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Cross - Enterprise Screening Mammography - Workflow Definition (XSM-WD) White Paper for 2011/2012 presented to the RAD Technical Committee, Planning Committee,

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Presentation on theme: "Cross - Enterprise Screening Mammography - Workflow Definition (XSM-WD) White Paper for 2011/2012 presented to the RAD Technical Committee, Planning Committee,"— Presentation transcript:

1 Cross - Enterprise Screening Mammography - Workflow Definition (XSM-WD) White Paper for 2011/2012 presented to the RAD Technical Committee, Planning Committee, Mammography Arianna Cocchiglia, Francesca Vanzo, Luca Zalunardo December, 9 th 2011

2 IHE Radiology White Paper developing The work group started to draw up the draft version of the White Paper The main themes of the work are: description of the most common practices in mammography screening according to several workflows and conveying them in the Mammography Screening Task Diagramdescription of the most common practices in mammography screening according to several workflows and conveying them in the Mammography Screening Task Diagram definition of the actors and transactions needed in this clinical processdefinition of the actors and transactions needed in this clinical process definition of a common structure for the Workflow Documentdefinition of a common structure for the Workflow Document

3 IHE Radiology The Mammography Screening Task Diagram  As known, this White Paper relies on of the ITI XDW profile by using the Workflow Document which manages and gathers the details necessary about the screening process and collects:  Workflow and Tasks Information  Input Document References  Output Document References  In order to enrich the Task Diagram, Input and Output Documents items have been included

4 IHE Radiology The Mammography Screening Task Diagram INPUT …….. INPUT …….. OUTPUT - Invitation Letter OUTPUT - Invitation Letter TASK 1: RECRUITMENT TASK 2a: ADMISSION INPUT - Previous Exams - Invitation Letter INPUT - Previous Exams - Invitation Letter OUTPUT - Images (KOS Document) - Anamnestic Document OUTPUT - Images (KOS Document) - Anamnestic Document TASK 2b: ADMISSION INPUT - Invitation Letter …………… INPUT - Invitation Letter …………… OUTPUT - “No admission” Document END OUTPUT - “No admission” Document END TASK 3: EVALUATION 1 INPUT - Images (KOS Document) - Anamnestic Document INPUT - Images (KOS Document) - Anamnestic Document OUTPUT - Report 1 OUTPUT - Report 1 TASK 4: EVALUATION 2 INPUT - Images (KOS Document) - Anamnestic Document INPUT - Images (KOS Document) - Anamnestic Document OUTPUT - Report 2 OUTPUT - Report 2 If a woman misses her scheduled appointment OR  Task 1  4

5 IHE Radiology The Mammography Screening Task Diagram  Task 5  7 TASK 5: CS EVALUATION INPUT - Report 1 - Report 2 INPUT - Report 1 - Report 2 OUTPUT - Response Report (--,++,+-) OUTPUT - Response Report (--,++,+-) INPUT - Response Report INPUT - Response Report TASK 6a: END (--) OUTPUT - Letter to Patient END OUTPUT - Letter to Patient END TASK 6b: SECOND LEVEL (++) INPUT - Response Report INPUT - Response Report OUTPUT - Letter to Patient (“Alert”) - Planning Document END OUTPUT - Letter to Patient (“Alert”) - Planning Document END TASK 6c: EVALUATION 3 INPUT - Images (KOS Document) - Anamnestic Document INPUT - Images (KOS Document) - Anamnestic Document OUTPUT - Report 3 OUTPUT - Report 3 TASK 7: RESPONSE INPUT - Report 1 - Report 2 - Report 3 INPUT - Report 1 - Report 2 - Report 3 OUTPUT - Response Report (+-+,+--) OUTPUT - Response Report (+-+,+--) TASK 6b: SECOND LEVEL (+-+) TASK 6a: END (+--) OR

6 IHE Radiology Actors and Transaction XSM–WD Diagram CompleteDiagram

7 IHE Radiology Actors and Transaction XSM–WD Diagram CompleteDiagram XDS Lifecycle Management Tools coordinate Workflow Document updates

8 IHE Radiology Actors and Transaction XSM–WD XDW Specific Actors XDS Specific Actors

9 IHE Radiology Actors and Transaction XSM–WD Imaging Specific Actors 1/2

10 IHE Radiology Actors and Transaction XSM–WD Imaging Specific Actors 2/2

11 IHE Radiology Actors and Transaction XSM–WD OtherActors

12 IHE Radiology XSM–WD in the XDS environment  The complete Actor and Transactions Digram shows several transactions and groupable actors  Since the Workflow Document is meant to be constantly updated with the information conveyed by the XDS transactions, we will consider the XSM-WD Workflow Document from this point of view

