Product Information ------------------------------------------ ITL WarpSpeed RIS/PACS is a fully integrated, robust, state of the art RIS/PACS solution that exceeds the highest workflow and scalability standards in both small imaging facilities and large hospitals.  In addition to offering the best technology in the marketplace, ITL offers excellent customer service and data protection. ITL Enterprise Server      -ITL Workflow Manager      -ITL Schedule Server      -ITL Report Distribution Manager      -ITL HL7 Interface Engine      -ITL DFS Synchronization Engine      -ITL Liveness Monitor      -ITL DVD-Stack Archiver      -ITL Event Log Monitor      -ITL Resource Monitor      -ITL FileCleanup Engine      -ITL Startup Wrappers   ITL Archiving/Disaster Recovery   ITL Radiologist Workstation   ITL Web Viewer   ITL Steno Workstation   ITL Administrative / Scheduling Workstation   ITL Modality Workstation   ITL WebServer   ITL WebManager     WarpSpeed Product Line     ITL Enterprise Server ------------------------------------------ A true monolithic enterprise Radiology Information System (RIS) / Picture Archive and Communications System (PACS), offering unparalleled richness of function, scalability, and reliability Supports free-standing imaging centers, linked imaging centers, and hospital radiology departments of all sizes Optional redundant failover WarpSpeed server, with replication of image data, reports, and database, enhancing availability in the event of a catastrophic failure of the primary server Components include the ITL Workflow Manager, ITL Schedule Server, ITL Report Distribution Manager, ITL HL7 Interface Engine,  ITL DFS Synchronization Engine, ITL Liveness Monitor, ITL Tape Backup, ITL Database Shadower,  ITL EventLog Monitor, ITL Resource Monitor,  ITL FileCleanup Engine,  and ITL Startup Wrapper All image data is kept online within RAID5 subsystems in ACR/NEMA DICOM Chapter 10 file format for universal retrieval capability and transfer to other DICOM-compliant systems Windows 2003 Server Operating System (OS), Active Directory, Message Queuing, Distributed File System, COM/DCOM, DHCP, DNS SQL Server 2005 Database, resides on mirrored (RAID1) HDs   ITL Workflow Manager   Automates the workflow within an entire radiology practice, from an incoming study to report distribution, insuring that each study is performed, dictated, transcribed, optionally QA reviewed, signed, and distributed Ensures that the radiology information managed by the ITL WarpSpeed RIS/PACS is consistent and properly bound to the image data, thereby relieving radiology management staff from manually reconciling discrepancies Easily scalable from one to hundreds of stenographers, modalities, and radiologists Robust workflow routing that is impervious to power or network outages Time-stamped audit log for QA and performance review   ITL Schedule Server   Central scheduling of multiple sites with multiple imaging equipment (modalities) per site Prepares rendezvous between schedule studies and the performed studies for subsequent entry into the managed workflow Maintains schedule cancellation information Procedure based search for available times, including multiple step and multiple modality procedures Support for simultaneous schedule access from all workstations from all local and remote sites Global definition of times when modality equipment is available/unavailable each week Background integrity check and fix-up of all scheduled appointments   ITL Report Distribution Manager   Automatically prints, faxes or emails copies of report for requesting physician, consultants, patient records file, and billing after radiologist electronically signs report Logging of all report distributions, query of logs within Administrative Workstation Emailed reports are in PDF form and encrypted before transmission to physicians Capable of routing reports to printers located outside of the radiology department Site specific report templates Format embeds images within reports Support for multiple format reports such as a Billing copy that includes CPT codes and a Patient Records copy printed without images Automatic creation of Archive and Billing reports in PDF format Support for multiple PDF engines Verification of PDF format within generated files Report template definitions that allow for images to only be imbedded when report is distributed   ITL HL7 Interface Engine Provides an automated interface between a Hospital Information System (HIS) and the ITL RIS/PACS   ITL DFS Synchronization Engine Provides automatic deployment of software updates from the ITL Development Lab to a server at the customer site Software updates are then distributed to the other on-site servers and client machines using the ITL Startup Wrappers described below   ITL Liveness Monitor    Monitors network connectivity to all machines running ITL applications at the customer site Monitors critical management services executing on each machine The ITL Liveness Monitor resides on at least two machines at each site so