Displayable Reports Profile (DRPT) Marco Eichelberg OFFIS Technical Manager, IHE Europe Cardiology...

Displayable Reports Profile (DRPT)

Displayable Reports Profile (DRPT)

Marco EichelbergOFFIS

Technical Manager, IHE Europe Cardiology

Slides by Harry Solomon, Co-chair, IHE Cardiology Technical Committee

2006-02-06 Participant Workshop2

The ProblemThe Problem

• Most existing reporting applications operate with paper paradigm– Print– Scribble (signature)– Fax

• “Advanced” apps have some electronic capabilities– Storage / database– Electronic signature – Fax from system

• Increasing demand for electronic report to central repository– Inconsistent requirements for how to do this


Displayable Reports Profile Displayable Reports Profile Abstract / ScopeAbstract / Scope

• Management of Portable Document Format (PDF) formatted clinical reports– PDF retains many desirable features of paper-based reports, e.g.,

controlled display format, graphics

• Creation, signature/release, and distribution • Report repository/archive

– Archive at one level (nominally the department) is required– Additional archive at second level (enterprise) supported

• Standard format for electronic submission to central enterprise repository/registry– PDF document, or only document reference (URL)


Displayable Reports Profile Displayable Reports Profile Value PropositionValue Proposition

• Many clinical reporting applications use, or can be readily adapted to use, PDF for their display-ready reports

• PDF supports graphical content (critical to cardiology reports)• PDF allows the source system to control the “look” of the report,

which is important for both clinical and business reasons– In certain areas, it may also be a legal requirement for the presentation

of a report to be identical in all presentation contexts

• The Displayable Reports Profile specifies a consistent set of actors and transactions supporting the creation, revision, intra- and inter-department transmission, and reading of reports in PDF format

• Image Manager/Image Archive may be leveraged as departmental Report Repository

• Distributed enterprise report storage architecture supported


Example Displayable ReportsExample Displayable Reports


Displayable Reports ProfileDisplayable Reports ProfileTransaction DiagramTransaction Diagram

Encapsulated Report Storage [CARD-9]

Report Repository

ReportManager

Enterprise Report

Repository

Encapsulated Report Query [CARD-10]Encapsulated Report Retrieve [CARD-11]

Report Reader

Report Creator

Encapsulated Report Submission [CARD-7]

Storage Commitment [RAD-10]


Display

Retrieve Specific Info for Display [ITI-11] Retrieve Document for Display [ITI-12]

InformationSource

Report Reference Submission [CARD-8]

Retrieve Information for Display (RID) Profile Retrieve Information for Display (RID) Profile


Displayable Reports ProfileDisplayable Reports ProfileActorsActors

• Report CreatorReport Creator – A system that generates and transmits clinical reports.

• Report ManagerReport Manager – A system that manages the status of reporting, and distributes reports to report repositories.

• Report ReaderReport Reader – A system that can query/retrieve and view reports encoded as DICOM objects.

• Report RepositoryReport Repository – A departmental system that receives reports and stores them for long-term access. – Must be grouped with Information SourceInformation Source actor - A system that

responds to requests for specific information or documents and returns ready-for-presentation information to be displayed by the requesting actor.

• Enterprise Report RepositoryEnterprise Report Repository – A system that receives reports and/or references (pointers) to reports, and stores them for access throughout the healthcare enterprise.


Displayable Reports ProfileDisplayable Reports ProfileStandards UsedStandards Used

• PDF – report content format• HL7 v2 – Encapsulated Report Submission, and

Report Reference Submission– ORU

• DICOM – Encapsulated Report Storage, Query, and Retrieve – Encapsulated PDF Storage

– Storage Commitment

– Query

– Retrieve


DRPT - Standards UsedDRPT - Standards Used

Encapsulated Report Storage [CARD-9]

Report Repository

ReportManager

Enterprise Report

Repository


Report Reader

Report Creator


Storage Commitment [RAD-10]



MSH|^~\$|… PID|1|0123456‑1||R… OBR|1|X89‑1501^…OBX|1|ED|11528-7^LN…

HL7



HL7 MSH|^~\$|… PID|1|0123456‑1||R… OBR|1|X89‑1501^…OBX|1|ED|11528-7^LN…

MSH|^~\$|… PID|1|0123456‑1||R… OBR|1|X89‑1501^…OBX|1|RP|11528-7^LN…

http://serv.hosp.org/app?requestType=DOCUMENT&documentUID=”1.2.3”&preferredContentType=”application/pdf”

HL7

(0008,0005) IR_100(0008,0012) 20061113(0008,0013) 1109(0008,0016) 1.2.8401008.…

DICOM

(0008,0005) IR_100(0008,0012) 20061113(0008,0013) 1109(0008,0016) 1.2.8401008.…

DICOMDisplay


InformationSource

HTTP

But how can a non-DICOM Report Manager play?But how can a non-DICOM Report Manager play?


