IHE Cardiology Echo Profile Year 2 1/1/05 Version 0.1

Echo Y2 Profile Problem Statement The year two Echo profile addresses the need to track various reporting tasks for TTE, TEE, and Stress Echo. These reporting tasks include interpretation, dictation, transcription, verification, revision, and coding. While there may be differences in Cardiology from Radiology, IHE-Rad’s RWF, ED, and SINR are very applicable and provide a foundation to work from. Similar to year 1, a majority of this profile will a combination of several IHE-Rad profiles along with some adjustments to suite the Cardiology differences. This provides a proven framework to build on. IHE Cardiology

Echo Y2 Profile Diagram NOTE: Needs lots of cleaning up + split in to simplified phases Enterprise Report Repository External Report Repository ADT Pt. Registration [Rad-1] ¯ Patient Update [Rad-12] ¯ ¯ Pt. Registration [Rad-1] Query Reports [Rad-26] ¯ SR Export [Card-xx] ­ ¬ Patient Update [Rad-12] Placer Order Management [Rad-2] ­ Retrieve Reports [Rad-27] ® ­ Filler Order Management [Rad-3] DSS/ Order Filler Order Placer ­ Modality PS in Progress [Card-1] ¯ Procedure Scheduled [Rad-4] ­ Report Reader Report Creator Modality PS Completed [Rad-7] ¯ Procedure Update [Rad-13] ­ Performed Work Status Update [Rad-42] Image Display Procedure Scheduled [Rad-4] Procedure Updated [Rad-13] Patient Update [Rad-12] ¯ Report Manager Query Reports [Rad-26] ¯ Retrieve Reports [Rad-27] Report Submission [Rad-24] ¯ Query Images [Rad-14] ¯ ¯ ¯ ¬ Reporting WL Provided [Rad-46] ¯ Retrieve Images [Rad-16] Report Issuing [Rad-25] ¯ Query Reports [Rad-26] ¯ Retrieve Reports [Rad-27] ¬ Workitem Claimed [Rad-38] ¬ Workitem Completed [Rad-41] Query Evidence Documents [Rad-44] Report Repository ¯ ¬ Workitem PPS In Progress [Rad-39] Performed Modality PS Completed [Rad-7] ® Procedure ¬ Workitem PPS Completed [Rad-40] Retrieve Evidence Documents [Rad-45] Step Manager ¯ Instance Availability Notification [XXX-xx] Image Manager Image Archive ® Modality PS in Progress [Card-1] ® Modality PS Completed [Rad-7] Evidence Documents Stored [Card-xx] Storage ­ ­ Modality Image/Evidence Stored [Card-2] Commitment [Card-3] ­ Storage Commitment [Rad-10] ¬ Modality PS in Progress [Card-1] ¬ Modality PS Completed [Rad-7] Evidence Creator Acquisition Modality ¬ Query Modality Worklist [Rad-5] Blue indicates year 2 work IHE Cardiology

Actors DSS/OF PPS Manager Image Archive Report Manager Same as in current Cardiology TF 1:2.3 PPS Manager Image Archive Report Manager Same as in current Radiology TF 1:2.2 Report Repository Report Reader Report Creator Evidence Creator Enterprise Repository External Repository IHE Cardiology

Transactions Procedure Scheduled [Rad-4] Procedure Update [Rad-13] Same as in current Radiology TF 1:2.3 HL-7 2.3.1 Chapters 2-4 <Specializations or restrictions> Procedure Update [Rad-13] HL-7 2.3.1 Chapters 2,4 Modality Procedure Step Completed [Rad-7] DICOM 2003 PS 3.4: Modality Performed Procedure Step SOP Class DICOM 2003 PS 3.16: DCMR Context Groups (Normative) Storage Commitment [Rad-10] DICOM 2003 PS 3.4: Storage Commitment Push Model SOP Class Instance Availability Notification [xxx-xx] DICOM 2003 PS 3.4: Instance Availability Notification SOP Class Report Submission [Rad-24] DICOM 2003 PS 3.4: Storage SOP Class DICOM 2003 PS 3.16: Content Mapping Resource Report Issuing [Rad-25] DICOM 2003 PS 3.4: Storage SOP Class IHE Cardiology

