State of the Standards 2018

Transcription

1 State of the Standards 2018 Focus on Access to Imaging Content Kinson Ho, Solution Architect Change Healthcare IHE Radiology Technical Committee Co-Chair

2 We build bridges to connect information islands

3 Import and Display of External Priors (IDEP) Motivation Commonly priors are located outside the reading institution Cannot reliably locate, access, and view priors during the short time frame required to be relevant to reading DVDs, web portals are inadequate Prior radiology reports are rarely accessible Prior images, if available, cannot be presented for side-by side comparison using local hanging protocols Patients may need to be re-imaged (radiation, cost, and time) * Courtesy Teri Sippel, Vital Images

4 IDEP Imaging Study Flow * Courtesy Teri Sippel, Vital Images

5 IDEP Report Flow * Courtesy Teri Sippel, Vital Images

6 Connected Digital Health Ecosystem

7 Moving from Service Design to Ecosystem Thinking

8 Problems to Solve in Imaging Secure web access to imaging studies Image sharing & Interactive viewing Ease of integration Neutral to image sharing infrastructure: DICOM, XDS-I, MHD

9 DICOMweb x HL7 FHIR

10 What is HL7 FHIR? Fast Focus on design and implementation efficiency Healthcare Don t try to cover other domains Interoperable Systems should just work together Resources Fundamental building blocks <Patient xmlns=" <id value="31415"/> <identifier> <use value="usual"/> <label value="mrn"/> <system value=" <value value="123456"/> </identifier> <name> <family value="levin"/> <given value="henry"/> </name> <gender value="male"/> <birthdate value=" "/> <careprovider> <reference value="organization/2"/> <display value="good Health Clinic"/> </careprovider> <active value="true"/> </Patient> * Courtesy Elliot Silver, Change Healthcare

11 Mobile Access to Health Document (MHD) Document Source Document Recipient Provide Document Bundle Document Consumer Document Responder Find Document Manifest Find Document References Retrieve Document

12 MHD: XDS on FHIR Option

13 MHD x IDEP = Remote HL7 Report Access For remote HL7 report access Define a Report Access Gateway Use MHD as the interface for Query and Retrieve of reports Output continues to use HL7 ORU Local Report Manager HL7 ORU Importer MHD Tx Report Access Gateway Remote Report Source (e.g. EMR)

14 DICOMweb Overview Suite of RESTful DICOM protocols Recent work: Non-patient instances Redocumentation Retrieve thumbnail DICOMweb Service WADO-RS Description Retrieve instances or frames Non-rendered Rendered (e.g., JPG) Metadata, Bulk (pixel) data DIMSE Equivalent C-MOVE, C-GET Original WADO-URI still supported QIDO-RS Query Patient, study, series, instance C-FIND STOW-RS Upload instances C-STORE UPS-RS Workflow tracking MWL, MPPS * Courtesy Elliot Silver, Change Healthcare

15 Web-based Image Capture (WIC) Value Proposition A simple, lightweight, mobile-friendly mechanism to encode and send DICOM encapsulated images, videos and evidence documents from the mobile device to the Image Manager so that these objects can be easily integrated into the rest of the imaging workflow

16 WIC Technical Highlights Capture Patient and Study Context Implicit (e.g. with the integrated viewer, EMR, etc.) in case of the Append Case Explicit (via IHE ITI PDQm, QR code, bar code, manual entry, etc.) Uses DICOMweb for content and transport Content can be created using DICOM binary, XML or JSON Client is responsible for including all proper contents Use STOW-RS for transport Image Manager Converts received objects into DICOM binary instances Image Capturer Imaging Document Responder Store Instances over the web

17 Web-based Image Access (WIA) Value Proposition Methods for image sharing and interactive viewing of imaging studies using RESTful services such as WADO-RS and QIDO-RS.

18 WIA Technical Highlights Neutral about backend image sharing infrastructure XDS / XDS-I DICOM / DICOMweb Integrates with ITI MHD Document Consumer can locate and interact with imaging studies more efficiently using document metadata QIDO-RS Query Imaging Document Responder Imaging Document Consumer WADO-RS Retrieve Imaging Document Source

19 Recent Enhancements to XDS-I Imaging Document Source has a new Reference ID option CP-RAD-352 Required to provide Accession Number and Study Instance UID in ReferencedIdList Imaging Document Source has a new Delete Imaging Document Option CP-RAD-320 Grouped with ITI Remove Metadata and Document (RMD) Document Administrator actor Delete manifest or report from Document Registry and Repository

20 Participate Great opportunity to learn Great opportunity to contribute All three communities are open to new members/contributors Application process Patent policy