How to de-identify angiograms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor in Chief: Amanda Chirlin

Overview

In many juristictions it is illegal to transport medical images with patient identifiers. Patient identifiers include name, date of birth, patient ID, and more. It is imperative that angiograms are properly de-identified before they are transported. This page gives step-by-step instructions for how to properly de-identify angiograms before transporting them. Both programs are available to download for free. Note: The process of de-identification requires a new, blank CD to burn the de-identified angiogram onto.

De-identying angiograms using ViewPlus software

The ViewPlus software is the recommended software for de-identifying angiograms. However, ViewPlus has some issues when operating in Windows 7. If your computer runs on Windows 7, you can try to run ViewPlus under the Windows 7 virtual XP emulator. Otherwise, you can try the second program, provided below.

Loading ViewPlus software on your computer

Step 1: Go here to start the download process. The download will start automatically.

Step 2: A window with a security warning may pop up. This is normal. Click “Run.”

Step 3: A second window with a security warning may come up. This is normal. Click “Run” again.

Step 4: The file will begin downloading. It may take a few minutes. When the download is complete, the ViewPlus Installation program will automatically start. When this happens, click “Next.”

Step 5: The next window will ask you where you would like to save the program to. Simply click “Next,” unless you would like to save it somewhere other than the C drive.

Step 6: ViewPlus will ask you to select the proper drive that corresponds to your CD-drive. If you are not sure how to answer this question, go to “My Computer” and locate the drive that shows a CD or DVD drive. It will probably be shown under a header labeled “Devices with Removable Storage.” Once you have selected the proper drive in the ViewPlus Installation program, click “Next.”

Step 7: ViewPlus will ask you to choose a format for dates. Choose the second option (dd/mm/yyyy), and then click “Finish.”

Step 8: The installation will begin to load. It may take a few minutes for this step to completed. When the download is complete, click “OK” to return to the desktop.

The installation is now complete.

De-identifying angiograms with ViewPlus

Step 1: Put the angiogram that you wish to de-identify into the CD drive that you selected in Step 6 of the installation process. Wait for a moment to see if the CD opens up its own internal software. If it does, close the software.

Step 2: Locate the new ViewPlus icon and double click it to open ViewPlus. The icon is pink, black, white, and gray, and says “ViewPlus.”

Step 3: You will see the interface of the program. On the left side of the screen, there will be a column with thumbnail images of all the cineruns. Double check that the angiogram has multiple cineruns by double-clicking the thumbnails, or clicking "Play All" and watching them play one at a time. Look to see if any identifying information (name, date of birth, patient ID number, etc.) is shown on the images themselves.

• If there are no patient identifiers on any of the images, you may skip to Step 9. **Be sure to check every cinerun before skipping the next few steps.**

Step 4: If there is any identifying information on the cineruns themselves, click the button shown below.

Step 5: When the new screen shows up, click and drag the mouse across the area with identifying information to form a black-out bar (also called a “hider”). When you are done, press “OK,” or if you want to delete what you’ve done, press "Cancel" to go back to the previous screen. Note: You can only create one black-out bar at a time.

The red arrow is pointing to the black-out bar in this sample angiogram.

Step 6: When you press “OK,” a window will pop up. Click “Yes” and your blackout bar will be added to all images in the series.

Step 7: If you have made a mistake with a black-out bar, click the button with the red “X” through it, shown below. Then, click “Yes” when the next window pops up. Note: This button will delete ALL of the black-out bars you have created.

To make more blackout bars, repeat Steps 4-7 until all patient identifiers are obliterated.

• Always make the blackout bars as small as possible, and make multiple smaller blackout bars rather than one big black-out bar.
• When you have completed this task, be sure to click through all of the cineruns again to be sure that you haven't missed anything.

Step 8: Once you are sure that you have blacked out all identifying information on the angiogram, look for the word “Anonomyze,” and determine whether there is a check mark in the small box to the left of “Anonomyze.” If there is no check mark, click the small box so that a check mark appears. Then, click “Make CD.”

After you click “Make CD,” it may take a few minutes for the DICOM files to be de-identified. Once it is complete, the screen will look like this:

Step 9: Take out the CD and insert a blank CD or blank DVD into the drive.

Step 10: Click the small button with the downward arrow on it to pull down a list of possible drives. Select the appropriate drive, and then click “Write Disc.”

Step 11: When the CD is done burning, the CD drive will pop open, and the ViewPlus screen will become blank. Click the “Exit” button, which will return you to the desktop.

Step 12: Double check that the process was successful by re-inserting the new disc (the one that just popped out of the CD drive) into the drive and clicking the ViewPlus icon (see Step 2). When the ViewPlus opens, double click all of the thumbnails (see Step 3) to ensure that they play properly. Make sure that that all of the cineruns are present and that all identifying information is properly blacked out so that it cannot be viewed.

You have now successfully de-identified an angiogram!