echoes™: Electronic Case Handling and Order Entry System
In 1996, Medstrat went into business to provide the industry's first PACS designed specifically for the unique needs of orthopedic surgeons and their practices. It all started when the echoes project fulfilled a concept to provide electronic case handling for orthopedic surgeons and to provide a means for small offices to do order entry without the need for large electronic medical record system.
CR: Computed Radiography
Computed Radiography (CR) uses very similar equipment to conventional radiography except that in place of a film to create the image, an imaging plate (IP) made of photostimulable phosphor is used. The imaging plate housed in a special cassette and placed under the body part or object to be examined and the x-ray exposure is made. Hence, instead of taking an exposed film into a darkroom for developing in chemical tanks or an automatic film processor, the imaging plate is run through a special laser scanner, or CR reader, that reads and digitizes the image. The digital image can then be viewed and enhanced using software that has functions very similar to other conventional digital image-processing software, such as contrast, brightness, filtration and zoom.
DR: Digital Radiography
Digital Radiography (DR) is essentially filmless X-ray image capture. In place of X-ray film, a digital image capture device is used to record the X-ray image and make it available as a digital file that can be presented for interpretation and saved as part of the patient’s medical record. The advantages of DR over film include immediate image preview and availability, a wider dynamic range which makes it more forgiving for over- and under-exposure as well as the ability to apply special image processing techniques that enhance overall display of the image. The largest motivator for healthcare facilities to adopt DR is its potential to reduce costs associated with processing, managing and storing films. Typically there are two variants of digital image capture devices. These devices include Flat Panel detectors (FPDs), and High Density Line Scan Solid State detectors.
XA: X-Ray Angiography
A medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body, with particular interest in the arteries, veins and the heart chambers. This is traditionally done by injecting a radio-opaque contrast agent into the blood vessel and imaging using X-ray based techniques such as fluoroscopy.
XR: X-ray
Radiography started in 1895 with the discovery of X-rays, also referred to as Röntgen rays after Wilhelm Conrad Röntgen who first described their properties in rigorous detail. These previously unknown rays (hence the X) were found to be a type of electromagnetic radiation. It wasn't long before X-rays were used in various applications, from helping to fit shoes, to the medical uses that have persisted. X-rays were put to diagnostic use very early, before the dangers of ionizing radiation were discovered. Indeed, Marie Curie pushed for radiography to be used to treat wounded soldiers in World War I. Initially, many kinds of staff conducted radiography in hospitals, including physicists, photographers, doctors, nurses, and engineers. The medical specialty of radiology grew up over many years around the new technology. When new diagnostic tests were developed, it was natural for the radiographers to be trained in and to adopt this new technology.
Radiographers now often do fluoroscopy, computed tomography, mammography, ultrasound, nuclear medicine and magnetic resonance imaging as well. Although a non-specialist dictionary might define radiography quite narrowly as "taking X-ray images", this has long been only part of the work of "X-ray departments", radiographers, and radiologists.
NM: Nuclear Medicine
Nuclear medicine is a branch of medicine and medical imaging that uses radioactive isotopes (radionuclides) in the diagnosis and treatment of disease. Nuclear medicine thus relies on the process of radioactive decay. Molecular imaging may employ nuclear medical techniques when it uses radioisotopes to produce images that reflect biological processes that take place at the cellular and sub cellular level.
Nuclear medicinal tests differ from most other imaging modalities in that diagnostic tests primarily show the physiological function of the system being investigated as opposed to traditional anatomical imaging such as CT or MRI. In some centers, the nuclear medicine images can be superimposed, using software or hybrid cameras, on images from modalities such as CT or MRI to highlight the part of the body in which the radiopharmaceutical is concentrated. This practice is often referred to as image fusion or co-registration.
CT: Computed Tomography
Computed tomography (CT) is a medical imaging method employing tomography. Digital geometry processing is used to generate a three-dimensional image of the inside of an object from a large series of two-dimensional X-ray images taken around a single axis of rotation. The word "tomography" is derived from the Greek tomos (slice) and graphein (to write). Computed tomography was originally known as the "EMI scan" as it was developed at a research branch of EMI, a company best known today for its music and recording business. It was later known as computed axial tomography (CAT or CT scan) and body section röntgenography.
MR: MRI, Magnetic Resonance Imaging
A medical imaging technique most commonly used in radiology to visualize the internal structure and function of the body. MRI provides much greater contrast between the different soft tissues of the body than computed tomography (CT) does, making it especially useful in neurological (brain), musculoskeletal, cardiovascular, and oncological (cancer) imaging. Unlike CT, it uses no ionizing radiation, but uses a powerful magnetic field to align the nuclear magnetization of (usually) hydrogen atoms in water in the body. Radio frequency (RF) fields are used to systematically alter the alignment of this magnetization, causing the hydrogen nuclei to produce a rotating magnetic field detectable by the scanner. This signal can be manipulated by additional magnetic fields to build up enough information to construct an image of the body.
