Post on 27-Mar-2015
HIMSS/RSNA Vendor Workshop, Sep 2004
Notification Options forNotification Options forScheduled WorkflowScheduled Workflow
Feedback Enhancements
Andrei LeontievL S Consulting
HIMSS/RSNA Vendor Workshop, Sep 2004
IHE Radiology Integration ProfilesIHE Radiology Integration Profiles
Patient Info.
Recon-ciliation
Access to Radiology Information
Consistent Present-ation of Images
Basic Security
-
EvidenceDocs
KeyImageNotes
Simple Image & Numeric Reports
Presentation of Grouped Procedures
Post-
Processing Workflow
Reporting Workflow
Charge Posting
Scheduled Workflow
Portable Data for Imaging
NMImage
HIMSS/RSNA Vendor Workshop, Sep 2004
imagesstored
patientinformation
RIS
examination orders
imagesretrieved
HIS
PACS
procedurescheduled
Prefetch any relevantprior studies
modalityworklist
report
report
Scheduled Workflow ProfileScheduled Workflow Profile
Registration
Orders Placed
Orders Filled
Film
FilmFolder
Image Manager& Archive
FilmLightbox
report ReportRepository
DiagnosticWorkstation
Modality
acquisitionacquisitionin-progressin-progressacquisitioncompleted
acquisitioncompleted
imagesprinted
AcquisitionModality
HIMSS/RSNA Vendor Workshop, Sep 2004
NEW SWF OptionsNEW SWF OptionsDepartmental 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 Image Manager an option to
notify Order Filler and other workflow management actors of availability status of evidence objects.
HIMSS/RSNA Vendor Workshop, Sep 2004
imagesstored
patientinformation
RIS
examination orders
imagesretrieved
HIS
PACS
procedurescheduled
Prefetch any relevantprior studies
modalityworklist
report
report
Scheduled Workflow ProfileScheduled Workflow Profile
Registration
Orders Placed
Orders Filled
Film
FilmFolder
Image Manager& Archive
FilmLightbox
report ReportRepository
DiagnosticWorkstation
Modality
acquisitionacquisitionin-progressin-progressacquisitioncompleted
acquisitioncompleted
imagesprinted
AcquisitionModality
appointmentnotifications
instanceavailability notification
HIMSS/RSNA Vendor Workshop, Sep 2004
Departmental Appointment Departmental Appointment Notification OptionNotification Option
HIMSS/RSNA Vendor Workshop, Sep 2004
Value PropositionValue PropositionProvides a mechanism for the Order
Placer to keep track of appointments scheduled for a patient within Radiology Department
Includes notifications of scheduling, re-scheduling and cancellation events
Helps synchronization of scheduling processes between enterprise and radiology
HIMSS/RSNA Vendor Workshop, Sep 2004
BackgroundBackground Existing Placer Order Management Transaction
allows Order Placer specify preferred date and time of an order fulfillment (i.e., radiological examination)
Order Filler is ultimately responsible for scheduling of examination as a succession of Procedure Steps that may require one or more appointments to be created
Currently, Order Placer has no way to know when or where exactly the appointment will take place.
HIMSS/RSNA Vendor Workshop, Sep 2004
Departmental Appointment Departmental Appointment Booking Use CaseBooking Use Case
Order Placer
Image Manager
Placer Order Mgmt – New [2]
Department System Scheduler/ Order Filler
Procedure Scheduled [4]
Create Order
Schedule Procedure Steps and/or Assign Protocol
Appointment Notification - New Bookings [48]
Appointment Notification – Reschedule Bookings [48]
Reschedule Procedure Step(s)
Cancel Procedure or Procedure Steps
Appointment Notification - Cancel Bookings [48]
Procedure Update [13]
Procedure Update [13]
HIMSS/RSNA Vendor Workshop, Sep 2004
Appointment Notification Appointment Notification TransactionTransaction
Appointment Notification
Order Placer DSS/ Order Filler
Department System Scheduler/Order Filler generates Appointment Notification messages and sends them to the corresponding Order Placer actor.
Order Placer receives Appointment Notification messages and internally processes them.
