Secret Digital Image Sharing by Various Image Media Using Nvss Scheme
Image Sharing- the NIBIB/RSNA image sharing project employing IHE solutions
description
Transcript of Image Sharing- the NIBIB/RSNA image sharing project employing IHE solutions
Image Sharing- the NIBIB/RSNA image sharing project employing
IHE solutions
David S. Mendelson, M.D.
Professor of Radiology
Chief of Clinical Informatics
The Mount Sinai Medical Center
Co-chair IHE International Board
IHE-Providing the Foundation for Interoperability
Fourth China-U.S. Roundtable Meeting on Scientific Data Cooperation:
Presentation Objectives
Integrating the Healthcare Enterprise (IHE)Overview- How is IHE organized?
Healthcare Interoperability in the United StatesChallengesARRA (American Recovery and
Reinvestment Act)Image Sharing
Via HIEImage Sharing Project- Personal Health
Records (PHRs)
Integrating the Healthcare Integrating the Healthcare EnterpriseEnterprise
The state of IHE - 2010The state of IHE - 2010
David S. Mendelson, M.D.David S. Mendelson, M.D.
Chief of Clinical InformaticsChief of Clinical Informatics
The Mount Sinai Medical CenterThe Mount Sinai Medical Center
Co-chair IHE BoardCo-chair IHE Board
International Adoption of IHE
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France
Local Deployment National Extensions (Local
Adaptions) Promotional & Live Demonstration
Events Funding
USA
Germany
Italy
JapanUK
Canada
Korea
Taiwan
Norway
Holland
SpainChina
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Pragmatic global standards harmonization + best practices sharing Pragmatic global standards harmonization + best practices sharing
Austria
National and Regional Projects Using IHE Profiles
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Quebec, Toronto,Alberta, British Columbia
Canada Infoway
Denmark (Funen)Italy (Veneto)Spain (Aragon)
THINC- New YorkNCHICA – N. Carolina
Italy (Conto Corrente
Salute)
Boston Medical
Center - MA
FranceDMP
UK CfH(Radiology WF)
Philadelphia HIE
CHINA-MoHLab results sharing
CPHIC – Pennsylvani
a
CHINA-ShanghaiImaging Info Sharing
JAPAN-NagoyaImaging Info Sharing
South Africa
Malaysia
VITL-Vermont
CareSpark – TN & VA
NetherlandAmsterdam
LowerAustria
Austria
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IHE Organizational StructureIHE Organizational Structure
Contributing &Participating
Vendors
IHE International Board
Global Development
Radiology
Cardiology
ITInfrastructure
Patient CareCoordination
Patient CareDevices
Laboratory
Pathology
Eye CareRadiationOncology
Regional Deployment
IHE Europe
IHE North America
France
USA
Canada
IHE Asia-Oceania
Japan
Korea Taiwan
Netherlands
Spain Sweden UKItaly
Germany
Norway
China
Austria
ACCACCEACEP
JAHISJIRAJRS
METI-MLHWMEDIS-DCJAMI
RSNA SFRSFIL
SIRMBIREuroRec
COCIREAR-ECRDRG
ESC
Professional Societies / SponsorsACPGMSIHIMSS
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Thank You for Your AttentionThank You for Your AttentionProf. Jianping Dai, MD
IHE China: IHE China: http://www.ihe-c.orghttp://www.ihe-c.org
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Events: PromotionEvents: Promotion
Education and Promotion by Journals Education and Promotion by Workshop
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Events: ConnectathonEvents: Connectathon
The IHE-C Connectathon was held at April 26, 2008 in Beijing Tiantan Hospital
There are 7 companies attendedDr. Zhu, Chairman of IHE China, past vice Minister of Healthcare attended
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The IHE-C Connectathon was held at April 26, 2008 in Beijing Tiantan Hospital
Events: ConnectathonEvents: Connectathon
IHE – the processIdentify Interoperability issuesDevelop Integration Profiles
Actors and TransactionsWorkflowGather relevant standards
Connectathon TestingPublish Integration Statements
Vendors list tested profiles
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Problem to ProfileProblem Domain Integratio
