june 28-29, 2005ihe interoperability workshop 1 integrating the healthcare enterprise...
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June 28-29, 2005 IHE Interoperability Workshop1
Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise
Cross-enterprise Document Sharing for Imaging (XDS-I)
Rita Noumeir Ph.D.
University of Quebec
IHE Technical and Planning Committees
June 28-29, 2005 IHE Interoperability Workshop2
Abstract / ScopeAbstract / Scope
Sharing of Imaging Information across health enterprises
Imaging Information includes extensive sets of DICOM instances including images,
evidence documents and presentation states diagnostic reports provided in a "for display" form selection of diagnostically significant images associated
with the report content
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Value PropositionValue PropositionImaging component of the Electronic Health Record: Shared imaging Record, in a community, region, etc.
Effective means to contribute and access imaging documents across health enterprises.
Scalable sharing of imaging documents between radiology departments, private physicians, clinics, long term care, acute care with different clinical IT systems.
Easy access: Care providers are offered means to query and retrieve imaging documents (images and reports) of interest.
June 28-29, 2005 IHE Interoperability Workshop4
Value PropositionValue PropositionDistributed: Each Care delivery organization “publishes” imaging information for others. Actual images remain in the source/Image Manager.
Cross-Enterprise: A Registry provides an index for published information to authorized care delivery organizations belonging to the same clinical affinity domain.
Document Centric: Published clinical data is organized into “clinical documents”. using agreed standard document types (DICOM KOS, PDF and/or text report)
Document Content Neutral: Document content is processed only by source and consumer IT systems.
Standardized Registry Attributes: Queries based on meaningful attributes ensure deterministic document searches.
June 28-29, 2005 IHE Interoperability Workshop5
XDS-I DependenciesXDS-I Dependencies
XDS-I depends on IT Infrastructure Cross-Enterprise Document Sharing (XDS)
Actors are required to support XDS Document Source Document Consumer Document Registry Document Repository
Documents, and metadata are specialized
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XDS-I Actors / GroupingXDS-I Actors / GroupingSharing of an Extensive DICOM set Document Source shall be grouped with an Image
Manager/Image Archive
Sharing of a report that references selected images Document Source shall be grouped with an Image
Manager/Image Archive
Sharing of a report that references selected images from previously published extensive DICOM set Document Source can be grouped with a Document
Consumer
June 28-29, 2005 IHE Interoperability Workshop7
XDS-IXDS-INew TransactionsNew Transactions
RAD-Y1 Provide and Register Document Set
ITI-14 Register Document Set
ITI-16 Query Registry
ITI-17 Retrieve Document
ITI-18 Patient Identity Feed
RAD-Y6 WADO Retrieve
June 28-29, 2005 IHE Interoperability Workshop8
XDS-IXDS-ITransaction DiagramTransaction Diagram
Document Source
Document Consumer
Document Registry
Document Repository
Provide&Register
Document Set[RAD-Y1]
Register Document Set[ITI-14]
Retrieve Document
[ITI-17]
Query Registry [ITI-16]
Patient Identity Source
Patient Identity Feed [ITI-18]
ImageManager/ImageArchive
WADO Retrieve
[RAD-Y6]
Retrieve Images [RAD-16] Retrieve Presentation States [RAD-17] Retrieve Key Image Note [RAD-31] Retrieve Evidence Documents [RAD-45]
June 28-29, 2005 IHE Interoperability Workshop9
XDS-I Required TransactionsXDS-I Required TransactionsDocument Consumer at least one Retrieve (DICOM C-Move)
Document Source RAD-Y1 Provide and Register Document Set
Document Repository nothing specific to XDS-I
Document Registry nothing specific to XDS-I
Image Manager / Image Archive RAD-Y6 WADO Retrieve
June 28-29, 2005 IHE Interoperability Workshop10
XDS-IXDS-IOptionsOptions
Document Source, at least one of the following options Extensive Set of DICOM Instances PDF Report Text Report Multipart Text/PDF Report
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Sharing of Sharing of Extensive DICOM Extensive DICOM
Instance SetInstance Set
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Document Registry
Document Repository
Manifest
Reference to image 1
DICOM Manifest
Reference to image 2
Reference to image 3Manifest Manifest
Clinical Encounter
Clinical IT System
Query Registry
Manifest
Retrieve Manifest
Reference to image 1
DICOM Manifest
Reference to image 2
Reference to image 3
Retrieve Images
Register Manifest
Manifest
June 28-29, 2005 IHE Interoperability Workshop13
Extensive DICOM Instance SetExtensive DICOM Instance Set
XDS Document Repository
Image Manager/Archive / Document Source
XDS Document Registry
Provide and Register Document Set
Register Document Set
Query Documents
Retrieve Images
Create Key Object Selection Document
Document Consumer
Decode Key Object Selection Document
Retrieve Document
June 28-29, 2005 IHE Interoperability Workshop14
Sharing of Sharing of Extensive DICOM Extensive DICOM Instance SetInstance Set
The shared Document is a manifest a Key Object Selection DICOM Instance
Image Manager/Image Archive is required to ensure that the referenced images from within a
published manifest are available to be retrieved
Document Source is responsible for replacing a previously submitted manifest Document
when a change occurs to the manifest content (eg. Change of the DICOM SOP instances refrenced wihtin the manifest)
June 28-29, 2005 IHE Interoperability Workshop15
Sharing of Imaging Sharing of Imaging ReportReport
June 28-29, 2005 IHE Interoperability Workshop16
Radiology systemReport Source
…..
