September, 2005What IHE Delivers 1 Key Image Notes Evidence Documents Simple Image & Numeric Report...
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Transcript of September, 2005What IHE Delivers 1 Key Image Notes Evidence Documents Simple Image & Numeric Report...
1September, 2005 What IHE Delivers
Key Image NotesKey Image NotesEvidence DocumentsEvidence Documents
Simple Image & Numeric ReportSimple Image & Numeric Report Access to Radiology Information Access to Radiology Information
IHE Vendors Workshop 2006IHE Vendors Workshop 2006Rita Noumeir, Ph.D., Rita Noumeir, Ph.D.,
SoftmedicalSoftmedical
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Abstract / ScopeAbstract / Scope
Sharing of Imaging Information across health Sharing of Imaging Information across health enterprisesenterprises
Imaging Information includes Imaging Information includes extensive sets of DICOM instances including images, extensive sets of DICOM instances including images,
evidence documents and presentation states evidence documents and presentation states diagnostic reports provided in a "for display" form diagnostic reports provided in a "for display" form selection of diagnostically significant images associated selection of diagnostically significant images associated
with the report contentwith the report content
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Sharing Radiology Reports and ImagesSharing Radiology Reports and Imagesin a Regional Health Information Networkin a Regional Health Information Network
Radiology Enterprise A
Radiology Enterprise B
Physician Office
Regional Health Regional Health Information Information NetworkNetwork
PACS B
PACS A
Radiology-to-radiology
Radiology-to-Physicians
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Sharing Radiology Reports and ImagesSharing Radiology Reports and Imagesin a Regional Health Information Networkin a Regional Health Information Network
Radiology Enterprise A
Radiology Enterprise B
Physician Office
Regional Health Regional Health Information Information NetworkNetwork
Cross-Cross-Enterprise Enterprise RegistryRegistry
Patient Id= 3547F45• Report 5/21/1998 : CT Head B• Study 5/21/1998 : CT Head B• Report 2/18/2005 : Chest Xray A• Study 2/18/2005 : Chest Xray A
PACS B
PACS A
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Physicians and Systems within a Regional Health Physicians and Systems within a Regional Health Network - Routine Imaging ReferralNetwork - Routine Imaging Referral
Radiology Enterprise A
Radiology Enterprise B
Physician Office
Regional Health Regional Health Information Information NetworkNetwork
Query for Query for Documents Documents
Register Imaging Register Imaging Information for Information for
sharingsharing
Priorimaging
Reports & Studies
Cross-Cross-Enterprise Enterprise RegistryRegistry
Register Imaging Register Imaging Information for Information for sharingsharing
Patient Id= 3547F45• Report 5/21/1998 : CT Head B• Study 5/21/1998 : CT Head B
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Physicians and Systems within a Regional Health Physicians and Systems within a Regional Health Network - Routine Imaging ReferralNetwork - Routine Imaging Referral
Radiology Enterprise A
Radiology Enterprise B
Physician Office
Regional Health Regional Health Information Information NetworkNetwork
Register Imaging Register Imaging Information for Information for
sharingsharing
Cross-Cross-Enterprise Enterprise RegistryRegistry
Notification of Notification of Doc AvailabilityDoc Availability
Register Imaging Register Imaging Information for Information for sharingsharing
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Physicians and Systems within a Regional Health Physicians and Systems within a Regional Health Network for a Routine Imaging ReferralNetwork for a Routine Imaging Referral
Radiology Enterprise A
Radiology Enterprise B
Physician Office
Prior Imaging Report & Study
Regional Health Regional Health Information Information NetworkNetwork
Query for Query for documents documents
Imaging Report Imaging Report & Study& Study
Cross-Cross-Enterprise Enterprise RegistryRegistry
Patient Id= 3547F45• Report 5/21/1998 : CT Head B• Study 5/21/1998 : CT Head B• Report 2/18/2005 : Chest Xray A• Study 2/18/2005 : Chest Xray A
Notification of Notification of Doc AvailabilityDoc Availability
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Value PropositionValue PropositionImaging component of the Electronic Health Record:Imaging component of the Electronic Health Record: Shared imaging Record, in a community, region, etc.Shared imaging Record, in a community, region, etc.
