Workflow Radiologie (IHE) PACS HIS RIS . Actors and Transactions •Actor (HL7: Application...

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Transcript of Workflow Radiologie (IHE) PACS HIS RIS . Actors and Transactions •Actor (HL7: Application...

  • Workflow Radiologie (IHE)

    Nieuwegein, 20 mei 2014

    Sessie K (15:00-16:00)

  • 2

    René Spronk

    HL7/IHE roles:

    •Co-chair of the international HL7 AID User Group

    •Co-chair of various Committees, HL7 Netherlands

    •Contributor to the IHE Laboratory Technical Framework

    •HL7 Fellow, 2011

    Trainer / Senior Consultant

    Ringholm bv Haarlem, the Netherlands

    Tel. +31 (0)33 7 630 636

    eMail: Rene.Spronk@Ringholm.com

    Web: http://www.Ringholm.com

  • Het zes-lagen model

    3 Informatiestandaarden in de zorg

    Randvoorwaarden

    Samenwerking

    Informatie-inhoud

    Softwarekoppeling

    Infrastructuur

    WET & REGELGEVING

    ZORGPROCES

    INFORMATIE

    TECHNIEK

    APPLICATIES

    BELEID Richtlijnen

  • Agenda

    • Workflows in de zorg

    • Wat is IHE en wat kun je ermee?

    • Radiology scheduled workflow

    • Examples

  • 5

    Intro IHE

    • IHE = Integrating the Healthcare Enterprise

    • Based on existing standards such as HL7 and DICOM

    • IHE is not a standard; it is a constraint profile (a.k.a conformance profile).

  • IHE domains

    6

    Pathology since 2006

    Radiation Oncology since 2004

    Radiology since 1998

    Cardiology since 2004

    Patient Care Devices since 2005

    Patient Care Coordination since 2004

    Eye Care since 2006

    Quality Research & Public Health

    since 2006

    Laboratory since 2004

    (Healthcare) IT Infrastructure

    since 2003

    Pharmacy Since 2009

  • 7

    images

    stored

    patient

    information

    examination orders

    images

    retrieved

    procedure

    scheduled Prefetch any relevant

    prior studies

    modality

    worklist

    report

    report

    Radiology Scheduled Workflow

    Registration

    Orders Placed

    Orders Filled

    Film

    Film

    Folder Image Manager

    & Archive

    Film

    Lightbox

    report Report

    Repository

    Diagnostic

    Workstation

    Modality

    acquisition

    in-progress

    acquisition

    completed

    acquisition

    completed

    images

    printed

    Acquisition

    Modality

    PACS

    HIS

    RIS

  • Actors and Transactions

    • Actor (HL7: Application Role, DICOM: Service Class)

    – Functional grouping of the capability to exchange a specific set of Transactions in order to fulfill part of a workflow.

    • Transaction

    – (Functional) Information exchange

    – Abstract concept, could be the equivalent of multiple message exchanges or service calls.

  • Proven Standards Adoption Process

    IHE

    Integration

    Profiles B

    IHE

    Integration

    Profile A

    Easy to

    Integrate

    Products

    IHE

    Demonstration User Site

    RFP

    Standards

    IHE

    Technical

    Framework

    Product IHE Integration

    Statement

    IHE Integration Profiles at the heart of IHE :

    – Detailed selection of standards and options each solving a specific integration

    problem

    – Vendors can implement with ROI; Providers can deploy with stability

    IHE

    Connect-a-thon

    Product

    With IHE

    IHE Connect-a-thon Results

  • 10

    IHE - Connect-a-thon !

    USA / Asia / Europe

    Paris Aachen

    Padua Noordwijkerhout

    Berlin Oxford

    http://ihe.univ-rennes1.fr/gallery/Paris2001/aac?full=1 http://ihe.univ-rennes1.fr/gallery/album09/abg?full=1

  • IHE Integration Statement Product vendors take the next step

    11

  • SWF: Radiology Scheduled Worklfow

  • • Exchange of (electronic) ordering and results information from an imaging service request

    • Core

    – Patient registration

    – Order management

    – Worklist management

    – Image archiving and management

    Scheduled Workflow Profile

  • 14

    IHE Integration profiles

    Patient

    Informa-

    tion

    Reconci- liation

    Access to Radiology Information

    Consistent

    Presentation

    of Images

    Scheduled Workflow

    Basic Security

    -

    Evidence

    Documents Key Image

    Notes

    Simple

    Image and

    Numeric

    Reports

    Presentation

    of Grouped

    Procedures

    Post-

    Processing

    Workflow

    Reporting

    Workflow

    Charge

    Posting

  • 15

    SWF- Purpose

    • Preserve Order Continuity

    – “Close the Loop”

    – maintain accession number, avoid confusion with Filler #, Placer #, etc.

    • Improve Demographic Integrity

    – Data entry errors • significant occurrence

    • significant consequences

    – Enter once, pass from system to system

  • Radiology Scheduled Workflow

    16 16

    images

    stored

    patient

    information

    examination orders

    images

    retrieved

    procedure

    scheduled Prefetch any relevant

    prior studies

    modality

    worklist

    report

    report

    Registration

    Orders Placed

    Orders Filled

    Film

    Film

    Folder Image Manager

    & Archive

    Film

    Lightbox

    report Report

    Repository

    Diagnostic

    Workstation

    Modality

    acquisition

    in-progress

    acquisition

    completed

    acquisition

    completed

    images

    printed

    Acquisition

    Modality

    PACS

    HIS

    RIS

  • ADT

    Order Placer

    Order Filler

    Acquisition Modality

    PPS Manager

    Image Manager

    Image Archive

    Image Creator

    Image Display

    Blue: HL7 Messages Green: DICOM Messages

    Pt.Registration Pt.Registration

    Order Management

    Modality Worklist

    Procedure Scheduled

    Modality PPS

    PPS

    PPS

    Image Stored

    Storage Commitment

    Creator PPS

    Storage Commitment

    Image Stored

    Q/R Images

    SWF – Actor/Transaction Overview

  • Scheduled Workflow

    “HL7 Actors & Transactions”

    18

    HL7 Actors: • ADT/Patient

    Registration

    • Order Placer

    • DSS / Order Filler

    • Image Manager

     1: Pt registration

     12: Pt Update

    Pt registration: 1 

    Pt Update: 12   2: Placer Order Management

     3: Filler Order Management

    ADT

     4: Procedure Scheduled

     12: Patient Update

     13: Procedure Update

    Image

    Manager

    Order Placer Order Filler

  • Scheduled Workflow

    “DICOM Actors & Transactions”

    19

    DICOM Actors: • DSS / Order Filler

    • PPS Manager

    • Image Manager /

    Archive

    • Acquisition Modality

    • Evidence Creator

    • Image Display

  • Acquisition Workflow Management

    20

    DICOM: • Modality Worklist

    Management (MWL)

    • Modality Performed

    Procedure Step (MPPS)

  • Image Management

    21

    DICOM: • Image Storage

    • Storage Commitment

    • Query/Retrieve

  • Other standards

    • HL7 v2:

    – Patiënt registration

    – ADT

    – ORM

    – ORU

    • DICOM service classes

    • IHE merges these worlds together

  • Meer details?

    • Cursus IHE voor Radiologie - 12 juni 2014

    – 1 dag, zie www.iheacademy.nl

    • www.ihe.net

    http://www.iheacademy.nl/