6 DICOM Routing Rules Your Imaging Center Should Know

DICOM routing rules are incredibly important, but many people don't understand just how vital they can be in the process of routing to your imaging center. Medical imaging data is a huge part of the process and is essential for tele-radiology providers and imaging centers to do their work well. DICOM rules also play a massive part in the workflow, ensuring the cases, both urgent and routine, get to the right places at the right time.

This also takes into consideration things such as on-call staff, untimely downtime, 24/7 operators, and severe, urgent cases that need different treatment from the routine routed cases. Learn six DICOM routine rules your imaging center should know, so you aren't kept in the dark — and neither is your imaging center.

1. Route Based on Modality

It's time to drop the ‘send everything everywhere’ approach. This produces a chaotic, unreliable procedure that can't be carried over consistently to various workflows. Routing based on modality is by far the best way to approach your routine rules. Using a ‘one size fits all’ routing rule will only overwhelm your data workflows and create more problems down the line.

Here are a few things to consider when routing based on modality:

• Each modality contains different file sizes and urgency.
• Use the routing type (CT, MR, US, CR, etc.) as the condition.
• Use the routing rule to reduce unnecessary traffic.

2. Use Time-Based Routing

Imaging centers and the people within them often operate 24/7. By implementing time-based routing, you can use this to your advantage and build your routine rules around different workflows. This specifically benefits after-hours, urgent cases, and even makes daytime hours more accessible and easy to manage.

Here are a few benefits of time-based routing you might not have considered:

• Supports after-hours, 24/7 and urgent cases
• Automatically routes to on-call radiologists
• Improves reliability during unplanned downtime
• Reduces manual intervention and human error

3. Use Study Description and Procedure Codes

It's vital to drive routing decisions intelligently so the imaging center understands the severity, nature and details of each routed item. One way to do this is by using study description and procedure codes in a smart, identifiable way. Try DICOM tags such as ‘Study Description’ or ‘Requested Procedure’ and other CPT-aligned codes. 

This can look different depending on which exam needs which route. Flag stroke-related exams to rapid pathways, route mammograms to breast imaging specialists, and so on.

Here are a few key considerations and benefits when using route codes:

• Standardize route code names first — the data is only as good as the tag it relies on.
• Match the expertise to the exam type to simplify the workflow.
• Monitor process pipelines to see if study description and procedure codes are needed.
• When done well, this method should increase efficiency — monitor and log where you can.

4. Route Urgent Studies Differently Than Regular Ones

Routine, regular cases shouldn't be routed in the same systems as emergency ones, as it could overwhelm the system and slow down urgent routed cases that need fast-tracking. Urgent studies need different treatment than regular ones. There are a few ways to do this, such as using ‘STAT’ or urgency flags to trigger a priority outing, and paying particular attention to the routing systems housing urgent and regular cases.

Here are a few benefits of taking this approach to urgent study routing:

• Prioritize emergency cases and increase their visibility.
• Allow urgent studies to be seen and addressed at speed.
• Improve turnaround times for critical cases.
• Declog fast-track systems and save them for urgent cases.

5. Use AE Title Routing to Increase Precision

When working with a DICOM router, you'll notice that each device has its own AE title, which allows you to identify it anywhere on the network. This can come in handy, especially when trying to streamline your routing rules. Based on the device receiving the images, you can potentially organize based on type, urgency and other factors.

Here are a few key considerations/use cases for this routing method:

• Can be used to simplify the integration of new systems and tools
• Used to route studies from designated systems to PAC systems
• Improves efficiency in multi-system environments
• Supports advanced routing logic if you choose to implement it

6. Monitor, Log and Track Routing Performance 

Tracking your routing performance is one of the most important yet most overlooked aspects of DICOM routing. If you think about it, monitoring, logging and tracking routing performance could help to identify issues ahead of time, keep records of all data in case of emergency, and provide peace of mind to the people running the systems.

Here are a few benefits of consistent monitoring:

• Identify issues cropping up ahead of time before they get severe.
• Make appropriate changes to the system based on results.
• Provide detailed, comprehensive logs of your routing at a moment's notice.
• Monitor your performance and scale where needed.

Let's Get Your Routing Rules Sorted Out for Good

Do you need a system refresh or have questions about DICOM routing rules? You're in the right place. You can rely on our trusted experts at Candelis to help you find the best DICOM router for your needs. Reach out today to find out more and upgrade your workflow for good.