Imaging Science and Informatics – Deals with issues in the informatics used in medical

imaging and radiology.

HISTORY OF COMPUTERS

 Abacus - was the earliest calculating tool invented thousands of years ago in China and
still used in some parts of Asia.
 17th century- two mathematicians, Blaise Pascal and pegged wheels that could perform
the four basic arithmetic functions of addition, subtraction, multiplication and division.
 1842- Charles Babbage designed an analytical engine that perform general calculations
automatically.
 1890 - Herman Hollerich designed a tabulating machine to record census data. The
tabulating machine stored information as holes on cards that were interpreted by
machines with electrical sensors. Hollerich’s company later grew to become IBM.
 1939 - John Atansoff and Clifford Berry designed and built the first electronic digital
computer.
 December 1943 - the British built the first fully operational working computer, called
Colossus, which was designed to crack encrypted German military codes.
 The first general- purpose modern computer was developed in 1944 at Harvard University.
Originally called Automatic Sequence Controlled Calculator (ASCC), it is now known simply
as the Mark 1. it was an electromechanical device that was exceedingly slow and was
prone to malfunction.
 1946 - The first-general purpose electronic computer was developed at the University of
Pennsylvania by J. Presper Eckert and John Mauchly at a cost of 500,000 dollars.
 1948 - scientists led by William Shockley at the Bell Telephone Laboratories developed the
transistor- a transistor is an electronic switch that alternately allows or does not allow
electronic signals to pass.

1. First –generation computers - were vacuum tube devices (1939-1958)

2. Second-generation computers - became generally available in about 1958, were based
on individually packaged transistors.
3. Third-generation computers - used integrated circuits (Ics), which consist of many
transistors and other electronic elements fused onto a chip- a tiny piece of semi –
conductor material, usually silicon. These were introduced in 1964. The microprocessor
was developed in 1971 by Ted Hoff of Intel Corporation
4. Fourth-generation computers - which first appeared in 1975, was an extension of the
third generation and incorporated large-scale integration (LSI); this has now replaced
 by very large-scale integration (VLSI), which places millions of circuit elements on a chip
that measures less than 1 cm.

Hardware - is everything about the computer that is visible-the physical components of the
system that includes the various input and output devices. Usually categorized according to
which operation it performs. Operations include input processing, memory, storage, output,
and communications.

Bit - a single binary digit, 0 or 1. Depending on the microprocessor, a string of 8,16,32, or 64

bits is manipulated simultaneously.

 The 26 characters of the alphabet and other special characters are usually encoded by
8 bits
 Bits often grouped into bunches of eight called bytes.
 Computer capacity is expressed by the number of bytes that can be accommodated.
 One kilobytes (kB) is equal to 1024 bytes.

 is the sequence of instructions developed by a software programmer or computer

programs are the software of the computer.

a) Systems software
b) Application programs

SYSTEMS SOFTWARE - consists of programs that make it easy for the user to operate a
computer to its best advantage. Also known as the operating system (OS).

 MAC-OS, Windows, and Unix are popular operating system.

APPLICATION PROGRAMS - are those written in a higher level language expressly to carry
out some user function by a computer manufacturer, by a software manufacturer or by the
user themselves to guide the computer to perform a specific task.

Examples: iTunes, Spider Solitaire, and Excel.

Central Processing Unit (CPU) - is the primary element that allows the computer to manipulate
data and carry out software instructions.

Examples: The Intel Core i5 and AMD Phenom II

THE CT COMPUTER - A CT computer consists of four principal components:

a) an input device,
b) a CPU,
c) an output device,
d) and memory.

Input/output (I/O) devices - are ancillary pieces of computer hardware designed to place
raw data into a computer and received processed data from the computer.

 Input devices include: keyboard, tape, disk, CD-ROM, video display terminal, CT
detector, laser scanner, and plasma screen.
OUTPUT - Output devices include: video display terminal, laser camera, dry image processor,
printer, and image transmitter.
HARD COPY - refers to an image on film or printed.
SOFT COPY - means the image is displayed on a cathode ray tube (CRT), flat panel display,
or stored on magnetic or optical disk.
CPU - The brains of a computer are in the central processing unit (CPU), which contains the
microprocessor, the control unit, and the primary memory.
MICROPROCESSOR - The microprocessor is the “computer on a chip”, or wafer, of silicon
fabricated into many diodes and transistors.
CONTROL UNIT - The control unit interprets instructions, sequences tasks, and generally runs
computer functions.
SOLID STATE MEMORY
 RAM (Random Access Memory)
 ROM (Read Only Memory),
 WORM (Write One Read Many times
memory)
Primary memory- exists as read only memory (ROM) or random access memory (RAM) to
store data as it is used in computations.
Primary memory may be on the CPU or on an additional circuit board.
 Primary memory is solid state, made of silicon (semiconductor) technology, and very
fast but limited in size.

