MINI PACS

Built my own PACS....yeah nothing better to do.
used the Conquest PACS DB and built up a couple o' servers out of spare parts.
one runs the PACS App and the other runs the SQL DB.
using both KPACS and OsiriX viewers on the images -
OsiriX is the king of viewers...Free, easy to use, 3d processing and it just don't care what flavor of dicom it is...if it's even close OsiriX will launch it.
I also rep the for sale, FDA Approved version from Aycan.
http://www.aycanus.com/product_fst_pg.php?prod_id=2

or anything else from Aycan as well....
anyway this isn't a sales pitch...just letting you know that you too can build your own PACS if you so desire...
I have several modalities sending into 'MINIPACS' and she's humming along
I am also going to be building a dicom gateway and am still deciding on whether it should run on a windows or linux box.
several to choose from in either flavor - google it - but since my linux machine has been running for the last year without a reboot I may just be lean to linux in this one...the linux DAS's I have at the paying job have been up for 3 months without an issue and the unix gateways we use generally run for over a year without issue....
you really don't want to be messing with gateways...set em and forget em (except for updates) is the best policy. vxcz
vxcz

m,.\
XCZ
z

vxcz
...my keyboard is spontaneously typing this crap....
turn you back for a second an the damn thing starts typing chars from the bottom row of the keyboard keys....

time to go...

CIIP Exam

I know everyone has been waiting patiently for results -
I received a letter from ABII earlier in the week notifying me of CE Credits from the meeting.
I thought these were for the exam and was excited as one usually does not get points for failing an exam. Upon close inspection I found these point look like they were awarded for the pre-conference symposium.

Evidently $200 bucks gets you 3.5 cat A credits...

upon reflection the pre-conf sym did not help with the exam, well at least it did not help me.

I suppose and hope somebody got something out of it.

I received a sms from TK this morning. He told me the results were online but I had to wait till I got out of the IT Managers meeting to check. To bad my crackberry doesn't work in the site - script errors - :( something else to work on.
Speaking of crackberry's here is a good vid.


Anyway - the exam results are here if you remember your login...

Congratulations to all you newly minted CIIP's out there!

Wireless DR?

Met with our IT Director and got our IT 5 yr plan for IT Infrastructure Strategic Architecture.

Before yawning and clicking back on your browser consider this - how closely are you integrated into you hospitals plan?

This is particularly important when you consider the new generation of imaging devices coming into the market.

Wirelss DR, clustered rooms and mobile imaging are going to be hitting the market in a big way in 08'.

Consider the session I was lucky enough to attend yesterday. I saw the flyer for this a month ago and noticed wireless DR on the agenda.

If you know anything about wireless you know the dificulties in locking the AP down WEP and WEP2 encryption SSID broadcast etc. All these make it difficult for any one to get by but anyone with enough time and patience can simply sit and capture paeckets till they get enough data to piece together files, passwords or IP and MAC addresses. Admittedly, they would have to be dedicated and committed to the task but the threat is out there.


Think i'm crazy? well, i'm doing it now at a local coffee shop just to prove a point. Bad guy WarDrivers do it everyday and the last thing you want is your data (especially medical data) in the hands of a hacker. Furthermore, virtually every wirless expert would admit that even

"the most secure WLANs aren't 100% safe from the continuously evolving external threats that include espionage, identity theft and other attacks, such as denial-of-service and man-in-the-middle attacks."

I got a satellite pic from this computerworld article



"The satellite photograph on this page shows how radio signals from a single access point can travel several city blocks outside of a building. Without proper security measures for authentication and encryption, any laptop with a wireless card can connect with the network or eavesdrop on all network traffic across that access point from any area within the colored areas on the map"

Admittedly these are a couple of years old but a simple scan at the local coffe shop will show (below) the

plethora of AP's within walking distance and if one were so inclined, one could connect an capture a few packets -

Like this - using my OWN EQUIPMENT (i am not hacking!

Open your prefered packet sniffer and tune in the network you want to sniff.

Pick off a few thousand packets (about 5 minutes worth)

Notice the way etheral breaks down the packets nicely?
Copy the selected data and save it with your prefered extension...
here are the first few lines of the raw packet:

oo70 ff d8 ff e0 00 10 4a 46 49 46 MT..........JFIF

0080 00 01 01 00 00 01 00 01 00 00 ff db 00 43 00 09 .............C..

0090 06 07 08 07 06 09 08 07 08 0a 0a 09 0b 0d 16 0f ................

