PACS Presentation HIMSS 2015-Teleradiology

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Monief Eid BSc, Lean Six Sigma Black Belt, PROSCI, C A P, ITIL V3 Foundation and Prince2 Certified

National PACS Program Director

The National BIG Picture: Tele-medical Imaging, The Vision for Patient Services (modified based on non-disclosing

information about MOH)

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National Tele-Radiology Project

- Partnered with Canada Infoway to build up the RFP. Also participated in the evaluation

- Choose IHE Approach - Build up use cases and

business scenarios - Build up Project standard - Project is targeting all

MOH hospitals into stages

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MOH Tele-Radiology Project

Developing Imaging Use Cases

Like most eHealth programs around the world, the challenge to identify and document the very large number of business use cases and variants is avoided by using a “middle-out” methodology. The core requirements start with the Interoperability Use Cases, especially when those are “classical use cases” that have been analyzed by the profiles and standards development organizations in their prior work.

Middle-Out Methodology Steps for the eHealth Standard based Interoperability Specification and Policy Project illustrates the main steps of such a methodology, where the knowledge of the array of Business Scenarios come from the stakeholders and a validation performed through their experiences (i.e. issues and gaps corrected based on their feedback).

The Interoperability Use Cases provide a description of the workflows that need to be addressed and the main exception situations. They are not expected to cover all design details in term of error codes, data element specification and terminology code sets to be used.

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Developing Imaging Use Cases ……. Definitions

Business Scenario: A Business Scenario is a sequence of activities by one or more users (e.g. patients, clinicians, etc.) that reflects a real-world “story”. From this “story”, various use cases are derived. Some of these use cases relate to interactions between systems and facilities sharing health information, and are called Interoperability Use Cases.

Interoperability Use Case: In software engineering, a Use Case is a technique for capturing the potential requirements of a new system or a software change. Each Use Case provides one or more process flow scenarios that convey how the system should interact with the end user or another system to achieve a specific business goal. In the context of the specification of interoperability requirements, a use case provides one or more scenarios in the form of information flows that convey how systems should interact with other systems as driven by the end user to achieve a specific business or clinical goal.

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Imaging Use Cases Institutes (Hospital, PHC, Clinic) with Local RIS/PACS – and Tele-Rad Service Not Used (But connected to DIRS/TRS)

a) Acquire imaging study on local PACS

b) Local PACS accesses local and Saudi Imaging Repository prior images and reports

1 - Q/R Images and Reports

c) Radiologist reads images and creates report on local RIS/PACS

d) Store newly acquired images and reports into Saudi Imaging Repository

2 – Store Images and Reports

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Imaging Use Cases Institutes (Hospital, PHC, Clinic) with No Local RIS/PACS – and connected to National DIRS/TRS Service (But no Tele-Rad)

- Shared TRS/DIRS Service Platform - used as if local RIS/PACS - Gateway acts as a RIS/PACS - communicates with local HIS & Modality (acquires images) - Gateways use the same common standards (e.g. HL7 and DICOM) - very

well understood and implemented in many KSA hospitals, therefore not specified

a) Acquire imaging study from local modalities b) Q/R prior images and reports from Saudi Imaging Repository

1 – Q/R Images and Reports c) Radiologist reads images and creates report on National TRS (using

PACS Wks.) d) Store newly acquired images and report into Saudi Imaging Repository 2 – Store Images and Reports

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Imaging Use Cases Institutes (Hospital, PHC, Clinic) with No Local RIS/PACS – National DIRS/TRS and having Tele-Rad Services

a) Acquire imaging study from local modalities b) Store Images on Saudi Imaging Repository

1 – Store Images c) Issue Order to Tele-Rad Service d) Tele-Rad Mgr. manages workstation (reading worklist, relevant prior

images and reports, etc.) 2 – Q/R Images and Reports e) Tele-Rad Wks. creates report, Tele-Rad Mgr. stores report on Saudi

Imaging Repository 3 – Store Report

f) Tele-Rad Manager updates order status to “complete” g) National TRS/DIRS Q/R report and displays on National PACS

Workstation 4 – Q/R Report

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Imaging Use Cases Institutes (Hospital, PHC, Clinic) with Local RIS/PACS Uses Tele-Rad as Back Up Service

Tele-Rad Service used when local radiologist is not available a) Acquire imaging study on local PACS and store images to

Saudi Imaging Repository. 1 – Store Images b) Issue Order to Tele-Rad Service

2 – Issue Tele-Rad Order c) Tele-Rad Mgr. manages Tele-Rad workstation (reading

worklist, relevant prior images and reports, etc.) 3 – Q/R Images and Reports d) Tele-Rad Wks. creates report, Tele-Rad Mgr. stores on

Saudi Imaging Repository. 4 – Store Report

e) Tele-Rad Manager updates order status to “complete” 5 – Status Update

f) RIS/PACS Q/R report to store locally 6 – Q/R Report

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Imaging Use Cases Interoperability Comparison for the Four Configurations

1. Local RIS/PACS Tele-Rad Service Not Used

2. Local RIS/PACS Uses Tele-Rad as Back Up

3. No Local RIS/PACS National RIS/PACS Service (no Tele-Rad)

4. No Local RIS/PACS National RIS/PACS and Tele-Rad Services

1&3 – Same Interoperability Requirements 2&4 – Same Interoperability Requirements

Standalone RIS/PACS Workflow

Q/R Images and Reports (prior)

Store Images and Reports (new)

RIS/PACS Using Tele-Rad Workflow

Store Images (new)

Q/R Images and Reports (prior)

Issue Tele-Rad Order (new)

Store Report (new)

Update Order Status (completed)

Q/R Report

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Use Case Actors Example:

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Use Case Actors Example:

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Data Content:

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Use Case Actors: Imaging Information Source • Produces and publishes imaging documents Imaging Information Consumer • Queries and retrieves images Imaging Report Consumer • Queries and retrieves reports Imaging Repository • Store and provide access to images and reports • Maintains metadata

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Benefits of National Tele-Radiology Project: Sharing Images and Reports • Timely access to studies and reports • Reduce duplicated Imaging • Support for Tele-radiology

Tele-radiology Orders • Access to radiologists during off-hours • Access to specialists from all over Saudi • Load balancing during periods of heavy load • Better care and reduced errors

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Publish Document(s)

Query/RetrieveDocument(s)

Notification ofDocument Availability

Retrieve Images

Send Images

LegendLegend

Service

Actor

Imaging Information Source

Imaging Information Consumer

Imaging Report Consumer

Imaging Repository

Service Model

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Tele-Radiology Order Creator

Tele-Radiology Order Fulfiller

Tele-Radiology Order Forwarder

Manage Order

Service Model

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Data Content:

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Data Content:

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Thank You ………. Q & A

PACS Presentation HIMSS 2015-Teleradiology

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Transcript of PACS Presentation HIMSS 2015-Teleradiology