Findings:
Header:
Report Type: OB / Gyn
BPD ...…..
Radiology Report
Impressions: GestationalAge
...
Text Report
PDF Report
Text +PDF Report
June 28-29, 2005 IHE Interoperability Workshop17
Radiology systemReport Source
Document Registry
Document Repository
Report Report
Clinical Encounter
Clinical IT System
Query Registry
Retrieve Report
Register Report
Report
…..
Findings:
Header:
Report Type: OB / Gyn
BPD ...…..
Radiology Report
Impressions: GestationalAge
...
June 28-29, 2005 IHE Interoperability Workshop18
Imaging ReportImaging Report
Document Repository
Report Manager / Document Source Document
Registry
Provide and Register Document Set
Register Document Set
Query Documents
Retrieve of referenced Images
Create shared report and include pre-formatted WADO URI to reference relevant images
Document Consumer
Retrieve Report Document
Image Archive
June 28-29, 2005 IHE Interoperability Workshop19
Sharing of Sharing of ReportReportThe shared Report Document format is PDF, Text, or multipart PDF + Text
A report can embed selected images in its PDF format include fully resolved hyperlinks (interactively clickable) that
point to the selected images
Document Source is responsible for formatting the hyperlink to reference relevant images as
a DICOM WADO URI or as IHE RID Request for Document
Document Source is required to ensure that image references are valid links
June 28-29, 2005 IHE Interoperability Workshop20
Linking Report to Complete Set of ImagesLinking Report to Complete Set of Images
Document RepositoryDocument Repository
Document RegistryDocument Registry
Manifest
Report
DocumentEntry
DocumentEntry
SubmissionSet
June 28-29, 2005 IHE Interoperability Workshop21
Linking Report to Complete Set of ImagesLinking Report to Complete Set of Images
Document RepositoryDocument Repository
Document RegistryDocument Registry
Manifest
DocumentEntry
SubmissionSet 1
Report
DocumentEntry
SubmissionSet 2
June 28-29, 2005 IHE Interoperability Workshop22
Linking Report to Prior Images and Prior Linking Report to Prior Images and Prior ReportReport
Document RepositoryDocument Repository
Document RegistryDocument Registry
Manifest
DocumentEntry
SubmissionSet 3
Prior
Manifest
DocumentEntry
SubmissionSet 1
Prior
Report
DocumentEntry
SubmissionSet 2
Report
DocumentEntry
SubmissionSet 4
June 28-29, 2005 IHE Interoperability Workshop23
Linking Report to Selected Linking Report to Selected ImagesImages
Radiology systemReport Source
…..
Findings:
Header:
Report Type: OB / Gyn
BPD ...…..
Radiology Report
Relevant Image
GestationalAge
...WADO URI
Link to image
June 28-29, 2005 IHE Interoperability Workshop24
XDS-I MetadataXDS-I Metadata
eventCodeList R2 instead of Optional Code for Acquisition Modality from DCMR Context
Group CID 29 and Code for Anatomic Region from DCMR Context Group
CID 4
typeCode Requested Procedure Code of the Requested
Procedure, to which the shared document is associated
June 28-29, 2005 IHE Interoperability Workshop25
More information….More information….
IHE Web site: http://www.ihe.net
http://www.himss.org/IHEhttp://www.rsna.org/IHEhttp://www.acc.org/quality/ihe.htm
Technical Frameworks
Technical Framework Supplements – Trial Implementation
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Questions?
Questions?