Prioritization of IHE Radiology Profiles. Herman Oosterwijk, President, OTech, Inc.

Transcription

1 Prioritization of IHE Radiology Profiles Herman Oosterwijk, President, OTech, Inc.

2 Agenda What is IHE? Prioritization: Vendors Users/Providers Highlight of radiology profiles and priority

3 What is IHE and Current Issue HIMSS: Healthcare Information and Management Systems Society and RSNA (Radiological Society of North America) established: IHE Integrating the Health care Enterprise Too many options, gaps and overlaps in DICOM and HL7 Unclear to users what functionality would be necessary (Store, Storage Commitment, MPPS?) IHE is in year-6 For radiology only, already 20 profiles How to prioritize?

4 Vendor IHE Profile Selection Criteria Marketing leverage: User pressure vs ROI Ease of implementation: e.g. Incremental changes for additional functionality (Key Images when already implementing Structured Reports) Amount of effort: Not only implementing but also verification, testing and validation, in addition to participating in connectathon Fits with architecture/roadmap: Does it fit within the company product range/objective? Wide-spread support: Is and/or will the industry support this new profile? Compare with the support of GET in DICOM

5 User IHE Profile Selection Criteria Workflow impact: support of some profiles have a really big workflow impact, e.g. scheduled workflow using STC and MPPS will reduce additional checking/entries by technologists and SA s Maturity: How mature is a profile, do I want to be on the bleeding edge? However, this dos not apply for some of the modalities that are broken to start with (NM, MG) Other system support: A profile can be mature, however not widely supported (e.g. MPPS support by RIS!). This requires validation!

6 Determination of Priorities Steps: (see spreadsheet attached) Determine actor (e.g. acquisition modality) Determine where it most likely is allocated (RIS/PACS etc.) Check which profile it appears in Organization of the Technical Framework Integration Profiles Actors Integration Profile Actors Actors Actors

7 Workflow Profiles SWF; Scheduled Workflow: Continuity of orders and exams across HIS-RIS-Modality-PACS. Number 1 important profile PWF; Post-processing Workflow: Important for 3-D processing, CAD, etc. Important especially for CAD, but also 3-D, but uses DICOM Workstation Worklist (poor support) RWF; Reporting Workflow: For reports, similar to PWF Similar issue with Worklist support CHG: Charge Posting: Closes the loop for billing Not critical but could be advantageous

8 Workflow Exception Profiles PIR; Patient Information reconciliation: Reconcile patient information between PACS and RIS. Number 2 important profile; builds on SWF, but extends it with a Patient Update from the PACS back to RIS for trauma, patient demographic errors, etc. PGP; Presentation of Grouped Procedures: Especially useful for combined procedures, e.g. chest-abdomen CT. Implementation somewhat far-fetched, typically solved pragmatic in a system; poor support by vendors

9 Modality Specific Profiles NM; Nuclear Medicine Integration: Image encoding and presentation on PACS. Initiated because of poor support Critical for any NM modality and PACS CNM; Cardiac Nuclear Medicine: same as NM but for cardiology applications Must for any cardiology NM modality and PACS MGI; Mammography Integration (draft): Workflow, but specially presentation of digital MG images Must for all digital mammo and PACS, even although still a draft ED; Evidence Documents: CAD, measurements Especially useful for CAD

10 Radiology Information Management Profiles ARI; Access to Radiology Information: Reports on PACS Require DICOM report conversion, no broad support KIN; Key Image Note: Key images are critical to support on wstns for large studies, e.g. CT. Important, simple to implement SINR; Simple Image and Numeric report; DICOM reports for measurements, text, templates, etc. Poor support of DICOM reports among vendors

11 Image and Other Info Import/Export Profiles PDI; Portable Data for imaging: How to create CD s conforming with the DICOM standard. A must for any CD-burner and workstation to increase interoperability IRC; Import Reconciliation: How to preserve data that has been coerced in the image header Very useful when importing images from CD s into the permanent medical record and/or archive XDS-I; Cross Enterprise Document Sharing for Imaging: To register and retrieve images and related information on an enterprise/regional level Important when part of a larger enterprise

12 Image Presentation and Preservation CPI; Consistent Presentation of Images: Maintain both grey scale and presentation on different workstations and printers Grey scale consistency is a must; presentation state also, but full implementation might be lacking IF; Image Fusion (draft): How to map images from different modalities and exchange the mapping (registration) information, including preservation of color Highly recommended if fusion (e.g. PET/CT) is common

13 Security SEC; Basic Security: Audit trails, and exchange of this information (note: is replaced by RSEC, see below) Very important to prevent multiple, proprietary audit trail logs at many locations RSEC; Radiology Audit Trails: Standard audit trail exchange ATNA (audit trail and node authentications) Highly recommended to allow an institution to meet HIPAA requirements

14 Conclusion Prioritizing IHE profiles is important. Make sure to focus on the profiles with the most impact (SWF, PIR, KIN, PDI and modality specific profiles as well as RSEC)