Table of Contents



Requirements

  • Post Processing Rules may be managed by administrators that have the "Study Type Management" permission.  


Note:  Only studies received within the past 30 days are eligible for post-processing rules.


Overview

Post processing rules allow for automated changes to study metadata based on rules.

Use Cases

It may be efficient to process a study after receipt based on values in the DICOM header and take certain actions based on those values.   Post Processing rules can, for example, look at the study description for a study and automatically assign study types, mark the case as stat or critical (when enabled for the facility) and/or set the study status. 

  1. Study types are associated with CPT codes as the billing code.  The DICOM images have procedure codes sequence with the CPT code values.  The study types can be added automatically. 
  2. The HL7 order contains information indicating the case is a potential stroke.  A post-processing rule triggered on "Order Asociation" could mark the case priority "Stroke Alert" and flag as requiring critical findings callback.
  3. The DICOM study description contains "brain" and modality is "CT".   A "CT brain" study type is added to the study.

Managing Post Processing Rules

An authorized user may manage post-processing rules in the Admin -> Facilities section of the application.  Once created, post processing groups can be associated with individual facilities.  A single policy can be made into the default policy by selecting the policy and then clicking the "Set as facility default" button.   The facility default post processing policy will be invoked when a facility is not set to have any specified post processing policy. 

Post Processing Policy Group

A post processing policy group is a collection of post processing policies that may be associated with individual facilities.

The policy group allows configuration of the following properties:

PropertyExplanation
DescriptionThe name of the post processing policy group as it will be used throughout the system.
Max Study TypesThe maximum number of study types that may be associated with a study by post-processing rules.
Auto MappingEnabling this feature attempts to map the values DICOM procedure code sequence (0008,1032) with study types based on the billing id property.
PoliciesOne or more policies may be associated with the group.  Policies define what actions are performed and what criteria is required to trigger them.  Policies may be ordered to define prescience of study type mapping if a maximum is set (see "Max Study Types" property above).

Duplication of Post-Processing Policy Groups

Groups of post-processing policies may be duplicated through the "duplicate" option at the bottom of the management interface. This will duplicate a post-processing group in full, including all the policies therein. The new post-processing group will start out without any assigned facilities, and can be thereafter modified and assigned to facilities as desired. This is convenient when a facility requires post-processing policies similar to, but not exactly the same as, an existing policy group.

Post Processing Policy

A post processing policy defines a trigger event, rules, and actions that are to be performed if rule conditions are satisfied.

Enabled

A policy may be enabled or disabled.  Disabled policies are not processed.

Triggers

Post processing policies may be triggered by study arrival, order association, manual confirmation, or reinterpretation request.  It is recommended to only use the trigger(s) necessary to produce the changes required

Study Arrival

This trigger is based on when the study is stored to OnePacs and all the images are received (based on the facility-level timer setting).  A study may "arrive" multiple times if the images are sent in sufficiently spaced out batches.

Order Association

This trigger is based on when an external HL7 order message is linked with the study.

Manual Confirmation

This trigger is based on when a study is manually confirmed.

Reinterpretation Requested

This trigger is based on when a technician requests a reinterpretation of a study.




Actions

A post processing policy may perform a number of actions if rule conditions are satisfied.

ActionExplanationExampleLimitations
PriorityCase priority may be set to stat or criticalMark a study statPriority may only be escalated.
Study StatusStudy status may be modifiedMark a study as "For comparison"Only studies in the "Ready to Read" and "For Comparison" states may be modified.  The study is not manually confirmed.
Study TypeOne or more study types may be associated with the studyAdd "CT Chest" study typeStudy types may only be set when no other study types are associated with the study.  Number of study types may be limited by post-processing policy configuration.
LateralityLaterality may be populatedMark laterality as "R"
Requested Read TypeThe requested read type may set to override the facility default read typeSet requested read type to "Final"Manual confirmation read type cannot be overridden.
IV ContrastIV Contrast may be setSet IV contrast status to "With and Without"MR and CT only
Number of ViewsThe number of views in the study can be setSet number of views to 2Plain film studies only
Automation RuleAn automation rule may be invoked.  Automation rules may flag the study, add notes, etc.Flag case with a red flag, mark as requiring critical callback, and add a note visible to only radiologists
Case AlertA case alert may be added to the case.Add a case alert that the radiologist must acknowledge before interpreting the examUnavailable on "For Comparison" and "Disregarded" studies.  No existing case alert may exist on the study.


Rules

Each policy has a set of rules that must all pass for the policy action to be triggered.

PropertyExplanation
PropertyDefines the source property that will be used for the rule.  A number of DICOM tags and HL7 order properties are available.
Comparison Type
  • Equals - Requires an exact, but case-insensitive match
  • Like - Allows wildcards (%)
  • Not Equals - Requires any input other than the specified value
  • Not Like - Requires any input other than the specified value which may contain wildcards (%)
Value(s)One or more comparison values may be provided, each on a separate line.