Effective means to contribute and accessEffective means to contribute and access imaging imaging documents across health enterprises. documents across health enterprises.
Without XDS-I, access to the radiology report across health Without XDS-I, access to the radiology report across health enterprises is difficultenterprises is difficult
Scalable sharing of imaging documentsScalable sharing of imaging documents between between radiology departments, private physicians, clinics, radiology departments, private physicians, clinics, long term care, acute care with different clinical IT long term care, acute care with different clinical IT systems.systems.
Easy access:Easy access: Care providers are offered means to Care providers are offered means to query and retrieve imaging documents (images and query and retrieve imaging documents (images and reports) of interest reports) of interest
with the same mechanisms used to query other documentswith the same mechanisms used to query other documents
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Value PropositionValue PropositionDistributed:Distributed: Each Care delivery organization Each Care delivery organization “publishes” imaging information for others. Actual “publishes” imaging information for others. Actual images remain in the source/Image Manager.images remain in the source/Image Manager.
Cross-Enterprise:Cross-Enterprise: A Registry provides an index for A Registry provides an index for published information to authorized care delivery published information to authorized care delivery organizations belonging to the same clinical affinity organizations belonging to the same clinical affinity domain. domain.
Document Centric:Document Centric: Published clinical data is organized Published clinical data is organized into “clinical documents”. using agreed standard into “clinical documents”. using agreed standard document types (DICOM KOS, PDF and/or text report)document types (DICOM KOS, PDF and/or text report)
Document Content Neutral:Document Content Neutral: Document content is Document content is processed only by source and consumer IT systems.processed only by source and consumer IT systems.
Standardized Registry Attributes:Standardized Registry Attributes: Queries based on Queries based on meaningful attributes ensure deterministic document meaningful attributes ensure deterministic document searchessearches..
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XDS-I DependenciesXDS-I Dependencies
XDS-I depends on IT Infrastructure Cross-XDS-I depends on IT Infrastructure Cross-Enterprise Document Sharing (XDS)Enterprise Document Sharing (XDS)
Same Actors as in XDSSame Actors as in XDS Document SourceDocument Source Document ConsumerDocument Consumer Document RegistryDocument Registry Document Repository Document Repository
Added extension to support imaging data Added extension to support imaging data (images and reports)(images and reports)
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Document Consumer
Retrieve Document
Query Documents
Patient Identity Source
Patient Identity Feed
Document Source
Document Registry
Document Repository
Provide & Register Document Set
Register Document Set
XDS-I Actors and TransactionsXDS-I Actors and Transactions
Image ManagerImage Archive
Retrieve Images
Retrieve Presentation StatesRetrieve Key Image NoteRetrieve Evidence DocumentsWADO Retrieve
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XDS-I New Transaction XDS-I New Transaction requirementsrequirements
XDS Actors:XDS Actors: Document ConsumerDocument Consumer
• at least one Retrieve (DICOM C-Move or WADO)at least one Retrieve (DICOM C-Move or WADO)
Document SourceDocument Source• Provide and Register Document Set Provide and Register Document Set
Radiology ActorsRadiology Actors Image Manager / Image ArchiveImage Manager / Image Archive
• WADO RetrieveWADO Retrieve
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XDS-IXDS-IOptionsOptions
Document Source must support at least Document Source must support at least one of the following options:one of the following options: Extensive Set of DICOM Instances Extensive Set of DICOM Instances PDF Report PDF Report Text Report Text Report Multipart Text/PDF 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
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Sharing of Sharing of Extensive DICOM Extensive DICOM Instance SetInstance Set
The shared Document is a manifest The shared Document is a manifest a Key Object Selection DICOM Instance a Key Object Selection DICOM Instance
Image Manager/Image Archive is required Image Manager/Image Archive is required to ensure that the referenced images from within a published to ensure that the referenced images from within a published
manifest are available to be retrievedmanifest are available to be retrieved
Document Source is responsible Document Source is responsible for replacing a previously submitted manifest Document for replacing a previously submitted manifest Document
when a change occurs to the manifest content (eg. Change when a change occurs to the manifest content (eg. Change of the DICOM SOP instances referenced within the of the DICOM SOP instances referenced within the manifest)manifest)
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Sharing of Sharing of Imaging ReportImaging Report
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Radiology systemReport Source
…..
