Abstract:
Systems, methods and apparatus are provided for acquiring medical images through a flexible workflow process. The present application further provides a modular workflow having an operator interface that may be tailored and made unique for each individual application. The imaging system supports multiple user stations or terminals where multiple users can log into. The system has the capability to track and capture audit data for each user. In a multi terminal environment a terminal can perform acquisition of medical images, another terminal can be accessing medical images from a database and performing analysis of retrieved images. Additionally, the terminals can be assigned different roles based on whether is performing image acquisition, image retrieval, or foreground application processing.

Description:
FIELD OF THE INVENTION 
       [0001]    This invention relates generally to the field of non-invasive imaging, including medical imaging. More specifically, the present invention relates to a workflow for automated scheduling of procedures and resources in such environments. 
       BACKGROUND OF THE INVENTION 
       [0002]    The integration of different healthcare systems has increased the speed of information flow, however the workflow process is still not highly efficient. The conventional workflows do not allow for a method of information flow that can minimize undue delays involved in scheduling and analyzing the results of all requisite exams performed on the patient. At best the current workflow offer multiple imaging positions such as table, wall stand, flying detector. However, the conventional workflow usually allows only dealing with image data of a singe patient. With needs for faster throughput in facilities having more than 10 to 20 patients per hour, the single patient workflow would become a bottleneck. This bottleneck can be avoided or limited if a suitable workflow is available. 
         [0003]    For the reasons stated above, and for other reasons stated below which will become apparent to those skilled in the art upon reading and understanding the present specification, there is a need in the art for flexible workflow processing. There is also a need for an imaging system that supports multi users and multi patients. 
       BRIEF DESCRIPTION OF THE INVENTION 
       [0004]    The above-mentioned shortcomings, disadvantages and problems are addressed herein, which will be understood by reading and studying the following specification. 
         [0005]    The present invention is directed to a method and system for a flexible workflow process for acquiring medical images and for medical imaging data processing applications. The present application further provides a modular workflow having an operator interface that may be tailored and made unique for each individual application. The system supports multiple user stations or terminals with an operator interface where multiple users can log into. Further, the system has the capability to track and capture audit data for each user. In a multi terminal environment a terminal can perform acquisition of medical images, another terminal can be accessing medical images from a database and performing analysis of retrieved images. Additionally, the terminals can be assigned different roles based on whether is performing image acquisition, image retrieval, or foreground application processing. 
         [0006]    In one aspect, an imaging system for flexible workflow processing is disclosed with a plurality of systems having user interface; the systems able to perform image acquisition, foreground applications processing, coupling to a network so as to access information from a picture archiving communication system, a hospital information system, and a record information system. The flexible workflow imaging system associates auxiliary imaging equipment to those systems that are performing image acquisition. 
         [0007]    In another aspect, the flexible workflow imaging system partitions the room holding the auxiliary image equipment into sections that are independent of each other. 
         [0008]    In yet another aspect, the flexible workflow imaging system creates an imaging chain consisting of the auxiliary imaging equipment including the section of the room where the equipment is located. 
         [0009]    In still another aspect, the hospital information system sends a patient list with imaging prescription foe each patient on the list. The user through the interface can select or add the patient to be imaged. 
         [0010]    In a further aspect, the flexible workflow imaging system tracks and captures audit data for each of the first terminal and the one or more additional terminal and users of the first terminal and the one or more additional terminal. 
         [0011]    In yet a further aspect, system for flexible workflow processing employs a processor, a storage device coupled to the processor, and software means operative on the processor for: configuring a first terminal with a user interface to perform one or more image acquisition, foreground application processing, and coupling to a network; configuring one or more additional terminal with a user interface to perform one or more image acquisition, foreground application processing, and coupling to said network; and assigning auxiliary imaging equipment to said first terminal or additional terminal for performing image acquisition. 
         [0012]    In still yet a further aspect, the processor at the system for flexible workflow processing tracks and captures audit data for each of the first terminal and the one or more additional terminal and users of the first terminal and the one or more additional terminal. 
         [0013]    Systems, clients, servers, methods, and computer-readable media of varying scope are described herein. In addition to the aspects and advantages described in this summary, further aspects and advantages will become apparent by reference to the drawings and by reading the detailed description that follows. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0014]      FIG. 1  is a diagram illustrating a system-level overview of a workstation supporting multiple systems in accordance to an embodiment; 
           [0015]      FIG. 2  is a diagram illustrating an imaging system coupled to a network in accordance to an embodiment; 
           [0016]      FIG. 3  is a diagram illustrating a room holding auxiliary image equipment in accordance to an embodiment. 
