SynapseDirect for neurologists Q & A

Re: Date input field

If you remember what the first generation windows explorer looks like, comparing to the current version. This is what I mentioned before an organized filing system for scans. Just a more user friendly approach, instead of going through a long list looking a certain result, a tree structure is more convenient. Say I have 10 MRI pictures from a single series I want to save, I will highlight all 10 files, and drop them in a folder "MRI brain FLAIR mmddyyyy", and another 4 pictures into "MRI brain T1+C mmddyyyy". Later I can choose from a thumbnail to view interested pictures. In Synapse, I have to do 10 imports unless I zip them. And 10 entriesfrom a single MRI exam to blow the list of results is just not efficient.

Re: Date input field

Most viewers that the patients brought to me or the hospital PACS system that allows me to view from home do not let me save DICOM files, I can only export one picture at a time into bitmap. I have a possible CNS lymphoma case today, with very interesting MRI findings, positive findings involve about a dozen cuts. So I would prefer to save as many pictures as possible. This happens quite frequently in Neurology. Sometimes this involves a lot of pictures in multiple sequences. With the limitation of Synapse, I am sampling only one or two pictures now - which is OK but doesn't give you the whole idea.

Re: Date input field

Most neurologists don't do this at all, especially in the US. All people care is money nowadays.

Not an option, the quality of the printout on plain paper is not good enough.

It may not change my management, it just cost me more time []. But, I will feel much more comfortable to be able to view them any time I need. An MRI report may tell you a young woman has some white matter changes, but until you see the pictures, you will have no idea whether she needs a spinal tap to rule out MS ASAP, or it's something trivial likely from migraine, that you can ignore for now. Also it may save a lot of trouble to show the picture and explain to the patient than reading the reports to them.

Ask the patient to bring the scans every time they come? Over time, they may forget, they may loose the films. The doctor will also forget what the MRI looked like before. I will not trust a neurologist whototally depends on reports only and doesn't read films.

I had about 30 ISO files from the discs patients brought in in 2006. There are a lot of scans in hospital PACS system that potentially I can save to an EMR. Maybe a couple of times a month at least, I will get a positive scan worth archiving. There is always option of getting from the PACS again or have the patient bring the scans later. But, why we don't let the patient keep their medical charts themselves and keep them in the office instead?

Re: Date input field

or PDF. Should work for me.

this looks like we need support from Radiology. But usually I don't get the original DICOM files. I guess I will stick with PDF or tiff for now.

Re: Date input field

Tried saving MRI scans to PDF, combined 17 bitmap files saved from PACS - scans of my interesting patient today, created a file of 800k in size, took a few seconds to upload from home to Synapse server in the office, not bad, picture quality is quite acceptable this way. Thanks for the suggestions.

Re: Date input field

I used Acrobat pro, all default settings. Each .bmp is over 1 meg, but Acrobat compresses them pretty hard.

Re: Date input field

In Acrobat pro 7.0, use menu: File - create PDF - from multiple file, then you can add the picture files in the dialogue box and combine them to a single PDF file.

In Acrobat pro 8.0, this function is integrated into windows explorer shell, you can highlight the picture files in windows explorer, right click - combine supported files in acrobat... and follow the wizard.

combine multiple scan/pictures into a single PDF file

I have been happy with this approach. Had a another case today, combined 30 pictures from one MRI study and resulted in one 1.4 meg PDF file, very manageable.

Another thought for Graham: I would prefer to put the two windows under "results-text results" tab side by side. This way,more entries can be displayed in thelist on the left for easier selection for patient with many results. Metadata window on the right. And, of course, make the filter buttons customizable?

Like this:

Re: combine multiple scan/pictures into a single PDF file

Still not tall enough...