Digital processing system, archiving and transfers of images in GU MONICA to them. Vladimir

At the Moscow regional research clinical institute of M.F. Vladimirsky (GU MONICA) installation of a system for digital processing, archiving and the transfer of images developed by the Belgian company AGFA HealthCare is complete. As the general contractor of the project the CROC company, the Russian system integrator, in close cooperation performed with specialists of the Russian office AGFA and its distributor of Vitako performing consulting and logistics services within the project.

The system installed in GU MONICA includes a complex from nine devices for digitization (digitayzer and the associated equipment, in particular, of medical printers) and also a hardware-software complex for archiving and transfer of all types of medical images (PACS).

"Before us as uncommon tasks stood the general contractor. It was necessary to carry out very serious work to a short time at a preproject stage. And here, as well as at an implementation stage, we were very much helped by long-term experience of implementation of difficult and large-scale projects, – Dmitry Mugenov, the director of corporate clients of CROC company supervising this project noted. – The difficult complex of the numerous analog and digital equipment for obtaining medical images which is available in medical institution was united in a whole (mammographic installations, different type x-ray devices, KT and MPT, OUSE scanners, angiographs and so forth). The storage system meeting the high requirements was created; in addition to the installed server hardware (including the DB, web servers and the RIS server, etc.) the diagnostic stations built on thin clients and stations of clinical physicians with advanced functionality for viewing images and volume dynamic reconstruction of diagnostic quality of the general contractor of the project were set and connected. Besides, integration with the medical information system used in GU MONICA was carried out and also the local computer network (LCN) of a large medical complex is upgraded".

According to heads of institute, with system implementation significant economy of current expenses will be reached and all is made necessary for the subsequent accumulation of functionality of the created IC with the minimum capital expenditures; also the scaling option and free integration into other ICs within the programs of upgrade of national health care which are carried out in the country is provided.

The nature of activity and width of a range of the medical services rendered GU MONICA allows to draw an analogy to large industrial enterprise where not the complex of the used equipment, and the numerous difficult and interconnected medical practicians (medical, scientific, pedagogical) and skilled staff is of the main value. Automation allowed to expand the end-to-end kliniko-diagnostic communications which already developed at institute, having lifted work of its divisions, their interaction and exchange of medical data with other health facilities to qualitatively new level. The project was carried out to a short time, without derivation of medical staff from its primary activity. The particular emphasis was placed on training of medical employees of all levels and also the organizations of maintenance and complex service support.

"MONICA has centuries-old history and the most serious traditions of both clinical work, and the organization of the diagnostic service created by efforts of the outstanding scientists who laid the foundation of a domestic radiology — the head of radiological department, the manager tells. kaf. radiodiagnosis of FUV MONICA of the prof. Maria Vishnyakov. – Today MONICA – one of the medical institutions, largest in the country, based on which scientific and pedagogical work on training for health facilities is conducted. Taking into account scales of the informatization of medicine going in Russia we entered a row enough courses of basic preparation on work with the hi-tech medical equipment, unique for our country, constantly we complement the "classical" program of improvement of radiologists with training in adjacent specialties taking into account the most modern requirements to the medical personnel. MONICA is actually whole city, the multi-profile medical complex which does not have analogs in Russia. In particular, the department of diagnostics incorporates polyclinic, stationary departments, department of KM and RT, the department of an angiography performing endovascular diagnostics and treatment of vascular pathology of any localization. In addition to diagnostic departments, there is a laboratory of radiation control exercising interdepartmental control on a number of positions of a status of regional x-ray service. Our specifics cause that in MONICA always some of the first implemented and used the most advanced technological solutions and the equipment, the last among which was system implementation of storage and transfer of high-quality diagnostic images. MONICA are the regional center in a health care system that causes the width and variety of the tasks facing institute which quality of the solution is directly broadcast for work of all state health facilities of the Moscow region".

"Professional approach is necessary for successful implementation of any PACS project, – Alexander Verzunov, the CEO of Vitako LLC is sure. Such approach should meet the high requirements which were developed by the international medical community for this area for the last ten years".

