Inside NewLumen: How the Worklist, Hanging Protocols and Structured Reporting Work Together
Summary
A veterinary imaging workflow is the sequence from study acquisition through reading and reporting. NewLumen, Asteris' cloud-native veterinary DICOM platform, unifies this workflow by connecting the worklist (where studies arrive and are triaged), hanging protocols (layouts applied automatically when a study opens) and structured reporting (template-based report authoring) in a single clinical environment.
The Problem a Disconnected Workflow Creates
Before examining how NewLumen's three components work together, it helps to name the specific friction they address. In a disconnected veterinary imaging workflow, a radiologist might receive a study through one system, open it in a separate desktop viewer, manually arrange image panes to match their preferred layout, then switch to a word processor or a third application to type a report. Each context switch costs time. Manual pane arrangement is repeated for every study. Free-text reports vary in structure from one radiologist to the next, which makes it harder for referring clinicians to locate findings quickly.
For a solo practice reading its own films, this friction is manageable, if inefficient. For a teleradiology service reading studies submitted by dozens of referring clinics, the friction compounds. A remote radiologist opening a thoracic radiograph from one clinic should see the same layout, the same window and level presets, and the same report template fields as when opening a thoracic radiograph from any other clinic. Without automation, achieving that consistency requires manual effort on every case.
NewLumen addresses each friction point through three interconnected components: the worklist, hanging protocols and structured reporting. They are described separately below, then shown working together in a concrete scenario.
The Worklist: Where Every Study Begins
The worklist is the first surface a radiologist or reading service interacts with when a study arrives. In NewLumen, the worklist is browser-based, which means no local software installation is required to access it. A radiologist logging in from any location sees a single queue of studies submitted by all referring clinics on their account, without switching between separate logins for each practice.
Each row in the worklist draws its information from the DICOM header, the embedded metadata stored in every DICOM image file. The header contains patient name, species, body part examined, modality code, acquisition date and the submitting clinic's identity. NewLumen reads these fields into the worklist, and a reading service can search across patients, owners and clinics.
Five worklist views (All Cases, My Queue, Group Queue, Pending Review and Completed Today) show where each case stands, so coordinators can follow the queue without contacting individual radiologists for updates.
Opening a study from the worklist is a single click. The viewer loads the study directly, and hanging protocols fire automatically on load. No manual step sits between selecting the case and seeing the images arranged correctly.
Hanging Protocols: Eliminating Layout Work on Every Case
A hanging protocol is a saved display configuration. It specifies how many image panes open in the viewer, which series from the study loads into each pane, what window and level preset applies to each pane, and whether any prior study for the same patient should load alongside the current images for comparison.
A thoracic radiograph protocol might open two panes: a lateral view on the left and a ventrodorsal or dorsoventral view on the right, each with a soft-tissue window preset already applied. NewLumen ships with five species-tagged protocols (Canine Chest 3-View, Canine Abdomen, Canine Orthopedic, Feline Chest 3-View and Feline Thorax + Abdomen), and each applies when a matching study opens from the worklist.
The practical effect is that a radiologist reading thirty thoracic radiographs in a session never manually positions a single image. The layout is identical on case one and case thirty. This matters most in teleradiology, where a radiologist may read studies from multiple clinics using different imaging equipment. The images arrive with different series labels and file structures depending on which modality produced them, but the hanging protocol normalizes the viewing experience regardless of origin.
Hanging protocols apply the same way whether a study goes straight from the modality to the cloud or through a NewLumen edge node on the practice network. The protocol logic applies to the DICOM content, not to the submission path.
Structured Reporting: From Viewer to Completed Report Without Leaving the Session
Structured reporting replaces the blank page of a free-text report with a set structure. NewLumen reports run through clinical history, technique, comparison, findings, impression and recommendations, with 17 system templates and 13 system macros for canine, feline and equine studies, plus personal ones.
In NewLumen, the structured report panel opens within the same viewer session as the images. Images paste straight from the viewer into the report, and work autosaves every 3 seconds. Because every report follows the same sections, a referring clinician always finds the impression in the same place, regardless of which radiologist in the reading service produced the report.
