Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise

Departmental Appointment Notification Departmental Appointment Notification OptionOption

Eric PoiseauEric PoiseauLaboratoire IDM Faculté de MédecineLaboratoire IDM Faculté de Médecine

Université de Rennes 1Université de Rennes 1

February 9th 2005 IHE-EU Conference Workshop

imagesstored

patientinformation

RIS

examination orders

imagesretrieved

HIS

PACS

procedurescheduled

Prefetch any relevantprior studies

modalityworklist

report

report

Scheduled Workflow ProfileScheduled Workflow Profile

Registration

Orders Placed

Orders Filled

Film

FilmFolder

Image Manager& Archive

FilmLightbox

report ReportRepository

DiagnosticWorkstation

Modality

acquisitionacquisitionin-progressin-progressacquisitioncompleted

acquisitioncompleted

imagesprinted

AcquisitionModality

appointmentnotifications

February 9th 2005 IHE-EU Conference Workshop

NEW SWF OptionsNEW SWF Options

Departmental Appointment NotificationDepartmental Appointment Notification– Gives the Department System Scheduler Gives the Department System Scheduler

an option to notify Order Placer of date and an option to notify Order Placer of date and time of scheduled examinations.time of scheduled examinations.

February 9th 2005 IHE-EU Conference Workshop

Value PropositionValue Proposition

Provides a mechanism for the Order Provides a mechanism for the Order Placer to keep track of appointments Placer to keep track of appointments scheduled for a patient within Radiology scheduled for a patient within Radiology DepartmentDepartment

Includes notifications of scheduling, re-Includes notifications of scheduling, re-scheduling and cancellation eventsscheduling and cancellation events

Helps synchronization of scheduling Helps synchronization of scheduling processes between enterprise and processes between enterprise and radiologyradiology

February 9th 2005 IHE-EU Conference Workshop

BackgroundBackground Existing Placer Order Management Transaction Existing Placer Order Management Transaction

allows Order Placer specify preferred date and time allows Order Placer specify preferred date and time of an order fulfillment (i.e., radiological examination)of an order fulfillment (i.e., radiological examination)

Order Filler is ultimately responsible for scheduling of Order Filler is ultimately responsible for scheduling of examination as a succession of Procedure Steps that examination as a succession of Procedure Steps that may require one or more appointments to be createdmay require one or more appointments to be created

Currently, Order Placer has no way to know when or Currently, Order Placer has no way to know when or where exactly the appointment will take place.where exactly the appointment will take place.

February 9th 2005 IHE-EU Conference Workshop

Departmental Appointment Departmental Appointment Booking Use CaseBooking Use Case

Order Placer

Image Manager

Placer Order Mgmt – New [2]

Department System Scheduler/ Order Filler

Procedure Scheduled [4]

Create Order

Schedule Procedure Steps and/or Assign Protocol

Appointment Notification - New Bookings [48]

Appointment Notification – Reschedule Bookings [48]

Reschedule Procedure Step(s)

Cancel Procedure or Procedure Steps

Appointment Notification - Cancel Bookings [48]

Procedure Update [13]

Procedure Update [13]

February 9th 2005 IHE-EU Conference Workshop

Appointment Notification TransactionAppointment Notification Transaction

Appointment Notification

Order Placer DSS/ Order Filler

Department System Scheduler/Order FillerDepartment System Scheduler/Order Filler g generates enerates Appointment Notification messages and sends them to the Appointment Notification messages and sends them to the corresponding Order Placer actor.corresponding Order Placer actor.

Order Placer receives Appointment Notification messages Order Placer receives Appointment Notification messages and internally processes them.and internally processes them.

February 9th 2005 IHE-EU Conference Workshop

Interaction DiagramInteraction Diagram Order Placer Order Filler

Appointment Notification – New Bookings (SIU^S12)

Cancel Appointment for Scheduled Procedure Step

Reschedule Appointment for Scheduled Procedure Step

New Appointment for Scheduled Procedure Step

Appointment Notification – Reschedule Bookings (SIU^S13)

Appointment Notification – Cancel Bookings (SIU^S15)

February 9th 2005 IHE-EU Conference Workshop

Appointment Notification Appointment Notification TransactionTransaction

Three typical use casesThree typical use cases– New booking: initial scheduling of an examination New booking: initial scheduling of an examination – Re-schedule: change in date/time of examinationRe-schedule: change in date/time of examination– Cancellation: examination cancellationCancellation: examination cancellation

