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

scheduledPrefetch 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

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

scheduledPrefetch 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”

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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