Secondary Memory - is required when primary memory is insufficient and when data needs
to be transferred to another location.
  Secondary memory is useful for bulk storage of information, such as images.
 Secondary memory can be on-line as with magnetic hard drive disk or off-line as
with magnetic tape and magnetic or optical disk.
ANALOG-TO-DIGITAL CONVERTER (ADC)-
is a special type of computer that
converts the analog signal from each CT
detector to a digital form for computer
manipulation.

ARRAY PROCESSOR - is a special type of computer that is designed to do only a

special task, such as image reconstruction, and it does that task very fast.

a) PROM
b) EPROM
c) EEPROM

PROM (programmable read-only memory) - chips are blank chips that a user, with special
equipment, can write programs to. After the program is written, it cannot be erased.
EPROM (erasable programmable read-only memory) - chips are similar to PROM chips
except that the contents are erasable with the use of a special device that exposes the
chip to ultraviolet light.
EEPROM (EEPROM (electronically erasable programmable read-only memory) - can be
reprogrammed with the use of special electron impulses.

 Medical imaging involves radiological, nuclear, photon and positron emission,

nuclear magnetic resonance, ultrasound and light photon images.
 However, concepts and image quality measurement techniques of these various
types of image are derived from conventional radiographic imaging and
fundamental digital image processing principles.
Digitization - is a process that quantizes or samples analog signals into a range of digital
values. Digitizing a picture means converting the continuous gray tones in the picture into a
digital image.

 About 60% to 70% of radiological examinations, including skull, chest, breast,

abdomen, bone, and mammogram are captured on X-ray films or radiographs,
computed radiography (CR), and digital radiography (DR) techniques.

 Projection radiography - The process of projecting a three-dimensional body into a

two dimensional image.
 An X-ray film can be converted to digital numbers with a film digitizer.
 The laser scanning digitizer is the gold standard among digitizers because it can
best preserve the resolutions of the original analog image.
 Recently developed direct X-ray detectors can capture the X-ray image without
going through an additional medium like the imaging plate.
 This method of image capture is sometimes called direct digital radiography (DR).

Images obtained from the other 30% to 40% of medical imaging

examinations—
including computed tomography (CT),
2. nuclear medicine (NM),
3. positron emission tomography (PET),
4. single photon emission computed tomography (SPECT),
5. ultrasonography (US),
6. magnetic resonance imaging (MRI),
7. 7. digital fluorography (DF),
8. 8.digital subtraction angiography (DSA)
 - are already in digital format when they are generated.

 Test objects or patterns (sometimes called phantoms) used to measure the density
and spatial resolutions of radiological imaging equipment can be either physical
phantoms or digitally generated patterns.

is used to measure the performance of a digital radiological device. It is usually

constructed with different materials shaped in various geometrical configurations
embedded in a uniform background material (e.g., water or plastic).
 The commonly used geometrical configurations are circular cylinder, sphere, line
pairs (alternating pattern of narrow rectangular bars with background of the same
width), step wedge, and star shape.
 The materials used to construct these configurations are lead, various plastics, water,
air, and iodine solutions of various concentrations.

 is an ideal digital image. Any distortion of these images observed from the display is
a measure of the imperfections of the display component.
 SMPTE (Society of Motion Picture and Television Engineers) – the most common used
digital phantom.
 - is a measure of the performance of an imaging system that produces the
image for a specific medical examination.

 Although the process of making a diagnosis from a medical image is often subjective,
higher quality image does yield better diagnostic information.

 Conventional projection radiography accounts for 60% to 70% of the total number of
diagnostic imaging procedures.
 Therefore, to transform radiology from film based to a digital-based operation, we must
understand
1. radiology workflow,
2. conventional projection radiographic procedures,
3. analog-to-digital conversion, and
4. digital radiography.