           [0017]      FIG. 4  is a flowchart of a method for configuring a plurality of systems according to an embodiment; 
           [0018]      FIG. 5  is a diagram of an imaging chain data structure for use in an implementation in accordance to an embodiment. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0019]    In the following detailed description, reference is made to the accompanying drawings that form a part hereof, and in which is shown by way of illustration specific embodiments which may be practiced. These embodiments are described in sufficient detail to enable those skilled in the art to practice the embodiments, and it is to be understood that other embodiments may be utilized and that logical, mechanical, electrical and other changes may be made without departing from the scope of the embodiments. The following detailed description is, therefore, not to be taken in a limiting sense. 
         [0020]      FIG. 1  illustrates an exemplary diagram of a system  100  for flexible workflow processing in accordance with a possible embodiment of the invention.  FIG. 1  generally identifies workstation  102 , an acquisition terminal  105 , a foreground application terminal  110 , and image review terminal  115 . System  100  solves the need in the art for flexible workflow processing. 
         [0021]    System  100  includes workstation  102  having software for configuring the terminals ( 105 ,  110 ,  115 ) to perform the role of image acquisition, foreground application processing, and coupling to a network for accessing resources. The users can perform review tasks such as archiving, deleting, managing the image data in the terminals, and any other function within the functionality of the terminal. Additionally, workstation  102  contains an audit mechanism that captures or receives access requests for logging and analysis purposes such as security, transaction audit gathering and trending. Security usage identifies undesirable transactions for possible blocking the selected transactions. Trending focuses on suspect usage patterns and highlights or optionally blocks such transactions. Audit data gathering usage collects data required for regulatory compliance such as identifying access trails to sensitive data. Such audit data gathering includes tracking metadata changes resulting from administrative metadata commands, and tracking or correlating such changes with a tag label. 
         [0022]    Workstation  102 , and terminals  105 - 110  have computer hardware and a suitable computing environment in conjunction with which some embodiments can be implemented. Embodiments are described in terms of a computer executing computer-executable instructions. However, some embodiments can be implemented entirely in computer hardware in which the computer-executable instructions are implemented in read-only memory. Some embodiments can also be implemented in client/server computing environments where remote devices that perform tasks are linked through a communications network. Program modules can be located in both local and remote memory storage devices in a distributed computing environment. 
         [0023]    Workstation  102  and terminals  105 - 115  include a processor, commercially available from Intel, Motorola, Cyrix and others, random-access memory (RAM), read-only memory (ROM), and one or more mass storage devices. The memory and mass storage devices are types of computer-accessible media. Workstation  102  and terminals  105 - 115  can be communicatively connected to the Internet via a communication devices that are well known within the art. The workstation  102  and terminals  105 - 115  communication are connected through a network device  260  such an Ethernet® or similar hardware network card connected to a local-area network (LAN) that itself is connected to the Internet via what is known in the art as a “direct connection” (e.g., T1 line, etc.). 
         [0024]    A user enters commands and information into the workstation and terminal through input devices such as a keyboard or a pointing device. The keyboard permits entry of textual information, as known within the art, and embodiments are not limited to any particular type of keyboard. Pointing device permits the control of the screen pointer provided by a graphical user interface (GUI) of operating systems such as versions of Microsoft Windows®. Embodiments are not limited to any particular pointing device. Such pointing devices include mice, touch pads, trackballs, remote controls and point sticks. Other input devices (not shown) can include a microphone, joystick, game pad, satellite dish, scanner, or the like. A display device permits the display of information, including computer, video and other information, for viewing by a user of the computer. Embodiments are not limited to any particular display device. Such display devices include cathode ray tube (CRT) displays (monitors), as well as flat panel displays such as liquid crystal displays (LCD&#39;s). In addition to a monitor, computers typically include other peripheral input/output devices such as printers (not shown). Embodiments of workstation  102  and terminals  105 - 115  are not limited to any type of computer. Workstation  102  and terminals  105 - 115  comprise a PC-compatible computer, a MacOS®-compatible computer, a Linux®-compatible computer, or a UNIX®-compatible computer. The construction and operation of such computers are well known within the art. 
