Morphometry BIRN: Imaging Calibration Analysis Tools Data Sharing.
Sharing Images without CDs, The Next Imaging Sea Change
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Transcript of Sharing Images without CDs, The Next Imaging Sea Change
Slide 1
Sharing Images without CDs,
The Next Imaging Sea Change
GE Healthcare
Chris Lindop GE Healthcare
Interoperability & Standards
In the Beginning:
Film
Film – the First Standard for Image ExchangeIn the beginning….• open image exchange started with one reliable
method: FILMAdvantage:• Everyone can view the FilmIssue: to be solved:• Inconsistent visual quality• Annotations, notes, etc. were attached “stuck-on”IHE Solution:• Consistent Presentation of Images (CPI) Integration
Profile– Grayscale Standard Display Function (consistent
images)– Grayscale Softcopy Presentation State
(Annotations)
Radiology Enters the Digital Image Exchange:
Portable Media: CDs
Portable Media– the next interop challengeCDs or coasters?• Then came the introduction of CDs and other portable
media, but for most, was simply coasters for your morning coffee.
Issues to be solve:• Media in-compatibility• Inconsistent viewer capabilities • No import method to reviewer’s view station
IHE Solution:• Portable Data for Imaging (PDI) – Standard media
format• Basic Image Review (BIR) – Basic Viewer capability
requirements• Import Reconciliation Workflow (IRWF) – Standard
import method
Electronic Images Sharing beyond your
Institution
The Image Exchange
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Use of a shared XDS Community-based infrastructure to access Radiology Reports and Images (XDS-I)
Hospital
Imaging CenterPhysician Practice
Between Radiology and :• Imaging specialists• Non-imaging clinicians• Patients PACS Y
PACS Z
Radiology -to-
RadiologyRadiology –to –
Physicians
Specifies how Radiology Information Objects, Both DICOM Instances and non-DICOM Reports are distributed in an eHealth Community 7
XDS Affinity Domain Considerations
• Set of organizations/systems organized around a single Registry
• Common set of Codes• Single Patient ID Domain• Involves business and legal
agreements• Security model/agreements
IHE Integration Profiles for Health Info Nets What is available and in trial implementation
Emergency Referrals Format of the Document Content
and associated coded vocabulary PHR Extracts/UpdatesFormat of the Document Content
and associated coded vocabulary ObGyn Documents
Format of the Document Content and associated coded vocabulary
Lab Results Document Content
Format of the Document Content and associated coded vocabulary
Scanned Documents Format of the Document ContentImaging Information
Format of the Document Content and associated coded vocabulary
Medical Summary (Meds, Allergies, Pbs)
Format of the Document Contentand associated coded vocabulary
Clinical and PHR Content
Health Data Exchange
Patient Demographics Query
Patient Identifier Cross-referencing
Map patient identifiers across independent identification
domains
Document Subscription and
Notification
Request Formfor Data Capture
External form with custom import/export scripting
Patient ID Mgmt
Other
Final Text Approved Trial Implementation
Cross-Enterprise Document Sharing
Registration, distribution and access across health enterprises of clinical
documents forming a longitudinal record
Cross-Enterprise Document Pt-Pt Reliable InterchangeCross-Enterprise Document
Media InterchangeCross-Community Access
Security & Privacy
Consistent TimeCoordinate time across networked
systems
Audit Trail & Node Authentication
Centralized privacy audit trail and node to node authentication to create
a secured domain.
Basic Patients Privacy Consents
Establish Consents & Enable Access Control
Document Digital Signature
Attesting “true-copy and origin
Cross-Enterprise User Assertion
Provides Trusted Identity
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Cross-Enterprise Document Sharing (XDS.b) Actor/Transaction Diagram
Document Consumer
Retrieve Document Set
Query Documents
Patient Identity Source
Patient Identity Feed
Document Source
Document Registry
Document Repository
Provide&Register Document Set
Register Document Set
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XDS-I.b Actors and Transactions
Imaging
Document Source
Document Consumer (XDS.b)
Document Registry (XDS.b)
Document Repository (XDS.b)
Provide & Register Imaging Document Set – MTOM/XOP
Register Document Set – b
Retrieve Document Set
Registry Stored Query
WADO Retrieve RAD-69 Retrieve Imaging Document Set
Retrieve Images Retrieve Presentation States Retrieve Reports Retrieve Key Image Note Retrieve Evidence Documents
Imaging Document Consumer
Pateint Identity Source
Pateint Idenity Feed
Same XDS Infrastructure (Registry and Repositories) for medical summaries and imaging
information !
