scheduled workflow and patient information reconciliation
TRANSCRIPT
![Page 1: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/1.jpg)
Scheduled Workflowand
Patient Information Reconciliation
![Page 2: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/2.jpg)
Scope
• Genesis 1: In the beginning, …
• [ or better yet ]
• Genesis 11: Tower of Babel – “and there confound their language, that
they may not understand one another's speech. “
![Page 3: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/3.jpg)
Scope
• Backbone of IHE Radiology
• Integrates Registration, Scheduling, Acquisition Workflow and Image Content
• Bridges HL7 and DICOM Spaces
![Page 4: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/4.jpg)
imagesstored
patientinformation
RIS
examination orders
imagesretrieved
HIS
PACS
procedurescheduled
Prefetch any relevantprior studies
modality worklist
report
report
Use Case
Registration
Orders Placed
Orders Filled
Film
FilmFolder
Image Manager& Archive
FilmLightbox
report ReportRepository
DiagnosticWorkstation
Modality
acquisitionacquisitionin-progressin-progressacquisitioncompleted
acquisitioncompleted
imagesprinted
AcquisitionModality
![Page 5: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/5.jpg)
Value Proposition
• Preserve Order Continuity– “Close the Loop”
– maintain accession number, avoid confusion with Filler #, Placer #, etc.
• Improve Demographic Integrity– Data entry errors
• significant occurrence
• significant consequences
– Enter once, pass from system to system
![Page 6: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/6.jpg)
Value Proposition
• Improve Workflow Efficiency– Use of Worklists
• less time spent doing data entry/selection• enables semi-automation of setup
• Reliable Storage– Storage Commitment
• fewer lost studies• more confidence in results
![Page 7: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/7.jpg)
Value Proposition
• Improve Order Tracking– MPPS from Modality to RIS & PACS
• more timely feedback• more precise feedback
• Reduce Integration Effort at Site– Get Vendors on the Same Page– Provide Implementation Guidance– Pre-test at Connectathon
![Page 8: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/8.jpg)
Participant Actors
• ADT Patient Registration• Order Placer• Order Filler – Department System
Scheduler• Image Manager – Archive• Acquisition Modality• Image Display• Evidence Creator
![Page 9: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/9.jpg)
Order Flow
HL7 Actors:• ADT/Patient
Registration• Order Placer• DSS / Order Filler• Image Manager
1: Pt registration 12: Pt Update
Pt registration: 1 Pt Update: 12
2: Placer Order Management 3: Filler Order Management
ADT
4: Procedure Scheduled 12: Patient Update 13: Procedure Update
Image Manager
Order Placer Order Filler
![Page 10: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/10.jpg)
Order Flow
• Patient Registration– Admit: In Patient, Out Patient, Pre-Admit– Cancel
• Patient Update– Transfer, Discharge, Outpatient-to-
Inpatient, Inpatient-to-Outpatient– Update Patient Demographics– Merge Patient Records– Cancel Transfer, Cancel Discharge
![Page 11: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/11.jpg)
Order Flow
• Order Management– New Order: Enterprise and Department– Cancel Order– Order Status Update
• Schedule Procedure– Schedule new Procedure for an order– Reschedule/Change Procedure details
![Page 12: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/12.jpg)
Procedure Flow
DICOM Actors:• DSS / Order Filler • PPS Manager• Image Manager /
Archive• Acquisition Modality• Evidence Creator• Image Display
Query Images [14] Retrieve Images [16]
Image Display
Storage Commitment [10]
Modality Image Stored [8] Storage Commitment [10]
Creator Images Stored [18]
Procedure Scheduled [4] Image Availability Query [11] Procedure Updated [13] Performed Work Status Update [42] Performed Work Status Update [42]
Modality Worklist Provided [5]
Evidence Creator
Performed Procedure
Step Manager
Modality PS in Progress [6] Modality PS Completed [7] Creator PS in Progress [20] Creator PS Completed [21]
Modality PS in Progress [6] Modality PS Completed [7] Creator PS in Progress [20] Creator PS Completed [21]
Modality PS in Progress [6] Modality PS Completed [7]
Creator PS in Progress [20] Creator PS Completed [21]
Acquisition Modality
Image Manager
Image Archive
DSS/ Order Filler
![Page 13: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/13.jpg)
Acquisition Workflow Management
DICOM:• Modality Worklist
Management (MWL)• Modality Performed
Procedure Step (MPPS)
Query Images [14] Retrieve Images [16]
Image Display
Storage Commitment [10]
Modality Image Stored [8] Storage Commitment [10]
Creator Images Stored [18]