         [0025]      FIG. 2  is an illustration of the operation of an imaging system  200  showing a first terminal  105 , second terminal  110 , and third terminal  115  all coupled to a network  260 . The network couples the terminals ( 105 ,  110 ,  115 ) to resource  250  consisting radiology information system (RIS), picture archiving and communication system (PACS), and hospital information system (HIS). The terminals may be hardwired to the network  260  or may communicate with it wirelessly. In this manner, the terminals can communicate with each other or computers or remote means, which are connected to the network  260 , enabling images in the PACS database and patient records in the HIS database to be forwarded to the appropriate personnel and displayed on associated monitor of the terminal. 
         [0026]    Auxiliary imaging equipment is maintained in room  230 , the equipment can include CT scanner, x-ray tube, tables, wall stands, an array of radiation detectors and x-ray tubes, and overhead tube suspension. 
         [0027]    Typically, the imaging operator or user performs a scan using a terminal such as terminal  105  loaded with software  240  that permits the terminal to manipulate the auxiliary imaging equipment through image acquisition hardware  220  and network  260 . Diagnostic data from the equipment is reconstructed by a reconstruction processor (not shown) into electronic image representations which are stored in a diagnostic image memory (not shown). The reconstruction processor may be incorporated into any of the terminals ( 105 ,  110 ,  115 ), the auxiliary imaging equipment, or may be a shared resource among a plurality of imaging equipment and workstation  102 . Other hardware at image acquisition  220  can include diagnostic image memory for storing a three-dimensional image representation of an examined region of a patient, a video processor for converting selected portions of the three-dimensional image representation into appropriate format for display on a video monitor. The operator controls the imaging process, production and display of images by using a user interface screen or screens which are incorporated into the terminals ( 105 ,  110 ,  115 ) and displayed on the monitor to guide the operator through the imaging process. An interface r processor controls the user interface. The operator uses an operator input device, such as a keyboard or mouse to interact with an applications database  250  by navigating the user interface screen. The user interface screen can include a plurality of icons and buttons to navigate through the interface screen and to control scanning workflow. 
         [0028]    PACS database in application database  250  is a repository, and may include various types of storage devices and databases for receiving and storing the medical information, including images from all exams that are performed at acquisition modality. The PACS database can be a central repository, which contains medical information and images from a number of acquisition modalities or can be in the form of a number of different repositories, each containing medical information specific to an acquisition modality. Moreover, any suitable type of repository may be employed for the present purposes, including dedicated memory devices, shared memory devices, magnetic and optical storage technologies, and so forth. 
         [0029]      FIG. 3  is a diagram illustrating a system-level overview of an exemplary embodiment of a radiographic system  300 . System  300  includes a radiographic table  302  and/or a radiographic wall stand  304 , and a radiographic positioning system  305 . The radiographic table  302  and the wall stand  304  each contain an image receptor,  306  and  308 , respectively. 
         [0030]    An overhead tube support (OTS)  310  for performing diagnostic imaging procedures is also included. The OTS  310  provides three linear motions (longitudinal X  312 , lateral Y  314  and vertical Z  316 ) which are perpendicular to each other, and two rotational rotations (rotation about the vertical axis “a”  318 , and rotation about one horizontal axis “b”  330 ). 
         [0031]    Longitudinal positioning rails  322  are mounted to a ceiling (not shown). Lateral positioning rails  334  move along the longitudinal positioning rails  322  in the longitudinal X  313  motion. In other embodiments, the lateral positioning rails  334  are mounted to a ceiling and the longitudinal positioning rails  322  move along the lateral positioning rails  334  in the lateral Y  314  motion. 
         [0032]    A carriage  336  moves along lateral positioning rails  334  in the lateral Y  314  motion. The OTS  310  is mounted on the carriage  336 . A tube mount assembly  322  includes an X-ray source  338  and collimator  330 . The tube mount assembly  322  is mounted to the OTS  310 . The tube mount assembly  322  and/or the OTS  310  rotate about the vertical “a”  318  axis and the vertical “b”  330  axis. 
         [0033]    The OTS  310  can be positioned at any attitude and position within the reaches of radiographic system  300 . This flexibility in positioning is important in achieving alignment of the OTS  310  to an image receptor for imaging of a subject that is positioned on the radiographic table  302  or the radiographic wall stand  304 . The alignment of the OTS  310  with an image receptor may be directed and/or controlled automatically by a control unit  344  or the alignment may be directed and/or controlled manually. 