 Picture archiving and communication system (PACS) is a system integration of both

patient workflow and diagnostic components and procedures.
 A thorough understanding of radiology workflow should allow efficient system
integration, and hence a better PACS design for the radiology department and the
hospital operation.
 Radiology workflow can vary from department to department and hospital to hospital.
For these reasons workflow analysis is the first step for PACS design and implementation.

1. New patient arrives at hospital for radiological examination (exam).

2. Patient registers in Radiology area. If the patient in new, patient is registered in the
Hospital Information System (HIS).
3. Exam ordered at Radiology Information System (RIS) upon arrival at Radiology
registration desk. Exam accession number is automatically assigned, and a requisition
is printed.
4. Technologist receives information from clerk and calls the patient in the waiting area
for exam.
5. Patient escorted into the modality room.
6. Examination is performed by a technologist.
7. Examination is completed.
8. Clerk pulls out old films.
9. Clerk prepares all necessary papers and films for radiologist.
10. Films are hanged for radiologist’s review.
11. Radiologist reviews films (images), check examination record and dictates reports.
12. Transcriptionist types the draft report from the dictation.
13. Radiologist reviews the report and signs it off.
14. Final reports are input into RIS for clinician viewing.
 Essential environments of a medical imaging system.
 Image processing may be a post-imaging or pre-analysis operator.
 Functions of Image processing and Image analysis may overlap each other.

1. Quantification: Measuring the features on medical images, eg., helping radiologist

obtain measurements from medical images (e.g., area or volume).
 To make the features measurable, it is necessary to extract objects from images
by segmentation.
2. Computer Aided Diagnosis (CAD): given measurements and features make a
diagnosis. Help radiologists on their diagnosis procedure for accuracy and efficiency.

 incorporation of prior knowledge

 classification of features
 matching of model to sub-images
 description of shape
  many other problems and approaches of AI...

 Formal definition: A digital image is a multi-dimensional signal that is sampled in

space and/or time and quantized in amplitude.
 Looser definition: An image is a “picture." The brightness values in the picture may
represent distance, reflectivity, density, temperature, etc.

 For medical images, pixels may represent parameters such as: – X-ray attenuation
(density) – Water (proton) density – Acoustic impedance (distribution) – Optical
reflectivity (or impedance) – Electrical activity, etc. . . .

 Manual analysis: processed by human

 Semi-automatic analysis: human and computer work together to process
image.
 Automatic analysis: computer processes image, human reviews the results.

 Preprocess image to reduce noise and blur (filtering)

 Identify structures within the image (segmentation)
 Extract “useful” information from the image (quantification)
 Prepare the image for visualization (enhancement,
 reconstruction)
 Exact processing steps depend on the application.

1. Enhancement:
 Noise reduction
 Deblur
 Improve contrast
 Identify structures in image (segmentation)
 Identify homogeneous regions in an image (label image pixels = segmentation).
2. Measure:
For example:
 Heart chamber volumes
 Heart wall motion
 Brain activity
 Fetus size/gender
 Lesion size and extent
3. Visualize:
For example:
 Surgical/Therapy planning
 Image-guided surgery
1. Medical image processing - Deals with the development of problem specific
approaches to enhance the raw medical data for the purposes of selective visualization
as well as further analysis.
2. Medical image analysis
 Concentrates on the development of techniques to supplement the usually
qualitative and frequently subjective assessment of medical images by human
 experts.
 Provides quantitative, objective and reproducible information extracted from the
medical images.

1. Can’t distinguish between tissues

 The nature of the physiological system under investigation and the procedures
used in imaging may diminish the contrast and the visibility of details.
2. Data is too noisy for computer algorithm to perform well.

 Medical images are often deteriorated by noise due to various sources of

interference and other phenomena that affect the measurement processes in
imaging and data acquisition systems.

 Increase contrast
 Remove noise
 Emphasize edges: Edge boost, Unsharp masking.
 Modify shapes
 Image enhancement techniques range from linear to
 nonlinear, from fixed to adaptive, and from pixel-based to
 multiscale methods, …
Segmentation - separation of structures of interest from the background and from each
other, is an essential analysis function for which numerous algorithms have been
developed in the field of image processing.