Procedure Scheduled [4] Image Availability Query [11] Procedure Updated [13] Performed Work Status Update [42] Performed Work Status Update [42]
Modality Worklist Provided [5]
Evidence Creator
Performed Procedure
Step Manager
Modality PS in Progress [6] Modality PS Completed [7] Creator PS in Progress [20] Creator PS Completed [21]
Modality PS in Progress [6] Modality PS Completed [7] Creator PS in Progress [20] Creator PS Completed [21]
Modality PS in Progress [6] Modality PS Completed [7]
Creator PS in Progress [20] Creator PS Completed [21]
Acquisition Modality
Image Manager
Image Archive
DSS/ Order Filler
![Page 14: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/14.jpg)
Image Management
DICOM:• Image Storage• Storage
Commitment• Query/Retrieve
Query Images [14] Retrieve Images [16]
Image Display
Storage Commitment [10]
Modality Image Stored [8] Storage Commitment [10]
Creator Images Stored [18]
Procedure Scheduled [4] Image Availability Query [11] Procedure Updated [13] Performed Work Status Update [42] Performed Work Status Update [42]
Modality Worklist Provided [5]
Evidence Creator
Performed Procedure
Step Manager
Modality PS in Progress [6] Modality PS Completed [7] Creator PS in Progress [20] Creator PS Completed [21]
Modality PS in Progress [6] Modality PS Completed [7] Creator PS in Progress [20] Creator PS Completed [21]
Modality PS in Progress [6] Modality PS Completed [7]
Creator PS in Progress [20] Creator PS Completed [21]
Acquisition Modality
Image Manager
Image Archive
DSS/ Order Filler
![Page 15: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/15.jpg)
Scheduled Workflow Options
• Tune up Workflow Management– Patient-based or Broad Worklist Queries, – Assisted Protocol Setting, – Exception Management, – Billing and Material Management
• Notification of Performed Work Status or Availability of Results: – Images, – Other Evidence documents, – Appointments
![Page 16: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/16.jpg)
Exception Management Option
• Provides better feedback on discontinued studies
• Handles selection of wrong worklist item
![Page 17: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/17.jpg)
Exception Management OptionMechanism
• Modality can provide Discontinued Reason Code to indicate WHY the procedure has not been completed, for example:– Equipment failure– Incorrect procedure ordered– Incorrect worklist entry selected– Patient condition prevented continuing
![Page 18: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/18.jpg)
Patient Information Reconciliation
Expect the Unexpected
![Page 19: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/19.jpg)
Patient Information Reconciliation
• Extension of Scheduled Workflow
• Coordinated update of demographic information in workflow and content objects
![Page 20: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/20.jpg)
Patient Information ReconciliationValue Proposition
• Handle “exception” cases– Trauma/Emergency Treatment Cases
• Patient Unknown or no time for Registration
– Entry Errors by Operator– Other Demographic Changes
• (e.g. married name)
• Multiple sources/destinations for updates– High risk of unsynchonized/inconsistent data
• Workflow must continue• Need to pull together past & current patient
records
![Page 21: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/21.jpg)
Use Cases
• ALL ER patients are pre-registered (“John Doe”, “Jane Doe”):– Case 1: Unidentified Patient registered at ADT
and order is placed at Order Placer.– Case 2: Unidentified Patient registered at ADT
and order is placed at DSS/Order Filler.– Case 3: Unidentified Patient registered at ADT
but acquisition completed at Modality prior to order.
![Page 22: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/22.jpg)
Use Cases
• ER patients are registered with Departmental IDs:– Case 4: Unidentified Patient assigned
temporary Departmental ID and scheduled at DSS/Order Filler.
– Case 5: Image Acquisition completed prior to assigning temporary Departmental ID or Order (Patient ID entered at the Modality).
![Page 23: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/23.jpg)
“Emergency” - Case 3
ADT OrderPlacer
ImageManager Modality
Department SystemDatabase/Scheduler/
Order Filler
Filler Order Mgmt
New Order [3]
ProcedureScheduled [4]
Patient Reconciliation
J.Doe -> J.Smith
PatientUpdate [12]
Schedule Procedure
ImagesAcquired
Modality ProcedureStep Completed [7]
Modality ProcedureStep Completed [7]
Register J.Doe
Patient
Update [12]
Patient
Registration [1]
![Page 24: Scheduled Workflow and Patient Information Reconciliation](https://reader030.vdocument.in/reader030/viewer/2022032516/56649c6f5503460f94921c27/html5/thumbnails/24.jpg)