DxECHO

Detailed Overview


 

Image Management & Reporting for Cardiology

DxECHO® systems are DICOM compliant and work with DICOM digital and video data. Workstations operate in local area network (LAN) or Web only modes and run on Windows operating systems. Storage solutions utilize the latest high performance RAID 6 file servers, located remotely or on site. HL7 interfaces provide communication with HIS, RIS, CIS and billing systems. DxECHO® exceeds HIPAA requirements with full security, an audit trail, and electronic signature capabilities.

 

Digital Image Review

Digital images can be displayed on demand via local area network, or read from a CD/DVD-ROM or external storage device. DxECHO® has no study size or clip length restrictions. Images stored on a DxECHO® system can be accessed at other workstations on the network, through a web browser to any computer having web access, or sent to remote sites via DICOM push or SFTP, where any typical computer running Windows 7 or higher can view the reports or images.

Image review tools include a study Preview Screen for fast review of all images in the study. Dual and quad screen matrices can display loops using images from different views, different studies, and different modalities (Cath, Echo, X-ray, MRI, CT, etc.). Clips may be saved as slides or AVI clips for conferences or teaching purposes. Intuitive controls allow the user to adjust the speed of playback, step through the clip frame by frame, control brightness & contrast, and zoom images.

 

On-line Storage and Archive

Studies may be read from or stored to the network and most devices connected to the workstation. Supported formats include DICOM, JPEG, AVI, & BMP. RAID 6 file servers are highly scalable, providing reliable, fail-safe storage space for hundreds of thousands of studies at standard data rates. Archive solutions include everything from external USB hard drives to Network Attached Storage (NAS) devices, or enterprise grade Storage Area Networks (SAN).

 

Modality Integration

The DxECHO® package includes on-screen calculations for 2-D, Doppler, M-mode, and Tissue Doppler. Measurements can also be uploaded from supported ultrasound systems, or entered through forms. The Vascular modality includes reports and forms for carotid, lower extremity arterial and venous, upper extremity arterial and venous, abdominal aorta-iliac, renal, arterial bypass, arterial treadmill, and venous reflux studies. Vascular templates can be annotated or marked as desired. The Cath modality includes on screen measurements, forms for entering cath data, and coronary artery templates for documenting angiography results.

The DxECHO® package provides professional reporting and a single clinical database for multiple cardiology modalities including echo, vascular, stress, cath, and nuclear studies. DxECHO® systems provide a solid foundation for comprehensive cardiology information and imaging networks. Core DxECHO® systems include general reporting and clinical database with modality specific forms and reporting. Options include specialized reporting tools for additional modalities, a comprehensive on-screen measurements package, links to HIS and ultrasound systems, and upgrades to digital image management.

 

Efficient, Professional Reporting

DxECHO® systems provide professional, well-organized, descriptive reports. Statements appearing in the report may be customized by the user for preferred clinical terminology and specific patient population. Report macros provide templates for procedures, conclusions, and recommendations by study type. In addition, the user can also create new study types.

No longer is there a need for dictation or separate report creation. Now, the reports are available as soon as the study has been read and can be distributed directly from the DxECHO® workstation via fax, email, or HL-7 links to hospital information systems.

Reports are professional, concise (one page or less), and highly configurable, with embedded images and graphics. Report titles, logos, patient/study work lists, precision of results, and measurement names may all be customized. Multiple, customizable normal range templates are included. Reports can be faxed or securely transferred directly from the application.

Practice and department statistics can be immediately compiled through the Report Query option. The Search program allows the user to mine the patient database for demographic data, diagnostic statements, quantitative results, and combinations of these.

 

RAID-6 File Server

RAID-6 file servers range in capacity, typically between 2TB and 50TB. In order to provide fast response time to multiple users, top-end file servers are configured with dual, quad-core, 3.00GHz Xeon processors, 32GB to 128GB of DDR SDRAM memory as needed and a RAID-6 disk system with a minimum of a 12 disk array for image cache. Raid-6 storage logic provides data striping at the byte level and also stripes error correction information. This results in excellent performance and good fault tolerance.

Departmental and Accreditation Reports

RAID-6 file servers range in capacity, typically between 2TB and 50TB. In order to provide fast response time to multiple users, top-end file servers are configured with dual, quad-core, 3.00GHz Xeon processors, 32GB to 128GB of DDR SDRAM memory as needed and a RAID-6 disk system with a minimum of a 12 disk array for image cache. Raid-6 storage logic provides data striping at the byte level and also stripes error correction information. This results in excellent performance and good fault tolerance.

