U.S. patent application number 12/686701 was filed with the patent office on 2010-05-06 for systems and methods for obtaining readings of diagnostic imaging studies.
This patent application is currently assigned to AGMEDNET, INC.. Invention is credited to Michael Goldner, Abraham Gutman.
Application Number | 20100114603 12/686701 |
Document ID | / |
Family ID | 38534609 |
Filed Date | 2010-05-06 |
United States Patent
Application |
20100114603 |
Kind Code |
A1 |
Gutman; Abraham ; et
al. |
May 6, 2010 |
Systems and Methods for Obtaining Readings of Diagnostic Imaging
Studies
Abstract
Systems and methods for method providing a diagnostic image
study to one or more interpreters may include receiving the
diagnostic image study at a first translator, making the diagnostic
image study available to one or more board certified and
credentialed interpreters substantially simultaneously, and
selecting one or more of the interpreters to provide an
interpretation of the images based on one or more variables.
Inventors: |
Gutman; Abraham; (Chestnut
Hill, MA) ; Goldner; Michael; (Natick, MA) |
Correspondence
Address: |
Sunstein Kann Murphy & Timbers LLP
125 SUMMER STREET
BOSTON
MA
02110-1618
US
|
Assignee: |
AGMEDNET, INC.
Boston
MA
|
Family ID: |
38534609 |
Appl. No.: |
12/686701 |
Filed: |
January 13, 2010 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
11334919 |
Jan 19, 2006 |
|
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12686701 |
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Current U.S.
Class: |
705/2 |
Current CPC
Class: |
G16H 30/40 20180101;
G06Q 40/04 20130101; G06Q 40/08 20130101; G16H 40/67 20180101; G16H
40/20 20180101 |
Class at
Publication: |
705/2 |
International
Class: |
G06Q 50/00 20060101
G06Q050/00 |
Claims
1. A method providing a diagnostic image study to one or more
interpreters comprising: receiving the diagnostic image study at a
first translator; making the diagnostic image study available to
one or more board certified and credentialed interpreters
substantially simultaneously; and selecting one or more of the
interpreters to provide an interpretation of the images based on
one or more variables.
2. A method according to claim 1, wherein the first translator
compresses and encrypts the diagnostic imaging study before the
study is made available to the one or more interpreters.
3. A method according to claim 2, wherein the first translator
performs bit wise compression on the diagnostic image study.
4. A method according to claim 1, wherein the diagnostic image
study is made available to the one or more interpreters by
transferring the diagnostic image study to a central server.
5. A method according to claim 4, wherein the central server is
connected to the Internet.
6. A method according to claim 1, wherein the step of selecting is
based upon one or more of the following variables: time of
response, the cost for the interpretation sub-specialty, years of
experience, physical location, availability to the interpreter of
specialized hardware or software, and number of previous
interpretations by the interpreter.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. application of,
and claims priority from U.S. patent application Ser. No.
11/334,919, filed Jan. 19, 2006, which is hereby incorporated by
reference herein in its entirety.
TECHNICAL FIELD AND BACKGROUND ART
[0002] The present invention relates to the transport and
distribution of diagnostics image studies and, in particular, to
systems and methods for obtaining readings of diagnostic images
from interpreters in locations remote from where the diagnostic
images were created.
[0003] It is known in the prior art to utilize the Digital Imaging
in Communication and Medicine (DICOM) standard to electronically
transfer diagnostic imaging studies from a modality or PACS
(Picture Archiving and Communications System) (both of which may be
referred to as an "imaging device" herein) to a remote user.
Examples of modalities include CAT scanners, X-ray machines, and
MRI machines. The output of these devices may be referred to herein
as a "diagnostic imaging study". In many cases the diagnostic
imaging study will include one or more images. In many cases, the
diagnostic imaging study will contain several images.
[0004] Many operators of imaging devices may experience
difficulties in ensuring timely and competent interpretations of
imaging studies. These difficulties may arise from many different
sources. For example, the imaging device operator may create more
studies than may be interpreted by on location interpreters. That
is, the interpreters that are located at the operator of the
imaging device (e.g., a hospital) may not have the time to return
interpretations in a timely manner.
