Thursday, June 11, 2015

GEe Whiz
...Waiting For Godot Metadata

Two steps forward, one step backward. The story of my life with Universal Viewer. The phrase above is what was displayed when I tried to view the PET images from a comparison PET/CT. I never thought I would appreciate the old Advantage Workstation but like an old Chevy pickup truck, it still does the job when the shiny new Maserati is in the shop, which happens more often than not. (No, I don't have a Mas, but a friend once did, and he always had to have someone follow him in case it broke down.)

We have made some progress, as I alluded to in the last post. It seems that our measurements and markups were being saved after all, but hidden in what I'm going to call a non-standard application of the Presentation State. It seems that they are ONLY saved in a presentation state. Whether this is actually the GSPS (Grayscale Softcopy Presentation State) or something else, I'm not certain.

The key to getting this far was discovered by the chief tech at the GE site, and one of my bosses (former partners) who isn't all that into software. My colleague was subsequently awarded Level Four Status by the techs as he had discovered something Level Four Technical at GE had not, that the measurements were being saved somewhere. I'm not really sure just how he found this but I was able to take it from there.

The secret lies buried in a sub-sub menu, "Done Options", a drop-down from the exit button:

Here, we find several very important check-boxes:

Now, some of these don't seem to work. Clearly, we must be doing something wrong in that we can't designate key images, and so they don't save, check-box or not. For the longest time, we did not have the "Load Presentation State on Startup" checked, and since measurements are saved in the Presentation State, this seems to explain why we weren't seeing them. We've been live with UV for almost two months and no one at GE knew this software well enough to tell us how to make this work. I'll be waiting on my check in the mail.

I'm thinking we are still not configured at all correctly. I cannot believe that measurements and such are ONLY saved in the Presentation State. UV would be the ONLY PACS out there to do so as far as I'm aware. But I guess the developers used their imagination.

But I have only just begun to whine.

So far, I cannot import CD's into the system directly via UV. The mechanism seems to be there, but it doesn't work. To be fair, the Centricity backend spat back or distorted the images of a significant number of outside disks, studies which AMICAS/Merge PACS would handle with aplomb, and even AGFA IMPAX would open nicely. This has made my life miserable, as the outside disks have to be loaded by ME and not preloaded by the staff in downtime. They must be viewed with their native software (although I usually crack them with Merge instead) and I have to compare across different machines. Really poor patient-care, boys and girls. Most every other PACS can do better. We paid extra for this?

Hanging protocols work oddly, but then this is nothing new from Centricity 3.x. Sometimes my standard protocol will display the proper CT series. Sometimes it will show the Smart-Prep single image instead. Sometimes the image will be windowed as I set it, and sometimes not.

The zooming issue seems to relate to field-of-view as saved in the Presentation State, which can be fixed by pressing the "1" key that rezooms all images to the same degree. But we shouldn't have to do that, should we?

I could go on...

I have to take a moment to trash the IDX Centricity RIS-IC. When it works, it works OK. But periodically we get the following set of nag messages when we attempt to sign EVERY SINGLE report:

We have similar problems when using Centricity RIS-IC via Citrix. And every single time we open PACS (via Internet Explorer), we get a nag about its certificate being invalid. It has been said this is due to local site problems rather than something intrinsic, but I'm not sure that is the case and frankly I'm not sure I care whose fault it is at this point.

And one more thing... The Zero Footprint Viewer has some really strange windowing behavior:

This is the most advanced system from the biggest name in the business? Seriously?

Need I say anything about which product suite you should probably avoid if you are in the PACS market?

I'll wait for Godot.

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