DICOM Modality Worklist

Dicom Modality Worklist: How to Get Started

If you work in the medical or radiology field, then you’re likely to be familiar with Dicom images. But did you know that there’s a tool that can help streamline the process of producing these images?

Dicom modality worklists are a crucial part of any radiology department’s workflow. By creating a list of patients and their corresponding exam requests, radiology staff can ensure that each patient receives the care they need promptly. However, the terminologies and technicalities can be intimidating to learn. Particularly for those new to the healthcare IT field. Let’s clear that up.

To help you better understand dicom modality worklists, we’ve compiled a list of answers to some of the most commonly asked questions. Plus we’ll show you how to set it up.

This module is for radiologic technologists and beginner PACS Administrators to become familiarized with the high level concepts. While avoiding a deep dive into the technicalities. We’ll make sure you grasp the concepts by repetition of the terminologies in different aspects, Through the workflow, configuration, definitions and frequently asked questions.

What is a Dicom Modality Worklist, and What are its Benefits

A Dicom Modality Worklist (MWL) is a standard that allows information to be exchanged between medical imaging devices and clinical applications.

MWL is essential because it ensures that patient information is accurately transmitted between devices, which can help improve patient care. 

There are many benefits of using MWL standards, including the following: 

• MWL can help to reduce errors in the transmission of patient information.
• MWL can help to improve the efficiency of medical imaging procedures.
• MWL can help to standardize the way in which patient information is exchanged between devices.
• MWL can help to improve the quality of patient care.
• Examples in the clinical setting
  • Selecting pre-populated patient information from the worklist prevents human errors such as
    • Typos from misspelt name or study description
    • Fat fingering the wrong string of numbers into the keypad for patient ID or MRN
    • Entering middle name into incorrect fields 
  • Improves efficiency by time saved.  It may take 5 minutes per patient to enter name, ID, accession manually. Selecting the mwl entry takes a few seconds. 
  • Decreases technologist fatigue. 5 minutes per patient adds up for high volume sites. 30 patients adds up to a whole hour of mind numbing data entry.

Understanding the Workflow – High Level Overview. 

Here’s how it works.  An order containing the type of study and patient information must be created by the RIS/HIS/EMR/EHR. This order must be sent to the Modality Worklist Provider via HL7. Typically this would be the Radiology Information System (RIS). Though this can vary depending on site preference. The MWL provider takes this HL7 order and populates the information unto a worklist. The tech at the modality (CT, MR, US, etc) can now perform a search against the worklist. Using DICOM communication, the modality will reach out to the MWL to populate a list on its screen. The technologist can simply select their patient from the list. Done.

The metadata containing important information such as name, id, accession and study description get written to the images that are produced from the modality. This allows proper archival of studies in the PACS. Techs can rest assure they’ll find their recently obtained images under the right patient in PACS.

Confused yet? Let’s break it down below. Starting from how to set one up.

How To Create A Dicom Modality Worklist

There are two ways to create a MWL: manually or automatically. If you choose to create your MWL manually, you will need to enter all of the necessary information into a text file. This is an advanced method we would normally leave to the developers. But let’s briefly explore.

The information that you will need to include are as follows: 

• • Patient ID
• • Patient Name
• • Patient Birth Date
• • Patient Gender
• • Study ID
• • Accession Number
• • Referring Physician
• • Study Description
• • Scheduled Procedure Step Start Date and Time
• • Modality
• • Requested Procedure ID
• • Requested Procedure Description
• • Scheduled Station AE Title
• • Scheduled Performing Physician
• • Scheduled Procedure Step Location
• • Pre-Medication
• • Special Needs

The more common way of setting up a worklist is by using vendor provided software that populates the list automatically, once properly configured. If you choose to create your MWL automatically, you will need to use a worklist provider that supports the Dicom MWL feature.. Additionally your RIS/HIS/EMR or EHR must be able to send the patient information through HL7. Many different medical software applications are available that support the MWL workflow, and you should choose one compatible with your MWL-supported modality. You can refer to the software’s Dicom Conformance Statement document to check compatibility.

Once you have selected a software application to serve as the MWL, you will have to integrate the MWL worklist provider to receive HL7 ORM orders. You will need the above list of criteria to be sent via the ORM. You may need to configure the IP address and a Port for the ORM to reach the MWL Provider. Then you will need to configure an AET name, static IP and Port for your MWL Provider. Lastly, you will need to configure each of your modalities to query against this MWL by entering the AET, IP and Port you previously configured above. Again, this is a very high level overview so there may be exceptions and variations to this set up in the real world.

How To Populate an MWL

The MWL provides a set of parameters that tells a medical imaging device what imaging protocol to acquire and who to acquire them for. To populate an MWL, the necessary information must first be entered into a HIS/RIS system. 

This includes the patient’s demographics, the imaging procedure that is being requested, and any relevant clinical information. This consolidated information is called an order. The order is placed by a referring provider. A physician, nurse practitioner or physician’s assistant.

Once this information has been entered, it can then be transferred to the MWL. The exact process for doing this will vary depending on the HIS/RIS system that is being used. Commonly, the information is sent via an HL7 order message called an ORM.

From the end user perspective, most systems will allow the user to select the desired patient and procedure from a list and then send the information to the MWL with just a few clicks and through an HL7 API. 

Tips For Creating An Effective Worklist

The DICOM Modality Worklist (MWL) is an integral part of the Radiology Information System (RIS). To reiterate… It provides information about the patient, the imaging procedure, and the modality that will be used. While the RIS typically generates the MWL, there are some tips that PACS Administrators can follow to create an effective MWL during initial configuration.

• First, it is vital to include all relevant information about the patient. This includes the patient’s name, ID (Medical Record Number), and date of birth. 
• Second, the procedure should be accurately described in the Study Description. Be sure to include the specific imaging modality that will be used, as well as any special instructions. 
• Third, ensure the correct study code is used and mapped to the appropriate fields.

By following these tips, PACS Administrators can help to ensure that the MWL is accurate and complete.

Important Technical Terms Related to DICOM Modality Worklist

There are a number of technical terms related to the DICOM modality worklist.  It is crucial to become familiarized with the following:

By understanding these key terms, you will be better equipped to effectively use the DICOM modality worklist.

FAQs about Dicom Modality Worklists

What information is included on a dicom modality worklist?

The dicom modality worklist order will include the patient’s name, date of birth, ID/medical record number, and the requested exam. In addition the referring physician’s name or the specific body part that needs to be imaged.

How often should I update my dicom modality worklist?

It is important to keep your dicom modality worklist up-to-date in order to ensure that all patients receive the correct care they need in a timely manner. As such, you should aim to update your list periodically. On some modalities, you may be able to configure the device to automatically query the worklist regularly for the latest list. Some devices automatically refresh this list in timed intervals. For example, every hour or every 5 minutes depending on the frequency of use.

Conclusion: Manage Your Radiology Workflows Efficiently through MWL

By taking the time to understand dicom modality worklists, you can ensure that your radiology department runs smoothly and efficiently. By including all relevant information on the list and keeping it up-to-date, you can rest assure that all patients receive the medical care they need in a timely and efficient manner. 

You may contact us for any questions about further reading recommendations. Also, consider our Premium Imaging Informatics Professional Study Guide when you’re ready to review certification materials. 

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