JiveX Enterprise PACS Solutions

JiveX Enterprise PACS Solutions Product Description Version 4.3

2 Index JiveX...Page 3 PACS Server...Page 5 Modality Gateways...Page 8 Workflow Management...Page 10 JiveX DICOM Worklistbroker... Page 12 JiveX Mammo Screening Manager... Page 14 JiveX HL7 Gateway... Page 16 JiveX Study Verification Manager... Page 17 JiveX Routing Scheduler... Page 18 JiveX DICOM Mail Gateway... Page 19 JiveX DICOM Router... Page 20 JiveX DICOM Import Gateway... Page 21 JiveX Presentation Manager... Page 22 Digital Archiving...Page 24 JiveX Offline Storage Service... Page 26 JiveX Archive Manager... Page 28 JiveX Archive Manager DR... Page 28 JiveX Archive Gateway... Page 31 JiveX DICOM PACS Gateway... Page 32 Client Applications...Page 33 JiveX Diagnostic... Page 37 JiveX Diagnostic Mammo... Page 40 JiveX Mammo Report Manager*... Page 43 JiveX Demonstration... Page 46 JiveX Quality Assurance... Page 49 JiveX Review... Page 50 JiveX Review Web... Page 52 JiveX DICOM Viewer... Page 53

3 JiveX The Modern Image Management System for All Fields of Medicine In today s era of DRGs and continuously mounting cost pressure, there is a growing need to design PACS solutions as integrated comprehensive solutions, and they have to represent the entire image management of a hospital or a group of hospitals. This is the only way they can meet the aim of integrating all diagnostic activities into a uniform patient record. This way they contribute to a reduction of reading times and patient stays, and help improve quality of patient care through optimized communication. JiveX makes it possible to realize integral solutions of this kind, still taking into account the specific requirements of the respective fields of medicine. The concept consists of making available all relevant applications at each workplace of an organization, based on a unified platform of modern Web technologies. This platform takes on all the logistics, from image acquisition to distribution of images and reports including digital reading, to X-ray conferences and image archiving. Organizational units have become larger in today s health sector. Actors are no longer individual hospitals but, to a growing extent, groups with increasingly challenging requirements regarding image distribution and archiving. JiveX adopts this approach in the way of an Enterprise PACS solution which integrates external clinical partners e.g. GP practices, hospitals, and specialized clinics consistently into a care giver s workflow, with the parties involved profiting from all benefits of fast communication of images and reports. Modern image management in healthcare calls for legally compliant management of data, integrated reading and reporting, and unified processes. JiveX pursues this holistic approach consistently. The JiveX portfolio of applications ranges from departmental PACS solutions for various fields of medicine to cross-departmental Enterprise PACS including teleradiology, and to complex, multi-site group solutions with data center operations. In addition, JiveX offers solutions for GP practices and for health care centres. JiveX Product Description - JiveX

4 JiveX is characterized by its particularly high speed, and lends itself perfectly to integration in an existing system infrastructure thanks to its flexible interfaces. The modular structure and the modern distributed system architecture allow for free scaling and tailoring according to individual requirements. The various server variants, extension modules, and workstations are configured to an individual image management solution which meets your needs. Thanks to total DICOM compliance, the system is independent from large equipment manufacturers (such as Siemens, GE, Philips); in addition, it runs on various operating systems e.g. Windows, Apple Mac OS X, Linux, and Sun Solaris, depending on the application area. JiveX supports common standard hardware and facilitates system maintenance through the single-point-of-administration concept. Important Note: The following product description has a modular structure like that of the JiveX product. Based on the PACS server with its various versions, it is possible to enlarge the system by activating various extension modules. Additional modules required are marked * in the following. JiveX Product Description - JiveX

5 PACS Server Custom-tailored Communication and Crosslinking JiveX can be connected smoothly to any image source. Via the DICOM interface, CT, MRT, or digital X-ray can be linked; via the video interface, integration of endoscopy or of analog ultrasound devices is possible. In this context, the JiveX Communication Server acts as the communication hub: it provides all connections to the PACS, it ensures end-to-end work processes as well as safe and fast retrieval of images and reports within the practitioner s IT system, the HIS, RIS, or other documentation systems. Based on national and international standards, JiveX works in conjunction with the systems of other leading manufacturers. Of course it complies with the requirements of IHE specifications. The JiveX Communication Server boosts an extreme scalability, and is available in various versions catering for your individual needs. The JiveX PACS Server which fits Your Individual Needs JiveX Communication Server This is the standard version of the PACS Server. It is capable of making available all relevant services required for smooth operation of the PACS. For this purpose, it generates all connections and combines the various modules into an individual image management solution. The integrated image database allows for the DICOM images of various modalities to be managed online at any time. With the suitable extension module, the desired long-term archiving strategy can be realized. Just by connecting various JiveX Communication Servers, a flexible DICOM communication platform can be created. JiveX Product Description - PACS Server

6 This allows to realize, e.g., the networking of sites, focused load separation, as well as campus-wide image management. The JiveX System lends itself to perfect integration into an existing system infrastructure thanks to its flexible interfaces, and can be extended at any time due to its modular set-up. JiveX TWIN Server The JiveX TWIN Server is the highly available PACS server in the JiveX family of products. It features all functions of the JiveX Communication Server plus additional options for high availability. For this purpose, two servers are installed which are independent from, and synchronized with, each other. Depending on the available hardware and network infrastructure as well as customer requirements, an individual high availability concept can be realized based on the JiveX TWIN Server. All extension modules for the PACS server need to be licensed for one server only in the case of TWIN Server installations. The same is true for services running on both servers. JiveX Communication Server (Embedded Version) The embedded version is a version of the JiveX Communication Server with reduced functionality which is embedded in individual independent modules and system components of JiveX. Examples include the JiveX DICOM Worklist Broker, the JiveX DICOM Router, as well as the various versions of the JiveX workplace systems. This JiveX Communication Server is laid out exactly in accordance with the DICOM communication requirements of the respective JiveX system. JiveX Data Center Server The JiveX Data Center Server is the key system component for longterm archiving in the data center. This solution is the final brick in the bridge between an inhouse PACS solution and the archiving systems in a data center. JiveX Product Description - PACS Server

