759 VI – New Imaging Applications and Technologies

1. 759 VI – New Imaging Applications and Technologies

2. Introductions Scott Madsen, Chief of Clinical Services Larry Carlson, Project Manager for VistA Imaging Maryann Shovestul, Project Manager for VistA Imaging Dr Ruth Dayhoff, MD, VHA, VistA Imaging

3. Development Team

4. Other Key Imaging Staff

5. Year in Review • During FY10 the following patches were released or are soon to be released • MAG*3*54 DICOM Maintenance IV • MAG*3*101 VistARad Maintenance V • MAG*3*93 Clinical Display Maintenance II • MAG*3*111 Broker Security Enhancements • MAG*3*83 VistA Imaging Exchange Service • MAG*3*53 DICOM Import • RA*5*90 Radiology Order and Exam API • MAG*3*90 VistARad Maintenance • MAG*3*94 Clinical Capture Maintenance • MAG*3*108 Import API • MAG*3*49 HL7 ADT Interface • RA*5*47 Standardize VistA RIS Messaging Interface • MAG*3*39 Background Processor Enhancements • MAG*3*114 Telereader Configurator • MAG*3*66 DICOM Query Retrieve • MAG*3*98 Site Storage Utilities

6. Document & Ancillary Imaging

7. Document and Ancillary Imaging

8. Document and Ancillary Imaging

9. Filmless Radiology VistARad

10. Filmless Radiology

11. Filmless Radiology

12. VA/DoD Image Sharing

13. VA/DoD Image Sharing

14. VA/DoD Image Sharing

15. Core Infrastructure

16. Core Infrastructure

17. Core Infrastructure

18. Core Infrastructure

19. Core Infrastructure

20. Core Infrastructure

21. Storage Architecture

22. Storage Architecture

23. Storage Architecture

24. Telemedicine

25. Telemedicine

26. Telemedicine

27. New Features for Telemedicine Dr. Ruth Dayhoff, MD

28. The Basic Elements of Telemedicine for Many Different Specialties CPRS Tele Reader VistA Imaging

29. New Features for Telemedicine • New Specialties • TeleDermatology • TelePathology • TeleWound Care • Ability to Create DICOM Standard Images in VistA Imaging • Improved TeleReader Capabilities • Annotations • New Graphical Interface for TeleReader Configuration • New Terminologies • Body Parts • Laterality • Study Description

30. Primary Care Clinic Visit • No dermatologist is available • A consult is ordered • Photographs are taken and attached to local consult at the clinic • Regional dermatologist can take the case • Similar procedure if a dermatologist requests a Second Opinion

31. Provider Orders a Teledermatology Consult

32. Dermatology Images are Transferred to VistA Imaging Import Directory Camera Drag and Drop Patient’s Images to Import Directory List Camera Chip

33. Select and Capture Images Individually or in Batch Mode

34. DICOM Images Created Automatically When Capture Button Clicked • Only two pieces of information must be provided by the user:

35. Imported Images Stored in DICOM Format • Information placed in DICOM Image Header • Patient and study information • Allows information to be a permanent part of the image • Still necessary to put ruler in the camera shot to gauge size

36. TeleReader Configuration Tools Enhanced

37. Reading Studies with TeleReader • Lock the study

38. Imaging, CPRS & Telereader Automatically Open to Patient

39. Image Annotation Arrow Line Rectangle Letters Free hand Oblong Ruler Square Circle Tools

40. Templates Can Be Used in Resulting the Consult

41. Specialist Documents Observations in Interfacility Consult

42. Consult Completed in CPRS

43. Completed Study Appears on TeleReader READ List

44. Many Emerging Bio Technologies May Benefit from Telemedicine Capabilities • New non-invasive melanoma screening using skin heat signatures (JHU) • New glaucoma testing techniques that identify chemical changes in the cells at an early stage that indicate glaucoma is present (VACPTVL) • Use of fluorescent and magnetic tags to identify tumor cells and reduce those remaining after treatment (UCSD)

45. Questions?