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Workflow

1

Order and bill the examination

Billing makes the radiology requisition open and assigns a unique accession number. HMIS queues publication of the accession to OIE.
2

Acquire the examination

The modality queries the PACS worklist using DICOM MWL, the operator selects the matching accession, and the images are acquired.
3

Mark the examination pending

A radiology user selects Mark pending in HMIS. This records who performed the examination and when, and changes the requisition from open to pending.
4

Store and link the study

The modality sends the study to PACS using DICOM C-STORE. OIE detects the stable study and posts its normalized identity to HMIS. HMIS links it by accession number.
5

Report and authorize

Entering the report changes pending to completed. Clinical review changes completed to authorized.

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Status meanings

Receiving or linking a study does not complete the requisition. The clinical report is what changes the requisition to completed.
The study-ingestion API accepts a study only when the matching requisition is pending, completed, or authorized. An image received while the examination remains open is retained in the integration audit as quarantined rather than silently linked.