Integrating the Healthcare Enterprise

Transcription

1 Integrating the Healthcare Enterprise IHE IHE-J IHE-J JIRA IHE Radiology Integration Profiles Patient Info. Reconciliation Scheduled of Grouped s - Charge Posting Reporting Consistent of s Evidence Docs Key Notes Simple & Numeric Reports Access to Radiology Information Portable Data for Imaging Basic Security 2004/10/7 1

2 Patient Info. Reconciliation Scheduled of Grouped s - Charge Posting Reporting Consistent of s Evidence Docs Key Notes Simple & Numeric Reports Access to Radiology Information Portable Data for Imaging Basic Security 2004/10/7 2 PGP of Grouped PWF CHG Charge Posting KIN Key Notes 2004/10/7 3

3 Patient Info. Reconciliation Scheduled of Grouped s - Charge Posting Reporting Consistent of s Evidence Docs Key Notes Simple & Numeric Reports Access to Radiology Information Portable Data for Imaging Basic Security 2004/10/7 4 The Group Case Approach One Order Two s One Acquisition - Two Reports Step ORDER A request for Radiologic Service CT Chest & Abdomen Requested CT Chest Requested CT Abdomen Radiology Department Acquisition Modality One or more series of images Report CT Chest Report CT Abdo Set of Codifiable, Billable, Acts Set of Codifiable, Billable, Acts

4 Group Case ORDER A request for Radiologic Service DICOM Modality Worklist Requested 1 Requested 2 Scheduled Step A Scheduled Step B Radiology Department Performed Step P1 One or more series of images Report Report Set of Codifiable, Billable, Acts Set of Codifiable, Billable, Acts Acquisition Modality IHE Integration Profiles Scheduled Admit, order, schedule, acquire images, notify of completed steps + Consistent of s Softcopy grayscale and presentation state Required for of Grouped s of Subsets of a Single Acquisition 2004/10/7 7

5 IHE of Grouped s Requested : CHEST Scheduled Step Chest Requested : ABDOMEN Scheduled Step Abdo RIS / PACS Report: CHEST Chest View Report: ABDOMEN Abdomen View MODALITY Performs a single exam Chest View Abdomen View Operator groups 2 procedures 2004/10/7 8 Scheduled - Charge Posting Patient Info. Reconciliation of Grouped s Reporting Consistent of s Evidence Docs Key Notes Simple & Numeric Reports Access to Radiology Information Portable Data for Imaging Basic Security 2004/10/7 9

6 with Manager grouped with Manager 3-D Workstation Worklist Measurements CAD report Workitem Claimed Workitem Completed Worklist Store s Store SR OF/DSS PP-Performed Step Started PP-Performed Step Completed Storage Commitment List of s/sr Storage Commitment PP-Performed Step: Performed PP-Performed Status Step: = Started Pat Performed Name/ID Accession Status = Completed #, Study UID Complete List of s/sr Manager/Archive & Post Manager 2004/10/7 10 Modality and Steps ORDER A request for Radiological Service DICOM Modality WorklistRadiology Department Requested 1 Scheduled Step A Scheduled Step B DICOM Worklist M-Perf. Step P1 PP-Perf. Acquisition Step P2 Modality One or more series of images Performed Step One or more series of images Report Set of Codifiable, Billable Acts 2004/10/7 11

7 IM/IA Actors & Transactions Query s Query Evidence Documents Retrieve s Retrieve Evidence Documents Availability Query Performed Work Status Update Evidence Documents Stored s Stored Manager Manager Storage Commitment Worklist Provided Workitem Claimed Display Evidence Creator Workitem PPS In Progress DSS/Order DSS/OF Filler Workitem PPS Completed Workitem Completed 2004/10/7 12 Patient Info. Reconciliation Charge Posting Scheduled of Grouped s - Charge Posting Reporting Consistent of s Evidence Docs Key Notes Simple & Numeric Reports Access to Radiology Information Portable Data for Imaging Basic Security 2004/10/7 13

8 Patient Info. Reconciliation Key Notes Scheduled of Grouped s - Charge Posting Reporting Consistent of s Evidence Docs Key Notes Simple & Numeric Reports Access to Radiology Information Portable Data for Imaging Basic Security 2004/10/7 14 for referring physician Here you can see the renal osteopathy. For teaching Fibroosteoclasia 2004/10/7 15

9 Note1 for referring physician Here you can see the renal rupture. Different notes on different images Note3 Note2 for referring physician Hematoma everywhere for referring physician This is the hematoma. Note1 for refering physician Here you can see the renal rupture. Note2 for refering physician This is the hematoma. Same note on different images Note3 Note3 for refering physician for refering physician Hematoma everywhere Hematoma everywhere Note3 for refering physician Hematoma everywhere Note3 for refering physician Hematoma everywhere 2004/10/7 16 PDI: Portable Data for Imaging : Notification Options for Scheduled Departmental Appointment Notification Instance Availability Notification 2004/10/7 17

