Sunday, August 09, 2009

All Around The Mulberry Bush....

My faithful readers know by now that when I'm on call at our local Trauma Center, little annoyances become BIG PROBLEMS. And so it is today.

There has been yet another ongoing problem with our IMPAX installation. In brief, when I try to look at a study, say a CT, which has more data coming in from the modality, say a sagittal reformat, the client crashes. We get the error dialogue below:

which contains the following text:

Application_ThreadException unhandled exception
Object reference not set to an instance of an object. at AgfaHC.Pacs.Application.ApplicationController.OnStatusUpdateEventArgs(IController source, StatusUpdateEventArgs statusArgs) at AgfaHC.Pacs.Application.ApplicationController.OnApplicationEventOccured(IController source, ApplicationEventArgs aeArgs) at AgfaHC.Framework.BaseController.FireApplicationEvent(IController source, ApplicationEventArgs appEvent) at AgfaHC.Pacs.Application.DictationControllers.StudiesByStatusListBuilder.FireUpdateStatusEvents() at AgfaHC.Pacs.Application.DictationControllers.ClassicDictationController.StartDictation(Object sender, ArrayList workListItemList) at AgfaHC.Pacs.Application.DictationControllers.BaseDictationController.OnDictationApplEventOccured(Object sender, DictationEventArgs args) at AgfaHC.Pacs.Application.ApplicationController.OnDictationEventArgs(IController source, DictationEventArgs args) at AgfaHC.Pacs.Application.ApplicationController.OnApplicationEventOccured(IController source, ApplicationEventArgs aeArgs) at AgfaHC.Framework.BaseController.FireApplicationEvent(IController source, ApplicationEventArgs appEvent) at AgfaHC.Framework.BaseController.FireApplicationEvent(IController source, ApplicationEventArgs appEvent) at AgfaHC.Pacs.ImageDisplay.DisplayController.dictate(DisplayToolbarButtonDictation dictationButton) at AgfaHC.Pacs.ImageDisplay.DisplayController.displaycontroller_FeatureClick(Object sender, FeatureClickEventArgs e) at AgfaHC.Pacs.ImageDisplay.DisplayBaseToolbar.OnFeatureClick(Object source, FeatureClickEventArgs eventArgs) at AgfaHC.Pacs.ImageDisplay.DisplayBaseToolbar.button_FeatureClick(Object source, FeatureClickEventArgs eventArgs) at AgfaHC.Pacs.ImageDisplay.DisplayToolbarButton.OnFeatureClickEvent(FeatureClickEventArgs e) at AgfaHC.Pacs.ImageDisplay.DisplayToolbarButton.OnClick(EventArgs e) at System.Windows.Forms.Button.OnMouseUp(MouseEventArgs mevent) at AgfaHC.Pacs.ImageDisplay.DisplayToolbarButton.OnMouseUp(MouseEventArgs e) at System.Windows.Forms.Control.WmMouseUp(Message& m, MouseButtons button, Int32 clicks) at System.Windows.Forms.Control.WndProc(Message& m) at System.Windows.Forms.ButtonBase.WndProc(Message& m) at System.Windows.Forms.Button.WndProc(Message& m) at System.Windows.Forms.ControlNativeWindow.OnMessage(Message& m) at System.Windows.Forms.ControlNativeWindow.WndProc(Message& m) at System.Windows.Forms.NativeWindow.Callback(IntPtr hWnd, Int32 msg, IntPtr wparam, IntPtr lparam)

Have lots of fun reading that, folks.

The crash occurs AFTER I have clicked the study into "Dictation Started" status, and so when the client comes back to life, I have to remember the name of the victim, or the study runs the risk of being lost to me, only to turn up later in the "you didn't read this on time!" pile. Dare I even hint at the possibility of an impact upon patient care?

Here's the problem as I understand it: We don't want people reading studies before all the data is in. Thus a study has a built-in delay that should keep it off the worklist until it's ready. But sometimes there is an even longer delay between the acquisition of the various parts of the study, and it appears on the list anyway. But if we access the study whilst more data is coming in, the system gets confused, since we shouldn't be reading it, and it crashes. Hence, my image of the monkey chasing the weasel. POP goes the Impax!

There ought to be a solution for this. If there is, please let us deploy it. If there isn't, please create one. Very quickly, please.

POP goes the Dalai!


Anonymous said...

one of the many reasons we have added "dictation started" in addition to "new" to the worklists.

we had this error commonly in mammo. After an upgrade, an image arrives and it re-hangs the study (6.3.1 su12) but knocks it our of comparision review mode which is better than a crash.

Anonymous said...

you should set up your modalities/PACS to use MPPS. Then, the PACS can be configured to not allow dictation for 'Open" studies. Also, the application has a history button which keeps track of the last 20 or so studies viewed. the button is called 'histiory' on the top center of the screen.


Anonymous said...

I hope you (Agfa PACS Admin) are not implying that it is acceptable in any way to get this type of error message; you are offering a work around, not a solution (and by the way, the history button is at the top or bottom depending upon how the user has configured things). As an Impax user (and someone with a degree in Computer Science) I find it totally unacceptable that a live clinical product has this type of bug. Furthermore, Agfa makes little or no active effort to correct or prevent these types of bugs. Frankly, I have given up on reporting bugs.

The usual response from Agfa support is...after 1 week level 1 support says you are doing something wrong...after 1 month level 2 support says they will look into it, and have never seen this problem before...after several months level 3 support says 'Oh yes, that is a known issue, but it has not been given priority'.