7 For this purpose, the JiveX Data Center Server communicates directly with the JiveX Archive Gateway* which on the part of the customer - manages the connection with the PACS server via the DICOM protocol. The JiveX Archive Gateway handles encryption, compression, and caching of the DICOM data. In the data centre, the JiveX Data Center Server creates the interfaces to a monitoring system (e.g. HP OpenView) and, wherever required, to the billing systems. For long-term archiving, connections can be made to the archiving systems of the leading vendors. The JiveX system can be easily integrated into an existing system infrastructure thanks to its flexible interfaces. This solution was laid out in a way that IT staff in the data center can run it successfully with no DICOM know-how required. It makes possible high-availability operation 24x7. It is fully multiclient enabled and provides transaction safety which is in accordance with the highest requirements in healthcare. JiveX Product Description - PACS Server

8 Modality Gateways JiveX Independent and Flexible JiveX Modality Gateways provide the link between the PACS and the imaging devices (modalities). The JiveX system offers interfaces for the most diverse image and video formats, enabling it to connect almost any image source be it digital or analog - with the PACS. No matter whether you work with CT, MRT, digital X-Ray, angiography, nuclear medicine, ECG, or video endoscopy and photography with JiveX you can archive data from any type of medical imaging. Based on national and international standards, JiveX works in conjunction with systems from other leading manufacturers. It goes without saying that JiveX complies with IHE requirements. Modality Gateways for the JiveX PACS Server JiveX DICOM Modality Gateway Via this interface, all devices which comply with the DICOM standard are connected digitally within the network. This is how the communication between the modality and the PACS typically takes place. This gateway allows for image data to be sent directly, through the DICOM Storage Service, from the modality to the JiveX Communication Server. Via the same route, image data can be sent back. The JiveX Communication Server* is indexing incoming DICOM image data automatically. In addition, it is capable of processing data entry fields, keeping a log of the modifications, as well as to forward such data to other DICOM systems. Via the JiveX Study Verification Manager*, all incoming image data can be reconciled with, and attributed to, jobs from worklists. JiveX Product Description - Device Interfaces

9 JiveX ACR/NEMA2 Modality Gateway Via this gateway, image data can be integrated directly from older modalities which support the ACR/NEMA2 format and can export images into a shared network folder. The transferred image data is then migrated into the DICOM format and sent to the JiveX Communication Server via the DICOM Storage Service. In order to optimize data consistency, this module allows for DICOM Worklist queries. The DICOM Worklist query is a key step towards quality assurance. Via this worklist, the DICOM exams are linked with the respective patient before import. This allows for permanent integration of the image data into the reporting processes, and for data retrievability at any time. In addition, manual synchronization of data is possible via the graphic user interface. Any modifications of the data are logged in the DICOM files; they can be reproduced and are absolutely transparent. JiveX Analog Modality Gateway The JiveX Analog Modality Gateway supports the acquisition of image data via a frame grabber, scanner (TWAIN), or digital camera (USB), as well as the conversion of various image formats into the DICOM format by way of stills (single images). In order to attribute data to a patient, the module queries the DICOM worklist. As an alternative option, key patient and exam data can be entered manually. JiveX Analog Modality Gateway AV The JiveX Analog Modality Gateway AV is the standard tool for the acquisition and digitization of video signals and video sequences. This module communicates with other IT systems via standard protocols, which makes it possible to connect it with systems from the JiveX family of products as well as other PACS solutions. In addition, DVDs for documentation purposes can be created directly, and the image and video data can be exported into a directory. The key application areas of the JiveX Analog Modality Gateway AV are endoscopy, microscopy, sonography, and OR documentation. JiveX Product Description - Device Interfaces

10 Workflow Management JiveX Open and Transparent Key benefits of the JiveX system are the support for, and simplification of, key work processes of all clinical departments which work with the PACS solution. As an example, the flow of image data is supported from capture and reporting to generation of patient CDs and image distribution. For this purpose JiveX offers numerous options for automated data processing and data communication. In addition, flexible interfaces and modules help to achieve ideal quality of data. Workflow Modules for the JiveX PACS Server JiveX DICOM Worklist Broker Via the JiveX DICOM Worklist Broker, the integration of practitioner s computer systems, hospital information systems, and department solutions (RIS, CIS, OR planning, functional diagnostics) into a DICOM network is realized, and also worklist management. For this purpose, the system supports all relevant data exchange formats and interfaces*. JiveX Mammo Screening Manager This JiveX solution represents all processes for image management in mammography screening. It consists of a management component which has certified interfaces with the screening solutions MaSc (KVWL) and MammaSoft (KVB) driven by German payoraccredited physician organizations (KV), as well as an image database for the cache. The system was designed specifically for compliance with the demanding requirements regarding image logistics in mammography screening. JiveX HL7 Gateway Via this gateway module, data communication with clinical information systems is realized. Application areas include the communication of orders and reports, as well as the safeguarding of data consistency. JiveX Product Description - Workflow Management

