Category - Healthcare Contents Under Construction Contents: ------------------------------------------------------------------------------------------------------------------------------------------ DICOM Analysis - My Device Can't Send To PACs ------------------------------------------------------------------------------------------------------------------------------------------ Δ DICOM Analysis - My Device Can’t Send To PACS! Written by Eddie Jackson on Saturday, 09/06/2009 01:45:00 PM [filed under Healthcare] ------------------------------------------------------------------------------------------------------------------------------------ I had a job interview where knowing a little bit about DICOM would be a plus.  So I delved into the technology and found out that I knew more than I thought.  Working in the healthcare industry for the past 8 years has shaped me into a pretty well-rounded administrator.  I count myself very lucky to have had the opportunity to be exposed to so much technology on a daily basis.  So what is DICOM?  Let's start off by defining what DICOM is.  DICOM is digital imaging and communications in medicine. It is a standard that defines how medical imaging information is handled, stored, printed and transmitted. It also defines a network communications protocol and the file format. DICOM communications occur at the applications level using TCP/IP to communicate between systems. This standard is what allows the various imaging devices, servers, workstations, film printers and network hardware to perform DICOM transactions between devices regardless of vendor or platform. When you get the inevitable call, “I can’t send my images to PACS!” you are set into action. If you are new to the IT side of PACS however, you may ask yourself, “Where do I start?” Troubleshooting PACs calls tend to be networking issues or server issues rather than issues related to DICOM problems. However, this page will help develop the list of questions you need to ask in order to communicate between systems. Your goal to resolve these types of issues will be to employ a plan that allows you to immediately eliminate the factors that are currently causing the issues. Now I know that may sound elementary but it is the most critical step to quickly identifying the issue and resolving it. You can create a list of questions that can drive your troubleshooting actions and eliminate items. Remember to think calmly and logically. Step 1. Try to ping that device. If you can ping the device, go to step 2. If you cannot ping the device, try to ping other known devices on that subnet. If other devices on the same subnet respond to ping requests, you can focus on that specific device. IF other devices do not respond to a ping, you may need to start looking at the local switches.  Example ping device:  go to start > run > cmd > type ping 199.199.1.1 Step 2. Try to ping the PACS servers. If you can ping the PACS servers, go to step 3. If you can’t ping the PACs servers you have major problems, restart PACS serves or the servers themselves.  Example ping server:  go to start > run > cmd > type ping 199.199.1.99 Step 3. Access the DICOM logs on the PACS server and look for the DICOM send from the device that is having the issues. Typically, the DICOM logs are stored by AE title or you can search the log files for the AE title that is having issues. The log files will tell you if there is some DICOM specific issue. I.e. Disk space is full; the AE title is unknown (sometimes a device upgrade will reset all the DICOM configuration) or some aspect of the DICOM association is failing and why.  Example access:  access logs either by UNC \\servername\logs or log into server and navigate to logs folder REMINDER!  This is not the definitive or the absolute way to troubleshoot when a device cannot send to PACS but merely a way to get started. | Having some basic troubleshooting skills can go a long way in determining where  | the problems are, what the solutions may be, and how to implement those  | solutions.   |   | One of the most important troubleshooting skills you can develop is OSI  | Model knowledge.  It's a 7 layer abstract model that basically breaks  | up communication and design of the entire digital process; it's a kind of workflow.   | What this means to you, if utilized properly, it can actually show where the  | problem lies and the most likely solutions.  I will not go into detail on the layers  | because you can find that anywhere on the internet, but what I willl give you is  | an example of just how useful it is.  |  | The 7 layers are physical-data link-network-transport-session-presentation and | application.  So let's say you get a call that the PACS is down.  And your question | will of course be, what exactly do you mean down?  Well, they say, I can get to PACS | but no one in radiology can.  Right away, you bring up the OSI Model in your | head.  You verify that  customer can actually get to PACS from her workstation,   | and she can.  That tells you that ALL 7 of the layers are working for this user.  So | right away, you want to try to ping a workstation in radiology...you do not get a | response.  Because you now know for fact that the PACS system is up, but certain | workstations cannot communicate with it, this will lead us to believe that | this sounds like something between the network and physical layer issue in | that department.  Well, you ask, what happens at the network-physical layer?  | Switching, routing, addressing and bits on a wire. |  | This tells you that the problem lies somewhere between network and | physical.  Let's rule out cut wires-physical, addressing problems-datalink, routing- | network, because on this segment there are no routers, that leaves us with | switching.  So you walk over to the wiring closet, and peak inside, and low and | behold, the radiology switch appears to be locked-noticing it  has all lit amber | lights!  You power cycle the switch, walk over to the rad department, and sure | enough, they are communicating once again with the PACS.  |  | Now with a little experience with the OSI Model, not just the layer 2 | issues, but many common PACS problems and other IT related issues will receive | faster attention in the precise areas where you should be examining.  There is | nothing more frustrating than not knowing where to begin troubleshooting.  | Learn how to use the OSI Model and you will thank yourself later. |  | Here are a few OSI Model links: |  | Link 01-info      Link 02-troubleshooting      Link 03-video01      Link 04-video02 * article compiled from link ------------------------------------------------------------------------------------------------------------------------------------ Δ (doc) * (pdf) * email -----------------------------------------------------------------------------------------------------------------------------------

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