00a0 0d 0c 0c 0d 1b 14 15 10 16 20 1d 22 22 20 1d 1f ......... ."" ..

00b0 1f 24 28 34 2c 24 26 31 27 1f 1f 2d 3d 2d 31 35 .$(4,$&1'..-=-15

00c0 37 3a 3a 3a 23 2b 3f 44 3f 38 43 34 39 3a 37 ff 7:::#+?D?8C49:7.

00d0 db 00 43 01 0a 0a 0a 0d 0c 0d 1a 0f 0f 1a 37 25 ..C...........7%

00e0 1f 25 37 37 37 37 37 37 37 37 37 37 37 37 37 37 .%77777777777777

00f0 37 37 37 37 37 37 37 37 37 37 37 37 37 37 37 37 7777777777777777

0100 37 37 37 37 37 37 37 37 37 37 37 37 37 37 37 37 7777777777777777

0110 37 37 37 37 ff c0 00 11 08 00 5b 00 8d 03 01 22 7777......[...."

And the final product:

To be sure, its 'only' a jpeg - but wait, remember what standards dicom images are based on?

And you probably have a freeware dicom viewer on your machine too...

Cabling nightmare

hello all, anyone a cabling wiz out there?
I know it been a few days since the last one here but work piled up while at SIIM.
I am sure some of you are waiting breathlessly for their CIIP certs to arrive in the mail - I personally run to the mail box every evening and...actually I haven't yet picked up the mail - the wife usually does that and I haven't really thought about the exam since I took it. I expect most everyone else is like that as well.

If you are like me you probably have about a million other things to worry about and CIIP ain't one of them. Kids, friends, home, will a server go down tonight are way higher on my list than CIIP. But since I am talking about it here now, I'll say I will be pleasantly surprised to pass.
as noted in my other posts and...(well I was going to say others but only clubpacs and I seem to show up on google) many of the test questions were terribly written. I am sure there are a few forums that have threads and please email me the links. in all the lack of chatter out there is underwelming...
...but there's always work!

A list of my active and soon to be active projects: (in no particular order)

Voice Recognition / Speech Recognition
Contract is in negs now. Lawyers are fighting over words and I am praying they get this thing done yesterday. I so need a new dictation system

QA
Getting quotes together to buy new monitor QA HW & SW
I spent a few days at an excellent SENCOR seminar and am unsatisfied with our current monitor QA.

Cath Lab
the above mentioned cabling has been a nightmare - first the second monitor boom never gets sent and ends up arriving 2 weeks late...which means the vendor must pull a crew from another site to come install...the new crew then doesn't want to pull cables to their competitors EP system - we fight, I win (sort of). I at least get them to pull near enough so I can get the EP guys to perform their end. Believe it or not the ADT's between 3 vendors were easier than this. THOROUGHLY unimpressed with all vendors at this point.

Vascular US
I am a bit upset with our vendor we've got a system that needs MS patches but the vendor won't let us patch and still support the app. oh yeah, did I mention that the vulnerabilities allow the machine to propagate worms across out network...so far antivirus is catching everything. No word yet on when or if we will be able to patch. Doesn't make me real excited about buying another system from them and I may not despite the fact that one of their products may well be a very nice fit for us.
FYI - All new systems going in will have a clause in the contract stating when and how the vendor will support updates.
Also see this which is a top ten list on when to change your PACS vendor but can easily be applied to other areas.

Reading Room
finally got everyone happy in there...maybe they're more comfortable now - at any rate the complaining has stopped and productivity is getting back up there. we'll see in a couple weeks when I receive the Turn-Around-Time for this month.

Inventory
This will be a new one, for a while now I've been wondering just what the hell I have out there, where the hell is it and how old it is. No records from previous caretakers could be found. Since I now have some help (RD started this week) I think this will be a good project to take on - familiarize him with the area and we'll get a better picture of what we got.

Training
Going to have the vendor bring in some apps people to refresh / retrain our superusersmastertrainers or what ever you call them. I have a few and with turnover and previous admin's priorities on other things I am wanting to make a fresh start.

DR
making progress with this one. We've seen about 6 vendors give us proposals. This is a joint effort with IT (as it should be) to find the solution which will fit every one's needs and I have a warm fuzzy feeling inside about this one.

