Imaging in ehealth, XCA-I

Transcription

1 Imaging in ehealth, XCA-I Christopher Lindop, MSEE GE Healthcare - Interoperability & Standards IHE International Radiology - Committee Co-chair Monday, November 8, :30 am 12:45 pm NEC Birmingham, UK

2 Emergency Referrals PHR Extracts/Updates ObGyn Documents Lab Results Document Format of the Document Content Scanned and associated Content Documents coded vocabulary Format of the Document Content Format Imaging and associated of the Information Document coded vocabulary Content Medical Summary Format of the Document Content and associated coded vocabulary Format of the Document Content and associated coded vocabulary Format of the Document Content and (Meds, associated Allergies, coded Pbs) vocabulary Format of the Document Content and associated coded vocabulary Basic Patients Privacy Consents Establish Consents & Enable Access Control Cross-Enterprise User Assertion Provides Trusted Identity Document Digital Signature Attesting true-copy and origin Patient Demographics Query Patient Identifier Cross-referencing Map patient identifiers across independent identification domains Cross-Enterprise Document Sharing Registration, distribution and access across health enterprises of clinical documents forming a longitudinal record Cross-Enterprise Document Pt-Pt Reliable Interchange Cross-Enterprise Document Media Interchange Cross-Community Access Audit Trail & Node Authentication Centralized privacy audit trail and node to node authentication to create a secured domain. Consistent Time Coordinate time across networked systems Request Form for Data Capture External form with custom import/export scripting Document Subscription and Notification 2

3 Presentation & Content Evidence Document Radiation Exposure Monitoring SWF - Image NM Image Teaching Files & Clinical Export Mammography Image Chest XR CAD ehealth Data Exchange - Imaging Portable Data for Imaging Cross-Enterprise Document Sharing for Imaging.b 3

4 PACS Y PACS Z 4

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7 (89:,-+(+,(%;/7507(<'=9*+.( * Reference: IHE Radiology Technical Framework Vol 3 Section 4.45

8 acquire evaluate store new data register index Image/ Report Repository Document Registry Ultrasound report and images (XDS architecture) 8

9 retrieve evaluate store new data Image/ Report/ Document Repositories index Document Registry query register index Document Repository Report, letters (incl. images) (XDS architecture) 9

10 Practice Mgt Patient Demographics Query Patient Id Services Imaging Services Shared Image Repository Image Document Source Images, report (PACS, RIS) Watson Imaging Center DICOM Send HL7 MDM Shared XDS repository Document Registry Community ehealth Services 10

11 Admissions ADT Patient ID Feed PIX Query Patient Id Services Radiology Department Image Document Source Images, report Image Document Consumer (PACS, RIS) Provide and Register image references and report Register image references and report XDS repository Edison Hospital Document Registry Community ehealth Services 11

12 Admissions ADT Patient ID Feed PIX Query Patient Id Services Radiology Department PACS, RIS Image Document Source Images, reports Provide and Register image manifests and report Shared XDS repository Register image Manifests and report Image Document Consumer Images, reports Wales Hospital Document Registry ehealth Services 12

13 Admissions ADT Patient ID Feed PIX Query Patient Id Services Radiology Department PACS, RIS Short term Image Storage Image Document Consumer DICOM C-Store, Storage Commit, MPPS Shared LT Image Repository Image Document Source Shared XDS repository Register image manifests Provide & Register image references Canadian Hospital Document Registry ehealth Services 13

14 Cross-Enterprise Document Sharing GP 2 Data Centre Shared Storage Services Practice Enterprise Repository Hospital A GP 1 Practice Enterprise Cross- Enterprise Document Registry (XDS) Imaging Center Repository Emergency Room Enterprise Repository Hospital B Admin Patient 14

15 September, What IHE Delivers

16 ! XDS only addresses document sharing within an XDS Affinity Domain! Cross-Community addresses the questions:! How to share documents between XDS Affinity Domains?! How to share documents with non-xds Affinity Domains? 16

17 ! Community! Definition: A community is defined as a coupling of facilities/enterprises that have agreed to work together using a common set of policies for the purpose of sharing clinical information via an established mechanism.! XDS Affinity Domain is an example of a community. Community expands the scope to include sharing of clinical information by a mechanism OTHER than XDS.! Cross Community! Transactions that support sharing of clinical information across Community boundaries. 17

18 Cross Community Access (XCA) Scope! Sharing of documents across communities! Re-use of XDS.b transactions.! Document Consumer consistency! Requirements of Document Consumer are the same as for local document query and retrieval! Out of scope:! How to identify which communities to interact with! How to identify the patient id to use when interacting 18

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23 Cross Community Access Actors and Transactions! Initiating Gateway! On behalf of internal actors, initiates all transactions leaving the community! Receives Registry Stored Query and Retrieve Document Set from Document Consumer! Propagates transaction to local Document Registry and Repository, if appropriate! Propagates transaction to other communities by contacting their Responding Gateway and sending: Cross Gateway Query and Cross Gateway Retrieve! Responding Gateway! Single contact point for all transactions coming in to the community.! Propagates incoming transactions to local actors! New Transactions:! Cross Gateway Query: from Initiating Gateway to Receiving Gateway, mimics Registry Stored Query! Cross Gateway Retrieve: from Initiating Gateway to Receiving Gateway, mimics Retrieve Document Set! Document Consumer! Supports Registry Stored query and Retrieve Document Set! New requirement: propagation of the homecommunityid requirement Applies to XDS.a, XDS.b and XCA profiles 23

24 XCA Process Flow RSQ Registry Stored Query XGQ Cross Gateway Query RDS Retrieve Document Set XGR Cross Gateway Query Community A XDS Registry RSQ RDS Initiating Gateway XGQ Responding Gateway Community B RSQ XDS Registry XDS Repository XDS Repository RSQ RDS XGQ XGR Responding Gateway RSQ Community C XDS Registry Document Consumer RDS XDS Repository

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26 Proposed XCA I Process Flow RSQ Registry Stored Query XGQ Cross Gateway Query RDS Retrieve Document Set XGR Cross Gateway Query RTIS Retrieve Image Set XGRI Cross Gateway Retrieve Images Community A XDS Registry XDS Repository RSQ RDS Initiating Gateway XGQ XGR XGRI Responding Gateway RSQ RDS Community C XDS Registry XDS Repository Image Document Source RTIS RTIS RSQ RDS RTIS Image Document Consumer Document Consumer Image Document Source

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