Displayable Reports Profile Displayable Reports Profile Options and Actor GroupingsOptions and Actor Groupings

• Report Manager may support DICOM Storage option– For use of Image Manager/Archive as Report Repository, using

DICOM Encapsulated PDF• If DICOM option not implemented, Report Manager must

be grouped with Report Repository– Allowed to implement proprietary internal communication

• DICOM Encapsulated PDF Query/Retrieve is an option for Report Repository – If not implemented, workstations must use RID to access reports

• Enterprise Report Repository may receive either encapsulated documents, or document references– Report Manager must support both formats (configurable)– Document reference is RID Retrieve Document for Display URL


DRPT – DRPT – Grouped Report Manager and RepositoryGrouped Report Manager and Repository

Report Repository

ReportManager

Enterprise Report

Repository


Report Reader

Report Creator

Encapsulated Report Submission [CARD-7] Encapsulated Report Submission [CARD-7]




HL7



HL7 MSH|^~\$|… PID|1|0123456‑1||R… OBR|1|X89‑1501^…OBX|1|ED|11528-7^LN…

MSH|^~\$|… PID|1|0123456‑1||R… OBR|1|X89‑1501^…OBX|1|RP|11528-7^LN…

http://serv.hosp.org/app?requestType=DOCUMENT&documentUID=”1.2.3”&preferredContentType=”application/pdf”

HL7

Display


InformationSource

HTTP

DICOM optionDICOM optionnot implementednot implemented


Summary of Requirements – Summary of Requirements – Report CreatorReport Creator

• Create PDF report• Create HL7 v2 ORU message

– Include DICOM Study UID in OBX segment if associated with a DICOM Procedure

– Encapsulate PDF in OBX segment– Set status in ORC and OBX segments– Send to Report Manager

• Does NOT persistently (long-term) store reports– Report Manager is responsible for content of released report, and

any local storage on Report Creator may become inconsistent with official report (e.g., on Patient Update)


Summary of Requirements – Summary of Requirements – Report ManagerReport Manager

• Receive PDF encapsulated in HL7 v2 ORU message• Manage release of report

– May release preliminary, or only final (per product feature or configured rules)

– Optionally manage electronic signatures– Add cover page in PDF with correct demographics and

signature/status

• Store report– Via DICOM Encapsulated PDF to ungrouped Report Repository– Via unspecified means to grouped Report Repository

• Forward report to Enterprise Report Repository– Via encapsulated PDF and/or via RID URL, as configured


Report Manager IssuesReport Manager Issues

• Must support external Report Creators, even if product groups a Report Creator with Report Manager

• Report Manager may not restrict types of reports (report titles) it supports– Unlike a DICOM Image Manager, which may restrict the types of

images it supports– All Displayable Reports are fundamentally the same – an

encapsulated PDF, which is not semantically processed

• Report Manager actor also appears in Patient Information Reconciliation Profile– For Patient Update and Procedure Update transactions

• Report Manager may be an enterprise-level actor


Summary of Requirements – Summary of Requirements – Report Repository (ungrouped)Report Repository (ungrouped)

• Receive PDF encapsulated in DICOM message• Serve report via RID Information Source using HTTP Get

– Summary List of Reports – Bare PDF report document

• Serve report via DICOM– DICOM Query/Retrieve of Encapsulated PDF

• Reasonable functionality to add to Image Manager / Image Archive (PACS)


Summary of Requirements – Summary of Requirements – Report ReaderReport Reader

• Query/Retrieve DICOM Encapsulated PDF – Allows access to report in context of study images and

evidence – retrieve of complete DICOM study will also retrieve report

• Render PDF content

• Reasonable functionality to add to Image Display (workstation)


Summary of Requirements – Summary of Requirements – Enterprise Report RepositoryEnterprise Report Repository

• Receive PDF encapsulated in HL7 v2 ORU messageor

Receive PDF reference in HL7 v2 ORU message• Serve report to enterprise via unspecified mechanism

– Additional to RID service from Report Repository actor

– Enterprise Report Repository may implement references only (fully distributed architecture)


DRPT and XDSDRPT and XDS

• Displayable Reports Profile specifies production of reports within an organization

• Cross-enterprise Document Sharing (XDS) Profile specifies distribution of reports outside the organization

• Typically, only a subset of internally generated reports will be shared outside

• Externally shared reports must be identified with Patient ID used in the XDS “Affinity Domain”

• XDS Document export is a reasonable function to group with the Enterprise Report Repository


More information….More information….

• IHE Web sites: www.ihe.net• Technical Frameworks, Supplements

• Cardiology Technical Framework • IT Infrastructure Technical Framework • Displayable Reports Supplement

• 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

http://www.ihe.net/


W W W . I H E . N E TW W W . I H E . N E T

Providers and VendorsWorking Together to Deliver

Interoperable Health Information SystemsIn the Enterprise

and Across Care Settings

Displayable Reports Profile (DRPT) Marco Eichelberg OFFIS Technical Manager, IHE Europe Cardiology...

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