HIMSS/RSNA Vendor Workshop, Sep 2004
Interaction DiagramInteraction Diagram Order Placer Order Filler
Appointment Notification – New Bookings (SIU^S12)
Cancel Appointment for Scheduled Procedure Step
Reschedule Appointment for Scheduled Procedure Step
New Appointment for Scheduled Procedure Step
Appointment Notification – Reschedule Bookings (SIU^S13)
Appointment Notification – Cancel Bookings (SIU^S15)
HIMSS/RSNA Vendor Workshop, Sep 2004
Appointment Notification Appointment Notification TransactionTransaction
Three typical use cases– New booking: initial scheduling of an examination – Re-schedule: change in date/time of examination– Cancellation: examination cancellation
Mechanism– HL7 SIU messages– One message may convey multiple appointments
corresponding to a single order– One appointment corresponds to one or more
Scheduled Procedure Steps
HIMSS/RSNA Vendor Workshop, Sep 2004
SIU Message StructureSIU Message StructureSIU^S12, SIU^S13, SIU^S15
Schedule Information Unsolicited
Chapter in HL7 V2.4/2.5
MSH
SCH
{ RGS
{ AIS
[ { NTE } ]
}
}
Message Header
Schedule Activity Information
Resource Group Segment
Appt Information – Service
Notes and Comments
2
10
10
10
2
HIMSS/RSNA Vendor Workshop, Sep 2004
SCH SegmentSCH Segment Specifies common information for one or
more appointments associated with single order– Placer Appointment ID is not used– Filler Appointment ID is required
Appointment timing is defined on the Resource Group level, per Scheduled Procedure Step– SCH-6 has fixed value of 1– One message can have multiple resource groups,
thus multiple appointments (procedure steps) No patient identification information is
required, thus Order Numbers are required
HIMSS/RSNA Vendor Workshop, Sep 2004
AIS SegmentAIS Segment Specifies Procedure Code and Description to
for the Scheduled Procedure Step(s) included into this appointment– Procedure Code in components 1-3– Not all steps of the procedure may be included– Those included are identified by a the text in
component 5 Date/Time of an appointment is expected to
be in UTC– If local, UTC offset is required
No specification of location or resources (one should use AIG, AIL, AIP segments within the same group, as appropriate)
HIMSS/RSNA Vendor Workshop, Sep 2004
What is not in the optionWhat is not in the optionDepartmental Appointment Notification
Option does not allow Order Placer to request re-scheduling – it only can do it by cancel and re-order
Transaction does not require AIL segment – thus notifications on re-scheduling of the service from one location to another may not be sent
This option does not address needs of enterprise-wide scheduling
HIMSS/RSNA Vendor Workshop, Sep 2004
ReferencesReferencesProfile Option - Volume 1, Section 3.3.6Transactions - Volume 3, Section 4.48
HIMSS/RSNA Vendor Workshop, Sep 2004
Instance Availability Notification Instance Availability Notification OptionOption
HIMSS/RSNA Vendor Workshop, Sep 2004
Value PropositionValue PropositionEnhances mechanism that allows to
obtain information about availability of newly-acquired images and other evidence objects, for further use in workflow
Provides this information to all workflow management actors
HIMSS/RSNA Vendor Workshop, Sep 2004
BackgroundBackground DSS/Order Filler, Post-Processing Manager,
Report Manager need to know when acquired evidence objects made it to the Archive– MPPS may be sent before objects are stored, and
storage may fail– MPPS is not available to all “managers”– MPPS may fail or not be sent at all (media import)
Existing query mechanism forces “managers” to poll Image Manager/Archive for availability of SOP Instances.
HIMSS/RSNA Vendor Workshop, Sep 2004
Use CasesUse CasesThis option only addresses the use
case when MPPS referencing evidence objects has been received by Image Manager.
Image 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
HIMSS/RSNA Vendor Workshop, Sep 2004
Instance Availability Notification Instance Availability Notification TransactionTransaction
Instance Availability Notification
Image Manager/ Image Archive
DSS/ Order Filler
Post-Processing Manager
Report Manager
HIMSS/RSNA Vendor Workshop, Sep 2004
Instance Availability Notification Instance Availability Notification TransactionTransaction
Image Manager/Image Archive generates an Instance Availability Notification message and send it to the DSS/Order Filler and optionally to other workflow managing actors (Post-Processing Manager, Report Manager).