US: Ultrasound
Ultrasound is cyclic sound pressure with a frequency greater than the upper limit of human hearing. Although this limit varies from person to person, it is approximately 20 kilohertz (20,000 hertz) in healthy, young adults and thus, 20 kHz serves as a useful lower limit in describing ultrasound. The production of ultrasound is used in many different fields, typically to penetrate a medium and measure the reflection signature or supply focused energy. The reflection signature can reveal details about the inner structure of the medium. The most well known application of this technique is its use in sonography to produce pictures of fetuses in the human womb.
DICOM: Digital Imaging and Communications in Medicine
DICOM is a standard for handling, storing, printing, and transmitting information in medical imaging. It includes a file format definition and a network communications protocol. The communication protocol is an application protocol that uses TCP/IP to communicate between systems. DICOM files can be exchanged between two entities that are capable of receiving image and patient data in DICOM format. The National Electrical Manufacturers Association
(NEMA) holds the copyright to this standard.
DICOM enables the integration of scanners, servers, workstations, printers, and network hardware from multiple manufacturers into a picture archiving and communication system (PACS). The different devices come with DICOM conformance statements which clearly state the DICOM classes they support.
HL7: Health Level 7
The name "Health Level-7" is a reference to the seventh "application" layer of the ISO OSI Reference model. The name indicates that HL7 focuses on application layer protocols for the health care domain, independent of lower layers. HL7 effectively considers all lower layers merely as tools.
IHE: Integrating the Healthcare Enterprise
IHE is an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information. IHE promotes the coordinated use of established standards such as DICOM and HL7 to address specific clinical needs in support of optimal patient care.
CCOW: Clinical Context Object Workgroup
An HL7 standard protocol designed to enable disparate applications to synchronize in real-time, and at the user-interface level. It is vendor independent and allows applications to present information at the desktop and/or portal level in a unified way. CCOW is the primary standard protocol in healthcare to facilitate a process called "Context Management." Context Management is the process of using particular "subjects" of interest (e.g., user, patient, clinical encounter, charge item, etc.) to 'virtually' link disparate applications so that the end-user sees them operate
in a unified, cohesive way.
HIS: Hospital Information System
A hospital information system (HIS), variously also called clinical information system (CIS) is a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital. This encompasses paper-based information processing as well as data processing machines.
It can be composed of one or a few software components with specialty-specific extensions as well as of a large variety of sub-systems in medical specialties (e.g. Laboratory Information System, Radiology Information System).
RIS: Radiology Information System
A radiology information system (RIS) is a computerized database used by radiology departments to store, manipulate and distribute patient radiological data and imagery. The system generally consists of patient tracking and scheduling, result reporting and image tracking capabilities.
Radiology information systems commonly support the following features:
* Patient Registration and scheduling
* Patient List Management
* Interface with modality via Worklist.
* Radiology Department workflow management
* Request and document scanning
* Result(s) Entry
* Reporting and printout
* Result(s) Delivery including faxing and e-mailing of clinical reports
* Patient Tracking
* Interactive Documents
* Technical Files Creation
* Modality and Material management
PACS: Picture Archiving and Communication System
Computers or networks dedicated to the storage, retrieval, distribution and presentation of images. The medical images are stored in an independent format. The most common format for image storage is DICOM (Digital Imaging and Communications in Medicine).
PACS has two main uses:
(1) Hard copy replacement: PACS replaces hard-copy based means of managing medical images, such as film archives. With the decreasing price of digital storage, PACSs provide a growing cost and space advantage over film archives in addition to the instant access to prior images at the same institution. Digital copies are referred to as Soft-copy.
(2) Remote access: It expands on the possibilities of conventional systems by providing capabilities of off-site viewing and reporting (distance education, telediagnosis). It enables practitioners in different physical locations to access the same information simultaneously for teleradiology.
EMR: Electronic Medical Record
In health informatics and most contexts, EMR and EHR (electronic health records) are used synonymously, but many people define an EMR as just the physician interface and EHR including both a physician and patient interface. The term has sometimes included other systems which keep track of medical information, such as the practice management system which supports the electronic medical record.
PMS: Practice Management Software
PMS is a category of software that deals with the day-to-day operations of a medical practice. Such software frequently allows users to capture patient demographics, schedule appointments, maintain lists of insurance payers, perform billing tasks, and generate reports. In the United States, most PMS systems are designed for small to medium-sized medical offices. Some of the software is designed for or used by third-party medical billing companies. PMS is often divided amongst desktop-only software, client-server software, or Internet-based software.
PMS is often connected to electronic medical records (EMR) systems.
While some information in a PMS and an EMR overlaps, for example, patient and provider data in general the EMR system is used for the assisting the practice with clinical matters, while PMS is used for administrative and financial matters. Medical practices often hire different vendors to provide the EMR and PMS systems. The integration of the EMR and PMS software is considered one of the most challenging aspects of the medical practice management software implementation.
EHR: Electronic Health Record
An electronic health record (EHR) refers to an individual patient's medical record in digital format. Electronic health record systems co-ordinate the storage and retrieval of individual records with the aid of computers. EHRs are usually accessed on a computer, often over a network. It may be made up of electronic medical records (EMRs) from many locations and/or sources. Among the many forms of data often included in EMRs are patient demographics, medical history, medicine and allergy lists (including immunization status), laboratory test results, radiology images, billing records and advanced directives.