Geneva PACS Project: A Hospital-wide Integrated System
The development of a hospital-wide PACS project is currently underway at the University Hospital of Geneva. This system is designed to handle radiological as well as non-radiological medical images and is fully integrated with the Hospital Information System (HIS) Diogène developed in our institution. It is based on a multi-vendor open architecture and a set of widely available industry standards, namely: Unix as the operating system, TCP-IP as network protocol and an SQL-based distributed database (INGRES) that handles both the PACS and the HIS. The PACS is based on a distributed architecture of servers of two types: the Archive Servers connected to the sources of images and equipped with large optical disk libraries (Juke Boxes) and Display Servers distributed over the hospital. A standard image storage format was developed based on the ACR-NEMA standard. This file format called the PAPYRUS format, allows to store sets of images as a sequence of ACR-NEMA messages in an “encapsulated” file structure. In order to provide a more uniform user interface on a variety of different workstations a common platform for image display and manipulation called OSIRIS is developed based on X-11 windowing system and OSF/Motif extension. Such a platform is designed to be portable to any computer running Unix and equipped with a graphic display system running X-11. The current configuration comprises a first cluster of an Archive Server connected to 2 CT scanners, an MRI scanner and a ultrasound unit. A Display Server supports a high resolution workstation with two 2Kx2K displays and several workstations with single 1Kx1K display. A concurrent project is underway for the implementation of multimodality workstations in intensive care units. These workstations will provide access to digital images, patient monitoring data, lab results and nursing observations. A second PACS cluster for emergency room is under development. Future plans include the integration of images from digital angiography and Cardiology, Nuclear Medicine and images from non radiological sources such as protein electrophoresis, autoradiography and histological images.
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