 The principal goal of the segmentation process is to partition an image into regions
that are homogeneous with respect to one or more characteristics or features.
 Segmentation is an important tool in medical image processing, and it has been useful
in many applications.
 In medical imaging, segmentation is important for feature extraction, image
measurements, and image display.
 In some applications it may be useful to classify image pixels into anatomical regions,
such as bones, muscles, and blood vessels, while in others into pathological regions,
such as cancer, tissue deformities, and multiple sclerosis lesions.

 coronary border in angiograms

 multiple sclerosis lesion quantification
 surgery simulations
 surgical planning
 measurement of tumor volume and its response to therapy
 functional mapping, automated classification of blood cells
 study of brain development
 detection of micro calcifications on mammograms image registration
 atlas-matching
 heart image extraction from cardiac cineangiograms
 detection of tumors, etc.
1. BASED ON THE CLASSIFICATION SCHEME:
 Manual, semiautomatic, and automatic
 Pixel-based (local methods)
 region-based (global methods).
 Low-level segmentation (thresholding, region growing, etc.),
2. Model-based segmentation (multispectral or feature map techniques.
 Model-based techniques are suitable for segmentation of images that have
artifacts, noise, and weak boundaries between structures.

Image Visualization - Visualizations have always been used to:

 Study relationship between anatomical structure and function
 Detect and treat trauma and disease.
 Traditional visualizations were direct, via surgery, biopsy, or indirect, via extensive
mental reconstruction.
 The revolution in 3D/4D biomedical imaging (CT, MRI, PET) and computer
reconstruction and rendering provides new powerful opportunities.
 Image Processing and Visualization can help unlock critical information of objects
and their properties in medical images.

 Multi-modal 3D and 4D imaging from CT, MRI, PET, MEG, Ultrasound, Microscopy
have fueled developments in data differentiation, fusion, visualization
 Datasets are generally very large (mega-giga-tera bytes).
 Management, Processing, Analysis and Visualization requires high performance
computing.
 Advances in visualization technology will provide new tools/procedures that
physicians “must have” to treat patients.
 Quote from a physician, “If I can see it, I can fix it”
 Ability to see anatomical structures permits surgery planning, rehearsal, to minimize
trauma, avoid critical areas.
 Real-time interactive visualization, advanced display technologies including VR,
open new realms into medical practice.
 Images displayed and manipulated with immediacy, sufficient detail and speed to
evoke a sufficiently” real” experience.
 Interactive 3D environments permit physicians to view anatomy and function from
any viewpoint, make accurate online measurements.

Structure: From individual molecules, tissues and interstitial interfaces to complete

organs and organ systems;
Functional attributes: Biophysical, Biomechanical and physiological properties.

2D images from 3D/4D biomedical imaging

datasets can show.
 Original data
 No occlusion problems

DIFFICULTY: Optimal image plane might not

be possible:

 Limitations of the imaging system

 Need sophisticated reconstruction
techniques.

1. Surface-Based Volume Rendering:

Data is converted to geometric
primitives and a standard graphics
pipeline is used to render the volume;
Examples: Isosurfacing(Marching
Cubes, Dividing Cubes), Contour
connecting.

2. Direct Volume Rendering: Volume is

directly sampled and projected to the
final raster image (rendering).
Examples: Ray Casting, Projection Methods (VBuffer), Volume Splatting.

1. Data acquisition: Includes processing to increase data value range, contrast

enhancement, free of noise.
2. Aspect Ratio Adjustment: Volume dimensions correspond to physical dimensions of
the acquired data - may require interpolation, additional slice generation, estimate
missing values.

 Mapping operations: Transformation to geometric or display primitives.

 a complex computer network, it has been created to manage images. This network is
called a picture archiving and communication system (PACS) and can be likened to a
“virtual film library.”
 Images stored on digital media are housed in PACS archives.
 is a sophisticated array of hardware and software that can connect all modalities with
digital output (nuclear medicine, ultrasound, CT, MRI, angiography, mammography,
and radiography.
 All PACS, whether they span the entire enterprise or a localized within a department,
should also interface with exiting hospital information systems:
a) Hospital Information System (HIS)
b) Radiology Information System (RIS)
 There are several data flowing into PACS as inputs for next procedures and back to HIS
as results corresponding inputs.
 The information systems support the operations of an imaging department through
examination scheduling, patient registration, report archiving, and film tracking,
integration with PACS maintains integrity of patient data and records and promotes
overall efficiency.
 When PACS is used, instead of hard-copy radiographs that must be processed,
handled, viewed, transported, and stored, the softcopy digital images are processed
with the use of a computer, viewed on a monitor, and stored electronically.
 Most PACS use Web browsers to enable easy access to the images by users from any
location. Physicians may view these radiologic images from a personal computer at
virtually any location, including their home.

