sept 13-15, 2004ihe interoperability workshop 1 integrating the healthcare enterprise scheduled...
TRANSCRIPT
Sept 13-15, 2004 IHE Interoperability Workshop1
Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise
Scheduled Workflow:The First Profile
Don Van Syckle, DVS Consulting, Inc.
Modified version of profiles delivered in workshop identified below – delivered by Kevin O’Donnell
Sept 13-15, 2004 IHE Interoperability Workshop2
Profile SummaryProfile Summary
Fundamental Starting Point of IHE
Addresses Registration, Scheduling, Acquisition Workflow and Image Content
Bridges HL7 and DICOM Spaces
Sept 13-15, 2004 IHE Interoperability Workshop3
MotivationMotivationPreserve 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
Sept 13-15, 2004 IHE Interoperability Workshop4
MotivationMotivationImprove 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
Sept 13-15, 2004 IHE Interoperability Workshop5
MotivationMotivationImprove 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
Sept 13-15, 2004 IHE Interoperability Workshop6
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
Sept 13-15, 2004 IHE Interoperability Workshop
IHE Workflow ConceptsIHE Workflow Concepts
PROCEDURE STEP : The smallest unit of work in the workflow:
Scheduled Procedure Step: ‘A unit of work to do’
Performed Procedure Step: ‘A unit of work done’
IHE has selected three UNAMBIGUOUS IHE has selected three UNAMBIGUOUS HL7/DICOM TERMS : TERMS :
ORDERORDER : : A request for radiologic serviceA request for radiologic service
REQUESTED PROCEDUREREQUESTED PROCEDURE : A Unit of work resulting in : A Unit of work resulting in one Reportone Report (with associated codified, billable acts) (with associated codified, billable acts)
Sept 13-15, 2004 IHE Interoperability Workshop
Workflow Concept MappingWorkflow Concept Mapping
This 3 level workflow structure is user oriented:
OORDER:RDER:A request for A request for imagingimaging service service
(Accession Number)(Accession Number)
REQUESTED PROCEDUREREQUESTED PROCEDURE : : Units of work resulting in one Units of work resulting in one ReportReport
with with associated codified, billable actsassociated codified, billable acts(Requested Procedure ID)(Requested Procedure ID)
PROCEDURE STEPPROCEDURE STEP : :The smallest unit of workThe smallest unit of work
in the workflowin the workflow(modality worklist entry)(modality worklist entry)
CLINICIANCLINICIANOR REFERING DOC:OR REFERING DOC:
The Imaging Dept CustomerThe Imaging Dept Customer
RADIOLOGISTRADIOLOGIST : : In Charge of producingIn Charge of producing
thethe ReportReport
TECHNOLOGISTTECHNOLOGIST(and RADIOLOGIST)(and RADIOLOGIST)
In charge of acquiring In charge of acquiring images, etc.images, etc.
Sept 13-15, 2004 IHE Interoperability Workshop
AcquisitionModality
Normal WorkflowNormal Workflow
ORDERA request for RadiologicService
Radiology Department
Set of Codifiable,
Billable, ActsOne or more series of images
PerformedProcedure
StepRequestedProcedure
ScheduledProcedure
Step
Report
DICOMModality Worklist
Typical workflow: One Order – One Procedure – One Report
Sept 13-15, 2004 IHE Interoperability Workshop
AcquisitionModality
AcquisitionModality
Multiple Modality StepsMultiple Modality Steps
ORDERA request for RadiologicService
Radiology Department
Set of Codifiable,
Billable, ActsOne or more series of images
PerformedProcedure
Step P1
ScheduledProcedure
Step B
RequestedProcedure
1
ScheduledProcedure
Step A
Report
One or more series of images
PerformedProcedure
Step P2
DICOMModality Worklist
DICOMModality Worklist
Sept 13-15, 2004 IHE Interoperability Workshop11
Modality Worklist Provided [5]
ADT Order Placer
Image Manager
Acquisition Modality
Placer Order Mgmt – New [2]
Department System Scheduler/ Order Filler
Procedure Scheduled [4]
Register/Admit Patient
Create Order
Schedule Procedure and/or Assign Protocol
Patient
Registration [1]
Administrative Administrative Normal Process FlowNormal Process Flow
Sept 13-15, 2004 IHE Interoperability Workshop12
Image Manager
Acquisition Modality
Department System Database/Scheduler
/ Order Filler
Image Archive
Modality Procedure Step Completed [7]
Perform Acquisition
Modality Images Stored [8]
Modality Presentation State Stored [9]
Modality Storage Commitment [10]
Modality Procedure Step In Progress [6]
Images Availability Query [11]
Modality Procedure Step Completed [7]
Modality Procedure Step In Progress [6]
Print Composer
Print Request [23]
Print Server
Procedure PerformanceProcedure PerformanceNormal Process FlowNormal Process Flow
Sept 13-15, 2004 IHE Interoperability Workshop13
““HL7 Actors” in SWFHL7 Actors” in SWF
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
Sept 13-15, 2004 IHE Interoperability Workshop21
““DICOM Actors” in SWFDICOM Actors” in SWF
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
Sept 13-15, 2004 IHE Interoperability Workshop22
Acquisition Workflow ManagementAcquisition 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
Sept 13-15, 2004 IHE Interoperability Workshop23
Image ManagementImage 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