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The imaging order, the accession, the study identifiers and the signed report live in Vantra. The images themselves stay in your PACS - and this page is careful about which is which.
A radiology information system manages orders, scheduling, worklists, examination status and reporting.
A picture archiving and communication system stores, retrieves and presents the medical images produced by modalities.
DICOM is the standard used to format and exchange medical images and related information between compatible systems.
In short: RIS coordinates the work, PACS manages the images and DICOM lets the systems exchange imaging information. Read the detailed RIS vs PACS vs DICOM guide.
Drawn from the module's own worklist. Every name, number and time below is sample data.
| Patient | Item | Priority | Accession | Modality | Status | Placed |
|---|---|---|---|---|---|---|
| Verified patientAmara NjokuMRN 402181991-04-12 · F | CT head without contrastCT-HEAD-NC | Stat | RIS-000421-8 | CT | In progress | 08:14 |
| Verified patientHalima YusufMRN 402601996-11-03 · F | Obstetric ultrasoundUS-OB | Urgent | - | - | Ordered | 08:31 |
| Verified patientPeter KamauMRN 401831978-02-25 · M | Chest X-ray PAXR-CHEST-PA | Routine | RIS-000419-2 | CR | Reported | 07:52 |
| Identity not verified - actions lockedpat_7f3c…a91b4d2 | MRI lumbar spineMR-LSPINE | Routine | RIS-000418-4 | MR | In progress | 07:05 |
The accession and modality columns read from the recorded study, so an order that has not been acquired yet shows a dash. Cancellation is an EMR action: the radiology workstation has no cancel button of its own.
Vantra reserves the accession and the scheduled UID when the order arrives, so the modality worklist can carry them. A performed study must come back with the same UID and modality; anything else is refused rather than attached to a chart.
EMR imaging orders enter a role-gated radiology worklist with patient, encounter, indication, modality request, priority and provenance.
Record the existing DICOM StudyInstanceUID and accession against the Vantra order manually or through the authenticated site Bridge; the system never guesses the order association.
Save drafts, finalise reports electronically and create reasoned amendments while retaining the prior report and sign-off trail.
Launch a zero-footprint viewer through a validated HTTPS URL template. The workspace reports DICOMweb probe status and broader PACS readiness separately instead of treating a configured URL as proof of connectivity.
Vantra stores imaging metadata and reports, not DICOM pixels. Archive storage, retention, device compatibility and image availability remain explicit PACS responsibilities.
A deployment package is available for isolated Orthanc, DICOMweb and OHIF services behind a TLS boundary, with validation, backup, restore and no-patient-data smoke tooling.
A draft carries a version and an optimistic check, so two radiologists cannot quietly overwrite each other. Finalising signs the report, freezes it and moves the order to reported in one transaction.
CT head without contrast · RIS-000421-8 · CT
Draft v2Final · signedFindings
No acute intracranial haemorrhage, mass effect or midline shift. Ventricles and sulci are appropriate for age.
Impression
No acute intracranial abnormality.
A final report is never edited. A correction is a new linked amendment with its own reason, and the original stays exactly as it was signed.
Chart return to the EMR
okThe signed findings, impression, accession and modality go back to the clinical chart under a deterministic key, so a retry cannot duplicate the fact.
Imaging charge request
queuedOne charge for the clinical order, priced from the canonical service.
Queued means the durable outbox row exists and delivery is not confirmed yet. The status only reads ok once that exact row is confirmed delivered.
Placing the order creates no charge. An amendment returns a new chart fact and creates no second charge.
A configured URL is not a connection. Each surface reaches only the states its evidence supports, and two of them can never say connected at all.
| Surface | States it can reach | What the strongest state proves |
|---|---|---|
| Viewer session or template | Not configuredConfiguredConnected | The enabled session endpoint has a saved signing secret, or the credential-free template is valid. A browser launch is never called connected. |
| DICOMweb endpoint | Not configuredConfiguredConnectedFailed | A real HTTPS test succeeded within the last 24 hours. A stale or failed test cannot claim connectivity. |
| HL7 endpoint | Not configuredConfiguredConnected | An endpoint is saved. Serverless code cannot verify the on-site bridge, so this adapter never reads connected. |
| PACS AE title and host | Not configuredConfiguredConnected | An AE title and host are saved. A DICOM C-ECHO needs the on-site bridge, so this adapter never reads connected either. |
Facility readiness
Reporting works with no PACS at all. Image access is only called verified after a recent real probe, and the archive mode never reads as anything but external.
Read from the module's own contracts, its settings screen and the deployment package.
The EMR order appears in the radiology worklist for the correct facility and authorised team.
Staff or an approved modality/PACS relay supplies the existing order ID, modality and StudyInstanceUID; no identifier is fabricated.
The radiologist drafts, signs or amends the report, returning the final result to the clinical chart and downstream billing workflow.
Authorised users launch the configured external viewer. DICOMweb probe state and facility PACS readiness remain visible as separate deployment checks.
The RIS holds the order, the identifiers and the report. The pixels, the archive and the viewer belong to the PACS. This page says so because the code does.
What Vantra stores
What stays in the PACS
Where a facility selects it, Vantra supplies a per-site package: an Orthanc archive with DICOMweb and modality worklists, an OHIF viewer, an Nginx TLS boundary, and a gateway that issues one-study, fifteen-minute launches - with pinned image versions, backup and restore scripts, and a smoke check that never touches patient data.
It is an infrastructure baseline, not a DICOM conformance statement. Certificates, per-device conformance evidence, modality worklist query tests, storage sizing, identity policy and a witnessed restore remain facility go-live gates.
The RIS workstation requires an entitled hospital account. PACS is deployed per facility and intentionally has no public or default login; prospective clients can request a synthetic workflow walkthrough and device-conformance plan.
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