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DICOM WG13 in Kyoto IHE-J Endoscopy in Clinical Practice Hideto Yokoi, MD, PhD IHE-J Endoscopy Planning Committee, Kagawa University Hospital.

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Presentation on theme: "DICOM WG13 in Kyoto IHE-J Endoscopy in Clinical Practice Hideto Yokoi, MD, PhD IHE-J Endoscopy Planning Committee, Kagawa University Hospital."— Presentation transcript:

1 DICOM WG13 in Kyoto IHE-J Endoscopy in Clinical Practice Hideto Yokoi, MD, PhD IHE-J Endoscopy Planning Committee, Kagawa University Hospital

2 DICOM WG13 in Kyoto Two methods of standardization Standardization of contents –Terminologies, Classifications… SNOMED, ICD-10… –Data models, Ontology… MST (Minimal Standard Terminology) Standardization of communication. –Protocols for communication between systems HL7, DICOM, TCP/IP, SSL… Integrating the Healthcare Enterprise (IHE) Making concrete guidelines for HL7 and DICOM usage Endoscopy has the international terminology. OMED (World Organisation of Digestive Endoscopy) supporting

3 DICOM WG13 in Kyoto Our Target Flexible Endoscope Biopsy Forceps Main targets: Digestive tracts Bronchial tubes…

4 DICOM WG13 in Kyoto The Workflow of Endoscopy Pt PACS Report DB Ordering System Endoscopy System Pt Pathology System Order of Pathological Study Endoscopist Pathology Dpt. Result Order and Reservation Endoscopy Study Outpatient Service after the study Physician Pre-medication Order for Study Nurse

5 DICOM WG13 in Kyoto What is a workflow fitting endoscopy procedure? The workflow needs an interaction with pathology department system. Decided to have transactions for the linkage information between Endoscopy order/report and Pathology order/report. The interaction needs data of endoscopy procedure report describing where specimens were gotten. Included reporting procedure in the “Endoscopy SWF”.

6 DICOM WG13 in Kyoto GUI image that endoscopists want DateEvent 2007/10/30Endoscopy (EGD) Pathology (biopsy from stomach) Germ culture 2. 1. Report of endoscopy There is “Ulcer” in the stomach. stage: A1 Bleeding: (+) … biopsy:1. from the side of ulcer :2. oral side of 1. 2. 1. Endoscopy Image 1. Group 1: ulcer 2.Group 3: anomaly of some cells… Pathology results Window of EMR

7 Non-Rad PACS Konica I-PACS Capacity : 2.5TB Oto-system (3Z) Secondary capture system(3Z) EzCAP2× 5 Oto-Endoscope×5GI Endoscope×3 DICOM Gateway (Olympus) US (GE-YMS) Logic3×1 EMR Client (Fujitsu) GI Endoscopists can create reports EMR system (Fujitsu) DICOM Storage Endoscopy Order retrieve Endoscopy Order Resistration Trial Implementation in Kagawa University Hospital DICOM MWM Endoscopy Order ( HL-7 ) Endoscopy report Pathology order ( HL-7 ) Images and report retrieve ( URL ) Images and report retrieve ( URL ) Pathology Department System (JR west) Pathology order

8 EMR / Order- Entry-System Server Report Server Endoscopy PACS Pathology Department system Report Client Software ① Endoscopy Order ② Patient Information ③ Endoscopy Study Information 【 OMI 】 ⑦ Endoscopy report and order for pathology study ⑥ Order for Pathology Study Endoscopy Department System ⑤ Creating Report ② Patient Information ③ Endoscopy Study Information 【 OMI 】 Trial Implementation Workflow Conventional Electronic Medical Record (Fujitsu) Client Machine Legacy messages HL7 messages ④ Endoscopy order Acknowledge ⑤ Entry the Endoscopy Procedure Result for finance Start from Department Client software Endoscopy Department System Client Software Japan Railway West PACS (Konica)

9 Actors, Transactions and Master Tables Order Placer Endoscopy Order Filler Pathology Order Filler Report Manager →ES-2 Endoscopy Order ( OMI ) →ES-1 Endoscopy Order ( OMG ) ←ES-3 Endoscopy report and order for pathology study ( MDM ) ↓ES-4 Order for Pathology Study ( OML ) Conventional Master Table for Endoscopy Order EEE MP P Conventional Master Table for Pathology Order MST Master Table of Endoscopic Findings P

10 DICOM WG13 in Kyoto “MST” Reporting system (structured) Terminology of organ & siteTerminology for endoscopy study

11 DICOM WG13 in Kyoto “MST” Reporting system

12 DICOM WG13 in Kyoto Active cases Ehime University Hospital Kagawa University Hospital Okayama University Hospital Yamaguchi University Hospital Four University Hospitals share the RFP (Request For Proposal) Based on IHE endoscopy workflow Easy connectivity High reliability Low cost for integration Diagnostic accuracy with pathology as a gold standard can be accounted quickly.

13 DICOM WG13 in Kyoto Look!!! “Fifth” University Hospital Coming soon!!! Hearing from endoscopists. Revealing clinical demands

14 DICOM WG13 in Kyoto Thank you.


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