[0005] Delays in receiving an interpretation may effect the
profitability of an operator of an imaging device. This effect may
come from billing requirements imposed upon the operator of the
modality. In particular, the operator is not allowed to charge for
a procedure until a final interpretation of the images has been
completed. A final interpretation may only be made using diagnostic
quality images, i.e., where the images being interpreted
essentially are an exact facsimile of the images output by the
modality, without any change in resolution.
[0006] In addition, the costs associated with hiring additional
interpreters (e.g., radiologists) may exceed the budget of a
particular image operator. For instance, a small hospital in a
relatively unpopulated area may not have the resources or the
demand to hire a full time specialist to interpret images. The
small hospital, however, may still need, for time to time, to have
interpretations done on imaging studies.
[0007] Furthermore, some interpreters at one location may have free
time that they could devote to interpreting imaging studies from
other locations.
SUMMARY OF THE INVENTION
[0008] Embodiments of the present invention may solve one or more
of the above mentioned limitations of the prior art. For instance,
embodiments of the present invention may allow operators of imaging
devices to make a particular imaging study available to one or more
interpreters that may be located in a location remote from the
operators. In addition, some embodiments may allow for interpreters
to place "bids" on the interpretations. Bidding could include
price, time of interpretation or any other requirement. For
instance, if multiple interpreters are simultaneously presented
with a imaging study, the first to respond may provide
interpretation. In another example, the interpreter that offers to
provide the interpretation for the lowest amount may be awarded the
interpretation. In this manner, operators of imaging devices may be
able to receive more timely or more cost efficient (or both)
interpretations of medical imaging studies.
BRIEF DESCRIPTION OF THE DRAWINGS
[0009] The foregoing features of the invention will be more readily
understood by reference to the following detailed description,
taken with reference to the accompanying drawings, in which:
[0010] FIG. 1 is an example of a system on which embodiments of the
present invention may be implemented;
[0011] FIG. 2 is a flowchart showing one embodiment the process
that occurs in the translator;
[0012] FIG. 3 shows an embodiment of the operations that may be
performed in the second translator;
[0013] FIG. 4 is a flow diagram showing one embodiment of
distributing image data; and
[0014] FIG. 5 is a flow diagram by which the operator of an imaging
device may get one or more interpretations of a study.
DETAILED DESCRIPTION OF SPECIFIC EMBODIMENTS
[0015] Referring now to FIG. 1, in some embodiments of the present
invention, the system 100 may include imaging device 102. Of
course, an imaging device is not required and the system may
receive images from any source. This imaging device 102 may be any
type of modality that may take diagnostic images of a patient. For
example, the imaging device 102 may be an MRI machine, a digital
X-ray machine, a CAT scan machine or any other type device. In
other embodiments, the imaging device 102 may be any type of
imaging device whether or not it is used for a diagnostic image of
the human or not. For instance, the imaging device 102 could be an
electron microscope or the like. The imaging device 102 transfers
the images to other devices in the internal network 105 at the
location where the imaging device 102 is located. For instance the
internal network 105 could be a local area network (LAN) that has a
plurality of devices connected to it. For instance, the imaging
device 102 could be connected via the internal network 105 to a
translator 104 and a PACS 107. As shown the network is connected to
a PACS 107. Of course, this element is optional and could be
omitted or other elements could be coupled to the network 105, or
the imaging device 102 could transfer the diagnostic imaging study
to a PACS 107 which in turn transfers it to the translator 104.