DxECHO

Technical Details


 

Departmental and Accreditation Reports

Practice and department reports can be immediately compiled through the DxECHO® Query option. These reports include total cases/procedures for each physician or technician by date period selected, number of patients by referring physician, total cases by diagnosis or clinical indication, plus a variety of other summaries.

Database Search package

An optional DxECHO® Search program allows the user to search the patient database for demographic data, diagnostic statements and quantitative results. By simply selecting the desired criteria to create the target subgroup, the user can display the data in question or export it to an ASCII or Excel file.

Archiving

Archiving can be provided through a range of devices including external USB hard drives to Network Attached Storage (NAS) devices or enterprise grade Storage Array Networks (SAN). Sites sometimes have their own backup solutions in place and DxECHO® networks easily integrate with these strategies.

When archiving software is needed, DxECHO® normally recommends Veritas or equivalent software.

Key features of archiving software include:

DxECHO® Access image database management software allows storage and retrieval of images from the Network File Server or stand-alone DVD/CD/MO drives

Device level integration (no proprietary file systems) ensures seamless integration.

User selectable cache system (dedicated, system disk partition, direct read/write to optical disk) allows optimal system performance

 

Data Links to Ultrasound Systems

DxECHO® also provides real time communication links to all major ultrasound systems. These data links provide background transmission of patient demographic data, measurements, and comments from echo systems to DxECHO® servers. DxECHO®reports are auto-populated and the database is updated after the patient data is parsed. It should be emphasized that the data links are an electronic real-time communication facility. They are not an OCR (Optical Character Recognition) technique, which is sometimes subject to errors.

Secure Internet Communication

Users may securely transfer images and reports to anyone to view on any PC. For example, users can read a study (either at the hospital or at home), make a diagnosis, and e-mail the study to a surgeon or referring physician, who could view it on any standard Windows PC, with no special or additional software. See the Remote mode section for more information on this comprehensive internet facility.

HIPAA Requirements for Security and Privacy

The Security and Privacy facilities within DxECHO® products meet HIPAA requirements as well as 21CFR part 11 FDA regulations for electronic records and electronic signatures. The Security facility within DxECHO® software provides an administrator with the tools necessary to set up passwords and user rights for all system users. With the security feature, each user is required to log on and provide a password in order to launch the program. Once logged on, the user has access to only those features included in the security level assigned to him/her.

Log for Failed Access

The security logon feature includes logging all unsuccessful login attempts. After 3 unsuccessful tries, the log on screen is closed and a message is written to the Failed Access file. The user name, date and time are included in this file. This prevents unauthorized users from successfully guessing passwords and puts a stop to automated dictionary attacks on user accounts.

Database

The DxECHO® database utilizes the open architecture Microsoft 2012 database engine. Users may access the database directly for interfacing with other applications. The powerful SQL query structure is available for users in constructing their own reports and/or searches.

The DxECHO® export facility includes a “flat file” export (one row per study) of database subgroups. This export, which can be set as an ASCII or Excel format, is exceptionally convenient for research purposes.

 

Mass Storage

DxECHO® helps sites select a storage solution based on current needs and projected growth. Suggested DxECHO® storage solutions include a range of choices from file servers to PACs archives. RAID 6 file servers, LTO tape backups and diverse storage array networks are currently supported solutions.

DICOM

DICOM is the imaging standard for multi-modality images (echocardiography, X-ray angiography, nuclear cardiology, OB/Gyn, radiology, etc.). DxECHO® systems are built on DICOM imaging standards both for network and media communication. Applications that utilize the DICOM standard can share images and image metadata with other applications.

HL-7 Interfaces

HL-7 interfaces provide connectivity between applications for text and data exchange. DxECHO® utilizes HL-7 interfaces to provide real time communication with hospital information systems. HL-7 interfaces include ADT, Order in, Results out, and Billing.

Export

A comprehensive export facility provides both automatic and explicit export of data in a variety of formats: ASCII (formatted and delimited), RTF, and PDF. Export files can be sent to pre-determined locations, upon pre-determined events (such as electronic signature), using user configurable file names. Special database export facilities are provided for Excel export and ASCII export using the DxECHO® Query function and an auto-formatting spreadsheet facility.

Electronic Signature

Once the physician has completed review of a study, he selects Electronic Signature, enters his password, and the report will be electronically signed. Distribution rules can be set so that the study is automatically sent through hospital distribution channels once a report is electronically signed.

Audit Trail

An associated Audit Trail facility provides user/date/time stamps of all changes to final reports together with a pdf version of the full revised report. The user/date/time stamps together with the changes are stored in an audit database so that audit queries can be run as needed.