A System for Improving the Management of the Lesion and Test Images of Patients

doi:10.4236/eng.2013.510B035

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Engineering, 2013, 5, 163-165

http://dx.doi.org/10.4236/eng.2013.510B035 Published Online October 2013 (http://www.scirp.org/journal/eng)

A System for Improving the Management of the Lesion

and Test Images of P atients

Sung-Bum Cho1, Kyung-Won Jin1, Jong-Soon Kim1, Soo-Jin Huh1,2, Segyeong Joo1,2

1Department of Biomedical Engineering, Asan Medical Center, Seoul, Korea

2Department of Biomedical Engineering, University of Ulsan College of Medicine,

Seoul, Korea

Email: [email protected]

Received May 2013

ABSTRACT

Nowadays, almost every hospital u tilizes picture archiving and communications system (PACS) and electronic medical

record (EMR) system to manage patient’s data digitally. However, patient’s pictures taken by nurses or physicians to

monitor lesions or various test results are not managed well in general. Although for some disease, these pictures pro-

vide meaningful information in diagnosis and treatment. In this paper, we propose a management system for these im-

ages to improve the accessibility and storability. To manage the images efficiently, the proposed methods utilized the

PACS system in the hospital. A fter sending the image data of each patient to a local monitoring computer, the patient’s

information, such as, name, age, male, and registration number were attached on the image. This file was then con-

verted to a DICOM (digital imaging and communications in medicine) files and transferred to the PACS Server. The

proposed system promises easy and convenient access on the images of lesions and various test results of patients to

support fast and appropriate treatment.

Keywords: PACS; Real-Time Transmission; DICOM; Patient Examination; Wireless

1. Introduction

Due to the rapid development of information technology

(IT), it is common for hospitals utilizing electronic med-

ical record (EMR) and picture archiving and communi-

cation system (PACS) for obtaining, transferring and

displaying patient data and images.

Images and various laboratory and other test results of

patients are important information in diagnosing and

treating the patients. Furthermore, some patients require

continuous observation to monitor lesions or bedsores.

For these patients, taking pictures of the site constantly

and checking the status ar e essential parts of treatment.

However, these photos are not managed well in general.

Some images are simply attached in the patient’s elec-

tronic chart but the quality of the image is not well

enough and one cannot find the image later conveniently.

The lack of storage management of the images could

induce missing or d elaying appropriate treatment for the

patients.

It is difficult to establish a storage management system

for the images in a general hospital since the system re-

quires a lot of manpower and operating cost. I n addition,

training nurse and physicians is another problem of

building the system. The system should be easy to use

and convenient for this reason. This is why there is no

such system that monitors the images of the lesions and

test results of patients in real-time so far.

In this paper, we propose a storage management me-

thod that enables automatic transmission of the lesion

and test image of the patients in a convenient manner.

The proposed system can be easily attached to the con-

ventional PACS system and does not require much cost

for adopting the system. The system ensures real-time

transfer of the ima ge s via wired or wireless network.

There is no worry about the loss of the image.

2. Materials and Methods

2.1. Diagram for Storage Management Methods

The proposed scheme for storage management is illu-

strated in Figure 1.

When a nurse or a physician takes pictures of lesions

or test results, the image is transferred to an automatic

converting computer for converting the transferred im-

ages to DICOM (digital imaging and communications in

medicine) format. After the conversion, files are up-

loaded to the PACS server. The uploaded images are

now accessible from any computer in the hospital. The

detailed process of the system will be described in the

following sections.

S.-B. CHO ET AL.

164

Figure 1. Schematic diagram of the proposed system.

2.2. Picture Acquisition System

To take pictures of lesions or test results of patients, a

digital camera, which is connected to a laptop computer

via a USB (universal serial bus) port or with wireless

network [1], was used. The pictures were stored in a

JPEG (joint photographic experts group) format. Figure

2 shows the camera unit (D60, Nikon, Japan) connected

to a laptop computer (SENS R60, Samsu ng , Korea).

Camera control program (camera control pro2, Ver.

2.13.0, Nikon, JAPAN) installed on the laptop automati-

cally recognizes the camera device when the power is

turned on and creates image files in JPEG format when

the sh utter on the camera pressed [2,3].

2.3. Real-time Automatic Convert DICOM Files

Transmission System

The images that are stored in the patient’s disease or tes-

ters need to match the patient information and physi-

cian’s prescription. Patient information must be entered

by the nurse to prescribe. To observe the patient’s dis-

ease continuously, we build a database of information

and images of the patient. Figure 3 shows the worksta-

tion laptop computer installed the real-time automatic

convert DICOM file transmission program (iview, Ver.

2.0.00, CAD I mpact. Inc, K OR E A ).