A. PACS resolves many of the problems that were associated with film. Film could only
be available in one place at a time and would frequently result in delayed patient
care if was not immediately available to the referring physician.
B. With PACS, patient studies can be viewed from any computer at any of our facilities
or from a referring physician’s office.
C. PACS also allows the radiologists to read studies performed at any of our facilities, from
any of our facilities, making them much more efficient and greatly reducing the turn
around time for report dictation.

 Faster delivery of medical images.

 Ability to report whenever you have free time.
 Reliable quality of images. Unlike film, there will never be any black spots on image
due to bad light.
 Flexible viewing with the ability to manipulate images on the screen which allows for
better analysis.
 Instant access to historic images and patient records, which enables the comparison
of patient images (old and new) and thus the measuring of the effectiveness of their
treatment or the development of their condition.
 Better collaboration, as PACS can be viewed from multiple terminals and locations
at the same time.
Improved learning and training chances, both for trainee radiologist as they develop
their skills and for existing radiologists as there is more chances to collaborate with
colleagues and share learning and experience

 Radiographers can very quickly determine the quality of the image taken.
 As a result of electronic requesting, radiographers have all the necessary information
available to them in digitalized format.
 Information only needs to be entered into the system once.
 Radiographers experience lower radiation doses, as PACS reduces the need for
repeat examinations.
 The ability to manipulate images once they are taken means that radiographers can
zoom in on areas of interest to ensure adequate information has been captured.
 PACS contributes to a better working environment, as the lack of film processing will
result in a quieter and chemical free workspace.

Non-radiology consultants will be affected by PACS, as this system contributes to the

following:
 Fewer wasted appointments and postponed procedures because of non-
availability of patient images.
 Instant access to patient images, regardless of location.
 Better collaboration and an increase in consultation between radiologist and
clinicians.
 Experience shows patients better informed when they can see their images on
screen, this can lead to better quality consultations for both the patient and the
consultant.
 For hospital managers.
 PACS frees up valuable space within a hospital as storage rooms will no longer be
needed for film.
 Administrative staff, responsible for image retrieval and filing, are be freed up to
undertake more productive tasks.
 Patients are processed more quickly with fewer delays.

The benefits of PACS for patients include:

 Not having to carry packets of film around the hospital and between sites.
 Less waiting to receive results a speedier move to the next point of treatment.
 Fewer appointments wasted and operations postponed because of non-availability
of images as a result of lost or poor quality images.
 Less re-testing, and therefore, lower radiation dosage
 Quicker discharge from hospital and better care planning resulting from easier
access to images and test results.
 PACS have been in existence for several years and have become an integral part
of the infrastructure of radiology and imaging departments across the world.
 PACS is a key workflow tool in the functioning of radiology departments worldwide,
today, and its utilization is rapidly growing. The key challengers in PACS
implementation are related to vendor and feature selection, integration with existing
HIS, user training, maintenance and scalability to meet increasing demands.
Additionally, the networking requirements that PACS imposes on hospital networks
are not insignificant.

 The practice of radiology is a complex system that includes generation of images

with multiple modalities, image display, image interpretation and reporting, and
image file management.
 Organizational systems that enable efficient functioning in small departments often
fail as departments grow larger.
 The development of systems to meet increasingly complex needs will be
challenging, the promise of a PACS is its ability to improve operational efficiency
while maintaining on improving
high diagnostic ability.
  The RIS is a computerized system used by radiology departments to store, manipulate
and distribute patient radiological data and imagery.
 A modern Radiology Information System (RIS) is a pre-requisite for the efficient
management of a department of Radiology.
 The system generally consists of patient tracking and scheduling, result reporting and
image tracking capabilities.
 Used to support both administrative and clinical operations.
 RIS complements HIS (Hospital Information Systems) and are critical to efficient
workflow to radiology practices.
 While RIS improves workflow and streamlines processes, systems such as PACS
provide storage and a long-term option for the management of patient
information. PACS also provides features and tools for advanced image
manipulation. RIS and PACS, therefore, act as two complementary systems and are
integrated in most radiology clinics.

