Imaging Informatics: Fundamentals

Introduction to Informatics
- Informatics means the science of processing data for storage and retrieval.

Radiology Informatics/ Imaging Informatics

- Imaging informatics is a collective name given to the field of work and combination of
technologies that provide the features of a paperless or paper-lite department.

-Imaging informatics is concerned as a specialty with electronic acquisition, storage, and

distribution of the text and image data produced and utilized within a diagnostic department.

- According to DOH (202), defined as the knowledge, skills, and tools which enable information
to be collected, managed, used, and shared to support the delivery of healthcare and promote
health.

> Radiology Informatics, also referred to as imaging information informatics, is a subspecialty of

radiology concerned with applying information science radiology.

> Imaging informatics is part of the larger field of clinical informatics which is in turn part of
biochemical informatics. Radiology informatics has some overlap with specific parts of the fields
of medical physics, computer science, data science, and cognitive science.

History of Development

1895- Sir Wilhem Conrad Roentgen discovered x- rays. First image was his wife, Bertha’s hand.
1901- Roentgen received Nobel Prize in Physics.
1952- Felix Bloch and Edward Purcell simultaneously and independently developed the concept
of Nuclear Magnetic Resonance and received the Nobel prize in the same year.
1967- Sir Godfrey Hounsfield invented the first CT scanner at EMI research laboratories
1971- Alan M. Cormack created the early mathematical models used in CT.
1972- PACS was first created by Dr. Richard J. Steckel
1979- Hounsfield and Cormack received the Nobel Prize for the development of computer-
assisted Tomography.
1983- American College of Radiology and National Electrical Manufactures Association develop
standard due to the emerging need for transfer of medical images
1985- First standard image was released entitled “Digital Imaging Communication.”
1988- DIC second version was released.
1993- Third version of image was released, and the name was change to Digital Imaging and
Communication in Medicine (DICOM)
American College of Radiology and National Electrical Manufactures Association develop
standard due to the emerging need for transfer of medical images:

1. Promote communication of digital image information, regardless of device manufacturer.

2. Facilitate the development and expansion of picture archiving and communication systems
(PACS) that can also interface with other systems of hospital information
3. Allow the creation of diagnostic information data bases that can be interrogated by a wide of
devices distributed geographically.

Third version of image was released, and the name was change to Digital Imaging and
Communication in Medicine (DICOM)

• It is applicable to a networked environment

• It is applicable to off- line media exchange
• It is a service-oriented protocol, specifying the semantics of commands and associated data,
and how devices claiming conformance to the Standard react to commands and data being
exchanged
• It specifies levels of conformance

Overview of Medical Imaging Informatics

Medical Imaging Informatics

• Information Science/ Technology

• Computer Science/ Technology
• Medical Physics
• Biomedical Engineering
• Clinical Services
• Cognitive Science

MEDICINE VS. BIOMEDICINE

MEDICINE
• IS THE FIELD OF HEALTH AND HEALING
• IT INCLUDES DOCTORS AND ALLIED HEALTHCARE PROFESSIONALS.

• IT COVERS VARIOUS DIAGNOSIS, TREATMENTS, AND PREVENTION OF DISEASES, MEDICAL

RESEARCH, AND MANY ASPECTS OF HEALTH.

BIOMEDICINE
• IS A BRANCH OF MEDICINE
A SYSTEM IN WHICH ALLIED HEALTH CARE PROFESSIONALS TREAT SYMPTOMS AND DISEASES
USING DRUGS, RADIATION, OR SURGERY
• THEORETICAL MEDICINE
• USES LABORATORIES (BIOLOGICAL MATERIALS)

BIOMEDICAL INFORMATICS
• IS THE INTERDISCIPLINARY FIELD FIELD THAT STUDIES AND PURSUES THE EFFECTIVE USES OF
BIOMEDICAL DATA, INFORMATION, AND KNOWLEDGE FOR SCIENTIFIC INQUIRY, PROBLEM-
SOLVING, AND DECISION-MAKING, MOTIVATED BY EFFORTS TO IMPROVE HUMAN HEALTH.

DIGITALIZATION

• DIGITALIZATION

- THE CONVERSION OF TEXT, PICTURES, OR SOUND INTO A DIGITAL FORM THAT CAN BE
PROCESSED BY A COMPUTER.