11 JiveX Study Verification Manager The JiveX Study Verification Manager offers the option of reconciling incoming image studies in the PACS with orders from the patient administration system. Orders can be accepted via the HL7 gateway and DICOM Worklist Protocol. This software module is a key component for structured quality assurance. JiveX DICOM Mail Gateway The JiveX DICOM Mail Gateway enables the PACS server to send and receive, as an e-mail, studies with images and reports in the DICOM format. This system was developed specifically for smooth and safe communication in non-time critical applications. Typical application scenarios are image transfer to referring physicians and caregivers handling post-acute treatment. JiveX DICOM Router The JiveX DICOM Router is the optimal routing solution for automated and rule-based forwarding (Auto-Routing) of medical images in a network. This system is perfectly suited for use in teleradiology, and is flexible in its adaptability to individual requirements. JiveX Routing Scheduler The JiveX Routing Scheduler is used, in particular, in large teleradiology networks. It allows for flexible, rule-based sending of data and reports (routing) according to a service schedule, and for the monitoring of work processes. JiveX DICOM Import Gateway With this software module, patient CDs and DVDs can be imported into the PACS with assured quality. For this purpose, a DICOM Worklist can be queried, and reconciled with the DICOM data on the CD/DVD. JiveX Presentation Manager The JiveX Presentation Manager allows to store and restore views as well as steps in reporting (Capture and Continue). Furthermore, this module can be used to prepare the presentation of images in clinical demonstrations, in the OR, and during rounds. It facilitates and accelerates the access to images and visualization to achieve optimal support for the physician. JiveX Product Description - Workflow Management

12 JiveX DICOM Worklist Broker DICOM Worklist Management for All Disciplines Via the JiveX DICOM Worklist Broker, the integration of practitioner s computer systems, hospital information systems, and department solutions (RIS, CIS, OR planning, functional diagnostics) into a DICOM network is realized, and also worklist management. For this purpose, the system supports all relevant data exchange formats and interfaces*. The JiveX DICOM Worklist Broker is capable of managing data communication between various systems via a set of different interfaces. The most frequent use is the conversion of messages received by the HL7 Gateway or the file interfaces into DICOM Worklist Protocol. Systems which are connected receive information concerning archiving of image data including the pertinent exam parameters. For data exchange, the system supports, by default, various file formats. Typical cases are text files (ASCII) in formats XML or CSV. However, other formats can also be interpreted via a generic parser (interfaces description). Exchange data is typically cached in an agreed network directory. Furthermore, for worklist communication, the integrated patient database can be used. This way, the DICOM Worklist management can mapped, in combination with the JiveX HL7 Gateway*, with HL7 Order communication. The JiveX DICOM Worklist Broker supports simultaneous communication with several systems. As an example, orders from radiology, cardiology, and functional diagnostics can be processed simultaneously. Furthermore, several worklists from various information systems can be merged. This function is used, e.g., in cases where various departments or organizational units utilize the same devices. JiveX Product Description - JiveX DICOM Worklist Broker

13 The JiveX DICOM Worklist Broker is available as an extension module for the JiveX Communication Server and TWIN Server, or as a stand-alone system with an integrated JiveX Communication Server (embedded version). In addition, the workstation versions of the JiveX workplace systems can be augmented by this service in a constricted way. HL7 communication is not possible in this case because the JiveX HL7 Gateway is not available for this purpose. DICOM Services Supported: DICOM Basic Modality Worklist Service (SCP+SCU) Operating Systems Supported (Stand-Alone): Windows 2k/XP JiveX Modules Required: JiveX Communication Server or TWIN Server JiveX HL7 Gateway if applicable JiveX Study Verfication Manager if applicable JiveX Product Description - JiveX DICOM Worklist Broker

14 JiveX Mammo Screening Manager Integrated Image Logistics for Mammography Screening This JiveX solution represents all processes for image management in mammography screening. It consists of a management component which interfaces to mammography screening invitation and management software. The system was designed specifically for compliance with the demanding requirements regarding image logistics in mammography screening. The solution bundle includes an embedded JiveX Communication Server which manages the entire system. It serves to generate all links and integrates the various systems into one holistic image management solution. The integrated image database allows for the management of all images from the most diverse modalities. The system enables a balanced and optimized flow of information between the mammography systems, the screening software, the PACS, and the mammography workstations. DICOM Worklist Management for Mammography Screening The JiveX Mammography Screening Manager carries out the coordination of the DICOM worklist in a mammography unit. For this purpose, it generates the DICOM worklist from the interface information of the screening software and integrates that information - wherever necessary - with the worklists of a local RIS or GP IT system. This enables the best possible connection of mammography systems which can query only a DICOM worklist. Retransfer of admission parameters for documentation purposes is carried out by the mammography system via the JiveX system to the screening software. For this purpose, the relevant information can be extracted either via the DICOM MPPS protocol or from the DICOM image data, provided the modality produces pertinent information. JiveX Product Description - JiveX Mammo Screening Manager

15 Managing Image Logistics in a Group The interface connector allows, via auto-routing, for automated availability of all exams at the right time in the right mammography unit and even at the right workstation. For this purpose, each mammography unit requires a local JiveX Mammo Screening Manager. This is where images are cached temporarily for direct and fast access. The system communicates via DICOM protocol - directly with the mammography systems, PACS solutions, and workstations of that unit. Data transmission between the mammography units is carried out online, with optimized bandwidth and optional lossless image compression. As an alternative, data transfer - e.g. for a mobile mammography unit - can be effected through various removable media, e.g. a USB hard disk or DVD. The JiveX system supports the mammography systems and workstations of all approved vendors, providing a platform which is completely vendor-neutral. This solution bundle is accompanied by the JiveX Diagnostic Workstation Mammo, which is a completely integrated reading and reporting (via the Mammo Report Manager*) workstation for mammography. It goes without saying that this system can also be integrated into Jivex PACS solutions. Imortant Note: Software interfaces descriptions are required to check availability or applicability for your project or country. DICOM Services Supported: DICOM Storage (SCP+SCU) DICOM Basic Modality Worklist Service (SCP+SCU) DICOM MPPS (SCU) Operating Systems Supported (Stand-Alone): Windows 2k/XP JiveX Modules Required: JiveX Communication Server or TWIN Server JiveX DICOM Worklist Broker if applicable JiveX Study Verfication Manager if applicable The Jivex Mammo Screening Manager is available as an extension module, for the JiveX Communication Server and TWIN Server, or as a stand-alone system with an integrated JiveX Communication Server (Embedded Version). JiveX Product Description - JiveX Mammo Screening Manager

