IHE – Reporting viewed from Radiology

Christoph Dickmann

March 2007

What is “reporting”?

• Data flow = content and transport– Report formats

– Messages transporting reports/ references/ statuses

• Workflow = control who does what on the report– Order / scheduling

– Tasks/ steps

– Codes

Separate these - decompose

Scoping: create

“Imagingspace”

DICOM SR DICOM SR

create make available

HL7 CDA HL7 CDA

PDF PDF

SINR (+)

DRPT

RID +

+ map

Q/R vs. push reports?

Scoping: Q/R, receive

“Externalspace”

DICOM SR(MWL ref.)

DICOM SR

Q/R, receive display, use, store

HL7 CDA(ORM, OMI)

Note: grouping is not shown, although combinations may be discussed (e.g. with RID Display)

DICOM enc.PDF

PDF

SWF, ARI

DRPT, RID

SWF + map

SWF + HL7 CDAMWL/ GPWL ref.

DICOM reporting strategy on CDA

ClinicalDocument

Order

HL7 Order Message containing:- Reference pointer to CDA documentor- MIME encoded CDA document

DIS

Patient MedicalHistory / RelevantPrior Documents

Departmental Information Systeme.g. Radiology Information System

Discussion of different options:- MWL/GPWL: Reference Pointers to CDA Documents (Supp101)- Transformation of meaningful parts of the clinical document: CDA -> DICOM SR- DICOM Encapsulation of CDA and CDR (Supp 114)- DICOM Encapsulation of PDF Documents (Supp104)

Modality/Workstation

Resulting systems view

RIS

Report Creating App.

Modality

Evidence Creating App.

DICOM App.,PACS

Report Translator

PDFCDA

Report Repository/ PACS

DICOM, e.g. image, evidence, SR, MWLHL7, e.g. MDM, OMI, ORMOptional (HL7, DICOM)

CDA PDF

*** Either RIS-pre-fetched encapsu-lated doc.or pointers to docs. in WL Mod. console!? Both for Rep.Cr.

The Report Crea-ting App. should not need to query for “any” report. But it may be grouped with an RID Display.

The RIS should not need to query for “any” report. But it may be grouped with an RID Display or XDS(-I) Consumer.

Department boundary

Insight on “Data Flow”

• Existing reporting profiles cover much of the needs no completely different new profiles needed– New profiles cannot guarantee faster/ better

acceptance and product implementation

• Rather re-use/ extend existing profiles• Rather clarify existing profiles

(e.g. Report Manager)

Proposed next steps

• Decide about approach– Separate data and work flow

– Role of DICOM strategy

– Assess pros/cons of existing profilesincl. content-related role of Report Manager

• Decide about content and data flow– What if there is no RIS?

– Recommend actor groupings?

• Decide about workflow