rsna 2003 the ihe technical approach identify the transactions required to integrate information...
TRANSCRIPT
RSNA 2003
The IHE Technical ApproachThe IHE Technical Approach
Identify the transactions required to integrate information flow between information systems
For each transaction, select a single standard for use in implementing the transaction
Specify in detail the use of the standard in implementing the transaction
RSNA 2003
What is IHE?What is IHE?IHE is a specification of transactions
between systems.
IHE describes only integration features.
IHE is not a product itself, but…
IHE is very useful in purchasing products that integrate into workflow
RSNA 2003
Integration ProfilesIntegration Profiles--Transactions packaged in solutionsTransactions packaged in solutions--
Coherent functional sets of transactions related to workflow
46 Rad. + 13 IT transactions grouped into 12 + 5 Integration Profiles
Integration Profiles are the only practical way to communicate integration requirements precisely.
RSNA 2003
Level 0: Level 0: Modalities connected to Modalities connected to printerprinter
No RIS integrationNo RIS integration
Laser Printer
DICOM Basic Print Service
RSNA 2003
Level 1: Level 1: Modalities connected to Modalities connected to printerprinter
No RIS integrationNo RIS integrationPost-processing workstationsPost-processing workstations
Laser Printer
IHE Integration Profile:Consistent Presentationof Images
Sameperception??
RSNA 2003
What the Technologist What the Technologist Displays:Displays:
What the Radiologist What the Radiologist Sees:Sees:
The Technologist’s Transformations Are
Saved
Grayscale Calibration& Presentation State
Original Image
Window Level
Flip
Zoom
Area Of
Interest
Annotate
The Technologist’s Transformations Are
Lost
Original Image
Area Of
Interest
Prepared Image
Original Image
Consistent Presentation of Images Consistent Presentation of Images
RSNA 2003
Level 2: Modalities with RIS ConnectionLevel 2: Modalities with RIS Connection
IHE Integration Profile:Scheduled Workflow
(DICOM Modality Worklist)
RSNA 2003
RISRIS
Scheduled Workflow (Modality Worklist)Scheduled Workflow (Modality Worklist)
Modality Modality WorklistWorklist
Proposed Protocols
Loaded and Reviewed
WorklistWorklistPatient Name, IDPatient Name, ID
Requested ProcedureRequested Procedure
Examination TypeExamination Type
Scheduled Date, TimeScheduled Date, Time
RSNA 2003
Level 3:Level 3: Modalities with RIS Modalities with RIS ConnectionConnection
PACSPACS
IHE Integration Profiles:•Scheduled Workflow (full)•Patient Information Reconciliation•Presentation of Grouped Procedures•Access to Radiology Information
RSNA 2003
Patient Registration/UpdatePatient Registration/UpdateOrder ManagementOrder Management
Order Order Protocol Protocol DefinedDefinedStore ImagesStore Images
Storage CommitmentStorage CommitmentStorageStorage
CommitmentCommitment
List of ImagesList of Images
PACS &PACS &ArchiveArchive
RISRIS
A Closed LoopA Closed Loop•Update Scheduling ISUpdate Scheduling IS
•Match Procedure with OrderMatch Procedure with Order•Support Billing Based on MPPSSupport Billing Based on MPPS
•Avoid Reading incomplete ProceduresAvoid Reading incomplete Procedures
Scheduled WorkflowScheduled Workflow
Modality Modality WorklistWorklist
Procedure Scheduled Procedure Scheduled
Proposed Protocols
Loaded and Reviewed
WorklistWorklistPt A, …, Pt A, …, SPS=P1, P4SPS=P1, P4
Pt C, …, Pt C, …, SPS=P1, P5SPS=P1, P5
Pt B, …, Pt B, …, SPS=P2SPS=P2
Pt E, …, Pt E, …, SPS=P4SPS=P4
ModalityModalityPerformedPerformedProcedure Procedure StepStep
With Performed With Performed Acquisition Acquisition ProtocolsProtocolsPerformed Step:Performed Step:
Status = CompletedStatus = CompletedPerformed Procedure: CT HeadPerformed Procedure: CT Head Performed Protocol Code=P1Performed Protocol Code=P1
Pat Name/ID, Dose, Pat Name/ID, Dose, Accession #, Study UIDAccession #, Study UIDComplete List of ImagesComplete List of Images
Scheduled Protocol Code=P1, PScheduled Protocol Code=P1, P55
RSNA 2003
Patient Information ReconciliationPatient Information Reconciliation
Extends Scheduled Workflow– Handles unidentified patient (e.g. trauma)– Handles demographic information mistakes– Propagates changes to all affected
systems, updates all affected dataReduces incorrectly identified or lost
studies
RSNA 2003
MODALITY
Presentation of Grouped Procedures Presentation of Grouped Procedures Requested Procedure:
CHEST
Report:CHEST
Report:AB/PELVIS
Performs a single exam
Operatorgroups
2 procedures
Chest Chest ViewView
RIS / PACS
Requested Procedure:AB/PELVIS
Chest Chest ViewView
Ab/Pelvis Ab/Pelvis ViewView
Ab/Pelvis Ab/Pelvis ViewView
RSNA 2003
Access to Radiology InformationAccess to Radiology Information
Radiology Department – Images and
Reports
Emergency Department
Referring Physician
Other Departments:- Oncology- Surgery- Neurology- Pediatrics- etc.