16 JiveX HL7 Gateway IHE Compliant Interface to all leading Information Systems Via this gateway module, data communication with clinical information systems is realized. Application areas include the communication of orders and reports, as well as the safeguarding of data consistency. The JiveX HL7 Gateway allows receipt of patient, exam, and reporting data for the optimization of the work processes. In conjunction with the JiveX DICOM Worklist Broker*, HL7 order messages can be converted into a DICOM Worklist ready for retrieval. HL7 queries to a patient database, e.g. in the HIS, can be carried out, too. The reconciling of orders with incoming image data is done via the JiveX Study Verification Manager*. The JiveX system is able to manage reports related to exams. Typically, reports are received as copies from a documentation system (RIS, CIS, etc.) and are then communicated together with the image data. This communication of reports takes place via the JiveX HL7 Gateway. JiveX supports automated data reconciliation with the leading information systems which manage the patient data, based on the specifications of IHE (Integrating the Healthcare Enterprise). Via the JiveX HL7 Gateway, change notifications are received. All relevant IHE profiles including Patient Merge and Patient Update are supported. All incoming messages are logged and entered in the patient database of the PACS server. This way, this database is available for subsequent work processes. Important Note: JiveX supports HL7 Version 2.x as a network-based interface via TCP/IP as well as via file import. Due to the multitude of individual formulations in HL7 communication, technical fine-tuning of work processes is required, as well as an adaptation to other systems. The JiveX HL7 Conformance Statement serves as a basis for this. JiveX Modules Required: JiveX Communication Server or TWIN Server JiveX DICOM Worklist Broker if applicable JiveX Study Verfication Manager if applicable JiveX Product Description - JiveX HL7 Gateway

17 JiveX Study Verification Manager Structured Quality Assurance for Your Image Management The JiveX Study Verification Manager offers the option of reconciling incoming image studies in the PACS with orders from the patient administration system. Orders can be accepted via the HL7 Gateway and DICOM Worklist Protocol. This software module is a key component for structured quality assurance. Increasing digital support of all work processes in medical care requires a high degree of integration and quality assurance. A multitude of subsystems need to be reconciled with the central administrative patient information. Obviously, this is also necessary for digital image documentation. The reconciliation of data of incoming imaging exams and pertinent orders can be handled in various ways: If a DICOM Worklist exists, it can be queried for reconciliation purposes. Verification is possible, too, based on HL7 Order messages received via the JiveX HL7 Gateway*. Of course, it is possible to combine these options in complex installations. The verification process can be automated by the system or carried out manually. For automated processes, error lists may be generated for unsuccessful matches. JiveX Modules Required: JiveX Communication Server or TWIN Server JiveX HL7 Gateway if applicable JiveX DICOM Worklist Broker if applicable JiveX Product Description - JiveX Study Verification Manager

18 JiveX Routing Scheduler Information Logistics for large Conglomerates The JiveX Routing Scheduler is used, in particular, in large teleradiology networks. It allows for flexible, rule-based sending of data and reports (routing) according to a service schedule, and for the monitoring of work processes. You define a set of rules for DICOM reception nodes in a time slot, using the integrated graphic service schedule with its web interface. Image data coming in, e.g. via a JiveX DICOM Router*, are then forwarded accordingly. All communication processes have been optimized for data transfer at maximum possible speed. For this purposes, highly compressed image data is sent in advance in order to allow the recipient to access the image material rapidly. This compression is lossy but of high quality (JPEG 2000). Subsequently, image data in lossless compression is sent. In large caregiver conglomerates, distribution of exams takes place in the shape of a star, via a central JiveX Communication Server with the service schedule as a switchboard. Exams are transferred per image. This limits the delay to one image only, and total transfer time goes up insignificantly due to the switchboard. JiveX Modules Required: JiveX Communication Server or TWIN Server JiveX DICOM Router if applicable JiveX Diagnostic Workstation if applicable The system supports automated dispatch and printing of reports. If reporting based on image data is realized, e.g. on a JiveX Diagnostic Workstation*, reports can be retransferred, via the central Routing Scheduler, to the JiveX DICOM Router which had fed the image data. This JiveX DICOM Router can subsequently print the reports on a connected printer. In this closed JiveX infrastructure, a consistency check of the telecommunications leg in line with the German legislation of data protection is supported by the generation of testing protocols. JiveX Product Description - JiveX Routing Scheduler

19 JiveX DICOM Mail Gateway E-Mail-based Image Communication The JiveX DICOM Mail Gateway enables the PACS server to send and receive, as an encrypted email, studies with images and reports in the DICOM format. This system was developed specifically for smooth and safe communication in non-time critical applications. Typical application scenarios are image transfer to referring physicians and caregivers handling post-acute treatment. The DICOM Mail Gateway is integrated seamlessly into the workflow. This makes possible efficient communication, causing no extra efforts. Each authorized user can initiate, with one mouse click, email dispatch of entire studies or single (key) images. Common image compression techniques are supported. Incoming DICOM emails can be adopted in the patient context of the image database. The optional Study Verification Manager* assures in a robust way data consistency by placing attributes to orders for third-party images from the leading system managing the patient data. This makes it possible to locate, even after years, third-party images used, e.g. as pre-exams for comparisons. All transfer data is protected by the international state-of-theart encryption standard open PGP which fulfils the requirements of the strict German legislation of data protection. Email adress and encryption key management is handled by the JiveX Software. It can be comfortably accessed through the graphical user interfaces (GUI). The JiveX DICOM Mail Gateway is available as an extension module for the JiveX Communication Server and TWIN Server, or as a stand-alone system with an integrated JiveX Communication Server (Embedded Version). In addition, the workstation versions of the JiveX workplace systems can be augmented by this service in a constricted way. Important Note: The e-mail protocol enables, as a matter of principle, fast and reliable transfer of data. Depending on the network infrastructure used, unexpected delays in transfer may occur due to problems on the part of the system. Therefore, we offer you, for application in teleradiology and in accordance with the German legislation of data protection, solutions optimized for transfer speed. They operate on the basis of point-to-point transfer, which makes optimal use of available bandwidths. DICOM Services Supported: DICOM Storage (SCP+SCU) Operating Systems Supported (Stand-Alone): Windows 2k/XP JiveX Modules Required: JiveX Communication Server or TWIN Server DICOM Mail Server JiveX DICOM Mail Viewer if applicable JiveX Product Description - JiveX DICOM Mail Gateway