10 Portable Data for Imaging - PDI Patient Info. Reconciliation Scheduled of Grouped s - Charge Posting Reporting Consistent of s Evidence Docs Key Notes Simple & Numeric Reports Access to Radiology Information Portable Data for Imaging Basic Security 2004/10/7 18 PDI Actors and Transactions Display Portable Media Creator Display Report Reader Print Composer Media Importer 2004/10/7 19

11 CDROM Structure DICOMDIR Directory of DICOM files INDEX.HTM README.TXT IHE_PDI Directory of web files Web content (optional) Other optional content 2004/10/7 20 Nuclear Medicine - Patient Info. Reconciliation Scheduled of Grouped s - Charge Posting Reporting Consistent of s Evidence Docs Key Notes Simple & Numeric Reports Access to Radiology Information Portable Data for Imaging Basic Security 2004/10/7 21

12 The Problem DICOM objects are different and support in products is inconsistent clinical display practices are different and support in products is inconsistent Clinical Analysis Programs are used extensively (particularly for Cardiology), but no support for distribution and display of those Result Screens Users are not adept at getting these requirements accurately included in RFPs Vendors (especially of general purpose systems) are not adept at accurately representing their support for such features 2004/10/7 22 PACS 2004/10/7 23

13 PACS 2004/10/7 24 The Solution New Profile for Users to request and Vendors to claim No New Actors or Transactions Additional requirements on existing actors and transactions Two New Options New Informative Text in Vol. 1 Clarifications of mapping to SWF Explanation of Data Explanations of Clinical Display concepts New Normative Text in Vol. 2 <See Following Slides> Connectathon to help test and confirm 2004/10/7 25

14 Profile Acquisition Modalities (Modality s Stored [8]) Create objects as specified (additional attribute & vector handling) Include specific codes in Cardiac studies Evidence Creators (Creator s Stored [18]) Create objects as specified (additional attribute & vector handling) Include specific codes in Cardiac studies Manager/Archives Store/Retrieve & Secondary Capture (SC & MFSC) Objects Displays (Retrieve s [16]) Display and Secondary Capture (SC & MFSC) s Support specified display capabilities 2004/10/7 26 Notification Options for Scheduled Feedback Enhancements 2004/10/7 27

15 Scheduled Profile Registration HIS patient information report Report Repository PACS report report Diagnostic Film Workstation Lightbox images retrieved Orders Placed examination orders RIS Orders Filled modality worklist acquisition in-progress completed procedure scheduled Prefetch any relevant prior studies Acquisition Modality Modality images stored Manager & Archive acquisition completed images printed Film Folder 2004/10/7 28 Film NEW SWF Options Departmental Appointment Notification Gives the Department System Scheduler an option to notify Order Placer of date and time of scheduled examinations. Instance Availability Notification Gives the Manager an option to notify Order Filler and other workflow management actors of availability status of evidence objects. 2004/10/7 29

16 Scheduled Profile Registration HIS patient information report Report Repository PACS report report Diagnostic Film Workstation Lightbox images retrieved Orders Placed examination orders RIS Orders Filled modality worklist acquisition in-progress completed procedure scheduled Prefetch any relevant prior studies Acquisition Modality Modality images stored Manager & Archive acquisition completed images printed Film Folder 2004/10/7 30 Film Departmental Appointment Booking Use Case Order Placer Department System Scheduler/ Order Filler Manager Create Order Placer Order Mgmt New [2] Appointment Notification - New Bookings [48] Schedule Steps and/or Assign Protocol Scheduled [4] Appointment Notification Reschedule Bookings [48] Appointment Notification - Cancel Bookings [48] Reschedule Step(s) Update [13] Cancel or Steps Update [13] 2004/10/7 31

17 SIU Message Structure SIU^S12, SIU^S13, SIU^S15 MSH SCH { RGS { AIS [ { NTE } ] } } Schedule Information Unsolicited Message Header Schedule Activity Information Resource Group Segment Appt Information Service Notes and Comments Chapter in HL7 V2.4/ /10/7 32 Instance Availability Notification Option 2004/10/7 33

18 Use Cases This option only addresses the use case when MPPS referencing evidence objects has been received by Manager. Manager generates Instance Availability Notification upon receiving of all objects referenced in particular MPPS. Cross-referencing of MPPS in IAN may compensate for MPPS missed by OF 2004/10/7 34 Instance Availability Notification Transaction Manager/ Archive DSS/ Order Filler Manager Instance Availability Notification Report Manager 2004/10/7 35

19 Interaction Diagram Manager DSS/ Order Filler Manager Report Manager Instance Availability Notification (N-CREATE) Instance Availability Notification (N-CREATE) Instance Availability Notification (N-CREATE) 2004/10/7 36