Integrating the Healthcare Enterprise

Feb. 07-10, 2005 IHE Europe Workshop1

Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise

– Radiology –

Established IHE Integration Profiles:

Dr. Nikolaus Wirsz – Siemens Medical SolutionsIHE Europe CommitteeIHE Radiology Planning Committee

• Post-Processing Workflow (PPWF)


IHE Radiology Integration ProfilesIHE Radiology Integration Profiles

Patient Info.

Recon-ciliation

Access to Radiology Information

Consistent Present-ation of Images

Basic Security

-

EvidenceDocs

KeyImageNotes

Simple Image & Numeric Reports

Presentation of Grouped Procedures

Post-Processing Workflow

(PPWF)

Reporting Workflow

Charge Posting

Scheduled Workflow

Portable Data for Imaging

NMImage


SummarySummary

Extension to the Scheduled Workflow to SupportTypical Post-Processing Workflow Procedures: Image Processing Image Reconstruction Computer Aided Detection

Ability to Schedule and Track the Status of Post-Processing Tasks


IHE Post-Processing Workflow Overview

Post-ProcessingPost-ProcessingWorklistWorklist

RetrieveRetrieveImagesImages

StoreStoreReportsReports Measurements

CAD Reports……....……… ArchiveArchive

ImagesImages

Post-ProcessingProcedure Step

STARTED

Work Item ClaimedWork Item Claimed


STARTED


COMPLETED


COMPLETED

Image &Post-Proc.Manager

PACS & Archive3D Workstation

RISDepartmentalSystem SchedulerOrder Filler

CompletedCompleted


AcquisitionModality

Modality and Post-Processing StepsModality and Post-Processing Steps

ORDERA request for RadiologicalService

Radiology Department

Set of Codifiable,

Billable ActsOne or more series of images

M-Perf.Procedure

Step P1RequestedProcedure

1

ScheduledProcedure

Step B

ScheduledProcedure

Step A

Report

DICOMModality Worklist

DICOMPost-Processing Worklist

Post-Processing

One or more series of images

PP-Perf.Procedure

Step P2


PPWF Actors & TransactionsPPWF Actors & Transactions

Additional Actor: Post-Processing Manager

Transactions: Worklist Provided Workitem Claimed Workitem PPS In Progress Workitem PPS Completed Workitem Completed Performed Work Status Update Evidence Documents Stored Query Evidence Documents Retrieve Evidence Documents


Post-Processing Manager GroupingPost-Processing Manager Grouping

Either with Image Manager (PACS)

Post-Processing Manager

IM/IA

DSS/OF

Performed Work Status Update (optional)


Post-Processing Manager GroupingPost-Processing Manager Grouping

Or with Departmental System Scheduler / Order Filler (RIS)

IM/IA

Performed Work Status Update


DSS/OF


Actors and TransactionsActors and Transactions


DSS/OF

ImageDisplay

Evidence Creator

Imag

e A

vail

abil

ity

Qu

ery

Per

form

ed W

ork

Sta

tus

Up

dat

e

Worklist Provided

Workitem Claimed

Workitem PPS In Progress

Workitem PPS Completed

Workitem Completed

Retrieve Images

Query Evidence Documents

Retrieve Evidence Documents

Images Stored

Storage Commitment

Evidence Documents Stored

IM/IA

Query Images


Worklist ProvidedWorklist Provided

Evidence Creator finds out what post-processing tasks have been scheduled or assigned to it by the Post-Processing Manager

Worklist provided for workitem codes e.g. Image Processing or Computer Aided Detection.

Evidence Creator includes received information in the resulting instances


Worklist ProvidedWorklist Provided

General Purpose Worklist SOP Class

Explicit definition of required matching and return keys for both Post-Processing Manager and Evidence Creator

Evidence Creator shall implements at least one of 3 query cases: Patient Oriented Query: Worklist for a specific patient / procedure Station Oriented Query: Broad Worklist for a particular workstation Class Oriented Query: Broad Worklist for a class of workstations

(e.g. workstations for CT 3D Reconstructions)


Evidence Creator

C-FIND-RQ

C-FIND-RSP


Workitem ClaimedWorkitem Claimed

Evidence Creator takes ownership of the workitem

Post-Processing Manager updates its worklist and permits other worklist users to detect that this SPS has been claimed


Workitem ClaimedWorkitem Claimed

General Purpose Scheduled Procedure Step SOP Class

N-ACTION (SPS in Progress) Post-Processing Manager

Evidence Creator


Workitem PerformedWorkitem PerformedProcedure Step In ProgressProcedure Step In Progress

Evidence Creator starts work on claimed SPS

Notifies Post-Processing Manager to create a Performed Procedure Step


Workitem PerformedWorkitem PerformedProcedure Step In ProgressProcedure Step In Progress

General Purpose Performed Procedure Step SOP Class

SPS and PPS relationships (Appendix III-D): Simple Case Unscheduled Case Append Case Abandoned Case

N-CREATE (PPS in Progress) Post-Processing Manager

Evidence Creator


Workitem PerformedWorkitem PerformedProcedure Step CompletedProcedure Step Completed

Evidence Creator notifies Post-Processing Manager of the PPS completion

Evidence Creator references any results created e.g. images, evidence documents


Workitem PerformedWorkitem PerformedProcedure Step CompletedProcedure Step Completed


Evidence Creator shall send to the Post-Processing Manager a list of all Composite SOP Instances in the Output Information Sequence (0040,4033)

N-SET (PPS Completed) Post-Processing Manager

Evidence Creator


Workitem CompletedWorkitem Completed

Evidence Creator notifies the Post-Processing Manager when it completes the scheduled workitem

Post-Processing Manager updates its worklist


Workitem CompletedWorkitem Completed

General Purpose Scheduled Procedure Step SOP Class

No further PPS will be created for this SPS

N-ACTION (SPS Completed) Post-Processing Manager

Evidence Creator


Performed Work Status Performed Work Status UpdateUpdate

Department System Scheduler and Image Manager inform each other of the status of performed post-processing work

Allows the system not managing the performed work to stay in sync


Performed Work Status Performed Work Status UpdateUpdate


IM/IA DSS/OF

N-CREATE (PPS in Progress)

N-SET (PPS Completed)

DSS/OF IM/IA

N-CREATE (PPS in Progress)

N-SET (PPS Completed)


Wrap UpWrap UpPost-Processing Workflow (Multiple Steps)Post-Processing Workflow (Multiple Steps)with Post-Processing Manager grouped with Image Managerwith Post-Processing Manager grouped with Image Manager

RIS PACS

Modality

DICOM MWL

DICOM Image StorageDICOM Storage CommitmentDICOM MPPS

DICOM MPPS

CAD StationPost-Processing

Station

DICOMPP-WL

DICOMPP-SPS

DICOMPP-WL

DICOMPP-SPS

DICOM PP-PPS

DICOM PP-PPS

DICOMPP-PPSDICOM

PP-PPS

DICOM Storage& Commitment

DICOMQ/R

DICOMQ/R

DICOM Storage& Commitment


Value PropositionValue Proposition

Improve Post-Processing Workflow Efficiency –Use of Worklists to Manage Post-Processing Tasks

Eliminate Errors Associated with Paper and Film Handling

Close the Information Loop: Integrating Post-Processing Results with Acquired Images Associate Post-Processing Results with Correct Order

Enable Sub-sequent Workflow Steps: Initiate Reporting Workflow Support for Billing Based on Post-Processing Results


References:IHE Europe: http://www.IHE-Europe.org

IHE Main Web Site: http://www. IHE.net

Questions ?