Using Workflow

The RamSoft software has been designed to work in a variety of medical environments. Therefore, it does not apply many restrictions on what can and cannot be done in terms of system Workflow. The benefit of this, is that the system can be configured to control the flow of studies through almost any type of clinical facility and can be customized to enhance the productivity of a site. However, to fully utilize these capabilities, the person administering the PACS and managing the Workflow of the system, will need to tailor it to the needs of the user.

The term Workflow refers to the flow of studies through the system and the impact users have on their status. Throughout the lifetime of a study in the PACS, the study's status is altered as different types of users interact with it. Instead of having users manually update the status of studies, the system can be configured to do this automatically. Furthermore, the studies will migrate between machines, as well as different users Worklists, based on these status changes. This section of the manual will give you a general overview of how to configure these features in order to get the most out of your RamSoft installation.

The first item to plan out and configure is the Study Statuses that your site will use. The system contains a list of default status names and a predefined ordering for those statuses, however these are just suggested values. The status names can be changed or deleted, and their order can be altered. You may also create custom statuses that will be intuitive and familiar to the staff using the system. It is also important to match up the names of the study statuses with those used by other integrated software such as the RIS. The information on how to configure these statuses can be found in the Setting Up Study Statuses section.

Once all desired statuses have been created, the user interaction with the studies can be defined. This involves telling the system how the different users will impact the study status changes. You will do this by defining the study status transitions for each type of user. Once these transitions have been defined, the users will have the option of indicating they have finished their processing of the study by clicking the Finish Reviewing Study button. Doing this, will commence the status transition defined for that user. The section Configuring Study Status Transitions describes this process in detail.

Often, reading physicians might feel that the transcription performed for a study requires amendment. In this case, the reading physicians can change the status of a signed study and send it back in the Workflow. The How Do I Change the Workflow of Studies with Amended Dictations section explains the process in detail.

After the statuses and status transitions have been configured, the study lifetime in the system has been defined. As different users work with studies, the statuses of these will change and automatically reflect these interactions. The next step is to configure the behavior of the system in response to these study status changes. The first part should consist of setting up Worklists. This will create the migration of studies between the Worklists of different users.

By customizing the Worklists, you will be able to determine what studies each user or group of users will see when they first login into the system. This is a very powerful feature as it prevents the users from having to manually search for studies they need to work with. Once this is configured, a user can login and will see a list of studies that they have to process. As the user finishes with each study, that study disappears off their Worklist and moves onto the Worklist of the next person that needs to interact with it. To learn how to configure this section of Workflow, go to the Creating & Editing Personalized Worklists section.

The next two sections that constitute Workflow are closely tied together. These are Configuring Routing and Pre-fetching Priors Overview. Routing is used to automatically distribute studies to different machines by physically moving the studies to the desired location(s). Routing occurs when one of the trigger field is updated. For example, routing can be triggered by the assignment of a Reading Physician or by the status change of a study. It is useful for tasks such as synchronizing two databases, or for automatically distributing studies to certain system users once they have been prepared to be sent to those individuals. Routing will distribute studies to other DICOM devices, PowerReader clients, as well as stand alone cache servers. It is especially important to route studies to users with a slow internet connection, as this will prevent the user from having to wait for the studies to download before they can be worked on.

Relevant Prior Prefetching is a feature that is directly tied into routing of studies. Relevant Prior Prefetching refers to identifying any studies that constitute a prior for a study that will be distributed through routing, and distributing those priors along with the new one. This gives the users working with the studies immediate access to prior studies and eliminates the need for the manual recovery of these studies.

The following sections deals with setting up the default search screen that will be loaded when the system is launched. Since this determines the type of Workflow that will be used, it is an important decision to consider. The How Do I set my Start Up Search Screen? section covers this in detail.

Once studies reach a certain status, they are finalized. At that point they become a legal record and should not be modified. The RamSoft software allows the system administrator to set up the status at which this prevention should occur. This feature is covered in How Do I Prevent Finalized Studies From Being Modified?

Once studies reach a certain status, you can prevent the users from making any further changes to the study status. You can also prevent any changes to the Assigned Personnel status for a study when a study reaches a selected status. These features are covered in the topics How Do I Disable Changing the Status of a Study? and How Do I Disable Changing the Assigned Personnel Status? in detail.

The last two topics deal with specialized scenarios. If the site is using barcode readers to locate patients in the system, the system can be configured to automatically open a study based on the result of a barcode reader scan. How Can Studies be Opened by a Barcode Reader? describes the configuration necessary in order to set up this Workflow. The last section deals with a scenario where the RamSoft software is put into a site that contains an existing online archive system. The software can be configured to automatically search the archive for prior studies when opening up new studies. The topic How Can I Get a List of Archived Studies in my Patient Explorer? explains the configuration necessary.