n ProfileTransaction
Actors
Patient Identity across multiple settings
IT Infrastructure
Patient Identifier Cross-Referencing (PIX)
Patient Identity feed
Patient Identity Source
Patient Identity Cross Reference Manager
Make CAD results available with images
Radiology Evidence Documents
Evidence Document Stored
Evidence Creator (Post Processing Workstation
Image Manager/Image Archive
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Interoperability in the US-ChallengesPrivacy rightsHIPAANo Single identifier
Office of the National Coordinator for Healthcare IT (ONC)Health Information Technology Standards Panel
(HITSP)Certification Commission for HIT (CCHIT)
American Recovery and Reinvestment Act (ARRA)Includes financial incentives for adoption of the
Electronic Health Record throughout the USInteroperability is a cornerstone
Funding for related research- NIHQuality -Comparative EffectivenessEHR
XDS (Cross-Enterprise Document Sharing)XDS.aXDS- I.aXDS.b
?? XDS-I.b
a vs. bRelated to web standards and transactions
XDS
XDS-I
NIBIB contract summaryConsumer ControlEmploy IHE
solutions whenever possibleIHE generally has
not focused on consumer driven solutions but rather on institutional and enterprise workflow
5 Academic InstitutionsMayo ClinicMount Sinai Medical
CenterUniversity of California
San FranciscoUniversity of ChicagoUniversity of Maryland
Establish a clearinghouse
Engage PHRs300,000 patients over 2
years
Elements of SolutionEdge Server
Register a patientListens to a Radiology Information System (RIS)-
looking for a complete examRetrieves Image set from PACS and Report from RISSend both to clearinghouse
Clearinghouse – functions as a secure routerTransiently hold encrypted patient data
PHRConsumer controls upload and future accessDevelop web based viewersDownload full DICOM data set
XDS (Cross-Enterprise Document Sharing)XDS.aXDS- I.aXDS.b
?? XDS-I.b
Protocol Flow
Web/JavaSrv
MIRTHHL7
DICOM
From RIS
Dbase
OS
PACS Qry/Rtrv
Firewall
Clearing House
XDS.b &
token
Edge Appliance
ADMIN
RSRCH
Software architecture
Prepare content Poll database, get report, get exam,prepare big fat file
Background java srvlet 25 days
Transfer content Poll database for transfer out, package content into xds.b
Background java srvlet 35 days
HL7 receiver Receive HL7 A04 messages, extract reports and store them in database
Mirth HL7 Channel. Let Mirth create its default database, all script work-but may have to customize per site
65 days for 5 sites
Token App Create new tokens based on two parts, associate token with accession numbers, update database, user interface with login, get patient info,create job
Ajax based web front-end ,JavaServlet for CFIND using dcm4che, creating job in the RSNA database, creating tokens using kerberos – tokens generated locally
30 days
Database Store reports, logs, audit trails, user accounts, etc.
Mirth instance for HL7 & DICOM, RSNA instance for everything else
50 days – 2 databases
Management App Create users, monitor logs, check health
Ajax gui front end, backend servlet, dicom targets etc.
45 days
Future DirectionsRefine Workflow
Initial workflow is to replace a CDExam updatesDownload DICOM data and archive in a local
PACSEdge server as a platform
Radiation MonitoringPeer ReviewQuality Metrics
Radiation Exposure Monitoring Profile -REMSupplement to Technical Framework for
Trail ImplementationAcquisition modalities inlcudes information
regarding dose exposureEstimates
Permits communication of that information to other systems
Useful for Individual lifetime estimates as well as Population analysis
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Radiation Exposure Monitoring (REM)Includes
CTPlain X-RayMammography
Current ExclusionsNuclear MedicineRTBrachytherapy
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DICOM Dose SR objectsDICOM 2008 PS 3.3: A.35.8 X-Ray Radiation
Dose SR IOD