In our current managed equipment service contract we have a number of radiologists workstations and radiographer QA workstations.
These systems are provided by Fuji, imaged (OS loaded) by Fuji and then our IT applies their security policies and AV. This dual management approach has had its issues where performance has struggled, applications breakage and security has been compromised due to the fact that both parties have their own goals.
I realise it is not a straight forward question but has anyone found a better way of managing these systems? In the bad old CSC days, GE fully managed the radiologists workstations. They were single task, completely locked down systems and wouldn’t cover the needs of radiologists now. But they were stable.
I know where the fence is. Where is that green grass?
We went out to market for a workstation specific managed service outside of the existing informatic and radiology MES provision.
Its more pressure on the PACs team in that ‘we’ had to own the spec, but the fact we have our own workstation specific image to work from make replacement easy for the service provider if there is a hardware fault and simple to reimage on site if its software related. The image covers a baseline version of our trust OS and core applications, including trust AV, VPN solutions, plus the Radiology specifics.
After first connection to the network, management of the AV security polices is automated though our AD groups and workstation specific group policies. The workstations themselves are onboard as much as possible before they arrive on site, with unique hostnames, DNS details etc already populated so they are as close to plug and play as they can be.
So our solution answers and mimics your solution to some degree, but whichever route you go down, the tech ( hardware and software) moves so quickly still, that what works well in year 1 is always struggling by year 4 and I wish I could point the finger elsewhere when the inevitable conflicts do arise. By the same token, the locked down workstation option was also a step too far, we aren’t a digital silo anymore, interoperability between applications is key to good workflow so we are going to have to accept that there is going to have to be day to day management of these bits of kit that a closed environment would have avoided, to the point that I have recently employed a dedicated PACS Network and IT support analyst.
I think the green grass is when it becomes someone else’s problem
The “green grass” I’m aiming for is having the PACS supplier host the servers and storage, then our Radiologists report either via a remote desktop client or something web based.
We’ve just started rolling out Insignia’s InStream system, mainly to enable cross-site reporting and improve home reporting, but the fact it can run on any bog-standard Trust PC (or any PC for that matter) with an internet connection makes it much less of a hassle to roll out and maintain.
Think we’re still a little way off using this as our main reporting platform in the hospital but it looks like the clear way forward to me.
As it stands, we source our own workstations for reporting - they’re all domain joined and have access to office and the internet as well as PACS, so good versatility for the reporters, but are vulnerable to windows updates killing GPU drivers or defender and GPO updates blocking key files and services.
Thanks for your replies. I’ll twist the saga in a slightly different direction.
We have issues currently with report systems slowing down, reporting solution stability and specifically VR performance.
I guess these problems have a dependency on
a) the quality of the product (how well its code has been written),
b) its interdependency on the underlying operating system.
As we are in the process of looking for a new supplier, I would like to specify something that reduces dependencies as much as possible. In the Linux world for example, this is provided by flatpak and snap packages; they are self contained solutions, not affected by OS updates (yes, I know, I’m looking over the wrong fence).
Is there a way to specify a technology that would simplify a viewing/reporting solution and reduce the IT and provider coordination and cooperation?
As mentioned above, a remote desktop is a thin layer that simply provides a tunnel to a system that is controlled by the supplier. Or are web streaming and web clients a better solution than any form of thick client, with its OS dependencies?
I like the green grass if you can divert the problem solution but I for me that is probably retirement
We have issues currently with report systems slowing down, reporting solution stability and specifically VR performance
I think I might be familiar with these sorts of issues. Is this related to RIS-based reporting? Can you confirm which application you’re having these issues? If related to a RIS, the choice of OS and configuration are unlikely to help in my opinion. Neither of the main RIS providers are supported on Linux as far as I know.
Remote desktop reporting is good to have available as an option but I don’t think it’s ready to replace traditional PACS for all users yet, at least with the same level of user experience.
The green(er) grass might be in PACS reporting and/or uncoupled less integrated VR so that you’re not reliant on the relationship between vendors and have the option to switch if VR isn’t performing for you.
No silver bullet answer I can think of I’m afraid. All the options come with pros and cons. Happy to show you what we have here (either teams or at UKIO?) – we’ve just moved to PACS based reporting using Augnito, and have sort of a hybrid of on-premise and cloud storage & viewer options at the moment.
Hi Mark, yes CRIS based reporting. CRIS - Dragon 15 is very unstable. We are planning to move to PACS driven reporting. I’m trying to understand what the better technology would be to deliver PACS, aiming for something as independent as possible from underlying OS.
“We have issues currently with report systems slowing down, reporting solution stability and specifically VR performance.”
Could be some server have a resource issue, specifically memory leak on a key process.
“As mentioned above, a remote desktop is a thin layer that simply provides a tunnel to a system that is controlled by the supplier. Or are web streaming and web clients a better solution than any form of thick client, with its OS dependencies?”
There’s also app virtualization, such as what Citrix and the like provide, so the end user doesn’t have to have their own full desktop session. This also uses remoting technologies of course. I have no clue how well VR could work with an app virtualization environment though.
Web streaming / clients, if the app is purely a web app running in a browser, good for IT, not so good for end users, as web apps are just not as good as desktop apps (in general). Though you’ll still run into issues with “works in Chrome but not Safari” just like it’s 1999 all over again ; -) despite the prevalence of the nice HTML5 standard.
java.lang.NullPointerException is part of daily use of CRIS. Just had 2, one using the stats module and the other adding a referrer to the back end. These are uncaptured exceptions that well designed software handles via a try … except statement. The end user should never see them.
java.lang.NullPointerException - Used to see a lot of this message when CRIS was trying to load old imported events because the site code was not valid and needed updating in the tables and then required an interface restart!