13 IHE Radiology Workflow Document: Creation and update  The Content Creator constitutes the first version of the Workflow Document  The Content Updater modifies and adds new data based on the tracking of the screening process  The Content Consumer retrieves the Workflow Document

14 IHE Radiology Workflow Document: Creation  The Content Creator constitutes the first version of a Workflow Document and places it into a new Workflow Context Folder (stored in the Document Repository) which will be a fixed reference for the Workflow Document. This actor shall:  Create a New Workflow Context Folder  Generate the First Version of the XSM-WD Workflow Document with the Description information, the Recruitment Task setting as “Completed” the Task’s status including the Input/Output Document References  Submit the Workflow Document to the Folder stored in the Document Repository

15 IHE Radiology Workflow Document: Update  The Content Updater modifies and adds new data based on the tracking of the screening process and provides it to the Document Repository and Registry by a Replace. The Content Updater shall:  Get the only “Approved” version of the Workflow Document in the Folder  Update XSM-WD Workflow Document Description elements  Include the new Task, added to the content of the latest Workflow Document version, with its own Input/Output Document References  Save all changes in a new Workflow Document, setting as “Deprecated” the last one and as “Approved” the current version)  Submit the updated Workflow Document to the Folder (stored in the Document Repository)

16 IHE Radiology Workflow Document: Update  The case with more Content Updaters which modify and add new data using a common latest version of the Workflow Document would succeed only for the first Content Updater who submits it. Infact the other(s) would submit the Workflow Document with the documentUniqueID of a “Deprecated” Workflow Document and this can not be accepted  Example Task 3-4: The second radiologist Content Consumer should always refer to the Evaluation 1 Worflow Document to avoid errors:  Into the Folder there will be only one Workflow Document with the “Approved” status. All the previous ones are located into the same Folder will have a “Deprecated” status  The second radiologist will not see the screening Images on his/her worklist until the first one will have finished his/her evaluation  Another etrieve of the “actual” Workflow Document and update of it only at the end of each Evaluation (for these two Tasks)

17 IHE Radiology Workflow Document: Retrieve  The Content Consumer retrieves the Workflow Document, obtains informations from it,…  This actor should retrieve the latest version which coincides with the unique “Approved” version  Input/Output Document references for each Task include :  XDSDocumentEntry.uniqueId  homeCommunityId  Possible queries:  Find the Workflow Folder for a Patient  Get the Workflow Folder in which a particular Workflow Document is stored  Get one or more document referenced in a Workflow Document  …

18 IHE Radiology XSM–WD Workflow Document  The XDM-WD Workflow Document cutomization complies the XDW XML Schema which includes elements from the following standards:  HL7 CDA  OASIS WS-Human Task  The four part Document composition:  See XDW Profile for the detailed description of all WD elements