20 JiveX DICOM Router Rule-based Forwarding of Image Data (Routing) The JiveX DICOM Router is the optimal routing solution for automated and rule-based forwarding (auto-routing) of medical images in a network. This system is perfectly suited for use in teleradiology, and is flexible in its adaptability to individual requirements. Forwarding rules can be entered in a very flexible rule base. Image data can be transmitted, e.g. by modality, referring physician, or current day of the week, to a specific recipient. All relevant DICOM fields can be combined with each other in a nested manner for rule definition. In addition, it is also possible to do a rulebased, logged overwrite, ex ante, of individual DICOM fields. This routing solution supports various network technologies based on TCP/IP. Image data can be exchanged, e.g. directly via ISDN, or via Internet/VPN using ADSL/SDSL. The router makes use of the DICOM protocol, and includes a license for the JiveX DICOM Modality Gateway* for connecting an imaging modality. As an option, the JiveX Analog Modality Gateway* allows to connect non- DICOM devices. DICOM Services Supported: DICOM Storage (SCP+SCU) Operating Systems Supported (Stand-Alone): Windows 2k/XP The JiveX DICOM Router is a stand-alone system with an integrated JiveX Communication Server (Embedded Version). Furthermore, the routing functionality is part of the JiveX Communication Server and TWIN Server; this allows creating highly complex high-availability routing systems. JiveX Product Description - JiveX DICOM Router

21 JiveX DICOM Import Gateway Quality Assured Data Import into Your PACS With the JiveX DICOM Import Gateway (previously the JiveX Patient CD Import Gateway), DICOM files can be imported into the PACS with assured quality. Data can be read from patient CDs and DVDs or from a directory. For this purpose, a DICOM Worklist can be queried, and reconciled with the DICOM data to be imported. The DICOM Worklist query is a key step towards quality assurance. Typically, a leading system managing patient data produces a third-party exam work order. Via this order, the DICOM exams are linked with the patient before import. This allows for permanent integration of the image data into the reporting processes and for data retrievability at any time. In addition, manual synchronization of data is possible via the graphic user interface. Any modifications of the data are logged in the DICOM files, they can be reproduced and are absolutely transparent. The PACS configuration permits to decide whether the third-party exams are supposed to be archived for the long term or whether they should be kept available only temporarily. Various scenarios are possible. Furthermore, the system can be adapted to individual customer requirements. This software module permits the import of all removable media integrated into the operating system as drives. Typically, this will be the case for USB sticks or removable disks. The usual use case is patient CDs and DVDs. However, image data from a USB stick or a removable disk can also be imported if used for, e.g. transport of data. During import, media with a DICOM directory (DICOMDIR) as well as media without one are supported. Please note: We recommend the use of an up-to-date virus scanner. DICOM Services Supported: DICOM Storage (SCU) DICOM Basic Modality Worklist Service (SCU) Operating Systems Supported (Stand-Alone): Windows 2k/XP The JiveX DICOM Import Gateway is available as an extension module for the JiveX Communication Server and TWIN Server, or as a stand-alone system to be connected with a third-party PACS. JiveX Product Description - JiveX DICOM Import Gateway

22 JiveX Presentation Manager On-Target Image Presentation and Information The JiveX Presentation Manager allows storing and restoring views as well as steps in reporting (Capture and Continue). Furthermore, this module can be used to prepare the presentation of images in clinical demonstrations, in the OR, and during rounds. It facilitates and accelerates the access to images and visualization to achieve optimal support for the physician. The collaborative work processes in hospitals require maximum levels of communication and reconciliation. Increasing information overload forces staff to concentrate on the crucial bits of information. For imaging-based diagnostics, this means making available exam results, including image and report, available for rapid and targeted retrieval. The image distribution technologies common today are reaching their limits due to information density. The JiveX Presentation Manager allows presenting relevant views of an image report in new ways, and integrating it into the communication processes. In contrast with so-called volatile captures, which capture process steps temporarily, the JiveX Presentation Manager allows for permanent archiving of these views, at any time and reproducible, in the database. During reporting, any status regarding the exam can be captured and archived similarly to bookmarks. In the exam list, each view is represented clearly by a screenshot. When these captures are retrieved from the list, JiveX automatically loads the respective exam and continues with the process at exactly that stage in the process. It goes without saying that the hanging protocols are reproduced, too. A click of the mouse takes you directly to the next view, which helps you navigate very rapidly through large volumes of data. Besides the demonstration, a multitude of further areas of application and work processes are supported. The solution is also used, e.g., in the operating room. Extremely insignificant effort is required for the preparation of image studies for rapid, on-target presentation in the OR. The same is true for digital rounds and for image distribution across the site. JiveX Product Description - JiveX Presentation Manager

23 During the reporting process, the method supports the acquisition of second opinions. The representation of a specific question can be captured by a click of the mouse and archived in the central database. The colleague can retrieve this view directly via the network at any time at another workplace and communicate his opinion to you. Key exam results can further be documented visually in a targeted manner, or entered in a collection of cases for student teaching. JiveX Modules Required: JiveX Communication Server or TWIN Server Pertinent JiveX workplace systems The workplace system JiveX Diagnostic for primary reporting is capable of archiving captures in the JiveX Presentation Manager and to reload them. The same is true for JiveX Diagnostic Mammo und JiveX Demonstration. The JiveX Review Client has only read access to captures. This means that no views can be added, but existing views can be loaded. JiveX Product Description - JiveX Presentation Manager