[0016] Typically, an imaging device 102 will transfer the
information, via the DICOM standard. As is well known, the DICOM
standard requires that while a transfer is occurring, the systems
at both ends need to be part of the transaction, and must be there
throughout the transaction. The transfer transactions (DICOM
push/pull) are very detailed and require interaction of the systems
for each study image being transmitted. In addition, the DICOM
standard requires that the imaging device provide all of the images
to whatever destination is selected. If an imaging device is
attempting to send the pictures/images to a remote site, the
transportation of the images may tie up the imaging device for a
substantial amount of time if the connection between the external
device and the imaging device 102 is not robust. That is, if the
imaging device 102 cannot get confirmation that each and every
image was transferred to the receiving device, the imaging device
may not move on to the next procedure until all of those images are
transferred. This, in turn, may lead to delays in the operation of
the imaging device and therefore increase the time of patient care
and, possibly, reduce the profitability of imaging device 102
because the profitability of such of a device increases as the
number of studies may increase.
[0017] In the system 100 as shown in FIG. 1 some of these problems
may be substantially reduced. For instance, the imaging device 102
is connected through a local area network, in some embodiments, to
a translator 104 as well as a PACS 107.
[0018] The translator 104, in one embodiment, compresses the stream
of diagnostic imaging data, as well as any data associated
therewith and then encrypts the data. In preferred embodiment, the
compression is lossless.
[0019] The translator 104 may include a central processing unit
(CPU) having a conventional microprocessor, random access memory
(RAM) for temporary storage of information, and read only memory
(ROM) for permanent storage of read only information. A memory
controller is provided for controlling system RAM. In one
embodiment, the translator 104 does not store any data to memory
until it is encrypted regardless of whether it has been
compressed.
[0020] Mass storage may be provided by known non-volatile storage
media, such as a, a digital versatile disk (not shown), a CD-ROM,
or a hard disk. Data and software may be exchanged with the
translator 104 via removable media, such as a diskette or a CD-ROM
or be downloaded via the internet or other connective network.
[0021] The translator 104 system preferably is controlled and
coordinated by operating system software such as Linux or DOS.
Among other computer system control functions, the operating system
controls allocation of system resources and performs tasks such as
process scheduling, memory management, networking, and I/O
services.
[0022] A network adapter also may be included to enable the
translator 104 to be interconnected to a network, such as the
internet 106 and LAN 105 or a dedicated wide area network. The
network, which may be a local area network (LAN), a wide area
network (WAN), or the Internet, may utilize general purpose
communication lines that interconnect a plurality of network
devices.
[0023] After compression and encryption are completed, the images,
in one embodiment, may be forwarded to the central server 110 to
which the translator may connect through the Internet 106 or
through a private network. In an illustrative embodiment, an
operator of the imaging device 102 will select which doctors or
other interpreters may have access to the images in a particular
study. That information dictates where and how the information is
stored in the central server 110. For instance, each doctor may
have an account at the central server 110, or each file may be
encrypted in such a manner that only particular doctors who are
authorized to see the images may access the information on the
central server 110. Advantageously, because the information is now
compressed and encrypted in such a way as to make it possible to
transport it using protocols other than DICOM, the information is
no longer subject to the DICOM requirements of image by image
protocol. Therefore, doctors may have access to the diagnostic
quality images much more quickly, and more doctors can have access
to the information in a completely flexible manner. In one
embodiment, the translator may direct the central server (based on
information received with the diagnostic imaging study) where to
study should be further sent without the need for any intervention
from the recipient(s) to whom the study was sent.
[0024] The system may also include an additional translator 108,
which decrypts and decompresses the information before it is viewed
by the device 112 (referred to herein as a viewer) used by the
interpreter to view the images associated with the diagnostic
imaging study. This additional translator 108 should be able to
decrypt the data and then decompress the data such that a perfectly
lossless representation of the original DICOM compliant data is
delivered to the viewer by the additional translator 108. As such,
any viewer 112 or any PACS will be able to display the study. This
allows for the many heterogeneous machines such as modalities or
PACS from different vendors to effectively communicate without any
involvement from the vendors or original manufacturers of the
modalities or PACS's. In one embodiment, the additional translator
108 may have the same or similar to capabilities as the translator
104 and vice-versa.