After entering patient information in accordance with

the prescribed is stored should be matched with the im-

ages in a specific folder. The real-time automatic convert

DICOM file transmission progra m automatically convert

to DICOM file [4,5]. The DICOM file transfer PACS

Storage to designated IP address. The laptop computer

using the Wireless LAN card (ATHEROS, 802.11b.g) is

sent to the PACS wireless.

2.4. Real-Time PACS System

Figure 4 shows The PACS System that is installed in the

Figure 2. Camera unit and laptop computer.

Figure 3. Program for real-time conversion to DICOM file

and automatic transmission.

Figure 4. PACS gateway (PETAGATE program).

hospital. The system consists of the PACS gateway,

PETAGATE program (PETAGATE, Ver. 201305021655,

and SEO U L ASAN Medical Center, KO REA) and PACS

Viewer program, PETAVISION program (PETAVISION,

Ver. 2.1.0.1012, Asan Medical Center, KOREA).

The PACS gateway, PETAGATE program before it is

sent to the PACS server DICOM file to final inspection.

DICOM PACS gateway permits to connect the PACS

Server. The PACS Viewer, P ETAVISION prog ram is an

easy-to-use application that allows users to view medical

DICOM images made from PACS Storage.

3. Result and Discussion

Storage management methods for automatic image trans-

mission of the image of the patients with disease and

patient examination were designed and initiated in 2013

for continuous observation and treatment Service.

S.-B. CHO ET AL.

165

Figure 5. PACS viewer (PETAVISION program).

After Patient information is entered to program infor-

mation window in workstation laptop computer, as soon

as images of the patients with disease and examination

are generated, they are automatically transferred to work-

station laptop computer and convert to DICOM file.

Whenever DICOM file are generated, it is automatically

transfer to PACS gateway real-time wireless. Physician,

nurse, particular administrator of patient disease could

check the information of patient image from anywhere in

the hospital PACS System.

Because it is already using a laptop computer equipped

the Wireless LAN card in the ward for EMR, Mobile

Workstat ion Laptop Computer-based environment was

implemented to reduce cost and take advantage of user-

friendliness, time, satisfaction of the user. Tremendous

benefits of Mobile Wireless Laptop Computer-based

environment see through PACS and Anywhere easily

store image of the patient with diseases and patient ex-

amination. In addition, it is only the cost of DICOM

convert program, Camera Control program and Camera

Unit.

Seoul Asian Medical Center PACS was designed with

its own technology and initiated in 2000. All radiologic

imaging including outpatient radiography are supported

by the PACS. In addition, Mobile HIS (Hospital infor-

mation system) has been built in 2010 became available

mobile-OCS/EMR/PACS. We can anytime, anywhere

check the patient information of the emergency room,

hospitalization, wards, in the operating room.

Images with the disease or the patient tester are im-

portant information for observation and treatment of pa-

tients with. Information and data of such patients should

not to be neglected, it should be managed efficiently.

To keep a fast speed and good quality, hospital must

be upgraded or replace laptop computer. If laptop com-

puters are replacing with the latest mobile PC, Physician

and nurse can explain Treatment over image to the pa-

tient through a separate monitor. So, Storage manage-

ment methods for improving the image of the patients

and patient examination at the hospital are currently be-

ing tested continuously.

4. Conclusions

In this study, we presented an improved management

system for managing patient pictures of specific lesion or

various test results. The system transfers the acquired

image of patients to a PACS system in a hospital. The

image data of each patient contains the patient’s informa-

tion, such as, name, age, male, and registration number

since the file is converted to a DICOM format before

transferred to the PACS Server. The proposed system

promises easy and convenient access on the images of

lesions and various test results of patients to support fast

and appropriate treatment.

Real-time transfer of the images via network allowed

medical doctors to monitor the status of the patient’s

diseases, or examination would undergo continuous ob-

servation and treatment. It was also able to explain the

progress of patients with diseases using the mobile pc or

mobile phone connected to the PACS.

The wireless data transmission could provide better

data management, reduced data transfer time, and conve-

nient operation.

Sensitive information, such as images of the disease,

or patient tester will be stored and managed on the PACS.

As a result, Nurse Representative is not discomforted,

and satisfaction increases.

5. Acknowledgements

This research was supported by Basic Science Research

Program through the National Research Foundation of

Korea (NRF) funded by the Ministry of Education,

Science and Tech nology (2010-0007281).

REFERENCES

[1] Radio-Frequency Wireless Technology in Medical De-

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[2] “The Implementation of Homecare Nursing Network Sys-

tem Using Wireless Network,” The Korean Society of

Medical Informatics, Vol. 7, No. 1, 2001, pp. 13-21.

[3] D60 Digital Camera Operation Manual, CANON, 2008

[4] Digital Imaging and Communications in Medicine (DI-

COM), National Electrical Manufactures Association,

2001.

[5] “iView User’s Guide ,” CAD Impact. Inc, 2010