HEALTH INFORMATION TECHNOLOGY

- is the area of healthcare that oversees the technology systems healthcare providers use to
manage patient data.
-refers to the electronic systems health care providers—and increasingly, patients—use to store,
share, and analyze information (Office of the National Coordinator for Health Information
Technology)
• ACCORDING TO PATRICK GAUTHIER (2019), HEALTHCARE CONSUMERS CONTINUE TO
DEMAND GREATER TRANSPARENCY, ACCESSIBILITY AND PERSONALIZATION.
INCLUDES THE TECHNOLOGY LIKE
• EHR
• PHR
• EPRESCRIPTION
• ERESQUESTING
• MPI
• RIS
• HIS
• DOSE MANAGEMENT/ DOSE MONITORING SOFTWARE
• PRIVACY AND SECURITY
ELECTRONIC HEALTH RECORDS
- EHRS ALLOW DOCTORS TO BETTER KEEP TRACK OF YOUR HEALTH INFORMATION AND MAY
ENABLE THEM TO SEE IT WHEN YOU HAVE A PROBLEM EVEN IF THEIR OFFICE IS CLOSED. EHRS
ALSO MAKE IT EASIER FOR YOUR DOCTOR TO SHARE INFORMATION WITH SPECIALISTS, SO THAT
SPECIALISTS WHO NEED YOUR INFORMATION HAVE IT AVAILABLE WHEN IT'S NEEDED

• THE BENEFITS OF ELECTRONIC HEALTH RECORDS INCLUDE: BETTER HEALTH CARE BY

IMPROVING ALL ASPECTS OF PATIENT CARE, INCLUDING SAFETY, EFFECTIVENESS, PATIENT-
CENTEREDNESS, COMMUNICATION, EDUCATION, TIMELINESS, EFFICIENCY, AND EQUITY.

EPRESCRIPTION
A PAPER PRESCRIPTION CAN GET LOST OR MISREAD. E-PRESCRIBING ALLOWS YOUR DOCTOR TO
COMMUNICATE DIRECTLY WITH YOUR PHARMACY. THIS MEANS YOU CAN GO TO THE
PHARMACY TO PICK UP MEDICINE WITHOUT HAVING TO BRING THE PAPER PRESCRIPTION.

PERSONAL HEALTH RECORDS

- A PHR IS A LOT LIKE AN EHR, EXCEPT THAT YOU CONTROL WHAT KIND OF INFORMATION GOES
INTO IT. YOU CAN USE A PHR TO KEEP TRACK OF INFORMATION FROM YOUR DOCTOR VISITS,
BUT THE PHR CAN ALSO REFLECT YOUR LIFE OUTSIDE THE DOCTOR'S OFFICE AND YOUR HEALTH
PRIORITIES, SUCH AS TRACKING WHAT YOU EAT, HOW MUCH YOU EXERCISE, AND YOUR BLOOD
PRESSURE. SOMETIMES, YOUR PHR CAN LINK WITH YOUR DOCTOR'S EHR

EREQUESTING
ALLOW REFERRERS TO PLACE REQUESTS FOR A RANGE OF DIAGNOSTIC TEST INTO A SINGLE
ONLINE APPLICATION, WHEN THEN DIRECTLY SENDS THE REQUEST TO THE RELEVANT
DEPARTMENT, REMOVING THE PAPER TRANSIT DELAY' AND POTENTIAL LOSS/MISDIRECTION

MASTER PATIENT INDEX/ HOSPITAL INFORMATION SYSTEM PATIENT ADMINISTRATION

SYSTEM
- it is a database application, which primarily stores the demographic and contact details of the
patient, as well as the national identifiers
- are the oldest MPI hospital informatics applications, and frequently remain running on
emulators of long since discontinued hardware.

RADIOLOGY INFORMATION SYSTEM

IS THE GENERIC NAME FOR AN APPLICATION OR GROUP OF APPLICATIONS USED TO HANDLE
THE TEXTUAL DATA RELATED TO IMAGING PROCEDURES, SUCH AS EXAMINATION DETAILS,
ATTENDANCE LIST, APPOINTMENTS DIARIES, REPORTS, AND BILLING DATA.

