Visit Management

DICOM patient management, study management, and visit management were defined as a mirrorof the HL7 protocol. They have been sparsely implemented, and parts of them are being replaced with other DICOM services such as the Modality Worklist and the Modality Performed Procedure Step. They have been retired from the DICOM standard.

Hospital Information Systems (HIS) typically interconnect with a variety of other clinical systems, such as laboratory systems and Radiology Information Systems (RIS), using the HL7 interface. The HL7 standard is a transaction based protocol. That means a message is generated as a result of a certain real-life occurrence or triggered event, such as the admission of a patient, the changing/transferring of a patient from one location to another or a patient discharge. Generally these occurrences generate unsolicited events which are sent to various points on the point-to-point connection or network.

The DICOM Visit Management services were originally specified and modeled to be consistent with the HL7 protocol. However this is not widely implemented because the transaction-based protocol does not fit the architecture and workflow of the modalities very well. When a modality is busy doing acquisition, it wants to dedicate all its resources and computing power to the acquisition process. Unsolicited events and network generated interrupts are not consistent with the traditional modality client-server architecture, and the event information is sometimes lost or ignored. 


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