IHE in Radiation Oncology

Transcription

1 IHE in Radiation Oncology

2 Managed workflow in Radiation Oncology n Introduction Harold Beunk Massachusetts General Hospital ICT Automatisering Intersystems n Challenges of the (MGH) RO department Complexity Problem n Information exchange, storage and management IHE profiles & DICOM RT n Workflows IHE-RO profiles 2 14 november 2014 IHE in Radiation oncology

3 The radiation oncology process (simplified) 3 november 14, 2014 IHE in Radiation oncology

4 4 14 november 2014 IHE in Radiation oncology

5 Where we are Today (John Wolfgang, Hanne Kooy MGH) Decentralized local workflows Each clinical ac8on manages independent data instances CBCT As number of clinical applica8ons increases, human management burden scales significantly workload frustra-on Adap8ve Linac / Cyclotron Resource planning PET/CT Fusion Clinical user must manually manage workflow and corresponding data CT/ Simulator IMRT QA is only visible to all clinical users through system interfaces Rescan Deform CT OIS 4DCT Resort/ Review Treatment 5 november 14, 2014 IHE in Radiation Oncology

6 Current Radiation Oncology Management Unable No direct Multiple to is link monitor copied/moved Multiple versions for data multiple users of communication treatment to may data different interact versions data points between with may as of data they care created current asynchronously are by passed clinical or at future different to users next Partners points manually EMR of care CT Treatment Delivery (Mosaiq/Proton) Contouring v2 v3 clinical users QA Partners ecare 14 november 2014 Treatment v2 v4 v5 IHE in Radiation oncology

7 Radiation Oncology Workflow & Management How this will be achieved: n Workflow management by defining workflow steps for the clinical workflow n Presentation of patient data and its clinical and functional context for each workflow step n Management of all patient activities and data in a patient radiotherapy treatment course record n Systems integration layer in the radiotherapy department, EMR, Treatment and Treatment Delivery Workflow Management Treatment Course Workflow & Management Management System Integra8on 7 november 14, 2014 IHE in Radiation Oncology

8 Enhanced Workflow & Management Whiteboard Whiteboard Using is built this upon links records global user same patient tasks data technology as to data it is passed structure, management, existing through, and future Partners whiteboard automatically EMR building can System moving audit a data (Intersystems) all structure correct points of data connecting care providing set to to ensure the all native next points data point communication consistency of care of care channels Treatment CT Delivery (Mosaiq/Proton) Contouring Whiteboard Workflow Engine RT Course CT Tx Plan Contours QA Result QA Partners ecare 14 november 2014 Treatment IHE in Radiation Oncology

9 How IHE profiles can help the development n Profiles on Infrastructure, Workflow, Content and Presentation n Solutions for common IT problems Authentication / security n Use of best practices Clinical workflows Technology Domain Specifical n Choice of standards n Specifying behavior in actors and transactions n Ensure interoperability, testable in connectathon n Simplifies the integration and extension of systems 9 14 november 2014 IHE in Radiation oncology

10 General IHE profiles n ITI Domain [CT] Consistent Time [ATNA] Audit Trail and Node Authentication [EUA] Enterprise User Authentication [PDQ] Patient Demographics Query [XDS] Cross Enterprise Document Sharing n Radiology Domain [SWF] Scheduled Workflow [XDS-I.b] Cross-enterprise Document Sharing for Imaging [PIR] Patient Information Reconciliation [PAWF] Post-Acquisition Workflow november 2014 IHE in Radiation oncology

11 IHE-RO : Profiles (content & workflow) n Basic Radio Therapy Objects: BRTO n Multimodality Image Registration Integration: MMRO: MMRO II MMRO III n Advanced RT Objects Interoperability: ARTI ARTI II n Dose Compositing: DCOM hqp:// ro.org n Treatment Delivery Workflow TDW TDW II n Integrated Positioning and Delivery Workflow: IPDW n Discrete Positioning and Delivery Workflow: DPDW n Quality Assurance with Plan Veto :QAPV n ROI templates 2012 hqp://wiki.ihe.net/index.php?8tle=radia8on_oncology november 2014 IHE in Radiation oncology

12 InterSystems Ensemble Coordina8on Business Process / Work Flow Composite Applica8ons Business Ac8vity Monitoring Universal Business Integra8on PlaZorm Applica8on Technology november 2014 IHE in Radiation oncology

13 Collaberation platform Pa8ent records Presenta8on & entry forms Expert system interface TPS workflow & monitoring Expert system interface Resources Schedules Expert system interface TDD workflow User interfaces Expert system interface EHR customizing Integra8on layer CT MWL / MPPS SIM & POS SOAP MIM & ASTROID Special interfaces UPS Worklist TDD RadOnc Systems DICOM november 2014 IHE in Radia8on oncology

14 MGH statements ( Order from in Chaos) q RT IT is insular and does not leverage up-to-date technologies and methodologies q Enterprise architectures, Cloud q structures, processes and evolution are dynamic and of considerable complexity q DICOM 2 / IHE-RO q MGH wishes to get a grip on the above q MGH & ICT: Concepts into Reality q Safety! The new may have side-effects q ICT: Expertise in depth and outside q Leverage known technologies q Fit the solution to the problem q Standardize & Compartmentalize november 2014 IHE in Radiation oncology

15 Questions:? november 2014 IHE in Radiation oncology

16 Thank you november 2014 DICOM & ESB in Radiation oncology