MechanismMechanism– HL7 SIU messagesHL7 SIU messages– One message may convey multiple appointments One message may convey multiple appointments

corresponding to a single ordercorresponding to a single order– One appointment corresponds to one or more One appointment corresponds to one or more

Scheduled Procedure StepsScheduled Procedure Steps

February 9th 2005 IHE-EU Conference Workshop

SIU Message StructureSIU Message Structure

SIU^S12, SIU^S12, SIU^S13, SIU^S13, SIU^S15SIU^S15

Schedule Information Schedule Information UnsolicitedUnsolicited

Chapter in HL7 Chapter in HL7 V2.4/2.5V2.4/2.5

MSHMSH

SCHSCH

{ RGS{ RGS

{ AIS{ AIS

[ { NTE } ][ { NTE } ]

}}

}}

Message HeaderMessage Header

Schedule Activity InformationSchedule Activity Information

Resource Group SegmentResource Group Segment

Appt Information – ServiceAppt Information – Service

Notes and CommentsNotes and Comments

22

1010

1010

1010

22

February 9th 2005 IHE-EU Conference Workshop

SCH SegmentSCH Segment Specifies common information for one or more Specifies common information for one or more

appointments associated with single orderappointments associated with single order– Placer Appointment ID is not usedPlacer Appointment ID is not used– Filler Appointment ID is requiredFiller Appointment ID is required

Appointment timing is defined on the Resource Appointment timing is defined on the Resource Group level, per Scheduled Procedure StepGroup level, per Scheduled Procedure Step– SCH-6 has fixed value of 1SCH-6 has fixed value of 1– One message can have multiple resource groups, One message can have multiple resource groups,

thus multiple appointments (procedure steps)thus multiple appointments (procedure steps) No patient identification information is required, No patient identification information is required,

thus Order Numbers are requiredthus Order Numbers are required

February 9th 2005 IHE-EU Conference Workshop

SIU Message StructureSIU Message Structure

SIU^S12, SIU^S12, SIU^S13, SIU^S13, SIU^S15SIU^S15

Schedule Information Schedule Information UnsolicitedUnsolicited

Chapter in HL7 Chapter in HL7 V2.4/2.5V2.4/2.5

MSHMSH

SCHSCH

{ RGS{ RGS

{ AIS{ AIS

[ { NTE } ][ { NTE } ]

}}

}}

Message HeaderMessage Header

Schedule Activity InformationSchedule Activity Information

Resource Group SegmentResource Group Segment

Appt Information – ServiceAppt Information – Service

Notes and CommentsNotes and Comments

22

1010

1010

1010

22

February 9th 2005 IHE-EU Conference Workshop

AIS SegmentAIS Segment Specifies Procedure Code and Description to Specifies Procedure Code and Description to

for the Scheduled Procedure Step(s) included for the Scheduled Procedure Step(s) included into this appointmentinto this appointment– Procedure Code in components 1-3Procedure Code in components 1-3– Not all steps of the procedure may be includedNot all steps of the procedure may be included– Those included are identified by a the text in Those included are identified by a the text in

component 5component 5 Date/Time of an appointment is expected to Date/Time of an appointment is expected to

be in UTCbe in UTC– If local, UTC offset is requiredIf local, UTC offset is required

No specification of location or resources (one No specification of location or resources (one should use AIG, AIL, AIP segments within the should use AIG, AIL, AIP segments within the same group, as appropriate)same group, as appropriate)

February 9th 2005 IHE-EU Conference Workshop

What is not in the optionWhat is not in the optionDepartmental Appointment Notification Departmental Appointment Notification

Option Option does not allow Order Placer to does not allow Order Placer to request re-schedulingrequest re-scheduling – it only can do it by – it only can do it by cancel and re-ordercancel and re-order

Transaction does not require AIL segment Transaction does not require AIL segment – thus notifications on re-scheduling of the – thus notifications on re-scheduling of the service from one location to another service from one location to another may may notnot be sent be sent

This option does not address needs of This option does not address needs of enterprise-wide schedulingenterprise-wide scheduling

February 9th 2005 IHE-EU Conference Workshop

ReferencesReferencesProfile Option - Volume 1, Section 3.3.6Profile Option - Volume 1, Section 3.3.6Transactions - Volume 3, Section 4.48Transactions - Volume 3, Section 4.48

February 9th 2005 IHE-EU Conference Workshop

Questions,Questions,

Comments,Comments,

and/orand/or

Suggestions?Suggestions?