Signing delivers the report by link email, as a PDF, and automatically to connected practice management systems, so nobody exports it by hand. A finalized report cannot be edited; any change goes in an addendum with a reason, linked to the original.
Measurement and annotation tools in the viewer let the radiologist mark findings alongside the images while working. These annotations are the radiologist's own markings, created during review. They do not populate report fields automatically. The radiologist reviews any annotations they have placed and enters the corresponding findings into the structured report fields by judgment. The report reflects the radiologist's interpretation; the annotations are a working aid during image review.
A Concrete Scenario: Thoracic Radiograph from a Referring Clinic
A small-animal referring clinic acquires a thoracic radiograph series on a patient presenting with a suspected cardiac condition. The clinic's digital radiography (DX) system pushes the DICOM study to NewLumen over a standard DICOM connection. No staff member at the clinic needs to do anything further; the study appears in the reading service's worklist automatically.
The reading service radiologist opens their worklist in a browser. The new study appears in the queue, labeled with the clinic name, patient identifier, modality (DX), body part (thorax) and acquisition date. The radiologist clicks the study. The viewer loads and the Canine Chest 3-View hanging protocol applies, with the views already arranged.
The radiologist reviews the images. They note enlargement of the cardiac silhouette and place a measurement annotation on the lateral view. They also note mild pulmonary vascular distension. These findings are the radiologist's own observations, recorded as annotations in the viewer.
With image review complete, the radiologist opens the structured report panel. The radiologist picks a thoracic template, writes the enlarged cardiac silhouette and the mild vascular distension into the findings, adds an impression and recommendations, and signs the report.
Signing delivers the report to the referring clinic by link email and PDF, and automatically to its practice management system if one is connected. The entire process, from the study appearing in the worklist to the report being transmitted, takes place within a single browser session and a single platform.
How the Three Components Depend on Each Other
The worklist, hanging protocols and structured reporting are each useful individually. A worklist that did not trigger automatic layouts would still organize studies. Hanging protocols applied through a separate viewer would still save layout time. Structured report templates in a word processor would still standardize terminology. But the friction eliminated by each component is only fully realized when all three operate within the same session.
When a radiologist opens a study from the worklist and the hanging protocol fires automatically, no time is spent on layout before structured reporting can begin. When the structured report panel is embedded in the viewer, no context switch interrupts the reading session. When signing delivers the report, no manual transmission step is required. The integration is the point: each component hands off to the next without requiring the radiologist to bridge the gap manually.
For teleradiology services in particular, this handoff matters at scale. A reading service handling studies from many referring clinics depends on the worklist to keep those studies organized, on hanging protocols to keep the viewing experience consistent across studies from different equipment, and on structured reporting to keep the output consistent regardless of which radiologist in the service read the case. Remove any one of those components and the reading service absorbs the coordination cost manually.
Understanding the mechanism behind each component, and how they connect, gives practices and reading services a concrete basis for evaluating whether their current veterinary PACS workflow handles that coordination automatically or leaves it to individual effort on every case.
Frequently Asked Questions
Does a radiologist need to install anything to use the NewLumen worklist?
No. The worklist, viewer and report panel run in the browser. A radiologist signs in from any location and sees one queue covering every referring clinic on the account.
What does a hanging protocol control in NewLumen?
The layout a study opens in, so the views are arranged before the radiologist starts. NewLumen ships five species-tagged protocols for canine and feline studies, and they apply when a matching study opens, even when tags are inconsistent. Priors for the same patient surface when the case opens.
Do annotations in the viewer fill in the report automatically?
No. Annotations and measurements are the radiologist's working marks during review. The radiologist enters findings into the structured report fields by judgment, and the signed report reflects that interpretation.
Do Keystone PACS and NewLumen work together?
Both are Asteris products. Keystone PACS is the on-premise option and NewLumen the cloud option, and Asteris offers both. Contact us to talk through which fits your practice.