24 Digital Archiving Your Flexible Archiving Concept with JiveX The archiving concept is tailored to your individual needs. A PACS or mini-pacs for a GP s practice, as a campus-wide hospital solution or as a multi-client enabled system for your group of hospitals JiveX archives your image and video data efficiently regarding effort and cost. In this context, the data can always be saved online. In addition, all exams are stored in compliance with legal requirements on a secure media or in a tele archive. Top resilience is offered by the JiveX TWIN Server. Modern image compression techniques make optimal use of the respective storage capacities. This puts all preexams directly at your disposal. Archiving Modules for the JiveX PACS Server JiveX Offline Storage Service This software module allows connecting optical disc writers for the creation of offline media. All image data of the PACS server can be burned and archived, automatically and rule-based, to media such as CD, DVD, or Blu-ray. In addition, this module enables the creation of patient CDs (Image Report). As an option, the CD writing process includes the JiveX DICOM CD Viewer for automated image and report presentation, as well as a representation for Web browsers. JiveX Archive Manager The JiveX Archive Manager handles online storage (SAN, NAS) as well as archiving in an HSM system on a layer underneath, e.g. with a tape library. For this purpose, several volumes can be managed and grouped according to function. The integrated image database provides a good overview of the complete data repository at any time. JiveX Product Description - Digital Archiving

25 JiveX Archive Manager DR (Data Replication) The JiveX Archive Manager DR version supports, in addition to storage pooling in the SAN, NAS, or HSM by tape, data replication. Data replication can be configured in a flexible manner, and runs completely independently from the storage technology underneath. As an example, for online archiving various storage locations in distributed NAS systems can be accessed. The integrated status management shows you that location and as well the archiving status at any time. JiveX Archive Gateway The JiveX Archive Gateway allows to store all image data, automatically and rule-based, in a remote tele archive. The JiveX Archive Gateway handles the connection of the PACS Server to the JiveX Data Center Server*. JiveX DICOM PACS Gateway The JiveX DICOM PACS Gateway permits to connect the JiveX system to DICOM compliant third-party archiving systems. This makes possible the import of data from third-party PACS solutions, or connection of such solutions online as departmental solutions. JiveX Educational Archive With the JiveX Educational Archive, you can save - in an easy and rapid manner - relevant and interesting cases in your daily routine, for academic courses or as a reference collection with keywords. For this purpose, an additional server is installed upon request. The educational content is displayed via the MIRC implementation (Medical Image Resource Center) of the RSNA. JiveX Product Description - Digital Archiving

26 JiveX Offline Storage Service Your Audit-Proof Archive This software module allows connecting optical disc writers for the creation of offline media. All image data of the PACS server can be burned and archived, automatically and rule-based, to media such as CD, DVD, or Blu-ray. In addition, this module enables the creation of patient CDs (Image Report). As an option, the CD writing process includes the JiveX DICOM CD Viewer for automated image and report presentation, as well as a representation for Web browsers. The system supports various types of media. Besides CD, DVD, and Blu-ray, the image data can be written to a removable medium such as a USB stick removable disk, e.g. for transportation purposes. In order to optimize the work processes, writers with automatic labelling can be addressed. Offline Media Archiving The creation of archiving media, e.g. CD or DVD, takes place automatically and rule-based in DICOM format. This process can be managed via an administration console. All archived image data is indexed with the unique media number in the image database, and can be retrieved and played back at any time. As an option, copies of all archive media can be created automatically for reasons of maximum safety. With this software, a filing cabinet for all image data can be realized in accordance with the German Röntgenverordnung. The created media are not proprietary, and are as a matter of principle - DICOM standard compliant. As an additional option, the data can be compressed lossless using standard compression technology (ZIP). JiveX Product Description - JiveX Offline Storage Service

27 Image Report The work orders for the creation of "Image Report" media can be generated and managed from each JiveX workplace in the network (physician s room, admission, etc.). CDs, DVDs, USB sticks, or removable hard disks can be used as media. All media comply with the DICOM standard, and include a DICOM directory (DICOMDIR). JiveX Modules Required (if applicable): JiveX Communication Server or TWIN Server JiveX HL7 Gateway The system supports various configurable layouts for the media. In case report copies exist in the system, or in case key images are marked, these will be written automatically onto the medium together with the image data. In addition, the JiveX DICOM CD Viewer is written to each medium, accessible from the CD / DVD directly without any installation. For older PCs and any (non-windows) operating systems, a simple quick view is created, for presentation in Web browsers. As an alternative, pure DICOM media with no viewer can be created, too. Optionally, the JiveX Image Report media content can be anonymized. The JiveX Offline Storage Service is available as an extension module for the JiveX Communication Server or TWIN Server. For this purpose, there is also a version with limited functionality, for the creation of Image Reports. Furthermore, the JiveX workplace systems as workstation versions can be extended by this service. JiveX Product Description - JiveX Offline Storage Service

