Success of DICOM standard - ITU · • need the capability to access the original medical images...
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International Telecommunication Union Workshop on Standardization in E-health Geneva, 23-25 May 2003 Success of DICOM Success of DICOM standard standard Cor Loef Industry Co-Chair DICOM Strategic Advisory Committee
Transcript of Success of DICOM standard - ITU · • need the capability to access the original medical images...
International Telecommunication Union
Workshop on Standardization in E-healthGeneva, 23-25 May 2003
Success of DICOM Success of DICOM standardstandard
Cor LoefIndustry Co-Chair
DICOM Strategic Advisory Committee
223-25 May 2003 Workshop on Standardization in E-health
ITU-T
Success of DICOM standard
o Mission and goal of the DICOM standardo Some recent new developmentso View on the future of DICOMo Summary
323-25 May 2003 Workshop on Standardization in E-health
ITU-T
Mission and goal of DICOM
o Mission of DICOM• Create and maintain international standards
for communication of bio-medical diagnostic and therapeutic information
o Goals of DICOM• Achieve interoperability and improve
workflow efficiency between imaging systems and other information systems
423-25 May 2003 Workshop on Standardization in E-health
ITU-T
Some recent new developments
o 16 parts of official DICOM 2003 edition available at: http://medical.nema.org
o Security• De-identification, Clinical Trials
o Applications of structured reporting (DICOM SR) – Evidence documents:• Chest CAD• Cath Lab Reporting• OB-GYN, Vascular US, Echocardiography
523-25 May 2003 Workshop on Standardization in E-health
ITU-T
Some recent new developments
o New Media• DVD-R, E-mail attachments, large capacity
MODso New Objects
• Multi-frame MR• New CT, XA, VL
o JPEG 2000o Configuration Management
623-25 May 2003 Workshop on Standardization in E-health
ITU-T
Multi-frame MR
o New object definition supporting latest advancements in MR technology
o Support for very large data sets, split of an acquisition between several multi-frame objects
o New concepts – functional groups
723-25 May 2003 Workshop on Standardization in E-health
ITU-T
Ultrasound Procedure Reporting
o A number of supplements covering different areas of US procedure reporting:• OB-GYN• Vascular• Echocardiography
o Further advances the concept of Evidence Documents –objects generated by machine, that are not images but are carrying the supplemental coded information for the procedure to aid in diagnosis
823-25 May 2003 Workshop on Standardization in E-health
ITU-T
DICOM Object Access via Net
o In addition to the e-mail distribution of DICOM objects, DICOM recently spearheaded a joint Work Item with ISO TC215 – WADOWeb Access to DICOM Persistent Objects• In currently prototype phase• Will allow for web-access to images in
different formats utilizing standardized URL (HTTP-GET)
• In conjunction with standardized MIME type allows for access using a Web Browser
923-25 May 2003 Workshop on Standardization in E-health
ITU-T
Charter of Strategic Advisory Committee
o To develop and maintain the long-term strategic plan of the DICOM Standards Committee;
o To review standards and technology trends in healthcare, biomedical imaging, commerce, telecommunications, and informatics;
o To consider issues and opportunities related to the strategic evolution of DICOM;
o To provide liaison to other standards developing organizations: ISO, HL7, JIRA, CEN.
1023-25 May 2003 Workshop on Standardization in E-health
ITU-T
Quality of care improved by information and IT
All relevant information the care giver and patient need, anywhere and anytime, for the best clinical decisions,through one common and simple user interface, adapted for the task.