Remote Clinics
Electronic Medical Record
RSNA 2003
Level 4:Level 4: More than images: More than images: Measurements, Key images, CAD Measurements, Key images, CAD
objectsobjects
IHE Integration Profiles:•Key Image Note•Evidence Documents•Post-processing workflow
RSNA 2003
RadiologistRadiologistFlags Images:Flags Images:
Referring PhysicianReferring PhysicianSees Key Images First:Sees Key Images First:
for refering physicianThis image showsthe renal rupture.
Note1
For referringphysician:This image showsthe renal rupture.
Note1
for refering physicianThis image has the hematoma.
Note2
For referring physician:This image hasthe hematoma.
Note2
for refering physicianThis image showsthe renal rupture.
Note1
for refering physicianThis image has the hematoma.
Note2
Study & Key Image Notes
Key Image NotesKey Image Notes
RSNA 2003
Findings:
Image Refs.:
Header:
Report
Type:
Evidence DocumentsEvidence Documents
Image data
from Modality
Coding Schemes
Thorax…..…..…..
Mass…..…..
Daim.Infiltr.
…..…..
(Pointer)
select
Evidence
Creator
application
(DIC
OM
) S
R O
bjec
t
Measurement Templates
RSNA 2003
PACS &PACS &WF MgrWF Mgr
RISRIS
Post-Processing WorkflowPost-Processing Workflowwith Post-Processing Manager Grouped with Image Managerwith Post-Processing Manager Grouped with Image Manager
Post-ProcessingPost-ProcessingWorklistWorklist
RetrieveRetrieveImagesImages
StoreStoreReportsReports Measurements
CAD Reports……....……… ArchiveArchive
DocumentsDocuments
Post-ProcessingProcedure Step
STARTED
Work Item Work Item ClaimedClaimed
Post-ProcessingProcedure Step
STARTED
Post-ProcessingProcedure Step
COMPLETED
Post-ProcessingProcedure Step
COMPLETED
RSNA 2003
Level 5: Reporting and billingLevel 5: Reporting and billing
IHE Integration Profiles:•Simple Image and Numeric Report•Reporting Workflow•Charge Posting
HIS
RSNA 2003
Findings:
Conclusions:
Image Refs:
Header:
Report
Type:
Simple Image and Numeric ReportSimple Image and Numeric Report
Image data
from PACS
Coding Schemes
Thorax…..…..…..
Mass…..…..
Daim.Infiltr.
…..…..
(Pointer)
select
Report Creator
application
RIS data
DICOM: Report Templates
(DIC
OM
) S
R O
bjec
t
RSNA 2003
PACS &PACS &Rep. MgrRep. Mgr
RISRIS
Reporting WorkflowReporting Workflowwith Report Manager Grouped with Image Managerwith Report Manager Grouped with Image Manager
ReportingReportingWorklistWorklist
RetrieveRetrieveImagesImages
ReportingProcedure Step
STARTED
Work Item Work Item ClaimedClaimed
ReportingProcedure Step
STARTED
ReportingProcedure Step
COMPLETED
ReportingProcedure Step
COMPLETED
IssueIssueReportsReports
StoreStoreReportReport Diagnostic
Reports……....………
RSNA 2003
Charge Posting ProfileCharge Posting Profile
ChargePoster
*Billing System
CAD*Workstation
ReportRepository……
Report Generated& Signed
CADPerformed
PostCharges
AcquisitionModality
ADT Terminal
3-D*Workstation
Account Management
3-DPerformed
StudyPerformed
MaterialsUsed
RSNA 2003
IHE Integration StatementIHE Integration Statement
RSNA 2003
Integrating the Integrating the Healthcare EnterpriseHealthcare Enterprise
The 2003 Radiology Connectathon:
36 vendors & 77 products
IHE is a reality, and it’s here to stay.
RSNA 2003
Where Is More Information Where Is More Information Available?Available?
www.rsna.org/IHE and www.himss.org/IHE – IHE RAD Technical framework for year 5 – V5.5– IHE IT Technical framework for year 1 – V 1.0
Non-Technical Brochures :– IHE Primer and IHE FAQ– IHE Integration Profiles: Guidelines for Buyers– IHE Connectathon Results