28 JiveX Archive Manager Always Online Storage for Your PACS The JiveX Archive Manager handles online storage (SAN, NAS) as well as archiving in an HSM system on a layer underneath, e.g. with a tape library. For this purpose, several volumes can be managed and grouped according to function. The integrated image database provides a good overview of the complete data repository at any time. A key task in storing large volumes of data is to support various physical and logical drives (LUN) and to set up so-called storage pools. This helps prepare for data migration processes, and works around any limitations at the level of the operating system (e.g. the 2TB limit under Windows) regarding storage of image data. This is the key functionality of the JiveX Archive Manager. It is capable of distributing all image data of a PACS solution, upon receipt of data, to various storage pools, and to design these pools according to individual customer needs. The logical and physical separation of large image data repositories can also make sense for organizational reasons. As an example, the image data can be stored to different pools by modality or by unit in the organization, in order to, e.g., keep departments separate from each other. Data pools can also be separated according to image formats to, decouple image distribution or to store video sequences in a separate data pool, for example. Separation of clients is supported as an additional area of application. This allows, e.g., separating image data from curative mammography from mammography screening data upon receipt of data by the PACS. Archive Manager DR (Data Replication) The JiveX Archive Manager DR version supports, in addition to storage pooling in the SAN, NAS, or HSM by tape, data replication. Data replication can be configured in a flexible manner, and runs completely independently from the storage technology underneath. As an example, for online archiving, various storage JiveX Product Description - JiveX Archive Manager

29 locations in distributed NAS systems can be accessed. The integrated status management shows you that location and as well the archiving status at any time. Increases in digitization and continuously rising volumes of data require storage and archive resources which, in turn, are continuously renewed. While the extent of digitization goes up, the degree of dependency on information technology and demand for high availability solutions is mounting. The response to that are highly available, audit-proof storage technologies as well as intelligent applications which can handle these resources efficiently. With the rule-based data replication by the JiveX Archive Manager DR, you can increase data security and optimize processes. In cases where, e.g., storage systems are available which differ in quality and performance, you can distribute these as you require. In a SAN, current image data can be stored for several months in a high-availability, performant manner. Subsequently or simultaneously, they can be copied automatically, upon request redundantly, to a NAS storage solution which is more economical. The utilization of audit-proof storage systems with WORM technology (Write Once Read Many) provides a different scenario. The respective storage sectors are configured by the storage vendor, using a rule base and so-called policies. This allows defining various lifecycle periods and safety mechanisms. In order to ensure audit-proof processes, these are typically restricted to merely one write cycle. These storage sectors require special treatment because copies are the only way data can subsequently be modified. For quality assurance purposes, however, direct modifications need to be possible for a certain period following the exam. The JiveX Archive Manager DR supports special system interfaces (APIs) of market leading vendors of storage solutions. These include, e.g., Hitachi and EMC 2. JiveX Product Description - JiveX Archive Manager

30 The JiveX Archive Manager DR allows reproducing modification processes by way of the integrated rule base for separation of client-related data pools. Neither the JiveX Archive Manager nor the JiveX Archive Manager DR is a substitute for SAN solutions or other intelligent storage systems. Quite to the contrary, they complete the functionality of such systems and make optimal use of their possibilities. JiveX Modules Required: JiveX Communication Server or TWIN Server JiveX Product Description - JiveX Archive Manager

31 JiveX Archive Gateway The Connection with the Data Centre The JiveX Archive Gateway allows to store all image data, automatically and rule-based, in a remote tele archive of a strong service provider. The JiveX Archive Gateway handles the connection of the PACS Server to the JiveX Data Center Server*. The JiveX Archive Gateway is capable of encrypting DICOM data in accordance with the German legislation of data protection, and to compress it lossless before it is outsourced to the long-term archive. A local image database enables caching in online storage for fast access. An administration console makes it possible to control archiving in the network at the site of the JiveX Archive Gateway, enabling a possible transparent access to the remote long-term archive. In addition, the system can be ordered, by a connected RIS or PACS via the DICOM interface, to reproduce (fetch) image data from the long-term archive and to dispatch these. The JiveX Archive Gateway is available as an extension module for the JiveX Communication Server and TWIN Server, or as a standalone system with an integrated JiveX Communication Server (Embedded Version). DICOM Services Supported: DICOM Query/Retrieve (SCP+SCU) DICOM Storage (SCP+SCU) DICOM Storage Commitment (SCP+SCU) Operating Systems Supported (Stand-Alone): Windows 2k/XP JiveX Modules Required: JiveX Communication Server or TWIN Server if applicable JiveX Data Center Server JiveX Product Description - JiveX Archive Gateway

32 JiveX DICOM PACS Gateway DICOM Communication with Third-Party PACS Solutions The JiveX DICOM PACS Gateway permits to connect the JiveX system to DICOM compliant third-party archiving systems. This makes possible the import of data from third-party PACS solutions, or connection of such solutions online as departmental solutions. Communication takes place, with no exceptions, via the DICOM Standard. All image data which is forwarded by the JiveX DICOM PACS Gateway to a different system is indexed ex ante, and can be researched via the integrated image database. The image data itself is stored only temporarily in the JiveX system, and retrieved on demand from the third-party system via DICOM protocol. In this context, the JiveX Communication Server can serve also for temporary storage. This means that image data can be cached for a defined period of time. In addition, a leading departmental system (RIS, CIS, etc.) can place an order via the DICOM interface for pre-fetching. DICOM Services Supported: DICOM Query/Retrieve (SCP+SCU) DICOM Storage (SCP+SCU) DICOM Storage Commitment (SCP+SCU) JiveX Modules Supported: JiveX Communication Server or TWIN Server JiveX Product Description - JiveX DICOM PACS Gateway

33 Client Applications Individuality and Efficiency The JiveX systems sport a modular system architecture and can be extended, in the network, by various platform-independent workplace systems. JiveX supports, for respective areas of application, several operating systems. The Communication Server, which is the switchboard of the JiveX Systems, manages the image database centrally and makes it available to the workplace systems. Depending on the concept for the network, access to images from the workplace can take place suited to particular needs directly from the server (on-demand) or rule-based via automatic autorouting/pre-fetching. In addition, the server makes available, via the DICOM Query/Retrieve protocol, a standard interface which allows for seamless integration of common third-party systems into the network at any time. Workstation or Client Workplace systems are differentiated according to workstation and client. Both systems offer benefits depending on the area of application and available network topology. Client Application Most workplaces are used as a normal JiveX Client application. This application accesses directly the PACS Server in order to load image data (on-demand). A prerequisite for this is sufficient network capacity which should suit demand. For common application scenarios, standard networks are absolutely sufficient. Even reporting and X-ray demonstration takes place in a highly performant manner via a usual network. Workstation Application A JiveX workstation disposes of an embedded JiveX Communication Server with an integrated image database and independent DICOM communication services. This is how that workplace can be operated even without PACS Server, with extension options for proprietary additional services. Via the integrated server, pre- JiveX Product Description - Workplace Systems