[0025] FIG. 2 is a flowchart showing one embodiment the process
that occurs in the translator 104. As shown, the process includes
steps performed in a specific order and includes a specific number
of steps. One of ordinary skill should readily realize that certain
steps may be omitted, certain steps may be added, and/or certain
steps may be performed in an order that is different from that
shown in FIG. 2 (or another flow chart shown herein) without
departing from the present invention.
[0026] As shown in FIG. 2, the process begins at step 202 where the
transmitter 104 receives images from the modality 102. The images
may be received in any manner but, typically, they are received via
the DICOM protocol. As such, the process of receiving the images,
in some embodiments, requires complying with all of the regulations
imposed upon DICOM and HIPAA (Health Insurance Portability and
Accountability Act of 1996). However, because the translator 104 is
located on the same internal network 105 as the imaging device 102
this transfer may be very fast as compared to point-to-point image
transmission to a remote location.
[0027] After the images are received at step 202, they are then
compressed at step 204. In some embodiments, the compression may
begin before the entire study is received. In other embodiments,
the compression may not begin until the entire has been received.
Regardless of when compression begins, in an illustrative
embodiment, the images as well as any meta-data associated
therewith may be compressed, for example, utilizing a "bitwise"
compression scheme. Bitwise compression is well known in the art
and may generally be described as applying bitwise logical
operators to a strings of bits to create a compressed version of
the original string independent of how these strings may be
interpreted by any computer software. In one embodiment, the
compression may be lossless compression. Of course, other types of
compression could be used and are within the scope of the present
invention.
[0028] After the information is compressed in step 204, the data is
then encrypted in step 206. In one embodiment, the data is
encrypted using an Assymetrical Encryption System (AES). In such an
embodiment, preferably 128-bit encryption is used. Of course, other
types of encryption may also be used.
[0029] In one embodiment, the operator of the imaging device 102
may be allowed to select certain doctors (or group(s) of doctors)
that may view or may be sent the particular study. In such a case,
the translator 104 may also encrypt the key to the data using a
particular individual or groups public/private pair, thus ensuring
that only those individuals may view the study. This aspect may be
important to the distribution of studies to certified and
accredited doctors as described in further detail below.
[0030] After steps 204 and 206 are completed, in one embodiment,
the information is stored to a hard drive of the translator 104.
Preferably, no data is ever stored to the hard drive of the
translator 104 until is has been encrypted, thus, even if the
translator is misplaced or otherwise unaccounted for, patient
information will not be readily available to anyone other than
those who were supposed to access to the information. In other
embodiments, the information is not stored to the hard drive of the
translator 104 but, rather, is immediately sent to another
location, such as the central server 110.
[0031] Regardless of whether the information is stored to the hard
drive, after encryption (and preferably after lossless compression)
the information may then be forwarded to the central server 110
via, for instance, the Internet 106. The information having been
translated may be transferred in any manner (e.g., via a packet
based connection) to the central server 110 rather than the
previously used and cumbersome DICOM protocol. The central server
110 may interpret the information that is received and forward the
study to specific doctors to whom the operator of the imaging
device 102 has previously selected. In this manner, the system may
allow for simultaneous point (the imaging device or PACS) to
multipoint (multiple individuals) distribution of diagnostic
images.
[0032] To ensure safety and privacy, as well as to comply with
HIPAA, the data (or the key to the data) may be further encrypted
using the doctor's public/private key. Of course, many other
methods of ensuring safety may be implemented and anything that
will ensure the compliance with HIPAA is preferred.
[0033] Of course, the reverse of steps 204 and 206 may be completed
in the second translator 108 as shown in FIG. 3. For instance, the
second translator 108 could decrypt and decompress the data so that
all the images of a particular study could be displayed on a viewer
112, for example.
[0034] FIG. 3 shows an embodiment of the operations that may be
performed in the second translator 108. The process includes a step
of receiving the encrypted and compressed images at step 302. In
one embodiment, the images may be received from a central server
110. In other embodiments, the images may be received from another
location such as, for example, a PACS or an imaging device. The
images are then decrypted at step 304 and then decompressed and
step 306. As one of ordinary skill in the art will readily realize,
many types of decompression and decryption techniques may be used.
