Citizen Potawatomi Nation Health Services

PACS, DR and RPMS Integration

Faced with an x-ray unit that had reached "end of life" status, and expensive repairs of out of date equipment in the future, Citizen Potawatomi National Health Services decided to install a Carestream DRX Evolution unit, along with a Carestream PACS with RPMS integration. InTelemed was chosen as the prime contractor to implement this new state-of-the-art system. InTelemed worked with the CPNHS IT staff to install a gigabit network, additional air conditioning in the server room (formerly the darkroom) and configure the PACS to have site-wide and Internet connectivity.

Below is a virtual tour of CPN Health Services and their new DRX Evolution and PACS system. To view the tour below, click your mouse anywhere inside the tour and drag to move the image. Click on the green cloverleaf for more information or to navigate to the next scene, or just click the scene below. You can zoom the image with your scroll wheel.

Carestream DRX Evolution at CPN Health Services

Sharon Gerards, Radiology Director at CPN Health Services, shows how they used the DRX Evolution in the video below.

Installing DR

The first phase of the project was to de-install their old system and install the new DRX Evolution. This would require downtime for the clinic, so speed was critical. The old xray unit was removed in 3 days. The following week a new Unistrut system was installed to support the new xray system. The DRX Evolution system was finally installed December 7, 2009.

Workers removing the old xray equipment.	A new unistrut system was installed under the old system..
Workers cutting concrete for electrical cables	Workers installing new Carestream DRX

PACS

While the room was being renovated, planning work began on the PACS system. The goal was to connect the PACS system to the Indian Health Service (IHS) RPMS RIS/HIS system. A Carestream EIS Broker was used to convert the HL7 order messages from RPMS to the DICOM format the PACS system and modalities could understand. Since the x-ray department would no longer need the darkroom, and the main CPN server room was at capacity, the darkroom was converted to the PACS server room. A portable rack was used to make it easier to service the PACS servers, and an air conditioning unit was installed to keep the room at a constant 65 degrees.

Networking

CPN Health Services used a seperate Internet connection for radiology so that their traffic did not impact the clinic's Internet traffic. IHS controlled the main Internet connection and firewall, which was part of the reason for CPNHS to have the secondary connection dedicated for radiology. InTelemed installed a new Sonicwall NSA 2400 firewall to control traffic to the Internet and secure the server for public access. The Sonicwall also was used to bridge the clinic network to the radiology network. This way any problems on one network would not affect the other. The PACS server was set up as a public web server so that physicians could view images from their office or home. A VPN was set up to Carestream for remote management of the PACS and DRX Evolution.

Automated CD Burning

CPNHS opted for the high end Carestream automated CD burning system. The automated system holds 100 CD's and automatically prints the patient name and birthdate on the label, along with the CPNHS logo, all with a click of a mouse on the Q/A station.

Workstations

Existing workstations throughout the clinic were used to view images. A simple web browser was all that was needed to view high quality images at the physician desktop. A dual monitor Q/A station was installed in radiology, along with a document scanner.

Results

The end result is CPN Health Services was able to double their throughput of patients, which is important for a busy clinic. Physicians are very happy to have images on their desktop even before the patient walks back to the exam room. Off-site radiologists read the images quickly and reports are put back into RPMS and PACS, available for viewing at any workstation in the clinic. "To be honest, no one wants to have a radiological exam done. With this system our patients spend less time and less effort for an exam.  And that is what it is all about…really.  The DRX Evolution room is truly evolutionary" says Gerards.

The new xray room at CPN Health Services.	The DRX 1 wireless detector.
Touch screen control of the DRX Evolution tube.	Motorized scissor arms of the DRX Evolution wall stand.