         [0034]    The lateral positioning rails  334  are operably coupled to the longitudinal positioning rails through one or more first motorized drives  334 . The carriage  336  is operably coupled to the lateral positioning rails  334  through one or more second motorized drives  336 . In some embodiments, the OTS  310  is operably coupled to the carriage  336  through one or more third motorized drives  338  that rotates the OTS about the vertical Z  316 . In some embodiments, the OTS  310  is also operably coupled to the carriage  336  through one or more fourth motorized drives  340  that extend the OTS along the vertical Z  316 . In some embodiments, the X-ray source  338  is operably coupled to the OTS  310  through one or more fifth motorized drives  343  that rotate the X-ray source  338  about the horizontal axis “b”  330 . 
         [0035]    Each motorized drive includes a motor, and a position feedback measuring device, and in some embodiments a clutch and/or a lock or a brake. Each position feedback measuring device further includes a potentiometer, an encoder, a resolver, or a similar device. In the embodiments that lack a clutch, an efficient motor (having high quality bearings and high quality gears) is directly coupled, so that in manual motion the operator causes rotation of the motor armature as well as the OTS. 
         [0036]    A control unit  344  is operably coupled to the one or more first motorized drives  334 , the one or more second motorized drives  336 , the one or more third motorized drives  338 , the one or more fourth motorized drives  340  and the one or more fifth motorized drives  343 . The control unit  344  controls operation of the motorized drives, which positions the X-ray source  338  and collimator  330  into alignment with a radiographic receptor  306  or  308 . The safety switch can be directly connected through a dedicated line or wireless channel to the control unit  344  so as to allow activation or deactivation of the motorized drives. 
         [0037]    In some implementations, more than one control unit  344  is included in system  300 . Each control unit controls one or more motorized drives  334 ,  336 ,  338 ,  340  and/or  342 . For example, in one implementation system  300  includes one control unit for each motorized drive. Each control unit communicates with the other control units, directly, or through other computers. 
         [0038]    The control unit  344  improves the accuracy of positioning of the apparatus  338  and  330 . The control unit  344  also maintains proper alignment of the apparatus  338  and  330  with the radiographic image receptors  306  and  308  over the full range of travel of the apparatus  338  and  330 . The control unit  344  also provides an ability to correct for imperfections in geometry in the apparatus and to allow for greater tolerance in precision in manufacturing and installation. The control unit  344  also reduces confusion of the operator in the relationship between the function of the switches and the motion of the OTS because the positioning of the apparatus  338  and  330  is performed by the control unit  344 . 
         [0039]    The system level overview of the operation of an embodiment has been described in this section of the detailed description. A control unit  344  controls the motorized drives to position an X-ray source of apparatus  338  and a collimator of apparatus  330  into alignment with a radiographic receptor  306  or  308 . 
         [0040]    While the system  300  is not limited to any particular radiographic table  302 , radiographic wall stand  304 , image receptors  306  and  308 , OTS  310 , longitudinal positioning rails  332 , lateral positioning rails  334 , carriage  336 , X-ray source  338 , collimator  330 , or control unit  344 . For sake of clarity, a simplified radiographic table  303 , radiographic wall stand  304 , image receptors  306  and  308 , OTS  310 , longitudinal positioning rails  333 , lateral positioning rails  334 , carriage  336 , X-ray source  338 , collimator  330 , and control unit  344  have been described. 
         [0041]    The system level overview of the operation of an embodiment is described above in this section of the detailed description. Some embodiments operate in a multi-processing, multi-threaded operating environment on a workstation, such as workstation  102  in  FIG. 2 . 
         [0042]    In the previous section, a system level overview of the operation of an embodiment is described. In this section, the particular methods of such an embodiment are described by reference to a series of flowcharts. Describing the methods by reference to a flowchart enables one skilled in the art to develop such programs, firmware, or hardware, including such instructions to carry out the methods on suitable computers, executing the instructions from computer-readable media. Similarly, the methods performed by the server computer programs, firmware, or hardware are also composed of computer-executable instructions. Methods  400  is performed by a program executing on, or performed by firmware or hardware that is a part of, a computer, such as workstation  102  of  FIG. 1 . 
         [0043]      FIG. 4  is a flowchart of a method  400  for configuring terminals, according to an embodiment. Method  400  solves the need in the art solves the need in the art for flexible workflow processing. 