Findings:
Header:
Report Type: OB / Gyn
BPD ...…..
Radiology Report
Impressions: GestationalAge
...
Text Report
PDF Report
Text +PDF Report
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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
...
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Sharing of Sharing of ReportReportThe shared Report Document format is The shared Report Document format is PDF, Text, or multipart PDF + TextPDF, Text, or multipart PDF + Text
A report can A report can embed selected images in its PDF format embed selected images in its PDF format include fully resolved hyperlinks (interactively clickable) include fully resolved hyperlinks (interactively clickable)
that point to the selected imagesthat point to the selected images
Document Source is responsible Document Source is responsible for formatting the hyperlink to reference relevant images for formatting the hyperlink to reference relevant images
as a DICOM WADO URI or as IHE RID Request for as a DICOM WADO URI or as IHE RID Request for DocumentDocument
Document Source is required Document Source is required to ensure that image references are valid linksto ensure that image references are valid links
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XDS-I Actors / GroupingXDS-I Actors / GroupingSharing of an Extensive DICOM setSharing of an Extensive DICOM set Document Source shall be grouped with an Image Document Source shall be grouped with an Image
Manager/Image Archive Manager/Image Archive
Sharing of a report that references selected Sharing of a report that references selected imagesimages Document Source shall be grouped with an Image Document Source shall be grouped with an Image
Manager/Image ArchiveManager/Image Archive
Sharing of a report that references selected Sharing of a report that references selected images from previously published extensive images from previously published extensive DICOM setDICOM set Document Source can be grouped with a Document Document Source can be grouped with a Document
ConsumerConsumer
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Linking Report to Complete Set of ImagesLinking Report to Complete Set of Images
Document RepositoryDocument Repository
Document RegistryDocument Registry
Study
Manifest
Report
DocumentEntry
DocumentEntry
SubmissionSet
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Linking Report to Complete Set of ImagesLinking Report to Complete Set of Images
Document RepositoryDocument Repository
Document RegistryDocument Registry
DocumentEntry
SubmissionSet 1
Report
DocumentEntry
SubmissionSet 2
Study
Manifest
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Linking Report to Prior Images and Prior ReportLinking Report to Prior Images and Prior Report
Document RepositoryDocument Repository
Document RegistryDocument Registry
DocumentEntry
SubmissionSet 3
Prior Study
Manifest
DocumentEntry
SubmissionSet 1
Prior
Report
DocumentEntry
SubmissionSet 2
Report
DocumentEntry
SubmissionSet 4
Study
Manifest
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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
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XDS-I MetadataXDS-I Metadata
Radiology specificRadiology specific Acquisition Modality (e.g. CT, MR)Acquisition Modality (e.g. CT, MR) Anatomic Region (e.g. Arm, Elbow, Hand)Anatomic Region (e.g. Arm, Elbow, Hand) Requested procedure (e.g. MRI Knee with Requested procedure (e.g. MRI Knee with
contrast)contrast)
Query example Query example find all “find all “CT of the HeadCT of the Head” of patient John Doe for ” of patient John Doe for
the last 2 yearsthe last 2 years
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More information….More information….
IHE Web site: IHE Web site: http://www.ihe.nethttp://www.ihe.net
http://www.himss.org/IHEhttp://www.himss.org/IHEhttp://www.rsna.org/IHEhttp://www.rsna.org/IHEhttp://www.acc.org/quality/http://www.acc.org/quality/iheihe..htmhtm
Technical FrameworksTechnical Frameworks
Technical Framework Supplements Technical Framework Supplements – Trial Implementation– Trial Implementation
Non-Technical Brochures :Non-Technical Brochures :
Calls for ParticipationCalls for Participation IHE Fact Sheet and FAQIHE Fact Sheet and FAQ IHE Integration Profiles: Guidelines for BuyersIHE Integration Profiles: Guidelines for Buyers IHE Connect-a-thon ResultsIHE Connect-a-thon Results Vendor Products Integration StatementsVendor Products Integration Statements
Questions?
Questions?