1123-25 May 2003 Workshop on Standardization in E-health
ITU-T
All relevant info accessible
1223-25 May 2003 Workshop on Standardization in E-health
ITU-T
Trends in Imaging-IT
o Horizontal Integrationo Vertical Integrationo Active workflowo Data explosiono Web based PACS
HIS
RIS
RadiologyPACS
CardiologyPACS
VL, US, NMPACS
Web distribution
OtherClinicalSystem
At the desktop
1323-25 May 2003 Workshop on Standardization in E-health
ITU-T
Vertical Integration
The Healthcare Enterprise
HISHIS
Order Placer
ADTPatient Registration
RISRIS
IMAGING:IMAGING:•• PACS / ArchivesPACS / Archives
•• WorkstationsWorkstations
•• ModalitiesModalities
Image Archive
Image Manager
Image Creator
Image Display
AcquisitionModality
DepartmentSystem Scheduler– Order Filler –
Modality Worklist
Patient Registration
New
Ord
er
Procedure Scheduled
ImagesStoredStorage
Commit
Q /R
Images
PPSIn-Progress
/ Completed
1423-25 May 2003 Workshop on Standardization in E-health
ITU-T
Active Workflow
1523-25 May 2003 Workshop on Standardization in E-health
ITU-T
Workflow in Radiology
DigitalRadiology
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Registration
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Preparation
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Examination
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Archiving
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Reporting
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Demonstration
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Review
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Image Distribution
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Post Examination
1623-25 May 2003 Workshop on Standardization in E-health
ITU-T
User’s default display protocol
1723-25 May 2003 Workshop on Standardization in E-health
ITU-T
Paradigm shift in PACS:Clinical Applications to PACS
1823-25 May 2003 Workshop on Standardization in E-health
ITU-T
Multi-slice CT: 1000+ images
1923-25 May 2003 Workshop on Standardization in E-health
ITU-T
Post-processing everywhereo Viewing and Advanced Image Processing:
• clinical SW packages• move towards modalities, PACS and web
3D
Spine
Endo3D Cardiac MR
2023-25 May 2003 Workshop on Standardization in E-health
ITU-T
Post-processing everywhere
o Analysis tools to enhance clinical decisions:• Echo measurements & calculations• Left Ventricular Analysis• Quantitative Coronary Analysis• Vascular X-Ray Analysis• Vascular X-Ray Post-Processing
2123-25 May 2003 Workshop on Standardization in E-health
ITU-T
Horizontal Integration
Radiology PACS
CardiologyPACS
UltrasoundPACS
Visible LightPACS
One Image Management Infrastructure
Radiologyworkflow
Cardiologyworkflow
Ultrasoundworkflow
Pathologyworkflow
Hospital Information System, Master Person Index
2223-25 May 2003 Workshop on Standardization in E-health
ITU-T
Horizontal Integration
o Image (information) management system supports archiving/retrieving of all types of clinical objects (incl. visible light) and Structured Reports
2323-25 May 2003 Workshop on Standardization in E-health
ITU-T
DICOM SR Creation - Example -Radiology
Report Type:
Findings:
Conclusions:
Image Refs.:
Header::RIS dataRIS data
Image data from PACSImage data from PACS
Report TemplatesReport TemplatesCoding SchemesCoding Schemes
behind popbehind pop--up menusup menus
ThoraxThorax…..…..…..…..…..…..
MassMass…..…..…..…..
DiamDiam..InfiltrInfiltr..
…..…..…..…..
(Pointer)
select select
Report Creator Report Creator
applicationapplication
(DIC
OM
) SR
Obj
ect
(DIC
OM
) SR
Obj
ect
2423-25 May 2003 Workshop on Standardization in E-health
ITU-T
Web based PACS
At ModalityPACS Viewing
Station
Web Viewer
Webserver
2523-25 May 2003 Workshop on Standardization in E-health
ITU-T
Web and Security
At Modality
Web Viewer
PACS ViewingStation
Webserver
Security
2623-25 May 2003 Workshop on Standardization in E-health
ITU-T
“Electronic Health Record”
o Image Management system and Departmental Information Systems must be EHR-prepared (Query/Retrieve)
o EHR: emphasis today on visual integration on the desktop, will become the integrated, secure, patient centric, source of health information
o Need for coded vocabularies to represent medical knowledge and the patient’s health condition
2723-25 May 2003 Workshop on Standardization in E-health
ITU-T
“Electronic Health Record”
o Web front-end: • viewing not only of images but also
waveforms, measurements, reports, lab results, etc
• need the capability to access the original medical images
• Support for (DICOM) Structured Reporting• XML and XML Schema for the exchange of
clinical documents
2823-25 May 2003 Workshop on Standardization in E-health
ITU-T
EHR: Visual Integation
messagesmessages
ClinicalClinicalInformationInformation
SystemSystem
ClinicalClinicalInformationInformation
SystemSystem
Back-Office
IntegratedIntegratedClinical ViewingClinical Viewingat the desktopat the desktop
Front Office
EfficiencyEfficiency
ImproveImproveClinicalClinical
DecisionsDecisions
2923-25 May 2003 Workshop on Standardization in E-health
ITU-T
Summary
o DICOM is well positioned to continue to serve integration needs of medical imaging, including workflow, evidence information recording, effective access to imaging results in the enterprise
o Active cooperation with other standards assures DICOM objects integration into future EHR – whether by reference, or through well-defined trans-coding mechanisms.