         [0044]    Method  400  includes configuration of a first terminal  405 , configuration of other terminals  410 , and assignment of auxiliary imaging equipment. 
         [0045]    The imaging system  200  usually has the information available on scheduled list of patients received from the HIS database  250  and the prescribed scans. In a high throughput medical facility the number of patients to be scanned would be in the order of 15-20 patients per hour and most of this patients will already be waiting for their turn. A large amount of time is spent in positioning the patient and the imaging chain to conform to the required anatomy/view protocols. This is usually done prior to the x-raying of the patients. 
         [0046]    Lets say that the imaging system  200  supports the following auxiliary imaging components: x-ray generator (Gen) with one or more tube support say Tube 1 , Tube 2 ; one or more Overhead tube suspension, OTS 1 , OTS 2  holding Tube 1  and Tube 2   
         [0047]    multiple receptors—Fixed/stretcher Table, one or more wallstand, one or more portable/wireless detectors; room layout configuration—in sectioning out the room layout; a host processor or workstation  102  computing system and acquisition terminal terminals ( 105 ,  110 ,  115 ) allowing selection of multiple patients at any given time; an allocation protocol that allows x-rays to be generated on available tubes based on user selection; one or more exposure switches available to take x-rays at the selected image chain; access control mechanism to allow exclusive x-ray generation control at either image chain, if simultaneous x-ray not possible. 
         [0048]    System can be partitioned into multiple subsections: Chain 1 —consisting of terminal  105 , Gen, OTS 1 -Tube 1 , Fixed Table; Chain 2 : consisting of Gen, terminal  105 , OTS 2 -Tube 2 , Wallstand, etcetera; Chain 2  consisting of terminal  110 , Gen OTS 2 -Tube 2 , Wallstand and stretcher table. In case of single tube, the Chain 1  and Chain 2  share the OTS-Tube between them. 
         [0049]    In many cases, the patients may only need x-ray scans in either table or WS. In some cases they may need scans on Table and WS. In the second situation, having a stretcher table &amp; fixed table and portable receptors will suffice for image acquisition. 
         [0050]    The partitions the room into multiple sections that can be used independent of each other. So in one of the ways that the partitioning can be done with distribution of the auxiliary imaging equipment: Section  1  or room partition  1  Consisting of Fixed Table &amp; WS 1  &amp; OTS 1 ; Section  2  or room partition  2 —Consisting of Stretcher Table &amp; WS 2  &amp; OTS 2 . The room sections could be physically isolated for privacy reasons by using barriers or screens. 
         [0051]      FIG. 5  is a data structure showing the image acquisition chain  505 , terminal assigned to the chain  510 , and room  515  assigned to the chain, and if the room can be partitioned the section assigned to the chain  520 , and the auxiliary equipment assigned to the chain  525 . Further, note that if the terminal is not assigned the role of image acquisition then it would not be assigned to a chain and it is most likely performing foreground application processing or accessing archived images. 
         [0052]    In some embodiments, methods  400  is implemented as a computer data signal embodied in a carrier wave, that represents a sequence of instructions which, when executed by a processor, such as processor found in workstation  102 , cause the processor to perform the respective method. In other embodiments, method  400  is implemented as a computer-accessible medium having executable instructions capable of directing a processor to perform the respective method. In varying embodiments, the medium is a magnetic medium, an electronic medium, or an optical medium. 
       CONCLUSION 
       [0053]    A method and imaging system for flexible workflow processing is described. Although specific embodiments have been illustrated and described herein, it will be appreciated by those of ordinary skill in the art that any arrangement which is calculated to achieve the same purpose may be substituted for the specific embodiments shown. This application is intended to cover any adaptations or variations. For example, although described in procedural terms, one of ordinary skill in the art will appreciate that implementations can be made in an object-oriented design environment or any other design environment that provides the required relationships. 
         [0054]    In particular, one of skill in the art will readily appreciate that the names of the methods and apparatus are not intended to limit embodiments. Furthermore, additional methods and apparatus can be added to the components, functions can be rearranged among the components, and new components to correspond to future enhancements and physical devices used in embodiments can be introduced without departing from the scope of embodiments. One of skill in the art will readily recognize that embodiments are applicable to future communication devices, different file systems, and new data types. 
         [0055]    The terminology used in this application is meant to include all database and communication environments and alternate technologies which provide the same functionality as described herein.