Abstract:
A system for adding an electronic signature chosen from a plurality of available electronic signatures to a report associated with an image file associates an electronic signature with a user of the system. When the user wishes to apply the electronic signature to the image file, or to a report associated with the image file, the user instructs the system to apply the electronic signature. The system can query the user of the system to determine whether the user is the individual that is currently logged on to the system. If the user is currently logged on, the system will apply that individual&#39;s electronic signature to the report associated with the image file. If the user is not the individual that is currently logged on, the system presents to the user a selection of electronic signatures, from which the user chooses the signature that identifies them as the user.

Description:
TECHNICAL FIELD 
   The present invention relates generally to imaging systems, and, more particularly, to a system for determining the user of an image management system and applying an electronic signature to a report and associated image file stored on the image management system, where the electronic signature corresponds to one of a plurality of users of the system. 
   BACKGROUND OF THE INVENTION 
   Imaging systems, and ultrasonic imaging systems in particular, have been available for quite some time and are commonly used in nondestructive, and sometimes destructive, testing and medical applications. Medical ultrasound imaging typically allows the internal structure of the human body to be viewed non-invasively in real time. The ultrasound imaging system may be capable of various types of imaging applications, including, for example, one and two-dimensional imaging. 
   Typically, one imaging device may be used by a variety of different users and the images analyzed and interpreted by a number of different technicians and physicians. In some instances, a number of imaging devices may be interconnected via a network. For example, a number of imaging devices may be located throughout a single facility, such as a hospital or doctor&#39;s office. These imaging devices may be interconnected via a network, such as a local area network (LAN). Alternatively, two or more imaging devices located at different locations may be connected via a wide area network (WAN), such as the Internet. 
   In some applications a computer may be connected to the imaging device or to the network to which the imaging devices are connected. When connected to the imaging device (either directly or via some network) the computer may exchange diagnostic information with the imaging devices. For example, the imaging device may transfer the diagnostic image files to the computer. In such an arrangement, the computer may be considered a “server” because it may contain and store image files from any number of imaging devices and make those files available to a user of the server. The server may also include additional software that enables the server to manipulate the image files. A user may wish to access the image files located on the server so that a diagnosis may be made. The user may access the image files on the server either directly from the server, or may access the computer from another computer, commonly referred to as a “client,” connected to the server either directly or via one of the above-described networks. When the server is accessed directly by a user, the server can be thought of as including the client application. In such an arrangement, the server is also considered the client. 
   Typically, the image file, any patient demographic data relating to the particular patient, and a report are combined in the server into what is referred to as a study. A user of the system, who wishes to review the image files, can access the study through the client application. Typically, the individual using the system is a sonographer or a physician. The user can access the study and the related image files and, after having analyzed the images, use the application software on the client to build a report, which will be sent to the physician who requested the diagnostic image. Peripheral data, such as measurements and diagnostic findings, may be added to the report. In some instances, a sonographer may develop a preliminary report, which can be saved and later reviewed by an attending physician. After the attending physician analyzes the report, the report is combined with the study, finalized and printed onto paper and then manually signed by the attended physician. The study is then conventionally mailed, or perhaps faxed, to the physician who requested the diagnostic image. 
   Unfortunately, printing and signing the report along with the image files and then mailing, or faxing, the report to the requesting physician is time consuming and prone to delay and error. 
   Therefore, it would be desirable to have an image management system that can automatically assign an electronic signature to the report and electronically forward the report to the requesting physician. 
   SUMMARY 
   The invention provides a system for adding an electronic signature chosen from a plurality of available electronic signatures to a report associated with an image file. Each of the plurality of electronic signatures is associated with a corresponding user of the system. When the user wishes to apply the electronic signature to the image file, or to a report associated with the image file, the user instructs the system to apply the electronic signature. The system can query the user of the system to determine whether the user is the individual that is currently logged on to the system. If the user is currently logged on, the system will apply that individual&#39;s electronic signature to the report associated with the image file. If the user is not the individual that is currently logged on, the system presents to the user a selection of electronic signatures, from which the user chooses the signature that identifies them as the user. 
   Other systems, methods, features, and advantages of the invention will be or will become apparent to one with skill in the art upon examination of the following drawings and detailed description. It is intended that all such additional systems, methods, features, and advantages be included within this description, be within the scope of the present invention, and be protected by the accompanying claims. 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The present invention can be better understood with reference to the following drawings. The components within the drawings are not necessarily to scale relative to each other, emphasis instead being placed upon clearly illustrating the principles of the present invention. 