1. The Digital Imaging and Communications in Medicine (DICOM)- standard specifies

a non-proprietary data interchange protocol, digital image format, and file structure
for biomedical images and image-related information.

2. DICOM was originally developed by the National Electrical Manufacturers

Association (NEMA) and the American College of Radiology for computerized axial
tomography (CAT) and magnetic resonance imaging (MRI) scan images.
3. Vendor Neutral Archive (VNA), in health information technology context, is a
medical imaging technology used by healthcare professionals that stores images in
a standard format and interface, making medical imaging data accessible through
different picture archiving and communication systems (PACS).

 Storing – Stores images obtained from RIS imaging devices and any other relevant
patient information on the database.
 Image Tracking – RIS enables keeping track of images obtained from medical
imaging devices and related patient data.
 Sharing – Enables distribution of medical images and patient data. Collaboration
between physicians is facilitated by enabling access to documents to anyone within
the computer network when RIS is integrated with a local software solution, or to
anyone with internet access when RIS is integrated with a cloud-based solution such
as PostDICOM.
 Patient Management – Significantly facilitates patient management as processes such
as patient registration and scheduling are digitized. The amount of time needed for
 patient registration and organizing schedules is greatly reduced by eliminating the
need for paper-based documentation. Booking appointments is made much simpler
and much less time-consuming.
 Patient Tracking – Keeping track of the patient’s treatment through the system is made
available. The patient’s complete medical history can be accessed and the patient’s
information can be checked for any updates throughout the diagnostic process by
logging into the system whenever is necessary. As a result, workflow management is
greatly improved.
 Interactive Documents – RIS systems enable the creation of interactive documents
which enhances communication between physicians and facilitates diagnosis.
 Results Entry and Distribution – Results are reported digitally but functions for paper-
based exporting are included. Medical reports can be swiftly and easily emailed or
faxed. The RIS system can create statistic reports for specific procedures, individual
patients, or patient groups.
 Procedure Billing – The system can store financial records, process electronic
payments, and automate billing.
 Resource Management – The management of materials is facilitated as information
on supply requirements is readily accessible and organized for a more efficient way
of managing the budget allocated for supply demand.
 Procedure Billing – The system can store financial records, process electronic
payments, and automate billing.
 Resource Management – The management of materials is facilitated as information
on supply requirements is readily accessible and organized for a more efficient way
of managing the budget allocated for supply demand.

1. A clinician orders a radiographic exam using the Hospital Information System (HIS).
2. Within minutes, the order subsequently appears at the modality in a
3. List of patients requiring radiographs that day.
4. The radiology technicians select the appropriate patient from the list and conducts
the study.
5. Once the images are generated, they are sent to a central local server and the
exam is automatically completed and charged in the HIS.
6. By simply clicking the ‘‘view images’’ button under the images tab in the HIS the
images appear in an easy to use browser- based medical image viewer, or on a
Digital Imaging and Communications in Medicine (DICOM) workstation program
on the local computer.
7. In addition, the images and reports are accessible from anywhere inside the local
area network (LAN) and also potentially available outside the clinic network via the
world wide web.
 stands for Digital Imaging and Communications in Medicine.
 It’s a standard protocol for the transferring, displaying, and storing of medical images
data.
 Most modern imaging machines are capable of producing DICOM images.
 DICOM Viewer: Is a specialized application software enables you to open, process,
and interpret DICOM images. There are a lot of DICOM Viewer applications available.
 MicroDicom (Free)
 RadiAnt
 The many functions of RIS all work together to provide a more reliable, faster system
for working with patient information. The diagnostic process is improved, errors in
data entry significantly diminished, staff efficiency improved, and staff shortages
mitigated.
 Another benefit that a computerized system like RIS provides is that it enables
practices to focus more of their efforts around patient care. The time saved with
reduced paperwork and the streamlining of a number of operations can be
devoted to offering a more comprehensive system of services for patients.
Decentralized work environments which are made possible by RIS imaging
accelerate the work of physicians and enhance communication between them,
leading to improved diagnosis.
 All administrative processes are made simpler and less time consuming. Even the
management of materials and managing the supply budget can be improved
through RIS systems.
 RIS enhances the management of workflow through features enabling patient
tracking in real time and provides one central source of medical records.
 Costs are reduced because of the faster processing of medical images and related
data, the reduced number of errors in data entry, and the streamlining of numerous
functions. Revenue is increased due to more effective appointment scheduling and
faster reporting. In addition to this, radiology practices treating Medicaid or
Medicare patients while using certified RIS systems have access to government
incentives.
 All of these benefits have made RIS critical for efficient workflow of radiology
practices. When it comes to integration with other medical software, RIS is able to
be integrated with and complements HIS (hospital information systems) and PACS
(picture archiving and communication systems).
 Medical software systems like RIS and PACS are the contemporary, digital equivalent
for paper and film based medical records storage systems. The degree of
optimization that they are able to achieve, particularly the significantly improved
reliability and time efficiency of these systems, has made them indispensable in
modern radiology departments and diagnostic centers.
 Medical software systems like RIS and PACS are the contemporary, digital equivalent
for paper and film based medical records storage systems. The degree of
optimization that they are able to achieve, particularly the significantly improved
reliability and time efficiency of these systems, has made them indispensable in
modern radiology departments and diagnostic centers.