that a failure of one machine does not result in loss of monitoring capability    ITL Event Log Monitor         Monitors the Windows event log for conditions that indicate a problem or changes,  for analysis by ITL support personnel Sources of events in this log include those produced Windows, ITL applications and ITL monitoring services. Records in the log cover hardware errors including disk i/o errors, software errors such as service or application failures, database errors and the result of ITL monitoring services such as disk free space nearing exhaustion. Events added to the log matching a set of pre-defined conditions result in email notifications to ITL support personnel, often before customer awareness of the problem   ITL Resource Monitor Periodically monitors dynamic resources on a machine When a monitored resource's property value cross a predefined threshold, an event is added to the Event log which in turn results in an email notification to ITL Personnel An example of a resource that is monitored using this service is disk free space.  When the available free space on a disk falls below 5%, an event log entry is produce. A corresponding event log entry is also produced when the free space crosses the threshold in the other direction so that ITL personnel know when the condition has been cleared This service can also produce periodic notifications for the state of a resource such as free space even if a critical threshold has not been crossed   ITL FileCleanup Engine Certain ITL applications cache temporary files locally for faster access or to provide another level of recoverability The FileCleanup Engine runs nightly to remove any of these cached files that have not been accessed for a configurable period of time   ITL Startup Wrappers All ITL applications are launched by a startup wrapper program, providing easier and automatic configuration setting changes and software updates, resulting in reduced support costs Should an application terminate abnormally, the wrapper will save pertinent information such as logs and dumps and then add a record to the event log,  sending a notification email to ITL personnel [   top of page  ]     ITL Archiving / Disaster Recovery ----------------------------------------- Provides data redundancy and file replication options for ITL WarpSpeed RIS/PACS customers as well as for users of other PACS systems. Configurable and scaleable for up to a 6X redundancy Improves post disaster recovery uptime of DICOM data, reports, database functionality, and overall system state  Solutions available in both local and remote configurations: Backup Server Fully redundant standby backup server with the ability to assume primary server functionality in less than an hour following an outage DVD Stack Archiver Accumulation of delta archives, including changes to files previously archived Archives DICOM files and reports for the current period, as well as database backups and other dynamic information and configuration files Configurable to produce multiple copies, thereby enhancing off-site disaster recovery storage strategies RAID Shadowing Includes multiple RAIDs in a replication configuration to enhance fault tolerance against failing RAID controllers Tape-based archiving   [   top of page  ]     ITL Radiologist Workstation ------------------------------------------ High degree of automation to increase efficiency Intuitive interface with both film (tiled) and stack hanging protocols Studies may be viewed within film and stack hanging protocols simultaneously Hanging protocols customizable by individual radiologists Film hanging protocol based upon a rotating view box paradigm Automatic cross-reference between stacks in different viewing planes Automatic stack splitting / linking for multi-echo MR series Stack magnification, stack linking Unique, medical multi-monitor capable design can display a virtually unlimited number of pixels of diagnostic image data Control of workstation via color touch-screen monitor, leaving medical monitor(s) available for image data Integrated report dictation with the ability to embed annotated images into reports Integrated report review, correction, electronic signoff, and amendment Integrated review of reports and comparison images from prior studies Full range of PACS tools including magnifier, window/level, ROI, measurement, and annotation Background image file pre-fetch from server, decompression into local cache Color-coded study priority [   top of page  ]   ITL WebViewer ------------------------------------------ This component provides for viewing of  patient information including images from a client computer anywhere on the internet or on your internal network.  Used by referring physicians and their staff to access reports, images, etc. from their office(s) Used by nursing and staff physicians on any computer within a hospital Used by radiologists for off-site reading The available capabilities are customized dynamically based on the role or assigned permissions of the login id that was used to connect to an ITL WebServer Secure communicate between ITL WebViewer and ITL WebServer Capabilities for all users: o   Automatically adapts to utilize all available monitors for image display.  