       FIG. 1  is a graphical view illustrating an exemplar network environment in which the server including the image management system resides. 
       FIG. 2  is a schematic view illustrating the server of  FIG. 1  in which the image management system resides. 
       FIG. 3  is a flow diagram illustrating the operation of one embodiment of the image management system of  FIG. 2 . 
       FIG. 4  is a graphical view illustrating an exemplar user interface of the image management system of  FIG. 2 . 
   

   DETAILED DESCRIPTION OF THE INVENTION 
   The image management system of the invention can be implemented in hardware, software, firmware, or a combination thereof. In the preferred embodiment(s), the image management system is implemented using a combination of hardware and software or firmware that is stored in a memory and that is executed by a suitable instruction execution system. If implemented in hardware, as in an alternative embodiment, the image management system can be implemented with any or a combination of the following technologies, which are all well known in the art a discrete logic circuit(s) having logic gates for implementing logic functions upon data signals, an application specific integrated circuit (ASIC) having appropriate combinational logic gates, a programmable gate array(s) (PGA), a field programmable gate array (FPGA), etc. 
     FIG. 1  is a graphical view illustrating an exemplar network environment  100  in which the server including the image management system resides. It should be noted that although illustrated in  FIG. 1  as connected through a network, the image management system of the invention is not dependent upon the network connectivity described. 
   The network environment  100  includes at least one image acquisition device  102  connected to a network  114  via connection  106 . The network environment  100  also includes an image acquisition device  104  connected to network  114  via connection  108 . The image acquisition devices  102  and  104  can be any electronic devices capable of developing an electronic image  101 , and in this embodiment, are ultrasonic diagnostic devices. The network  114  can be any local area network (LAN) or wide area network (WAN). 
   The network environment  100  also includes a server  200  connected to the network via connection  112 , and a client  300  connected to the server  200  via connection  122 . Alternatively, the client  300  may be included within the server  200  or may be connected to the network  114  via, for example, connections  116  and  118 . Furthermore, more than one client  300  may be coupled to the server  200 , either directly or via the network  114 . As will be described in further detail with respect to  FIGS. 2 ,  3  and  4 , the server  200  includes an image management system that works in cooperation with a client application, which is part of the client  300 , to add an electronic signature to an image file or a report associated with an image file. If the client  300  is contained within the server  200 , then the client application will also be contained within the server  200 . Furthermore, it is possible for the server  200  and the client  300  to be incorporated into the image acquisition device  102 , in which case all of the functionality described herein is included in a single device. 
   Information can be exchanged over the network  114  using, for example transmission control protocol Internet protocol (TCP/IP) if the network is the Internet, or possibly an emerging communication standard referred to as Digital Imaging and Communications in Medicine (DICOM). DICOM can be used as the communication model for transferring the ultrasound data across the network  114 . 
   In the currently contemplated best mode, the image management system is implemented in software and executed by a special or general purpose computer, such as a personal computer (PC; IBM-compatible, Apple-compatible, or otherwise), workstation, minicomputer, or mainframe computer. An example of a general purpose computer that can implement the image management system of the invention is shown below in  FIG. 2 . 
     FIG. 2  is a block diagram illustrating a computer  200  that includes the image management system  250  of the invention. The computer  200  can be a general purpose computer that can implement the image management system  250 , and will be referred to as a server. Generally, in terms of hardware architecture, as shown in  FIG. 2 , the computer  202  includes a processor  204 , a memory  206 , a disk drive  212 , an input interface  244 , a video interface  246 , an output interface  254 , and a network interface  242  that are connected together and can communicate with each other via a local interface  214 . The local interface  214  can be, for example but not limited to, one or more buses or other wired or wireless connections, as is known in the art. The local interface  214  may have additional elements, which are omitted for simplicity, such as buffers (caches), drivers, and controllers, to enable communications. Further, the local interface  214  includes address, control, and data connections to enable appropriate communications among the aforementioned components. 
   The processor  204  is a hardware device for executing software that can be stored in memory  206 . The processor  204  can be any custom made or commercially available processor, a central processing unit (CPU) or an auxiliary processor among several processors associated with the computer  200 , and a microchip based microprocessor or a microprocessor. Examples of suitable commercially available microprocessors are as follows: an 80×86 or Pentium series microprocessor from Intel Corporation, U.S.A., a PowerPC microprocessor from IBM, U.S.A., a Sparc microprocessor from Sun Microsystems, Inc, a PA-RISC series microprocessor from Hewlett-Packard Company, U.S.A., or a 68xxx series microprocessor from Motorola Corporation, U.S.A. 