34 fetching or auto-routing directly to the workplace is possible. In addition, on-demand access to a central PACS server or a remote server can be realized via a WAN (Wide Area Network) connection. JiveX Workplace Systems JiveX Diagnostic The independent reporting software JiveX Diagnostic was designed for all imaging modalities based on the DICOM standard. It sports a broad spectrum of image processing options, including multiplanar reconstruction. In conjunction with the integrated workflow management, it provides rapid image reporting and top work efficiency in radiology, cardology endoscopy, sonography, and further areas in imaging. JiveX Diagnostic Mammo The independent reporting software JiveX Diagnostic Mammo was developed specifically for curative mammography and mammography screening. The highly specialized hanging and reading protocols meet the most challenging requirements for smooth work processes. As an option, the system disposes of the JiveX Mammo Report Manager which is a fully integrated module for reporting. The optional JiveX Mammo Report Manager is an extension module for JiveX Diagnostic Mammo. This software allows you to manage the entire reporting process for screening from primary reporting to the consensus conference, with a connection to the mammography information system via the IHE reporting workflow interfaces. Furthermore, supervision is supported. Seamless integration of the reporting editor with partly automated documentation provides highest work efficiency and security. JiveX Product Description - Workplace Systems

35 JiveX Demonstration As a special workplace for clinical demonstration and image representation, JiveX Demonstration was laid out with functions for preparing and realizing presentations. The moderation mode provides you, on an additional managing monitor, with all relevant exam and reporting information in a clear manner. For image representation in the operating room and for digital rounds, too, JiveX Demonstration is the ideal solution. JiveX Quality Assurance The JiveX Quality Assurance Client enables direct access to the image database to allow for post-hoc correction of erroneously entered information. This process includes audit-proof logging of all modifications. JiveX Review This workplace system allows for interactive image viewing at each networked workplace. The transfer of image data takes place in a highly performant manner. The special JiveX transfer protocol transfers the image data, depending on the use scenario, in various qualities on-demand from the PACS Server to the workplace. JiveX Review Web This workplace system for image and report distribution allows for easy and extremely rapid retrieval of images and reports via a Web browser. For this purpose, all image data is prepared automatically. This means that greyscale and contrast settings can be prepared automatically, supported by standard parameters, or manually by the radiology staff. JiveX DICOM Viewer The JiveX DICOM Viewer is the image viewing software for DICOM files. It is capable of loading and displaying DICOM files from a file directory or a removable medium (CD, DVD, USB stick, etc.). System handling is extremely easy, and sports a multitude of image processing functions. The JiveX DICOM CD Viewer version was produced specifically for the display of DICOM image files from patient CDs. It is capable, as an additional function, of displaying available report texts, and thereby provides the direct relation between image and report. JiveX Product Description - Workplace Systems

36 The version JiveX DICOM Mail Viewer allows for the retrieval of DICOM e-mails, and can be coupled directly with the DICOM e-mail system. This makes it particularly suitable for referring physicians, as it enables easy and safe receipt of exams including image and report. The integrated image processing offers the usual functions regarding measuring, enlarging, and contrasting of image data. JiveX Product Description - Workplace Systems

37 JiveX Diagnostic The Multi-functional Reporting Software for All Imaging Modalities The independent reporting software JiveX Diagnostic was designed for all imaging modalities based on the DICOM standard. It sports a broad spectrum of image processing options, including multiplanar reconstruction. In conjunction with the integrated workflow management, it provides rapid image reporting and top work efficiency in radiology, cardiology, endoscopy, sonography, and further imaging fields. Diagnostic The system has been optimized for efficient and secure reporting, e.g. for CT, MRT, X-ray, angiography, sonography, and nuclear medicine, based on the DICOM standard. Highly specialized hanging and reading protocols for all imaging methods allow for automated preparation, compilation, and display of images including selected pre-exams. The system is used for standard reporting as well as for teleradiology and other telemedical applications. For this purposes, it disposes of all required certificates and approvals. JiveX Diagnostic is available in a Client and a Workstation version. The client always works directly via the network (on demand) with the image database of a JiveX PACS Server. In addition, the workstation includes a local integrated image database and various extension options. JiveX Product Description - JiveX Diagnostic

38 Overview Functions Rapid navigation and clear overview Unrestricted image research and configurable worklists Rapid loading of images (Pre-Loading) Workflow-optimized management via mouse, keyboard, and keypad Ergonomic multi-monitor layout Display of report texts and status information Overview representation (Thumbnails) Tile mode with free image layout (2x2, 3x3, etc.) Stack mode for scrolling and mouse-wheel support Cine mode Volatile Captures for work progress interruption Optional Capture and Continue with Presentation Manager* Process-optimized hanging protocols Automated preparation and compilation of image data Automated loading of selected pre-exams Automated monitor and display layout Function and full screen display Comparative presentation with image synchronization Easy creation of hanging protocols Linking of various hanging protocols for reading protocols Comprehensive image processing functions Real-time greyscale windowing (Window/Level) Labelling (text, arrows, shapes, polygons, etc.) Measurements (angle, distance, density, statistics, etc.) Rotation, mirroring, inversion Freehand zoom, magnification glass, ROI zoom, 1:1 Multiplanar reconstruction MPR with maximum/minimum intensity projection, average (MIP/ MINIP/AVG) Axial, Oblique, and Double Oblique Function JiveX Product Description - JiveX Diagnostic