XDS-I based medical image and report sharing networks are becoming a reality. Unfortunately, legacy PACS cannot participate in these emerging networks as they do not support the required IHE profiles. DeJarnette’s xDR provides an easy solution to this problem by acting as an XDS-I gateway for legacy PACS. xDR is a software solution suitable for any size health care facility and is PACS and HIS/RIS agnostic. xDR employs DeJarnette’s Context Management* feature so that foreign exams pre-fetched or retrieved from other facilities can be localized to match the requirements of the local PACS and RIS.
- xDR receives HL7 ADT messages from local RIS or HIS and acting as a patient identity source sends ITI-8 Patient Identity Feed transactions to a central eMPI
- xDR receives HL7 ORU messages from local RIS and acting as a XDS document source, converts the incoming diagnostic reports to CDA documents and transmits the documents to an XDS-I repository using RAD-68 Provide & Register Document Set
- xDR receives DICOM studies from local PACS, identifies the patient by querying the eMPI using ITI-9 PIX Query, normalizes the studies, and routes the studies to a central DICOM archive
- xDR supports image compression/decompression to reduce bandwidth requirements and reliable routing when deployed on a WAN
- xDR supports multiple patient identity domains whether or not the central DICOM archive does
- xDR publishes KOS manifests describing the DICOM studies to an XDS-I repository using RAD-68 Provide & Register Document Set
- xDR receives DICOM query requests from local PACS, queries the XDS-I registry using ITI-18 Registry Stored Query, and responds to the DICOM query with the results
- xDR receives DICOM retrieve requests from local PACS, retrieves the necessary documents from the XDS-I repository using RAD-69 Retrieve Imaging Document Set, retrieves the DICOM studies from the central DICOM archive, localizes the studies, and sends the studies to the local PACS.
- xDR supports pre-fetch by receiving HL7 order messages from a RIS, identifies the patient by querying the eMPI using ITI-9 PIX Query, locates all documents for the patient by querying the XDS-I registry using ITI-18 Registry Stored Query, retrieves relevant documents from the XDS-I repository using RAD-69 Retrieve Imaging Document Set and processing the pre-fetch rules, retrieves the relevant DICOM studies from the central DICOM archive, localizes the studies, and sends the studies with their reports to the local PACS and RIS
- xDR supports ATNA by authenticating nodes and recording audit events
- xDR provides a secure (SSL) web-based administrative GUI for configuring and managing the application
- xDR runs on a 64-bit Windows OS: Windows Server 2012, Windows Server 2016, or Windows Server 2019
- xDR runs on physical or virtual servers and supports high availability and business continuity architectures
* Context Management includes DICOM tag morphing and HL7 ORM pre-order messages to prepare the receiving PACS