Finally, the images may be displayed, for example, on a viewer 112
at step 308.
[0035] The foregoing discussion has provided an example of systems
and methods that may allow diagnostic quality images to be
transferred from a modality to one or more individuals. This
system, and others, may create a platform from which an operator of
an imaging device may make available to one or more remote
diagnostic image interpreters (for example, doctors, radiologists,
cardiologists, or other professionals qualified to interpret
diagnostic images) in a safe and efficient manner. In an
illustrative embodiment, the images may be made available to
interpreters that have been licensed and credentialed to interpret
images transmitted by the operator of the imaging device. For
example, the images may be transferred to a radiologist that is
remote from a hospital when the hospital needs an interpretation of
a study (or other collection of images) in a expedited manner but
does not have available on-site human resources to accomplish the
task. Additionally, this may allow a particular hospital to expand
its access to interpreting physicians who also have a translator,
while also allowing a single interpreting physician to provide
interpretations to several different hospitals, which also have a
translator on site.
[0036] FIG. 4 is a flow diagram showing one embodiment of
distributing image data. In general, FIG. 4 shows steps by which
diagnostic images may be distributed to one or more interpreters.
At step 402, the images that constitute a study (one or images) are
transferred from an imaging device 102 to a central server. For
example, and as discussed above, the images could be transferred,
after being compressed and encrypted to the central server 110
shown in FIG. 1. Of course, the images need not be either encrypted
or compressed. The images are then made available to one or more
licensed and credentialed interpreters at step 404. In order for an
interpreter to receive the images, under current law, the
interpreter must be licensed to practice medicine (for example, by
the state medical licensing board) in the state where the studies
were created. Also under current law, the interpreter needs to be
credentialed by the operator of the imaging device (for example, a
hospital or other health care provider) to provide diagnoses
related to the study. Of course, if the law were to change, then,
possibly, the interpreter would not need to be either credentialed
or licensed or either.
[0037] FIG. 5 is a flow diagram by which the operator of an imaging
device may get one or more interpretations of a study. In one
embodiment, the method shown in this flow diagram may facilitate
the more timely and cost effective interpretation of diagnostic
images. This may be achieved, for example, by allowing licensed and
credentialed interpreters to have a marketplace bid on "contracts"
to perform diagnostic interpretations. Such a market place may
reduce the time for receiving interpretations of diagnostic images.
In addition, such a marketplace may also reduce the cost of such
readings. For example, rather than having to have an interpreter on
staff at a particular imaging center, the imaging center could only
pay for the interpretations that it needs. This may be especially
beneficial in locations where it may be hard to recruit qualified
individuals, or where the cost employing such an individual is too
high.
[0038] The process begins at step 502 where interpreters that have
been selected by the operator of the imaging device are alerted
that a diagnostic interpretation is needed. This may be done in any
manner. For instance, the interpreter may have an account at, for
example, a central server that causes a notification (such as an
e-mail, a fax, a page, an instant message or any other means of
alerting the interpreter). Of course, the operator of the imaging
device may have selected the one or more interpreters from a list
of licensed and credentialed interpreters with which the operator
has an existing relationship. In some embodiments, the alert may be
represented as a possible interpretation placed on a message board
accessible by at least the selected persons, or at a location of
the doctor who referred the patient to the operator of the imaging
device.
[0039] The images may be provided to the final selected interpreter
at step 504. An interpreter may become the final selected
interpreter in at least the following ways: the interpreter that
first responds the desire and ability to perform the interpretation
is selected; the interpreter that offers the lowest price may be
selected; the interpreter that offers the quickest response may be
selected. Of course, other criteria may also be used to determine
the final selected interpreter. For example, the criteria may
include: sub-specialty, years of experience, physical location,
availability to the interpreter of specialized hardware or
software, and number of previous interpretations by the
interpreter.
[0040] The diagnosis (or final read) is then received at step 506.
The diagnosis could be received at any number of locations. For
instance, the diagnosis could be received at a central server or at
a location of the operator of an imaging device.
* * * * *