   The memory  206  can include any one or a combination of volatile memory elements (e.g., random access memory (RAM, such as DRAM, SRAM, etc.)) and nonvolatile memory elements (e.g., ROM, hard drive, tape, CDROM, etc.). Moreover, the memory  206  may incorporate electronic, magnetic, optical, and/or other types of storage media. Note that the memory  206  can have a distributed architecture, where various components are situated remote from one another, but can be accessed by the processor  204 . 
   The input interface  144  can receive commands from, for example, keyboard  248  via connection  262  and from mouse  252  via connection  264  and transfer those commands over the local interface  214  to the processor  204  and the memory  206 . The input interface  244  may also receive diagnostic images, in the form of image files, from image acquisition device  102  via connection  106 . The image files may be stored in memory  206  as image files  238 . 
   The video interface  246  supplies a video output signal via connection  266  to the display  256 . The display  256  can be a conventional CRT based display device, or can be any other display device, such as a liquid crystal display (LCD) or other type of display. 
   The output interface  254  sends printer commands via connection  268  to the printer  258 . The network interface  242  can be, for example, a network interface card that connects the computer  200  via connection  112  to a network  114 , which in this case would be a LAN. Alternatively, the network interface  242  could be a modulator/demodulator (modem) or any communication device capable of connecting the computer  200  to a network  114 , which in this example would be a WAN, such as the Internet. 
   The network interface may also be used to receive electronic image files from another image acquisition device connected to the network  114 . 
   The software in memory  206  may include one or more separate programs, each of which comprises an ordered listing of executable instructions for implementing logical functions. In the example of  FIG. 2 , the software in the memory  206  includes the image management system  250 , a client application  350  and a suitable operating system (O/S)  210 . A nonexhaustive list of examples of suitable commercially available operating systems  210  is as follows: a Windows operating system from Microsoft Corporation, U.S.A., a Netware operating system available from Novell, Inc., U.S.A., or a UNIX operating system, which is available for purchase from many vendors, such as Sun Microsystems, Inc., U.S.A., Hewlett-Packard Company, U.S.A., and AT&amp;T Corporation, U.S.A. The operating system  210  essentially controls the execution of other computer programs, such as the image management system  220  and the client application  350 , and provides scheduling, input-output control, file and data management, memory management, and communication control and related services. Preferably, the operating system  210 , the image management system  250  and the client application  350  are Windows NT elements. 
   The processor  204  and operating system  210  define a computer platform, for which application programs, such as the image management system  250  and the client application  350 , are written in higher level programming languages. The client application  350  also provides the user interface through which a user of the system communicates with the computer  200  and the image management system  250 . The user interface component of the client application uses, for example, the keyboard  248  and mouse  252  to provide input to the computer  200  and uses the display  256  to provide output. 
   If the computer  200  is a PC, the software in the memory  206  further includes a basic input output system (BIOS) (omitted for simplicity). The BIOS is a set of essential software routines that test hardware at startup, start the O/S  210 , and support the transfer of data among the hardware devices. The BIOS is stored in ROM so that it can be executed when the computer  200  is activated. 
   When the computer  200  is in operation, the processor  204  is configured to execute software stored within the memory  206 , to communicate data to and from the memory  206 , and to generally control operations of the computer  200  pursuant to the software. The image management system  250 , client application  350  and the O/S  210 , in whole or in part, but typically the latter, are read by the processor  204 , perhaps buffered within the processor  204 , and then executed. 
   The memory  206  includes a plurality of electronic signature files maintained in element  236 . Each electronic signature file includes a digitized image of a signature corresponding to each of the users of the image management system who may be required to sign a report  272  generated by the image management system  250 . The signatures contained in the electronic signature file element  236  may be electronically scanned and stored as, for example, joint photographic experts group (JPEG, file extension jpg), graphics interchange format (GIF, file extension gif) or another file format that is compatible with the computer  200  and the client application  350 . 
   The memory also includes a database  216 . The database  216  can be implemented using, for example, Microsoft SQLServer, and includes a referring physician list  218 , a reading physician list  222  and a study list  224 . Other database implementations, and alternatives to database implementations, such as indexed sequential access method (ISAM) tree implementations and file systems, as known to those having ordinary skill in the art, are possible. The reading physician list  222  is electronically linked to the electronic signature file  236  so that the files contained in the electronic signature file element  236  correspond to the physicians (reading physicians) that are expected to use the system. Typically, a system administrator accesses a tool (not shown) that allows the system administrator to correlate electronic signature files with system users. It is also possible to have a user that has no associated electronic signature file. In such a case, the system does not include the electronic signature file in the report  272 , thus providing backward compatibility with a traditional use model. 