19 IHE Radiology XSM–WD Workflow Document  The XSM-WD Workflow Document at Task 3 “Evaluation 1”: TASK 3: EVALUATION 1 INPUT - images (KOS Document) - anamnestic doc INPUT - images (KOS Document) - anamnestic doc OUTPUT - Report 1 OUTPUT - Report 1 Workflow Document Information:  id : documentId  title : « Screening Mammography Workflow Document »  effectiveTime : …  confidentialityCode : … languageCode : …  patient : Jane Doe   author : Dr.Kris   workflowIstanceID :  workflowDocumentSequenceNumber : « 3 »  workflowStatus : « OPEN »  workflowDefinitionReference : to workflow definition template (urn: OID:…) XDWdocumentHistory : …  Workflow Document Information:  id : documentId  title : « Screening Mammography Workflow Document »  effectiveTime : …  confidentialityCode : … languageCode : …  patient : Jane Doe   author : Dr.Kris   workflowIstanceID :  workflowDocumentSequenceNumber : « 3 »  workflowStatus : « OPEN »  workflowDefinitionReference : to workflow definition template (urn: OID:…) XDWdocumentHistory : …  XSM-WD Workflow Document TaskList   The main Workflow Document Informations are located in the first three part of the structure  Some elements are updated upon on the specific Task: author, workflowDocumentSequenceNumber workflowStatus,…  The fourth part is composed by the list of the actual and the previous Tasks Screening Mammography Workflow Document Workflow Document Information:  id : documentId  title : « Screening Mammography Workflow Document »  effectiveTime : …  confidentialityCode : … languageCode : …  patient : Jane Doe   author : Dr.Kris   workflowIstanceId :  workflowDocumentSequenceNumber : « 3 »  workflowStatus : « OPEN »  workflowDefinitionReference : to workflow definition template (urn: OID:…) XDWdocumentHistory : …  Workflow Document Information:  id : documentId  title : « Screening Mammography Workflow Document »  effectiveTime : …  confidentialityCode : … languageCode : …  patient : Jane Doe   author : Dr.Kris   workflowIstanceId :  workflowDocumentSequenceNumber : « 3 »  workflowStatus : « OPEN »  workflowDefinitionReference : to workflow definition template (urn: OID:…) XDWdocumentHistory : …  TaskList XDWTask taskEventHistory  taskData  Name : Recruitment  id :  Status : Completed  Date/time :  Input : Lists of eligible women  Output : Recruitment Letter  actualOwner : Dr.Smith  … taskData  Name : Recruitment  id :  Status : Completed  Date/time :  Input : Lists of eligible women  Output : Recruitment Letter  actualOwner : Dr.Smith  … XDWTask taskEventHistory  taskData  Name : Admission  id :  Status : Completed  Date/time :  Input : Invitation Letter, Previous exams  Output : KOS Document, Anamnestic Document  actualOwner : Dr. White  … taskData  Name : Admission  id :  Status : Completed  Date/time :  Input : Invitation Letter, Previous exams  Output : KOS Document, Anamnestic Document  actualOwner : Dr. White  … XDWTask taskEventHistory  taskData  Name : Evaluation 1  id :  Status : Completed  Date/time :  Input : KOS Document, Anamnestic Document  Output : Report 1  actualOwner : Dr. Kris  … taskData  Name : Evaluation 1  id :  Status : Completed  Date/time :  Input : KOS Document, Anamnestic Document  Output : Report 1  actualOwner : Dr. Kris  …

20 IHE Radiology XSM–WD Workflow Document  The XSM-WD Workflow Document at Task 3 “Evaluation 1”: TASK 3: EVALUATION 1 INPUT - images (KOS Document) - anamnestic doc INPUT - images (KOS Document) - anamnestic doc OUTPUT - Report 1 OUTPUT - Report 1  The taskList element includes all generated Tasks items OUTPUT - Report 1 OUTPUT - Report 1 XDWTask taskEventHistory  taskData  Name : Recruitment  id :  Status : COMPLETED  Date/time :  Input : Lists of eligible women  Output : Recruitment Letter  actualOwner : Dr.Smith  … taskData  Name : Recruitment  id :  Status : COMPLETED  Date/time :  Input : Lists of eligible women  Output : Recruitment Letter  actualOwner : Dr.Smith  … XDWTask taskEventHistory  taskData  Name : Admission  id :  Status : COMPLETED  Date/time :  Input : Invitation Letter, Previous exams  Output : KOS Document, Anamnestic Document  actualOwner : Dr. White  … taskData  Name : Admission  id :  Status : COMPLETED  Date/time :  Input : Invitation Letter, Previous exams  Output : KOS Document, Anamnestic Document  actualOwner : Dr. White  … XDWTask taskEventHistory  taskData  Name : Evaluation 1  id :  Status : COMPLETED  Date/time :  Input : KOS Document, Anamnestic Document  Output : Report 1  actualOwner : Dr. Kris  … taskData  Name : Evaluation 1  id :  Status : COMPLETED  Date/time :  Input : KOS Document, Anamnestic Document  Output : Report 1  actualOwner : Dr. Kris  …  The last Task’s actualOwner represents the author for the general information of the Workflow Document

21 IHE Radiology Example: taskData Element in XSM-DW 3 Requested Evaluation 1 COMPLETED YYYY-MM-DDTHH:MM:SS.0Z false XDWTask taskEventHistory  taskData  Name : Evaluation 1  id :  Status : COMPLETED  Date/time :  Input : KOS Document, Anamnestic Document  Output : Report 1  actualOwner : Dr. Kris  … taskData  Name : Evaluation 1  id :  Status : COMPLETED  Date/time :  Input : KOS Document, Anamnestic Document  Output : Report 1  actualOwner : Dr. Kris  …  Work in progress: The entire customization on the Screening Mammography Workflow Document


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