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The steps are described in the following.

Order Entry

The first step of RIS system is order entry. Patients come & wait in a queue in the reception. Every patient must register first to get service. The information desk identifies whether patient is registered or not. A registered patient holds an HN (Hospital Number) which uniquely determines the identity. A new patient has to provide some particular information to get HN. Patient's demographic information is stored in HIS. All of patient's radiology information is put in RIS. Patient's demographic information is retrieved through HN from HIS (Hospital Information System).

If a registered patient forgets HN the operator searches the details from HIS by different specifications.

 

A patient who is unconscious or unable to deliver information is considered “John Doe”. John Doe is a facility that assigns HN to an unconscious patient. When the patient is capable to deliver statistics the particulars is collected & put in HIS.

HIS

At this step registration of a new patient is done. The acronym ‘HIS' stands for Hospital Information System. HIS contains the demographic information of the patients. If the patient is not registered an HN will be created for the patient through registration process. This information is placed in HIS. All radiology information is stored in RIS.

If the patient is “John Doe” HN is given instantly as HN is a must for every patient who wants to take service. Total information of the patient is collected later & put in HIS when the patient is capable to deliver the required information.

Schedule

RIS provides facility to make scheduling in both ways- automatic & manual. Automatic means RIS generates the next available time for the patient or patient can decide it manually. For the later, patient can choose the schedule himself according to the free schedule list. Patient gets an appointment card after the schedule is confirmed. Based on this information RIS prepares appointment confirmation work list internally. Besides, it prepares arrival work list that maintains the list of patients scheduled at a specific date.

Scheduling depends on modality. Any kind of image capturing device is called modality. Generally one single room contains one modality. The time to capture image is different for different modality. Thus modality affects the process of scheduling.

If patient has to satisfy certain conditions for the test to be taken properly, patient is instructed to follow some steps. This information is provided from Preparation Checklist. Preparation Checklist carries the preparatory activities for those tests where patients must follow some instruction. The patient instruction is then sent to PACS.

Modality Maintenance

Any kind of image capturing device is called modality. For smooth continuation of the modality & its accessories, checking & servicing must be made on a regular basis. As RIS contains history of the modality, the technologists can quickly find when to take the actions for Modality Maintenance.

Service frequency, Service work list & expiry date of the elements used in modality- all these are included in RIS. Service frequency means how frequently the modality should be serviced to preserve its quality. Service work list shows the list of servicing for modality.

Room Wise Modality is another subject to assess. It points that every modality record is kept on room basis. Likewise, specific modality handling task is assigned to some specific technologists. Technologist Wise Modality keeps track of the technologists assigned for each modality.

 

Old Film Scanning

 RIS contains patient work list which records the patients to be served in a day. Another list is made in this level called arrival patient list. When a patient comes to radiology department, the information is entered into this list. It may be manual or auto. Auto listing occurs if patient brings appointment card. Otherwise, manually this information is stored in arrival patient list.

Old film scanning takes place when the patient's old films (which are not in PACS) are required to examine. In this case the images are scanned & put in PACS machine. PACS (Picture Archiving Communication System) is a dedicated machine that can store lots of images in its server. RIS is integrated with PACS. PACS also contain some of demographic information of the patient, referring & consulting doctor, patient type etc.

Technologist Work List

Technologist work list is maintained in RIS that shows work load of technologists of a Radiology department. If patient has to follow some instruction for a particular test the technologists get confirmed of it. It's is notable that Preparation Checklist contains the instructions required to be followed. Afterwards, technologists capture the image & those are stored in PACS. After image capture, system get the capture details

Quality Assurance (QA)

The image captured in the previous step is examined in this step. If the quality is not satisfactory or up to the level quality assurance operators send this information to technologist work list from where technologist gets it known & image is captured again & the final one is stored in PACS.

Reporting

In this process Radiologist gets the work list to prepare the report. They prepare report & keep in RIS. Report is again verified by another specialist radiologist. The radiologist concludes the report & saves in RIS.

In some complicated cases reporting require film servicing again to justify patient's real condition. If so, old films (film based hard copy) are scanned & saved in PACS. The radiologist can find assigned job from Radiologist Work List & collects the images from PACS according to the test number against HN number.

Film Service

Radiologists may require the old images of the patients (which are not preserved in PACS) to prepare the reports. If so, old films (film based hard copy) are scanned & saved in PACS.

Superb Functionalities of RBRIS

RBRIS has a variety of tools that characterizes itself exceptionally among which are PACS integration, web based accessibility, DIPE, Automatic distribution of reports features. RBRIS can make the task of overall supervision of each & every activity of the entities of Radiology Department easier through some advantageous features like Patient turn around time, Patient time to wait, Preparation turn around time, Reporting turn around time, Weighted work load estimation.

Patient turn around time

It's the time duration between patient's reporting of arrival to the information desk & leaving the department. The order entry identifies first the patient's arrival & put the entry information in RIS. Time counting starts at that moment. Then wherever in the department

 

Patient time to wait

It's the time duration between the patient's reporting of arrival to the Order Entry & the time to get the service.

Preparation turn around time

It's the time duration that a patient needs to be fit for image capturing. Some image capturing procedure requires preparation, that is, a patient is not considered fit for image capturing unless the patient takes early preparation. For instance, Abdominal/Gall Bladder Ultrasound Preparation Instructions is
nothing to eat or drink after midnight prior to the examination. So this is Preparation turn around time for Abdominal/Gall Bladder Ultrasound patient. So a patient of Abdominal/Gall Bladder Ultrasound must be instructed of this information earlier.

RBRIS maintains a Preparation checklist which contains this sort of information. So the operator can inform the patient whether to take any preparation for its case.

Reporting turn around time

It's related to appointment scheduling, re-scheduling or cancellation. During appointment booking patient is offered a certain period before which the patient must report to the department of arrival or cancel the appointment if unable to meet the schedule. This feature helps to meet need of more patients systematically by allocating freed schedule to another patient.

Weighted work load calculation

This functionality measures the performance of the personnel involved with RIS activities. For this purpose, depending on time & labor required to capture image, a predefined weight is associated with each type of image capture. For instance, Stomach & Small Bowel Follow-Through exam takes 2-3 hours. In contrast Abdominal Ultrasound takes 30 minutes. Consequently, in same working time an Abdominal Ultrasound technologist can capture more images than the other one. So a non identical weight is assigned for each job & when performance is calculated, we may get a realistic comparative view of their performance.

RBRIS contains each technologist's work history. Weighted work load calculation can make a proper measurement of performance & help to take any step regarding improving the technologists' performance.

Integrated with PACS

PACS replaces hard-copy based means of managing medical images & thus reduces a lot of hazards to preservation. An integrated PACS allows including images on reports. PACS also can be integrated via DICOM or HL7.

Web based

RBRIS allows to view images & write reports directly into the RIS from anywhere around the world through an easy to use, web based interface.

DIPE

RBRIS has option of DIPE (Dynamic Tracking of Patient Examination) which allows radiology center to track the day, time & agent where the exam order originated till the day time the exam has been distributed.

Automatic distribution of reports

Automatic distribution of reports to the preference of referring physician, it is a very important, critical & extremely helpful feature of RBRIS, especially for large centers where number of studies are very high. This feature makes delivery of reports very efficient.