Linking Report to Prior Images and Prior Report
Document Repository
Document Registry
DocumentEntry
SubmissionSet 3
Prior Study
Manifest
DocumentEntry
SubmissionSet 1
Prior Report
DocumentEntry
SubmissionSet 2
Report
DocumentEntry
SubmissionSet 4
StudyManifest
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Shared StorageServices
Enterprise
Enterprise
Enterprise
Imaging Center
Hospital B
Hospital A
Emergency Room
GP 1
PatientAdmin
Repository
RepositoryRepository
Cross-Enterprise Document Registry(XDS)
Cross-Enterprise Document Sharing
Practice
Data Centre
GP 2
Practice
Electronic Images Sharing beyond …..
Cross-Community Image Exchange
Cross-Community Access of Images (XCA-I) the next Sea change
Foundational with Standards incl. DICOM Web services– DICOM WADO-WS supp-148)
Interoperable with clinical portals– Compatible with IHE Web services profiles, including Security
and privacy
Interoperable with PACs and vendor neutral archives– Ready for cloud hosted apps
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Why extend XDS?
XDS only addresses document sharing within an XDS Affinity DomainCross-Community addresses the questions: How to share documents between XDS Affinity
Domains? How to share documents with non-XDS Affinity
Domains?
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Responding Community Initiating Community
Initiating Gateway
Responding Gateway
Cross Gateway Query [ITI-38]
Cross Gateway Retrieve [ITI-39]
XCA Transaction Diagramminimum required
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Responding Community Initiating Community
Initiating Gateway
Registry Stored Query [ITI-18]
Retrieve Document Set [ITI-43]
Registry Stored Query [ITI-18]
Retrieve Document Set [ITI-43]
Responding Gateway
Document Registry
Document Repository
Registry Stored Query [ITI-18]
Retrieve Document Set [ITI-43]
Cross Gateway Query [ITI-38]
Cross Gateway Retrieve [ITI-39]
XDS Document Consumer
Document Consumer
Document Consumer
Document Repository Document Registry
XCA Transaction Diagram
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10
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Registry Stored Query [ITI-18]
Responding Community Initiating Community
Registry Stored Query [ITI-18]
Retrieve Document Set
[ITI-43]
Cross Gateway Retrieve [ITI-39]
Cross Gateway Query [ITI-38]
XCA Responding
Gateway
Imaging Document Source
Retrieve Imaging Document Set [RAD-69]
XDS.b Document Repository
XDS.b Document Registry
Registry Stored Query [ITI-18]
Retrieve Document Set [ITI-43]
Responding Imaging Gateway
Retrieve Document Set
[ITI-43]
XDS.b Document Registry
XDS.b Document Repository
XCA Initiating Gateway
Initiating Imaging Gateway
XDS.b Document Consumer
Imaging Document Consumer
Retrieve Imaging Document Set[RAD-69]
Registry Stored Query [ITI-18]
Cross Gateway Retrieve Imaging Document Set
[RAD-75]
XCA-I Transaction Diagram
XCA-IFoundational with Standards incl. DICOM Webservices
– DICOM WADO-WS supp-148)
Interoperable with clinical portals– Compatible with XDS.b, XUA, ATNA
Interoperable with PACs and vendor neutral archives– Compatible with XDS-I.b, DICOM-WS– Ready for cloud hosted apps
Imaging Object Change Management (IOCM)
IOCM specifies how to communicate changes applied on existing imaging objects to other systems. Changes include
(1) rejection due to quality or patient safety reasons, (2) correction of incorrect modality worklist entry selection, (3) expiration due to data retention requirements.
IOCM is fully compatible with existing profiles!
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Providers and VendorsWorking Together to Deliver
Interoperable Health Information Systemsin the Enterprise
and Across Care Settings
http://www.ihe.nethttp://www.ihe.net.au