A Special Report from SIIM 2010

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At SIIM 2010, Herman Oosterwijk discussed issues
that deal specifically with PACS connectivity. He
outlined the following  problems:

Not necessarily falling under the network but related is the need to
manage AE titles making sure they are also unique. Realize that some
devices have multiple AE’s with potential different AE titles. Incorrect
net mask definitions and/or VLAN specifications might make certain
destinations unreachable. A rather frequent occurrence is the incorrect
setting of the switch, e.g. to half duplex or mismatching the device
setting, especially when auto-negotiating is configured. Switch issues
result in major performance issues and can only be made visible when
using a network sniffer.

In this particular instance, the Institution ID
could have been mapped from the RIS using a worklist, while not checking
for any length violations (note that the source of the data, i.e. the HL7
data elements might not have the same restrictions). Missing
and/or incorrect patient demographics can be caused by the RIS being
down, or a technologist not using the worklist. This will cause a study
to be unverified or “broken” at the PACS. Some PACS
applications sort and display images according to image and/or series
number instead of according to slice orientation and body part causing
the images to be displayed in the incorrect order. When retrieving
comparison exams, one can run across some of the older date and time
formats in the header, which might cause issues as well.


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