PACS Health
I usually don't put vendor names in here but in this case I will. I am absolutely stoked about this one. If you don't know what PACS Health does google em'

OB U/S
this one is a pain in my...you get the picture - a department with no idea about where they need to be with their system and so far continue to think they will continue with their outdated and in efficient work flow...I am so glad I will not be supporting their app! (knock on wood for me)

Data Center
We have to re-rack our entire data center! I am a happy camper about this one! Allows me to move everything off our older MOD(s) and onto spinning disk to make some more room

That's about it - not bad for one guy (well two now) and this doesn't include the modality integration for new equip, opening a new urgent care with rad services and supporting a remote station 100 miles away and there's always...well, there's always something

Good Bye Providence

Finally on the way home from SIIM.


-yes I did take the CIIP exam.

-No I did not really study other than to read this book and drill friends in the biz.

the guy sitting next to me during the test had about 100 sticky notes in Huang's tome when I saw him in the lobby. The book had tattered edges and unlike mine, was clearly read through more than once.

Hope it helped him.


I am mixed on giving anything away as to test content other than to say that you really do need to know both the IT and Radiology side of the job. I know a few PACS Admins that would not do to well on the test and they've been in the business for years.


I will say this though...well, maybe I won't since everyone did have to sign a 2 page confidentiality form...

Anywho...everyone hit the watering hole after the big test - I couldn't tell if there were more nervous people pre or post test.

The pre-testers were starting to freak me out a bit. And some from that same group seemed to be a bit shell shocked after the test too...

Weird - this was a pilot test and some were treating the thing like their careers depended on the 'passing' the thing.

I went through the test in about an hour and spent another 40 minutes commenting on questions I thought were off. A couple of questions had multiple correct answers and those I talked to over drinks in the evening echoed my concerns. Most of the questions we commented on related to IT which makes a lot of sense.

Only a couple of tough ones in radiology and there were a few out of left field on the project management part.

I the test content outline is here and who knew you would have to know so much about education and characteristics of the adult learner - I probably have a good overview but I know I missed at least one or two in this section.

Has anyone out there put together a training program and related it to Blooms taxonomy? ... I thought not.

These are probably questions that will get thrown out but still, PACS training is not rocket science - I suppose if one were putting together a PACS Administrator program at the university level you would think about the 'types of learners' and the 'characteristics of the adult learner' but on the street most of us assume if you are a medical professional, Rad Tech, Nurse or Physician you probably able to learn how to view images on a PACS.

And the taxonomy is not without it's detractors - HERE is a good one that only takes 99 seconds to read. Here is another one on Bloom.

In reality I could care less about the validity of Bloom. I try not to put to much weight in a 50 year old theory that is being rapidly bypassed by more pragmatic and/or scientific cognitive methods.

Blah, Blah, Blah...

Lets just hope they leave a bit of the cognitive stuff in and not place to much emphasis on it - it's good to know but are we seriously going to use it?

At any rate, the best way to recover from an exam is to do what we did - head over to Hemingway's and order the 4lb lobster and wash it back with a couple of 15yr old Glenmorangie's



Good luck to all who took the exam and we'll see how we did in a month or so...

SIIM 07 - CIIP Exam

heard there will be questions on the DICOM standard

links below...

PS 3.1: Introduction and Overview
PS 3.2: Conformance
PS 3.3: Information Object Definitions
PS 3.4: Service Class Specifications
PS 3.5: Data Structure and Encoding
PS 3.6: Data Dictionary
PS 3.7: Message Exchange
PS 3.8: Network Communication Support for Message Exchange
PS 3.9: Retired
PS 3.10: Media Storage and File Format for Data Interchange
PS 3.11: Media Storage Application Profiles
PS 3.12: Storage Functions and Media Formats for Data Interchange
PS 3.13: Retired
PS 3.14: Grayscale Standard Display Function
PS 3.15: Security and System Management Profiles
PS 3.16: Content Mapping Resource
PS 3.17: Explanatory Information
PS 3.18: Web Access to DICOM Persistent Objects (WADO)

SIIM - Test Time

ABII is running the Pilot Exam for the CIIP Certification today.

Yikes! rumors are running rampant as to the difficulty of the test. But if the content is anything similar to the level of knowledge I've seen here everyone should be fine...trouble is that anyone with any standing around here keeps saying that they haven't seen any test questions and that their presentations are NOT and CANNOT be depended on to provide adequate preparation.

So what was the pre-conference symposium about - did I waste $200?

this thing may be a crap-shoot...

The good news is when I fail the thing I can retake it in September for 1/2 price...

Time to go to the trade show floor and grab lunch and schwag...

Good Luck on the exam everyone! You just may need it!