PRIVACY AND SECURITY

ALL OF THESE ELECTRONIC SYSTEMS CAN INCREASE THE PROTECTIONS OF YOUR HEALTH
INFORMATION. FOR EXAMPLE, ELECTRONIC INFORMATION CAN BE ENCRYPTED SO THAT ONLY
AUTHORIZED PEOPLE CAN READ IT. HEALTH IT CAN ALSO MAKE IT EASIER TO RECORD AND
TRACK WHO HAS ACCESSED YOUR INFORMATION

DOSE MANAGEMENT AND DOSE MONITORING SOFTWARE

dose analysis and management software provide feedback to radiographers who may be
identified as having better techniques than other This allow the automated identification of
ageing or failing equipment requiring service/ replacement

Basic IT for Radiologic Technology

Human Factors
- The main consideration is digital literacy, which plays a large role in the smooth adoption and
correct, efficient use of informatics technologies, and includes examining the use of
information, managing digital, and understanding the impact of new technologies on the
existing processes.
- Training programs are put in place to support these people to ensure they are able to keep
pace with development in the IT’s that affects their clinical practice.

Computer
- An electronic device that stores, retrieves, and processes data, and can be programmed with
instructions.
- Is a programmable machine designed to perform arithmetic and logical operations
automatically and sequentially on the input given by the user and gives desired output after
processing.
- It is composed of hardware and software, and can exist in a variety of sizes and configurations.

Characteristics of a Computer
• speed
- a computer works at an incredible speed.
- a powerful computer is capable of performing about 3-4 million simple instruction second.

• Accuracy
- Errors that may occur an almost be attributed to human error.

• Diligence
- Computers are highly consistent.
- Can perform voluminous and repetitive jobs without boredom.

• Versatility
- Computers are versatile machine and are capable of performing any task as long as it can be
broken down into a series of logical steps.

• Storage Capacity
- Can store a very large volume of data.

History of Computers

Abacus
- Earliest calculating tools, invented in China.
Blaise Pascal and Gottfried Liebniz
- Built mechanical calculators using pegged wheels that could perform for basic arithmetic
function of addition, subtraction, multiplicand, and division.
Charles Babbage (1842) (Father of the Computer)
• Designed an analytical engine that performed general calculations automatically.

Herman Hollerith (1890)

• Designed a tabulating machine to record census data.
• Tabulating machine stored information as holes on cards that were interpreted by machines
with electrical sensor.
• Hollerith’s company later grew to become IBM
John Atansoff and Clifford Berry (1939)
• Designed and built the first electronic digital computer
Colossus
• The first fully operational working computer built by the British on December 1943
• This computer was designed to crack encrypted German military codes.

Automatic Sequence Controlled Calculator (ASCC) or Mark I

• First general-purpose computer developed in 1944 at Harvard University
• It was an electromechanical device that was exceedingly slow and prone to malfunction
(electromechanical device but prone to error.)

J. Presper Eckert and John Mauchly

• First general-purpose computer developed in 1944 at Harvard University
•The first general-purpose electronic computer was developed in 1946 at the University of
Pennsylvania
• This computer is called ENIAC (Electronic Numerical Integrator And Calculator)

William Shockley
> Developed transistor
• Transistor
• is an electronic switch that alternately allows or does not allow electronic signal to pass
• It made possible the development of the “ stored program” and thus the continuing
explosion in the computer science.

UNIVAC (Universal Automatic Computer)

• Due to the development of the transistor, the first commercially successful- purpose, stored
program, stored-program electronic digital computer was developed by Eckert and Mauchly

Generation of Computer

> First-generation computer

• Vacuum tube devices (1939- 1958)
> Second-generation computer
• Became generally available about 1958
• individually package transistor

> Third-generation computer

• Used integrated circuits (ICs)
• Consist of many transistors and other electrical elements fused onto a chip
-- a tiny piece of semiconductor material, usually silicon
> Fourth generation computer
• Appeared in 1975
• Was an extension of the third generation and incorporated large-scale integration.

Computer Functional Unit

Input- “How to tell it what to do”
• This unit is used for entering data and programs in the computer systems by the processing.
ex. keyboard and mouse
Storage unit- “How it saves data and program”
• It is used for storing data and instructions before and after processing.
example: Hard disk drives, DVDs, etc.
Output unit- “How it shows you what it is doing”
• The output unit is used for storing the result out produced by the computer after processing.
ex. monitor, speaker
Processing unit- “How the processing stores and uses immediate data”
• The task of performing operations like arithmetic and logical operations.
Ex. Central Processing Unit
• Takes data and instructions from the storage unit and makes all sorts of calculations based on
the instructions given and the type of data provided.

