Pre-conference primer on standards, privacy, technical lingo

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Salvador O. Tejeda, PACS administrator for Radiology & Imaging Specialists in Lakeland, Fla., presented “Information Technology and Systems Management” at the SIIM 2007 pre-conference on Wednesday. His talk covered a litany of terms common to healthcare IT.

Tejeda explained the different types of IP addresses--static, dynamic or automatic. Static addresses require manual assignment, someone has to track their use to prevent duplicates and they are ideal for servers. Dynamic addressing refers to a scenario in which a server has the job of assigning and tracking addresses. In an automatic set-up, in the absence of static or dynamic addressing, the computer signs its own.

Tejeda explained other terms such as subnetting, the segmenting of a network into smaller sections. Network security is a combination of hardware and software solution. He advised organizations to have formal policies and procedures. Policies indicate goals and procedures provide the steps to reach those goals.

Latency is the time it takes data to get from the source to the destination. Bandwidth is the amount of data that can be transmitted at one time.

PACS hardware includes a storage server, diagnostic workstations and an image acquisition gateway. PACS software includes an archive manager, database management and image viewer.

Tejeda said that many believe Integrating the Healthcare Enterprise (IHE) to be a set of standards, when it, in fact, refers to DICOM and HL7 standards. Structured query language is one language commonly discussed and it is compatible with HTML and XML. Extensible markup language (XML) is a relative of HTML but is hardware and software independent and customizable.

Simple access object protocol (SOAP) is a standard for exchanging XML messages over a network that uses HTTP. Essentially, it allows different operating systems to communicate with each other.

Tejeda briefly discussed PACS and how important it is to discuss any “break-up” plans early in the purchasing process. Most PACS last about 4 to 8 years, he said, so your contract should include details about what will happen after. If you decide to switch vendors, how will you get your data back? He also said organizations should plan on replacing their PACS workstations every 4 to 5 years. Basically, buying a PACS is not a one-time purchasing—there are numerous ongoing costs to consider.

Finally, when it comes to exchanging personal health information (PHI), Tejeda said to bear in mind that HIPAA regulations require you take reasonable and appropriate steps to protect the confidentiality, integrity and availability of electronic PHI. Safeguards should be administrative, physical and technical.