during the development of the Radiology module, I had advised Juan and Victor to start with dcm4che and they looked at it in depth.

You might want to read this with some translator - http://www.ehas.org/wp-content/uploads/2012/01/PFC-OpenMRS-telerradiologia.pdf

It should be fairly simple to integrate the two and the Radiology module should be easy to modify.
You'd want to send HL7 messages for orders to dcm4chee and those will be mapped as radiology orders against which reports will be stored.
You could then use the WADO services provided by dcm4chee and use Weasis to point to that url.
I assume it shouldn't be very different from the way in which the radiology module is currently working, but it would be good to know how it goes.

Please come back with questions and I can answer or may be if Juan or Victor are still on the list, they might be able to asnwer.

---
Regards,
Saptarshi PURKAYASTHA

My Tech Blog:  http://sunnytalkstech.blogspot.com
You Live by CHOICE, Not by CHANCE

[Pratap Kumar]

Thanks for your responses, Mark, Saptarshi

It certainly helps to see other taking a similar route.

Saptarshi - I'm taking a look at the document (trying to identify the most relevant bits for translation), but it certainly seems like Juan and Victor had a good look at the options.

Hope to be posting some specific queries here again soon.

Pratap

[Burke Mamlin]

Pratap,

I would suggest using the radiology module.  Ideally, it would use a complex observation handler that uses its own table to store a thumbnail & reference to the DICOM image within the PACS.  With this approach, you show a thumbnail preview in OpenMRS and, when someone clicks on it, either redirect the user to the PACS system or use some ajax to fetch the DICOM image from the PACS.  The radiology module could be extended to provide a few flavors of this complex obs handler and/or evolve the complex obs handler to be configurable (redirect to PACS vs. fetch the image & use a DICOM viewer).

-Burke

Pratap

--

[Akhil Ravindran]

He Pratap,

I'm working on something similar where I'm trying to display the DICOM image within OpenMRS in the browser. Along with Dcm4chee PACS service, their toolkit comes along with C-MOVE and C-GET operations implemented, which could used as part of the client. Their toolkit comes along with converting the DICOM object to Jpeg to avoid using a third party viewer and make it browser compatible.

Akhil

[awanth sen]

Hi, 

Do you have any module available that enables the integration of dch4chee with openmrs? we have already set up the dcm4che server and viewer and need to get the images to openmrs. 

many thanks

awanthika

[Akhil Ravindran]

If you want to retrieve images, dcm4che provides a toolkit application called 'dcmqr', and tinker with the cstore part of the application to enter details into Openmrs. You should be able to set it up in a separate module to retrieve images and store them. There is a module using the the old Xebra pacs client for the radiology workflow (radiology order/worklist, image storage and MPPS) but I'm not sure if that's what you want.

Akhil

--

OpenMRS Implementers: http://go.openmrs.org/implementers
Post: implem...@openmrs.org
Unsubscribe: implementers...@openmrs.org
Manage your OpenMRS subscriptions at https://id.openmrs.org/

To unsubscribe from this group and stop receiving emails from it, send an email to implementers...@openmrs.org.

[awanth sen]

Hi,

I want to have an imaging module for my openmrs. We couldnt find any available module that facilitate this. I came across hispIndia radiology module. does that give the facility i need?

we have set up dcm4che on a separate server and have radiology images stored in a database. i want to have access to those images through openmrs patients.

We thought of having a web service for this but my knowledge on webservices is limited.

Is there anyway that i can achieve this? or a current module that suports this? there is a documentation on  aradiology module in openmrs documentation. but i believe it is currently under dev.

many thanks,

Awanthika

[Akhil Ravindran]

dcmqr is the query/retieve part of the radiology workflow. It will retrieve images. You will need to set it up within OpenMRS. Check out the dcm4che2 toolkit, they are built in maven as well, integrating it in a new module should be relatively straight forward once you resolve dependencies. 

If you are accessing it through patients, won't you need some sort of link between patients in Openmrs and images in dcm4chee?

--

[Vindya Madhubhashinie Seneviratne]

Hello Akhil,

Actually me and awanthika are doing the same project. I have installed dcm4chee server and dcm4che2 toolkit in my computer. what we now trying to do is access the database I have here via openMRS.

The patient ID (which is the Natioanl ID number) would be used to differentiate people in both the systems.

I can retrieve the images from my computer and they are stored in the local database (That is the database of dcm4chee). The problem is how to access via openmrs which is installed separately in our main server.

Thanx!!

Vindhya