DSS/Order Filler, Post-Processing Manager, Report Manager receive an Instance Availability Notification message and internally process it.
HIMSS/RSNA Vendor Workshop, Sep 2004
Interaction DiagramInteraction Diagram
DSS/ Order Filler
Instance Availability Notification (N-CREATE)
Report Manager
Image Manager
Post-Processing Manager
Instance Availability Notification (N-CREATE)
Instance Availability Notification (N-CREATE)
HIMSS/RSNA Vendor Workshop, Sep 2004
Instance Availability Notification Instance Availability Notification SOP ClassSOP Class
New SOP Class introduced in DICOM Supplement 93– Normalized Service – N-CREATE Operation only– Can be used without association with MPPS– Does not convey and explicitly forbids adding of
patient or procedure identifiers– Provides list of all object UIDs and their availability
for retrieval, either over network or media (on per-image basis)
HIMSS/RSNA Vendor Workshop, Sep 2004
Instance Availability Notification Instance Availability Notification SOP ClassSOP Class
New SOP Class introduced in DICOM Supplement 93– No requirements when to generate notifications,
for example: availability of the first instance of a Performed Procedure
Step or Study upon its reception, availability of an entire set of instances comprising a
completed Performed Procedure Step or Study Can be used without association with MPPS
– Is not intended to satisfy scenarios or erroneous information reconciliation (see PIR profile)
HIMSS/RSNA Vendor Workshop, Sep 2004
Instance Availability ValuesInstance Availability Values “ONLINE” means the instances are immediately available from the
Retrieve AE Title, and if a C-MOVE were to be requested, it would succeed in a reasonably short time
“NEARLINE” means the instances need to be retrieved from relatively slow media such as optical disk or tape, and if a C-MOVE were to be requested from the Retrieve AE Title, it would succeed, but may take a considerable time
“OFFLINE” means that a manual intervention is needed before the instances may be retrieved, and if a C-MOVE were to be requested from the Retrieve AE Title, it would fail (e.g., by timeout) without such manual intervention.
“UNAVAILABLE” means the instances cannot be retrieved from the Retrieve AE Title, and if a C-MOVE were to be requested, it would fail. Note that SOP Instances that are unavailable from this AE may be available from other AEs, or may have an alternate representation that is available from this AE.
HIMSS/RSNA Vendor Workshop, Sep 2004
Trigger EventsTrigger Events
Image Manager shall send only one IAN message for each MPPS referencing at least one evidence object.
Image Manager shall sent IAN when it received ALL instances referenced in MPPS
Image Manager shall send IAN to DSS/OF, and optionally to other actors
HIMSS/RSNA Vendor Workshop, Sep 2004
Message SemanticsMessage Semantics Timing of a message can vary significantly
depending on timing of MPPS and object storage
No message may be sent if complete object set never arrives
No message may be sent if objects arrive without corresponding MPPS
Even when objects are included in IAN, the retrieval request may fail due to errors
HIMSS/RSNA Vendor Workshop, Sep 2004
Expected ActionsExpected Actions Actors receiving IAN message are expected
to use its content for workflow management. Examples of internal actions:
– The Department System Scheduler/Order Filler may update the procedure status internally, indicating that images for the procedure have been stored.
– The Post-Processing Manager may add or re-arrange items to a corresponding worklist.
– The Report Manager add items to a corresponding worklist.
HIMSS/RSNA Vendor Workshop, Sep 2004
ReferencesReferencesProfile Option - Volume 1, Chapter 3Transactions - Volume 3, Section 4.49
HIMSS/RSNA Vendor Workshop, Sep 2004
More information….More information…. IHE Web sites:
http://www.himss.org/IHEhttp://www.rsna.org/IHEhttp://www.acc.org/quality/ihe.htm.
Technical Frameworks: ITI V1.0, RAD V5.5, LAB V1.0
Technical Framework Supplements - Trial Implementation May 2004: Radiology August 2004: Cardiology, IT Infrastructure
Non-Technical Brochures : Calls for Participation IHE Fact Sheet and FAQ IHE Integration Profiles: Guidelines for Buyers IHE Connect-a-thon Results Vendor Products Integration Statements
HIMSS/RSNA Vendor Workshop, Sep 2004
Questions,Questions,
Comments,Comments,
and/orand/or
Suggestions?Suggestions?