No special hardware is required as the ITL WebViewer will adapt to high resolution or gray scale medical-grade monitors if present o      Supports connecting to multiple ITL WebServers at different sites simultaneously o      Provides various queries for finding specific patients or studies, display of study history o      Supports entering and viewing text or scanned notes that may be associated with a study, thereby making prescriptions, diagrams and other pertinent information available to radiologists that are off-site.  This capability is also useful for conveying preliminary findings from the radiologist or for allowing ED physicians to communicate their emergency diagnosis to the radiologist o      Dynamic notification of changes to notes made by other users o      Dynamic pan/zoom of the images in a stack o      Quick view mode that allows a stack within a grid layout be shown in full screen mode o      High speed scroll through a stack via mouse movement.  Regular stack scrolling is via wheel mouse or keyboard o      Stack linking for group scrolling of multiple stacks o      Supports dynamic Window/Level adjustments as well as selection of any presets, including built-in CT presets o      Image filters, such as sharpening o      Suite tools for measurement and annotation. o      Optional display of automatic cross-reference lines between stacks in different viewing planes. o      Multiple study display for comparison of old to new o      Viewing of prior and current reports. o      Differentiation of study priority through color coding of list items o      All locally cached patient information is encrypted for HIPPA compliance Additional capabilities for radiologists: o      Integrated report dictation with the ability to embed annotated images into reports o      Integrated report review, correction, electronic signoff and amendment o      Workflow login to the ITL Workflow Manager for presenting the global worklist of unread studies       as well as the signoff worklist for the logged-on radiologist. o      Flexible stack layout and hanging protocols that can be memorized for each radiologist o      Automatic download of images and other information in the background to minimize wait time and maximize interactivity [   top of page  ]       ITL Steno Workstation ------------------------------------------ Patient name, demographics, clinical data, and embedded images are automatically inserted into the report The stenographer need only type the findings and impression. Worklist-based report handling prioritizes urgent cases while still allowing the stenographer to select work out-of-order Efficiency is enhanced by automatically starting the next-highest-priority report as the transcription for the current report is completed Microsoft Word with Stedmans Medical/Pharmaceutical Spellchecker Name based work-list for easy access to transcribe specific patients This allows the institution to process reports in any order they desire Multiple template definitions to support reports of different formats Specifically, support for BIRADS and non-BIRADS formats and various formats based on the site from which the study was performed Multiple findings sections to allow interspersing editable sections and static text that is protected from being overwritten Protection of demographics, report static fields, and report specific fields such that they cannot be inadvertently changed by Stenographer Configuration to reduce transfer of images presented to the transcriptionist which greatly improves functionality over a slow network Creation of Radiologist Notes to indicate report sections where additional clarification is required by the radiologist These notes must be viewed and dispatched by the radiologist prior to signing the report Drop down selection of BIRADS categories to ensure institutional consistency of BIRADS descriptions on reports Flexible configuration of sounds to be played when reports are presented for transcription Flexible configuration of foot-pedals This includes automatic rewind on pause and variations in definition of what function each pedal performs Support for transcribing reports that are dictated outside of ITL PACS [   top of page  ]      ITL Administrative / Scheduling Workstation   ------------------------------------------ Add or change patient demographics Add or change referring physician demographics Add or remove cc: physicians to the report distribution list Full support for site-specific patient IDs and medical record location data View patient / study history View and redistribute reports View and schedule study appointments by site / modality Enterprise scheduler with ability to view schedule by modality for all days, or all modalities for one day Can schedule for multiple sites with automatic database replication Color-coded