Computer Language

Digits
• Comes from the Latin word for “finger” or “toe”

Binary Number System

• It includes only two digits, 0 and 1, and the computer performs all operations by converting
alphabetic characters, decimal values, and logic functions to binary values.

Binary Number System

Bits
- single binary digit, 0 or 1.
Bytes
- eight bits
Word
- Consist of 16 consecutive bits of information
- 1 byte is composed of 8 bits
Nibble
-Half a byte
- composed of 4 bits

Chomp
- two words (32 bits)
- composed of 4 bytes

Computers

• Hardware (tangible)
> Workstation Pc’s
> Input and Output device
> Display devices
> Printers
> Servers
> Networks

• Hardware
> Operating a system
> active directory
> Backups
> Clinical Digital Maturity Index
> PLDT, Globe, and other Internet Provider

Hardware

Processors
- the heart of every workstation
- takes the simplest form of digital inputs and processes them into outputs upon the
instructions received from the program currently running.
- Its speed directly influences the speed the users perceives when using the workstation

Random Access Memory

- is a high-speed place for items currently in used to be stored
- more RAM more items to be stored
- it's equivalent to human short-term memory
- measured in gigabytes (Gb)

Graphic Cards
- second processor and extra memory dedicated to displaying images.

Storage
- either hard disk (HDD) or solid-state drive (SSD) where data are stored, even when the power
is off.
Input/ Output devices
- This device can either be attached to the workstation or personal computers by wires or radio
frequently transmission.

Input devices

• Mouse
- provides navigation of the cursor on-screen.
• Keyboards
- inputs the alpha-numeric characters and other symbols
• Foot-pedal
- are used inputting shortcuts
• Dictation microphones
- reporting functions

Output devices

• Displays
- projecting mechanism that shows text and often graphic images to the computer user, using a
cathode ray tube (CRT), the liquid crystal display (LCD), light-emitting diode, gas plasma or other
image projection technology.
• Printers
- hardcopy printing
• Speakers
- playback audio

Dual purpose devices

• Memory sticks/ Digital Versatile Disk/Blu-Ray disk

- comparatively low capacity removal media used for physical transfer of images to solicitors or
by patients for onward care
• Floppy disc
- obsolete, firmware updates for some CR machines still utilize formats for both input and
output owing to resilience and longevity
• USB (universal series bus)
- USB v2.0
-USB v3 faster transfer, ports of this indicated a blue bar to indicate availability of the increased
speed.

Display Devices
- are primary outputs of a PC is displayed to the user
- Monitors (displays, screens, visible display unit) are the visible components
- used different types of cabling to connect monitors to the graphic cards

-HDMI (High-Definition Multimedia Interface)

- Display port
- DVI –D (Digital Visual Interface- Digital Output only)
- DVI –I (Digital Visual interface- Combine digital and analog output)
- VGA (Video graphics array) blue color
- S –video
Display Devices

Flat Panel Monitors

- most widely used color display
- composed of grid form by millions of alternating red, green, and blue pixels, which are backlit
by bright white emitting diodes.
Dead pixels
- are tiny sections of the screen that do not operate
Stuck Pixels
- are tiny areas that are permanently on, displaying their colors.

Printers

• Plain Papers
- for appointment letters, documents, printed list
• Thermal Paper
- for labels, stickers, CD/DVD top, or patients wristband,
• Film paper

UPS (Uninterruptible power supply)

- provides a temporary source of replacement battery power should main be lost, either
accident as part of a planned test
- they are recommended for all clinical workstations devices where abrupt shutdown of a
machine would present a clinical risk or disruption to the service
- this device also filter incoming main power of any harmful spikes in voltage, which may
damage the more expensive workstation
Servers
- are the devices that run centralized applications
- house with a dedicated environment managed by the local IT department (server room)

Networks
- provides the physical interconnections and backbone between pieces of IT
- main components of networks infrastructure are:
> routers
> switches with interconnecting tables
Cabling
- Physical make-up of network
> Traditional copper
> Fiber optics

Internet Protocol addresses

- postal system using telephone numbers of postcodes
- data to be moved around, such as webpage or radiology image, is broken down into thousands
of tiny pockets of data, each containing destination and technical data
- main addressing system used worldwide are IP (internet protocol)
IPV4 –block of numbers in fixed range (192.168.4.80)
IPV6 –uses hexadecimal addresses (fd00:ab4f:4201:fbc4:f1ac:ba53:abc1)
- offers more combination that with IPV4