   The study list  224  is electronically linked to the image files  238 . The studies contained in the study list  224  include the image file, any patient demographic data relating to the particular patient, and a report  272 . 
   The database includes the referring physicians list  218  so that after an electronic signature is applied to the appropriate report  272  associated with one of the image files  238  and study  224 , the study can be electronically transferred to the physician that requested the analysis (the referring physician). The study can be electronically transferred to the referring physician using, for example, email or fax, through the network interface  242 . Alternatively, the report  272  can be published to the Internet for the referring physician to access using a security password. 
   Once an electronic image file is made available to the image management system  250 , the image management system  250  can associate each of the image files  238  with the appropriate study  224  and present the image files and the study in the form of a report  272  to a user of the system  250 . In addition to providing the user interface into the computer  200 , the client application  350  may also include additional functionality, such as a measurements package, which allows the user of the system to append measurements to the image file, or a diagnostics package, which allows a user to append diagnostic findings to the image file. 
   When the image management system  250  is implemented in software, as is shown in  FIG. 2 , it should be noted that the image management system  250  can be stored on any computer readable medium for use by or in connection with any computer related system or method. In the context of this document, a computer readable medium is an electronic, magnetic, optical, or other physical device or means that can contain or store a computer program for use by or in connection with a computer related system or method. The image management system  250  can be embodied in any computer-readable medium for use by or in connection with an instruction execution system, apparatus, or device, such as a computer-based system, processor-containing system, or other system that can fetch the instructions from the instruction execution system, apparatus, or device and execute the instructions. In the context of this document, a “computer-readable medium” can be any means that can contain, store, communicate, propagate, or transport the program for use by or in connection with the instruction execution system, apparatus, or device. The computer readable medium can be, for example but not limited to, an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, device, or propagation medium. More specific examples (a nonexhaustive list) of the computer-readable medium would include the following: an electrical connection (electronic) having one or more wires, a portable computer diskette (magnetic), a random access memory (RAM) (electronic), a read-only memory (ROM) (electronic), an erasable programmable read-only memory (EPROM or Flash memory) (electronic), an optical fiber (optical), and a portable compact disc read-only memory (CDROM) (optical). Note that the computer-readable medium could even be paper or another suitable medium upon which the program is printed, as the program can be electronically captured, via for instance optical scanning of the paper or other medium, then compiled, interpreted or otherwise processed in a suitable manner if necessary, and then stored in a computer memory. 
   In an alternative embodiment, where the image management system  250  is implemented in hardware, the image management system  250  can be implemented with any or a combination of the following technologies, which are each well known in the art: a discrete logic circuit(s) having logic gates for implementing logic functions upon data signals, an application specific integrated circuit (ASIC) having appropriate combinational logic gates, a programmable gate array(s) (PGA), a field programmable gate array (FPGA), etc. 
     FIG. 3  is a flow diagram  370  illustrating the operation of one embodiment of the image management system  250  of  FIG. 2 . In block  372  an image is acquired on one of the image acquisition devices of  FIG. 1 . For example, if the image acquisition device is a diagnostic ultrasonic imaging device, then in block  372  a sonographer might acquire an ultrasonic diagnostic image ( 101  of  FIG. 1 ) on the image acquisition device  102  of  FIGS. 1 and 2 . 
   In block  374  the acquired diagnostic image is sent to the server  200 . If the image acquisition device  102  is connected directly to the server  200  via connection  106  as illustrated in  FIG. 2 , then the image acquisition device  102  directly supplies the image files representing the ultrasonic diagnostic image in electronic format to the input interface  244  of the server  200 . The diagnostic image is then forwarded via the local interface  214  to the processor  204  and memory  206  of the server  200  of  FIG. 2  where it is stored as image file  238 . If the image acquisition device is connected to the server  200  via the network  114 , then the diagnostic image is forwarded over the network to the network interface  242  of the server  200 . The diagnostic image is then forwarded via the local interface  214  to the processor  204  and the memory  206  of the server  200  of  FIG. 2 . Regardless of the manner in which the diagnostic image is forwarded to the server  200 , the diagnostic image is stored as the image file  238  in the memory  206 . 