 is used for storing imaging data and other relevant files. There can be 2D and
3D images. It is widely used in radiology and healthcare sector where the patient
related images and data is stored.
 The purpose of PACS is to allow the medical staff and doctors to maintain and store
medical images and restore them whenever needed. In short, this is just an archive
system where images and other data is stored for records and later use. The
paperwork and documented records are hard to manage and maintain in this time
and age of the latest technology so it offers a simple solution for data keeping.

 It is of great importance and has a wide range of uses in medical and healthcare
sector. From billing to record keeping and maintaining imaging data, RIS imaging
software is widely used in radiology departments. It is different than others in multiple
ways as it allows to maintain bills, patient record and data as well as offer a simple
solution for documentation.
 RIS imaging software is the need of every radiology department because most of
the hospitals have now adopted RIS. If a hospital is not using this system, they will not
be able to deal with the workload, number of patients, maintain their data and
provide them with reports immediately. The RIS system also helps when it comes to
referring patients to new doctors.

 Is a comprehensive, integrated information system designed to meet all the

information needs within a hospital.
 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.
 HIS is a comprehensive, integrated information system built for managing the
operations in running health care facilities (Hospitals).
 HIS as any other integrated system, needs time for developing, require special type
of professional skills for development and software production but most importantly
it costs money for development, installation, support and upgrade.
 A hospital information system has many different aspects incorporated within itself.
 Technology allows for the information within these systems to flow more easily and
more accurately.

1. Laboratory Information System (LIS)Nursing Information System (NIS)

2. Picture Archiving Communication System
(PACS)
3. Radiology Information System (RIS)
4. Pharmacy Information System (PIS)
5. Administration Information System.
6. Financial Information System (FIS)

1. Patient Registration and scheduling.

2. Patient List Management.
3. Interface with different modalities.
4. Department workflow management.
5. Requesting.
6. Result(s) Entry.
7. Reporting and printout.
8. Patient Tracking.
9. Modality and Material management.
10.Information storage and backup.

 Hospital Information System helps in maintaining a totally secured database of

Patients and business information. This information can be available at your
fingertips.
 Hospital Information System helps in improved healthcare delivery by providing
medical personnel with better data access, faster data retrieval, higher quality
data and more versatility in data display.
 Hospital Information System helps in improving efficiency, both on the cost and the
clinical care perspective. This is achieved by avoiding duplications, repetitions,
delays, missing records and confusions.
 Hospital Information System helps to force orderliness and standardization of the
patient records and procedures in the clinic and increasing accuracy &
completeness of medical records of Patient.
 Hospital Information System helps as a good managerial tool to provide total, cost-
effective access to complete and more accurate patient care data to offer
improved performance and enhanced functions.
 Hospital Information System helps in gathering information to meet management
challenges.
 Hospital Information System helps to educate patients about their diseases of
surgical procedures through pictures and animations.
 This function of Hospital Management
Information System deals with
registering the new Patient either for
OPD or IPD and giving unique
Identification Number to the Patient.
 This number is unique throughout the
System for identifying the patient. The
patient can be registered either at IPD
Front Office or at OPD Reception. The
OPD or IPD identification number is
also created for each separate visit
of the patient.
 This is also a part of registering patient.
IPD/OPD ID is used for tracking of
medical records of the patient for that
particular OP visit or IPD admission. All
the medical record of the patient is
identified by combination of numbers
i.e. Patient ID and OPD/IPD ID. The numbers give flexible search in terms of finding
patient's History Record.

