An Electronic Medical Record Information System Of DICOM-RT Module-Based In Radiation Therapy

The radiation therapy is one of the three most significant methods for tumor treatment, and also is a typical device-density therapeutic method. Throughout the whole course of treatment, the doctor need to cross-sector, cross-device for examination and treatment of patients, so it is more dependent on medical imaging and other medical information than the surgery, internal medicine chemotherapy. This separation between the department and equipment, lead to barriers to information sharing and transfer. With a wide range of digital imaging equipment applications in hospitals, as well as the promotion of the DICOM standard, more and more hospitals and medical device manufacturers have declared support for the DICOM standard, making the process of hospital information technology continues to accelerate, especially the introduction of PACS, specification the medical image acquisition, transmission, display and manage, and promote the process of hospital information technology.DICOM standard is means the Digital Imaging and Communication Standard.it is a data communication standard developed jointly by the American College of Radiology and the National Electrical Manufacturers Association, the goal is to be able to exchange images and related information in order to achieve the sharing of medical information between the different manufacturers to produce a variety of imaging equipment to meet the PACS system teleradiology needs. Detailed definition of the composition format and exchange of images and related information in the DICOM standard, by use this standard, one can build an interface on the imaging equipment to complete the data input/output. DICOM standard to the industrialization of the computer network standards, it can help more effectively to exchange of digital image transmission between medical imaging equipment, these devices include not only the CT, MR, nuclear medicine and ultrasound, but also the CR, film digitization systems, video capture system and HIS/RIS information management systems, radiation treatment planning systems, etc.But in modern radiation therapy system, it’s still lack of a system that can be unified management and effective use different imaging data between the simulation and treatment equipment the same as the PACS. Therefore, the international community establishes a special DICOM RT standard to regulate the exchange of information in the radiotherapy process. As the expansion of the DICOM standard, DICOM RT standard provides for a nine radiation therapy objects:RT image, the RT dose, RT planning, RT structure set, RT records (3) and RT ion beam (2). The nine objects cover the information in the process of radiation therapy, makes the establishment of a standardized, uniform radiation therapy information system has become possible.In the process of hospital information, in addition to using the DICOM standard, and also relates to HL7and IHE standards, these standards play an important role in their respective fields. In particular, the promotion of the HL7standard has made the electronic medical records acquired considerable development. Electronic Medical Records is the clinical diagnosis, guiding intervention and digital medical service record of outpatient, hospital patients (or care object) in medical institution. And it is the complete, detailed clinical information resource which has produced and recorded in all previous medical treatments.In order to facilitate the application of electronic medical records in hospital information, HL7, to establish a standard XML-based Clinical Document Architecture (CDA), which is a complete information object definitions, including text, images, sound and other multimedia content, it is not modeling the document content, it’s only standard the structure and semantics of the clinical documents. The DICOM standard is not a completely independent system, as it can be well adapted to HL7and the IHE, and then integrated into the hospital information technology environment. In the conversion process requires an understanding of the information model of the electronic medical records. Electronic medical records standards shows that the model of electronic medical record is in order to record the information (data) of various types of medical services, standardized data expression patterns and information classification framework, so that according to different features, different information can located in the corresponding hierarchy to achieve the scientific archive of the data elements, and to facilitate the electronic medical record users to quickly understand and share.At the same time, in the fusion process we need to convert data structures and data attributes, so the DICOM Standards Committee raise the DICOM SR standard, formally standardized in2002. IHE also defines a technical framework, make the DICOM-SR can be applied to actual medical services. DICOM SR main purpose is to improve the expressiveness, accuracy and comparability of diagnostic images document report. Using SR have a lot of advantages, such as the SR is process related, better to support clinical workflow to automate administrative tasks, and better service for the hospital management; the same time it is structured, better for use of clinical knowledge search, off-site sharing, macro of medical management services, is the bridge of filmless and paperless. But as the twentieth part of the new DICOM standard2011:conversion between HL7and DICOM standards will greatly facilitate the integration between them, to accelerate the process of information.Radiation therapy electronic medical records contain text, images, graphics and other information, is more complex than the average electronic medical records. Conversion between DICOM RT and electronic medical records information system has been part of research results in foreign, such as the Hong Kong Polytechnic University and the University of Southern California, they are extensions on the basis of the PACS, so that you can guarantee to meet the information transfer and sharing, but also for specific tumor types, they established a knowledge base module, so that once a similar patient to receive treatment, you can call the empirical data module, reducing the time of program design, to increase the efficiency. But there is a little research in inland, correlation is closer including University of Electronic Science and Technology of China, Southeast University, but both focus on the DICOM RT resolution, barely related to the integration of the HL7standard.Based on the above characteristics, this paper proposes an electronic medical record information system of DICOM RT module-based in radiation therapy. This system can integrated different DICOM RT objects generated from different systems to establish a scalable electronic medical records, doctors and physicists, the client can obtain current or previous patient treatment data, to facilitate the planning or evaluation of radiotherapy.First of all, we discuss the DICOM and DICOM RT standard content, principles and the latest progress in detail. In the introduction to the DICOM information model, descript the meaning of the Information Object Definitions, as well as the DICOM information object model of reality. These provide a theoretical basis for the database design. Also we have focused on the storage of the DICOM file and data encoding, these parts are directly related to the parsing and storage of DICOM medical images and DICOM RT objects in the electronic medical records system.Secondly, compared with domestic and foreign literature and information, this paper designed the framework of DICOM RT model-based electronic medical record information system. We have designed DICOM Gateway, the DICOM RT storage server, the DICOM RT application server and the client GUI. The DICOM-RT gateway is to receive a variety of RT objects, including the image data from the PACS, it is mainly to check the data integrity of the RT objects, the gateway obtain a small database, which provides patients-study-series-object hierarchy integrity definition. The storage server is mainly storage of patient’s basic information, as well as radiation therapy seven objects, responsible for unified management and archiving the RT data object which access to the information systems. After the DICOM RT objects through the DICOM RT Gateway, it will parse out the necessary information and stored it in the database, while establishing a connection between the application server and the application server to facilitate the retrieval and achieve. RT application server is designed for clinical applications in radiation therapy workflow, it can assist doctors, radiographers and the operator to planning and carrying out radiation therapy. The DICOM RT application server can get the object files from the DICOM RT storage server, then the object file parsing, and the parsing data stored in a SQL2008database.Finally, on the basis of theoretical studies, we write the corresponding process in Microsoft Visual Studio2008platform. DICOM data analysis used the DCMTK open source code which develops by Germany Offis Company. The database used is Microsoft SQL Server2008. Ultimately respectively achieve a storage server and client GUI functionality. This system involves a total of eight major modules and13user interfaces. For convenience, in addition to the basic processing functions for DICOM RT objects, but also contains some basic ancillary functions, such as database management and permission settings, and we have add a unique DICOM print convenient health care workers can print the interested medical image on the client. We have tested15cases in a lab environment, all data is from Affiliated Tumor Hospital of Guangzhou Medical College, and all functions are running good.With the continuous development of computer technology, IT and medical technology, the process of information technology in healthcare will continue to accelerate, and the development of patient-centered digital hospital will also be imperative. This subject has grasped the development direction of hospital information, and trying a little attempting in electronic medical records system for radiation therapy. At the end of this article we also give an explanation of the issues involved in the subject and the subsequent study directions.