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Caching images on Fuji Synapse
We cover a small hospital that uses the worlds most inefficient RIS/PACS solution. They contract this from a third party and our ability to change things is limited. The PACS is a Fuji Synapse web client, the workflow is driven by Epic RIS running through a Citrix server. The problem seems to be within the Fuji part of things. The web client doesn’t seem to cache studies and has to pull images real time across the network. With all the network security crap in between, this is agonizingly slow and there is no smooth scrolling. Everything jumps and skips and just getting through a kidney stone or chest CT is painful.
Is there a way in the Fuji Synapse universe to enable the caching of entire studies ?
Is there a ‘fat’ client available that doesn’t depend on pulling the images real-time across the network one slice at a time while you scroll ? -
14 Replies
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What version of Synapse PACS is the site running?
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Quote from nfennell
What version of Synapse PACS is the site running?
5.5.002
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Apparently what I am looking for is ‘hybrid mode’ where the client caches the study.
Edit: Found it! It works !
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If you are on Fuji Synapse v5 you can try hybrid mode and also enable AON subscriptions (you need 5.7). OR are you referring to Synapse Mobility?
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Quote from P/-\CSperson
If you are on Fuji Synapse v5 you can try hybrid mode and also enable AON subscriptions (you need 5.7). OR are you referring to Synapse Mobility?
‘Hybrid Mode’ did the trick. It now caches the series you have open and you can actually scroll through the images rather than slowly leafing through them. Now it does take a minute or two for the little dial to get to a solid ‘green’.
What does ‘AON subscriptions’ do ?
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Many readers will get good performance with Fuji Version 5.5 with Hybrid mode (local caching of single cases) turned on. Some readers on slow connections or with very large (typically CT) datasets, might want to update to Version 5.7.
Fuji Version 5.7 allows you to subscribe to a worklist. You click on the worklist you want to work on and Fuji will start downloading and locally storing cases (configurable at the system level, up to 10). It also caches prior studies.
As you read cases and get them off the worklist, Fuji will download additional cases from that list.
Clearly will work best if you can define a worklist that encompasses all the cases you will need to read. Even better if you have a way of dividing the work with other readers so you don’t all pre-download the same cases.
It looked good in testing. Going live next week, and will see how it does live.
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Make sure you set your temporary internet files in IE is to 1024 if you use cine mode (for tomo’s or Ct’s)Fuji uses that default location, not what hybrid mode uses. We were the first site on 5.7, glad to work out the bugs for you 😉
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We don’t use worklists inside of Fuji. As I said, this is the clunkiest most inefficient RIS/PACS implementation outside of the Soviet Union. The worklist is driven by EpicFailure RIS. So I doubt that the list subscription feature would do us any good.
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If you are RIS driven, rather than PACS driven, you might want to test opening up the Fuji application separately, and subscribing to a worklist that matches the list on your RIS. The caching still might work, even though you are launching the case from the RIS. Just an idea, I haven’t tested it.
Also, the Cache directory can be set by your administrator and can be separate from IE and bigger than 1 GB.-
This doesn’t look like a traditional RIS/PACS integration. You click on the case on EpicFailure and it launches Synapse for that case.
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The EpicFailure RIS guys probably “integrated” this using a standard URL call. I think this type of workflow is more for the reffering guys, not a Radiologist. In essence for a Radiology reviewing provider PACs driven is the way to integrate with an EpicFailure. This way you get to use the tools built in to the PACs that help you read exams, while still allowing the EpicFailure guys to claim “integration!”, all the while they collect some obscure worthless KPI. I really I am not fond of Epic
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Have to agree with Valin, with EPIC it appears the majority of study launching i’ve experienced or configured are done via PACS worklist first, then Radiant loads with a secondary app (if so configured). However, PACS worklist are becoming more robust so I can see where RIS is now not the controller of workflow.
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Everything in that system is configured for the maximal comfort of the IT drones. Users are an afterthought.
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If you are using Hybrid mode best practice is to add an additional SSD drive to your workstation and point the Hybrid cache to that location. Caching to the C drive defeats the purpose of Hybrid caching. Also make sure that all browser considerations are met and that network optimization is enabled. If your network is slow and your infrastructure is bogged down by security no matter what PACS you have it will have issues.
Kinda like blaming your car for a poor ride while driving down a bumpy dirt road..
Also make sure you are using the different scrolling options properly as each has its own purpose. Fast scrolling and fly-throughs should be accomplished by using the scroll bar. not the center scroll wheel.
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