 Hospital Management System deals with all kinds of Investigations suggested by

Doctors. The function enables the entry of Investigations /Procedures for a particular
patient.
 The entered investigations are rooted through the Billing/Cash office and once the
patient pays for the Investigations the entries of the same goes to respective Diagnostics
Center.
 This flow is not compulsory of IPD patients since the Billing for IPD patients is done at the
time of Discharge. Investigation requisition is created and printed with function and the
same is available at respective diagnostics center for preparation of Reports.
1. This function Patient IPD Admission gives facility to process patient admission and
allocate Bed to patient. System identifies the patient as new IPD patient or internal
referred from hospital OPD/CMO.
2. This function gives information on vacant beds in a Hospital. Occupancy status on that
particular position can be find out while allocating the Bed. The main function Patient
Admission facilitates admitting the patient according to requirement, considering the
type of admission and the patient condition.
3. The admission of the patient can be direct / Referred from a consultant / Hospital. The
category of the patient can be Company, Self, Government Schemes, Insurance, and
MLC depending on that the admission procedure is completed.
4. Once the patient is admitted in the Hospital the Room charge starts from the time of
Admission. The case paper of the patient is printed from the system and is send to the
respective Nursing Station.
5. Once the Admission of the patient is completed the IPD Identification Number is
created by the system for that particular Admission of Patient. The IPD Admit Card is
also printed along with the Case Paper.
6. The system informs with Audio Visual alert to the respective Nursing Station about
admission of the patient under them and to prepare Room for patient. In case of MLC,
system stores the details of the Police Station, Name of the official informed about
Medical Legal Case.

- This report gives information on

admitted/discharged patients during certain time period. This facilitates management
to know the Admission vs. Discharges ratio.
2. Bed occupancy Reports - This report gives information on Bed Occupancy at
any given time room category wise.
 3. Ward Allocation Reports - This report gives allocated rooms report for tracking of
patient.
4. Interim Bill v/s Advance Report - This report gives the ration of Interim Bill vs. Advances
paid by the patient with the percentage of payment.
5. Admission / Discharge Register - Admission and Discharge register is maintained by
the system. This report gives details of patient Admission and discharges during specific
period.
6. Consultant wise patients - This report gives Doctor wise patients at any point of time
to know referring or In-charge doctor.
7. Appointment List - The appointments for consultants are maintained on the system.

DIAGNOSTIC CENTRES - This module enables to get patient’s investigation, procedure

record from different locations i.e. IPD, OPD, Casualty.

 This function of HIS covers Laboratory System for Pathology, Radiology, Cardiology,
Neurology, and Chest Medicine. The prescriptions given by the Doctors are routed
through billing system to respective Diagnostic Centers.

 Laboratory module starts with receiving the online request from doctors. Laboratory
personnel can also generate requests. This facilitates investigations for referral
patients.
 Tests are grouped under various sections and sample type (specimen). Based on the
request the user can input the sample and generate the sample number. Results can
be inputted based on the sample type.
 Results can be inputted either to one test or multiple tests. If the test result requires
approval, the supervisor has to approve the result.
 Test results are available to concerned doctors. Test report can be made confidential.
 Tests can be performed only after the billing is done. This rule is exempted when the
case is declared as Urgent.
 Integration of tests Ordered from Clinical Modules
 Comprehensive On-line Laboratory Reports
 Fast Entry of Results
 Enables Doctors to see the Results On-Line from any Location at any time
 Up-to-date status about request
 Provision for templates of Input of test Results

 Radiology module caters to services such as X-ray, Scanning, Ultra sound etc.
Scheduling of Radiology resources is possible. The system stores all the result details of
various tests and makes a Report based on the Test Results.
 These Tests are carried out both for Inpatient and Outpatient. The system stores all the
details (like patient number, Test Report like X-Ray, scanning details) and for each scan
the system generates a unique number for the image. Investigations can be done only
after the billing is done. This rule is exempted when the case is declared as Urgent.
 CT Scanning: Direct Capturing of CT Scanned images, Easy Reporting facility
 MRI: Easy reporting
 X-Rays: Direct Capturing of
 X-Ray images

 Sonography Reporting
 Capturing of Images

 EMG Reporting
 Prescriptions Discharge Card