   In block  376 , a user of the image management system  250  accesses the server  200  using the client application  350 . The user could also access the server using a client ( FIG. 1 ) having the client application  350 . In block  376  it is assumed that the user is a preliminary reader of the image file  238 . The preliminary reader, who may be, for example, a sonographer, may wish to access the image file  238  to perform a preliminary analysis of the diagnostic image. During the analysis, the preliminary reader may wish to supplement one or more image files  238  with measurements, diagnostic findings, or patient demographic information. All of this information is contained within the memory  206  and made available through the client application  350 . The client application  350  works in cooperation with the keyboard  248  and the mouse  252  to supply inputs to the server  200  and uses the display  256  to display outputs to the user. 
   In block  378 , while the preliminary reader analyzes the image files  238 , the image management system  250  builds a preliminary report  272 . The report  272  may be developed using hypertext markup language (HTML) element  274 , so as to be compatible with Internet browser programs, and may include the diagnostic images and any appended information, such as measurements, diagnostic findings, patient demographics, etc. Typically, a web browser  276 , such as Microsoft&#39;s Internet Explorer, is embedded into the client application  350 . The report  272  is generated using HTML, which is accessed when needed by the client application  350 . When the reading physician finalizes the report, the client application  350  builds the HTML that adds the appropriate digitized signature, and instructs the web browser  276  to render the HTML document. As the preliminary reader appends such information to the image file  238 , all such information is saved in the memory  206  of the server  200 . This information combined with the image files  238  is saved in the studies list  224  as a study. 
   In block  382  another user of the system, in this case a reading physician responsible for verifying the diagnosis of the diagnostic image, may log into the server  200  via the client application  350  and access the subject study, which was previously saved, from the study list  224 . The reading physician may make any necessary additions, and/or changes to the study, and then finalize the report  272 . This can be accomplished using a password for security purposes. 
   In block  384 , through the client application  350 , the reading physician is presented with an option to finalize the report  272 . In addition, the reading physician is prompted by the client application  350  with a query window, such as the query window  400  shown in  FIG. 4 . The query window  400  is presented to the reading physician by the image management system  250  so that the reading physician may identify himself or herself to the image management system  250 . This step takes into consideration the situation where the reading physician may not be the individual that originally logged into the image management system  250 . For example, the preliminary reader mentioned above may have logged into the image management system and not logged out, leaving the study available for the reading physician to review. The system queries the user who requests the final report  272  so that the identity of the user (the reading physician in this example) can be communicated to the image management system  250 . Using the pointer  402  shown in  FIG. 4 , the user communicates his or her identity to the image management system  250 . The list of users (in this example, the reading physicians) is stored in the memory  206  as the reading physician list  222 . The reading physician list  222  is presented to a user (using the user interface shown in  FIG. 4 ), so that the reading physician may identify him or herself to the system. The user may also be requested to enter a password to authenticate his or her identity. 
   Each reading physician in the reading physician list  222  has an associated electronic signature file  236 . If a reading physician does not have an associated electronic signature, the system does not include an electronic signature in the report  272 , thus providing backward compatibility with the traditional use model. The electronic signature file  236  associated with each reading physician corresponds to a scanned image of the signature of the reading physician. 
   In block  386 , and after the user identifies him or herself to the image management system  250  in block  384 , the image management system  250  electronically inserts into the report  272  an electronic signature corresponding to the reading physician if an electronic signature exists for the reading physician. Further, it is possible to amend a report  272 . In such a case, when the modifications to the report  272  are saved, another report is generated, possibly with a new electronic signature. 
   In block  388  the report  272  is then saved and can optionally be electronically transferred, via the network interface  242  ( FIG. 2 ), to, for example, the referring physician. The referring physician is the individual who individually requested the diagnostic image. A list of referring physicians is maintained in the memory  206  of server  200  as the referring physician&#39;s list  218 . The referring physician&#39;s list  218  may include, for example, an electronic mail (email) address or facsimile (fax) number of each of the referring physicians. In this manner, the reading physician can quickly and accurately electronically apply his or her signature to the report  272 , and then have the report  272  electronically forwarded to the referring physician. This eliminates the necessity of printing the final report  272 , and then manually signing the report  272  and having the report  272  mailed conventionally, or manually faxed to the referring physician. 
   It will be apparent to those skilled in the art that many modifications and variations may be made to the preferred embodiments of the present invention, as set forth above, without departing substantially from the principles of the present invention. For example, the present invention can be used in any ultrasound imaging system. All such modifications and variations are intended to be included herein within the scope of the present invention, as defined in the claims that follow.