"Feature of the project in MONICA was the fact that we had to carry out qualitatively to a short time integration of the numerous equipment of different producers and also used at institute of MIS "Everest" (the supporting EMR, work of laboratory, distribution of drugs, maintaining protocols of transactions, the statistical recording and other functionality necessary for health facilities), with the PACS system installed by us based on AGFA IMPAX 6, – the director of AGFA HealthCare service Vladimir Svetlov reported. – The medical equipment of MONICA is distributed in rather large territory, on considerable removal from each other: in 5 different body, on different floors of high rise buildings. In total 115 nodes were connected, it is laid to the fiber-optic communication line. Thanks to use of the AGFA HealthCare technology fulfilled in practice, experience and qualification of the engineers who paid special attention to preparatory project stage we not only met the deadline provided by the contract, but also left several days in a reserve. In particular, installation of the server hardware took 4 days, in parallel with it high-performance otsifrovshchik (digitayzer of CR), medical AGFA printers, other peripheral equipment were connected. Connection to the system of "thin" workstations of clinical physicians and radiologists went along with integration of numerous analog and digital sources of medical images of the different producers (General Electric, Siemens, Kodak, Phillips, etc.) who are exploited in MONICA. The storage system of radiological data created for MONICA is very compact, occupies one 19" a rack. We integrated the whole complex of the sources of medical images of diagnostic quality working independently of each other on its base. The disk array meets the most strict requirements for performance and reliability, is supported by a high-speed switching system and an UPS system, conveniently administered by means of the single console of management and so forth. Data on all medical researches for the last year are now in second availability to the doctor to whom "PACS" in the interface of the electronic medical record of the patient for this purpose is enough to click. The system of archive storage based on tape drives is expected storage of all data which are saved up at institute for the last ten years".

"The medical world is very close, – professor Maria Vishnyakova continues. – All of us go on the international conferences, we know what is implemented in the leading domestic clinics, closely we communicate with each other, well we understand that as well as what it is necessary to compare today to. It is pleasantly struck with the speed of project implementation and those new horizons which before us gradually open as we master functionality of a system. It completely resolved an issue of digitization, standardization and archiving of images. A system will allow us to reach significant economy which consists not only of the cost of a sberezhenny film and chemical reactants, but also minimizes charges of archive, a photolaboratory, the organization of purchasing process and also will give the chance to optimize a number of our internal processes and it is essential to simplify interaction with other health facilities".

"You see how the self-assessment of employees in the eyes rises as in a new way they are positioned, perceived by colleagues of the and adjacent divisions. X-ray laboratory assistants (people of the most different age and level of acquaintance to IT technologies) who were trained still yesterday and radiologists get to work already today, receive much broader spectrum of tasks and opportunities for accounting of specific requirements of clinical physicians which benefits from the carried-out automation are rather obvious too. For example, when instead of several hundred axial KT-images (which clinical physicians learn "to read" not one year) you can provide them evident, high-quality three-dimensional reconstruction and mass of tools for studying of the revealed changes, it considerably facilitates understanding of an essence of pathological process and reduces time of adoption of adequate clinical solutions. We thought of this project long before in broad use the words "upgrade of medicine" appeared. I can tell already today that the AGFA IMPAX system meets our very high requirements in spite of the fact that we, in fact, only began learning process. Began to realize those opportunities which we did not have earlier and which now we can implement in practice, for example, such as use of a number of instruments of the automated diagnostics (CAD) when carrying out screening, etc. Therefore reasonably I believe that already in a year, it will be possible to add still a lot of things to told above", – Mrs. Vishnyakova does the forecast.

"Today we had an opportunity of viewing all researches of the patient executed in different modalities that is convenient both to diagnosticians, and clinical physicians, – the senior research associate of radiological department of MONICA Elena Stepanova emphasizes. – On color monitors of diagnostic quality it is possible "to twist" difficult graphic reconstruction, to synchronize an output of images on reference points, to see visually (in the animated type) and to estimate dynamics. At the same time it is not necessary to look for anything, everything is available on mouse click. It not only accelerates and facilitates workflow, but also in general improves final quality of treatment, allows to carry out scientific work on radiodiagnosis and to teach at the modern technology level".

During the project joint work of medical personnel and GU MONICA'S engineers with a project team of CROC, VITAKO and AGFA with involvement to it also of representatives of manufacturing companies of the different equipment was organized. Annual warranty service means the round-the-clock technical support, carrying out personnel training of MONICA by the employee of AGFA HealthCare working at its territory and can be prolonged at the request of the customer.

The shrinking algorithm and storage system are constructed in such a way that at transfer and storage of data any byte of information is not lost that it is necessary for use of high-quality medical images for the purpose of radiological diagnostics and providing medical services of the telepresence level. Data exchange in the GU MONICA medical complex is constructed on the basis of the IHE profiles (using the DICOM 3.0 protocols, etc.). The IMPAX system is constructed on modularity that considerably simplifies its operation and allows to increase an easy way functionality in process of emergence in it requirement at medical institution, according to the available development plans for infrastructure of GU MONICA. The complex of the installed server hardware includes the module allowing to scale the constructed IC, to integrate it with other health facilities of the Moscow region and other regions.