Managers of bone densitometry practices have the challenge of managing bone density (DXA) machines and a variety of health information systems. The most widely used systems include Radiology Information Systems (RIS), Hospital Information System (HIS), Picture Archiving and Communication Systems (PACS), and Electronic Medical Records (EMR) systems. We describe the workflow of a typical bone density office and how these systems integrate with each other.
Bone Density Work Flow from Scheduling to Report Delivery with BoneStation:
1) A bone density exam is scheduled by a bone density office staff, who enters the future exam date and patient information in the radiology information system.
2) Patient arrives for the exam on the scheduled day
3) A DXA technologist scans the patient on the bone densitometer. Patient information may be manually entered into the software for the DXA machine. Some information such as date of birth, ethnicity, and gender are required clinically. With functionality called DICOM worklist, the exams and patient information can be made readily available to the technologist by transferring it from PACS to the DXA machine.
After the bone density scans are performed, the technologist analyzes the scans and transmits them to BoneStation’s database. Scan images may also be sent to the PACS, which is often the central repository for all medical images produced at a center.
4) Next, a bone density specialist reviews the DXA scans from the BoneStation web application. The physician logs into BoneStation and views the list of scans to be reviewed. Each scan that is reviewed results in an automated bone density report.
5) BoneStation transmits the scan data, image and report to the HIS, RIS, or EMR. The actual destination varies based on the system used to provide results to primary care physicians.
6) Primary care physicians log in to their HIS, RIS, or EMR to check for patient results.
The purpose of PACS is mainly to store images. HIS, RIS, and EMR systems usually have different functions. In terms of results, these systems usually store just text. Many PACS systems provide the ability for HIS, RIS, and EMR systems to link to PACS, in order for primary care physicians to view images.