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Maximizing the Power of Centricity PACS Audit Data

Maximizing the Power of Centricity PACS Audit Data. Bill Gregg, MS, CIIP, CPSA PACS Administrator/IIP LSU Health Sciences Center Shreveport, LA.

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Maximizing the Power of Centricity PACS Audit Data

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  1. Maximizing the Power of Centricity PACS Audit Data Bill Gregg, MS, CIIP, CPSA PACS Administrator/IIP LSU Health Sciences Center Shreveport, LA

  2. The materials, presentations and content herein are the opinions and experiences, and represent the views, of the specific authors and presenters and are not statements of advice, opinion or information of GE Healthcare. Neither the materials, presentations nor content therein have been prepared, screened, approved, reviewed or endorsed by GE Healthcare.

  3. Overview • Start Simple • Historical perspective • Basic concepts regarding events and data • Look at basic data with the PACS Auditor • Finish up with workflow analysis • Goal is to give everyone something to take home today

  4. Getting Started • HIPAA (2004) – audit access to PHI • With Centricity 2.0 GE started providing XML audit log files • Direct conversion of XML to Excel wasn’t working for me • Wanted to work in the .NET environment • Used Visual Basic .NET to read audit files and load into MS Access

  5. Getting Started • First version of the PACS Auditor application Nov 2004 • IHE value growing, looked at ATNA • Used this platform for a poster presentation at SCAR/SIIM 2005 that was later published in the JDI • Found data useful for QC as well • What else can we do with this?

  6. Time Line • 11/04 Created first iteration of Audit Log app • 4/05 SCAR/SIIM GE/Eric Feingold talk • 7/06 Offered PACS Audit Log app as open source to GE User Community (SupportCentral) • 11/07 Added workflow analysis

  7. Talk Objectives • Objective 1: Understand how to get Centricity audit log files and what is in them   • Objective 2: Understand ways to access and manipulate the data   • Objective 3: Understand how to utilize this data to support HIPAA requirements and QC efforts

  8. Database Audit Log XML file Elements/Attributes Events ENM Table MS Visual Basic .NET MS Visual Studio MS Access MS SQL Server/SSE Oracle, Sybase Term Definitions

  9. Why Care About Audit Data? • To satisfy HIPAA requirements • Who looked at what • To support QC projects • Who verified/dictated that exam?! • Who rejected those images? • How long does it take to verify an exam?! • To Monitor DICOM events (not implemented) • Who created/changed KIN, ED, PGI • To support ILM (Information LifeCycle Management) (not yet implemented) • Who created/implemented/changed rules • What exams were deleted/moved

  10. Hugged Your Audit Data Today? • Audit data has a lot of value today • As more information is added to it, more value will be derived tomorrow

  11. Level I: The Basics • GE documents on audit data, events and fields (documentation folder) • What does this show us • How can we utilize the data (xml, spreadsheets, db)

  12. Centricity 2.0 • Centricity RA1000, some Exam Manager events logged • Start with initial set of audit data • Order event is not included • Must set 4 of the events in CA Tool • LogIn/Out, Exam Print, Exam View

  13. Centricity 2.1.x • Started capturing events from Centricity Web connections also • Added additional events in 2.1.3 that must be set in the CA Tool • User\ Created, LoginFailure, RoleChanged, StatusChanged, PasswordChanged, ExamPresentationSaved, ReportViewed • Some quirks where didn’t complete the XML file • Order event not included

  14. Centricity 3.0 • Added additional data events/elements that must be set in CA Tool • Order event now included giving the complete picture • Important shift in architecture to a DICOM view in v3.x • This allows us to start capturing data regarding DICOM events • Take a look at the events

  15. Basics • Note that in Exam Manager, EM and PM events are logged, as well as status changes (such as verify, unverify etc.), but no event if change patient name or MR directly. • Also note that my app now includes the 2.x/3.x events and data fields.

  16. Audit Files • XML files • File structure • How do you get them? (your FE) • Be aware that the ENM table only holds a set number of days of data, it is NOT a permanent repository • That is why they give it to you • Also be aware that the event data is 2 days behind

  17. Level I Summary • Basic terms • PACS Audit Events/data from ENM • Getting the audit log files from GE • Discussed version differences • Looked at XML file

  18. Level II: Tools • Have basic understanding of the audit data • Multiple ways to access the data • Multiple tools to access the data • PACS Auditor tool on SupportCentral site

  19. Installing the Audit Logger • Documentation (go ahead, read it…) • Need to have .NET 2.0 installed • File location structure • Issue with fixed db locations • Fix using UDL files • Need to change driver for Access 2007 • Just need to re-link tables in Access fe

  20. Auditor Trivia Game! • Frontend/Backend database • Access allows a file size of about 2 Gb • This holds approximately 2.9 million audit records (currently on my 3rd) • You can create front ends that limit access • You can implement some reasonable security

  21. Your ‘PAL’ • Loading files • Safeguards • Troubleshooting

  22. The ‘PACS Auditor’ Database • Basic front end (GUI) for immediate queries • Search fields • How the date fields work • Report buttons • Exam 2020, Patients 1228, 2003

  23. Level III: Workflow • Have basic reporting capabilities that can help address HIPAA requirements • Can answer basic questions about who did what using discrete event data • Take the data and extract more information from it by looking at time spans between events

  24. Workflow Reports • Going past event data to look at workflow • Time Reports • Issues with data • Start and end dates can caused partial spans • Accession range more complete • Skipped status levels (Arrived-Dictated etc.) • Manual manipulations (Unverify, Verify) • How these affect counts

  25. Update for 2.x/3.x Data • Completed the update to include 2.x/3.x data fields • Requires a database conversion • Will need to load prior archived db’s into a new empty database • New db won’t hold entire old ‘full’ db • Created routine to help import, but IMPORTANT to follow the documentation

  26. Future Work • Create new reports/views based on 2.x/3.x data fields • Login Failures • Image rejects • Any other suggestions? • Move from Access to SQL Express/SQL Server • Build in creation of summary data for use with pivot tables • Create de-identified data sets for research use

  27. Summary • Centricity PACS audit data • Satisfying HIPAA requirements • Satisfying basic QC needs • Using the Time Reports to satisfy advanced QC needs

  28. We Can Maximize the Power of Centricity PACS Audit Data

  29. Where is it? • Both the documentation and the application can be downloaded from GE’s SupportCentral site or our Radiology site • Everything we talked about today is in the documentation • You get it all as an open source app, but it can be used ‘out of the box’. • No logo’s in it, you can put in your own!

  30. Protected Healthcare Information • Have proper policies and procedures set up for access to this data • Limit user access where you can with specific front end forms

  31. Contact Information • Do have a day job, there is documentation • bgregg@lsuhsc.edu • http://www.shreveportradiology.com/department/pacs/downloads (look at end of list) • Also have a forum on the GE SupportCentral site

  32. Thank you for joining this presentation today. Any Questions?

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