Archiving

 

In addition to documenting findings in the patient chart, users are strongly encouraged to archive representative images and clips from their examinations. Archiving supports communication regarding ongoing care, QA, feedback, learner development, and clinical documentation.

Prior to scanning, ensure the correct patient information is entered into the ultrasound system. At minimum, archived studies should include appropriate patient identifiers (e.g name or accession number), operator information, exam type, and representative images/clips that support your interpretation.

Images should only be stored using approved institutional archiving systems and in accordance with local privacy policies.

The exact archiving workflow may vary depending on the ultrasound machine being used. However, the following general steps apply to most systems and should be followed whenever possible.

  1. Select “New Patient”
  2. Enter patient identifiers (name, ID, accession number etc.)
  3. Enter operator details
  4. Select “scan” or “start”
  5. Save representative images/clips
  6. Select “end study” or “end exam”
  7. Confirm successful upload to the institutional archiving system

 

*Most ultrasound equipment will automatically push the study to the archiving system. In some cases, studies may not automatically upload due to network interruptions, archive connectivity issues, or local machine configuration. In these situations, a manual transfer may be required.

      1. Open the patient list
      2. Select the exam/patient you wish to archive
      3. Select “send to”
      4. Select “archive”
      5. Choose desired archive destination/server
      6. Select “send”
      7. Confirm successful upload to DICOM server

 

Figure 16. Archiving Status

Q-Path

QPath is a commonly used ultrasound image management and archiving platform and is used at Alberta Children’s Hospital and many other institutions. Depending on your site, a different archiving or review platform may be used.

QPath allows users to:

· Review ultrasound images and clips

· Participate in quality assurance (QA) review (if done at your local site)

 

Access and Login

Access to QPath requires site-specific authorization. User accounts are typically created and managed by local administrators or ultrasound leadership.

Once access has been granted:

    1. Navigate to the institutional QPath login page
    2. Enter your username and password and login

 

*For AHS users, the link for accessing Qpath is: http://wsqpathapp02.healthy.bewell.ca/

*If accessing Qpath remotely, you will first need to connect to the healthcare institutions VPN using your RSA token, then proceed to the Qpath login page

 

Platform Navigation

When QPath is opened, users are typically brought directly to the exam list page. This page displays available studies and allows users to search, filter, and open examinations for review.

Studies can be searched using patient identifiers or filtered based on criteria such as operator/provider, study type, exam date, and patient identifiers.

The left sidebar provides access to key navigation functions (figure 17):

· Home – Returns to the main exam list/dashboard.

· Browse– Opens search and filtering options for archived studies.

 

The top sidebar provides function such as (figure 17):

· Refresh – Refreshes the study list.

· Open – Opens the selected study.

· Edit – Add or edit patient, exam or operator details.

· Export – Don’t use this function. It is best to export studies under the image operations function.

· Image operations – Allows you to select all or specific images within the exam to export.

· Export grid – Do not use this function. This will print a CSV file of all the exams/patient details on the exam list.

 

Figure 17. Qpath exam list page and functions

 

Once a study is opened, additional tools become available in the top toolbar (figure 18).

· Navigating through studies – previous or next exam.

· Edit – add or edit patient, exam or operator details.

· Submit for QA – allows you to select a reviewer for your exam and submit the exam for QA (if QA is done through Qpath at your local site)

· Image operations – allows you to select all or specific images within the exam to export.

Figure 18. Exam specific top bar tools on Qpath

 

Editing an Exam

Accurate patient, exam, and provider information is important for study identification and the QA review process. Ideally, these details should be entered prior to beginning an examination. However, if clinical circumstances or time constraints do not permit, they may be added or updated afterwards within QPath. Users should try to make it routine practice to enter and verify this information at the time of scanning whenever possible.

Editable information includes patient identifiers (name, ID, birthdate), exam information (date, exam type, comments) and provider information.  Select “Edit” to modify the desired fields, then select “Save” to apply the changes.

 

Reviewing an Exam

QPath includes image review and annotation tools that allow users to review cine clips, slow playback speed, annotate images (add text, perform measurements) adjust image layouts, and manage saved images. These functions can be found in the bottom right-hand corner, once an exam is opened.

 

Figure 19. Qpath image review and annotation tools

 

 

Privacy and De-identification of Exported Images

It is important to note that although the export function attempts to obscure patient names, this may not always be done completely (e.g., portions of the patient name may remain visible). Exported images may also continue to display patient identifiers such as accession or ID numbers. Users are responsible for ensuring all exported images and studies are appropriately de-identified prior to use or sharing.

All exported files must be handled in accordance with institutional privacy and confidentiality policies.