Next, Procida from Italy presented on 'PACS independent and IHE-like approach method for the analysis of PACS in a healthcare enterprise'. they noticed that the hospital had over 100, high cost, workstations connected to the PACS. However, the usage of these systems is unknown and many of them might be used only for a small part of the time. The display on/off status was recorded in a database and provided the possibility to record system usage. This method was limited by the fact that the displays had a delay of 10 min inactivity before they turned off automatically. The IHE ATNA (Audit Trail Node Authentication) profile was utilized to determine the exact use of the workstations since information about each exam view was recorded with the user information. A more accurate status was obtained with this second method about the workstation usage per workstation. This allowed reallocation and discontinuation of underused, high cost, workstations. Proposals are made to the IHE to adopt the ATNA profile to fully support this non-intended but very interesting use.
Final presentation was from Japan, presented by Ito on the improvement of clinical workflow of thoracic surgeons in distant hospitals by interactive teleconference using open source software. They used Osirix, VNC, Voice Chatter (voice communication software) and Wireshark (packet analyzer) to setup teleconference with only open source software. Using this they setup a four hospital teleconference system using VPN connection. Instead of travelling up and down they now upload anonymized DICOM data to the university hospital and do the consultation using the teleconference method saving hours of travelling time.