feedback from modalities to show status of exams Allows for alerting staff when a radiologist is required Automatic display of equipment that is offline with schedule blackout Easy reschedule of missed appointments with reason for missed appointment Procedure-based scheduling, flexible configurations and entirely client-defined Proxy signing of reports Full integration of Sticky notes on schedule and study entries Printing of Labels for scheduled appointments Flexible definition of institution specific modality subsets to allow easy picking of CPT procedure codes Support for entering and maintaining Patient Insurance information Scheduling: Entry/display of Schedule Notes that are tied to Modality Unit and date Display of Modality Unit Status while scheduling Flexible definition of schedule display filters to aid in selective highlighting of schedule entries Block-out of schedule entries when studies cannot be scheduled on a specific Modality Unit Flexible definition of a subset of modality units to be displayed on the schedule, allowing for specific schedulers to only see the modality units that they are scheduling Multiple formats of schedule printing Printing granularity from a single schedule entry, up to a full week of schedule entries Presentation of Hints/Instructions for each defined procedure, including font and color highlighting Automatic search of available time slots, including the ability to search multiple modalities for adjacent available time slots Presentation of first time slot(s) that meet requirements Scheduler can scroll though available time slot(s) with the Find Next function Allows for search for available time slots from a given date On the fly definition of multiple procedures to be scheduled together Definition of Schedule Procedures to allow for single or multiple steps on the same modality unit, or multiple steps on different modalities Definition of Schedule Procedures to specify time required for each procedure step Definition of Schedule Procedures to specify a range of required wait time between procedure steps Definition of Schedule Procedures to be performed on one or a set of specific Modality units Definition of Schedule Procedures to automatically include one or more CPT code when the study is performed Flexibility to set up procedure based scheduling only on specific modality units Display/Update of Patient specific comments while scheduling each appointment [   top of page  ]       ITL Modality Workstation  ------------------------------------------   One workstation located near each DICOM imaging modality, such as CT, US, MR, etc. Configured as the DICOM storage SCP push target of the associated modality Allows the technologist to monitor the DICOM transfer and designate study completion Allows the technologist to QA patient name, local ID, and demographics before the study images Are packaged and forwarded to the image file system and workflow manager Allows entry of necessary clinical data and study information. Allows technologist to review/change CPT Procedure codes that were automatically selected as part of Procedure Based scheduling Flexible definition of institution specific modality subsets to allow easy picking of CPT procedure codes DICOM Modality Worklist DICOM Film Print Embedded mini-viewer to review prior studies by technologist Can be optionally configured to automatically produce patient DVD for each study [   top of page  ]         ITL WebServer ------------------------------------------ The ITL WebServer provides access to the ITL Warpspeed RIS/PACS System for clients via the internet or a local network.  Secure access to patient information o      All communication (other than the initial install of the ITL WebViewer and other ITL Web Applications) is via HTTPS (HTTP over Secure Sockets Layer), encrypting all patient information as it crosses the networks. o      Backend network traffic to other on-site servers is restricted to a small set of protocols easily filtered by firewalls o      Minimal state is stored on the ITL WebServer in the event of a security breech, no patient information is exposed and the security of any internal network is maintained o      All access to the ITL WebServer requires authentication by a user id and non-trivial password o      End-user access is limited based on the permissions of the assigned role of an individual login id o      Auditing of all logins and accesses to studies [   top of page  ]       ITL WebManager ------------------------------------------ The ITL WebManager provides PACS administrators, IT support personnel, and radiology department management with many capabilities.   Add new login id(s) Modify the role and special permissions of each login id Associate physicians and their staff with Clinical Practice Groups for access control to patients and studies Reset passwords Reset user acceptance agreements Dynamically monitor connected end-users o        Activity o        Software Version o        Time Query access history of end-users [   top of page  ]