Transactions Query Reports [Rad-26] Retrieve Reports [Rad-27] Same as in current Radiology TF 1:2.3 DICOM 2003 PS 3.4: Query/Retrieve Service Class DICOM 2003 PS 3.16: Content Mapping Resource <Specializations or restrictions> Retrieve Reports [Rad-27] DICOM 2003 PS3.4: Storage SOP Class Structured Report Export [Card-xx] HL-7 2.3.1 Chapter 7 Workitem Claimed [Rad-38] DICOM 2003 PS 3.4: General Purpose Schedule Procedure Step SOP Class Workitem PPS In Progress [Rad-39] DICOM 2003 PS 3.4: General Purpose Schedule Procedure Step SOP Class Workitem PPS Completed [Rad-40] Workitem Completed [Rad-41] IHE Cardiology

Transactions Performed Work Status Update [Rad-42] Same as in current Radiology TF 1:2.3 DICOM 2003 PS 3.4: General Purpose Schedule Procedure Step SOP Class <Specializations or restrictions> Evidence Documents Stored [Card-xx] DICOM 2003 PS 3.4: Storage Service Class; Basic Text SR SOP Class; Enhanced SR SOP Class; Comprehensive SR SOP Class DICOM Supplement 72: Echocardiography Procedure Report Query Evidence Documents [Rad-44] DICOM 2003 PS 3.4: Query/Retrieve Service Class Retrieve Evidence Documents [Rad-45] Reporting Worklist Provided [Rad-46] IHE Cardiology

Echo Y2 Profile Scenarios Scenario 1: Report Manager and Image Manager grouped in one system Scenario 2: Report Manager and DSS/OF grouped in one system Scenario 3: Report Creator and Image Display grouped in one system Scenario 4: Report Manager is a separate system IHE Cardiology

Echo Y2 Profile Scenarios Workflow Event Transactions Originating Actor Receiving Actor Notes Ordered Placer Order Management [Rad-2] Order Filler DSS/OF   Filler Order Management [Rad-2] Scheduled Procedure Scheduled [Rad-4] Image Manager Report Manager Patient Arrives and is on table Query Modality Worklist [Rad-5] Acquisition Modality Start Procedure Modality PS "In Progress" [Card-1] PPS Manager Indications, measurements, & procedure info would be captured on echo machine to be sent as evidence via DICOM SR IHE Cardiology

Echo Y2 Profile Scenarios Workflow Transactions Originating Actor Receiving Actor Notes Stress ECG report, Nursing report for TEE, etc. Creator PS "In Progress" [Card-1] Evidence Creator PPS Manager Synch up with Stress Echo work as this is both an acquisition modality and evidence creator depending on the step in the workflow. The exact location of this event in this workflow is not precise, but suggesting another evidence creator in the workflow Creator PS "Complete" [Rad-7]   Modality PS "Complete" [Rad-7] Report Manager PARTIAL Creator Evidence Stored [Card-xx] Image Archive waveforms and/or SR templates Storage Commitment [Card-3] Image Manager End Procedure Acquisition Modality DSS/OF Modality Image/Evidence Stored [Card-2] Instance Availability Notification [XXX-xx] COMPLETE IHE Cardiology

Echo Y2 Profile Scenarios Workflow Transactions Originating Actor Receiving Actor Notes View Historical Reports Query Reports [Rad-26] Report Reader Report Repository/External Report Repository This step could occur anywhere in the workflow Retrieve Reports [Rad-27]   Review Reporting Worklist Provided [Rad-46] Report Creator Report Manager Preliminary reports can be created in this part of the workflow. Similar to Radiology’s workflow. Need to review the subtleties for differences.  Workitem Claimed [Rad-38] Performed Work Status Update [Rad-42] DSS/OF Query Images [Rad-14] Image Display Image Archive Query Evidence Documents [Rad-44] Retrieve Images [Rad-16] Retrieve Evidence Documents [Rad-45] Workitem PPS "In Progress" Rad-38] Report Workitem PPS "Complete" [Rad-40] Report Submission [Rad-24] Report Issuing [Rad-25] Report Repository Workitem Completed [Rad-41] SR Export [Card-xx] Enterprise Report Repository IHE Cardiology

In Scope / Out of Scope The scope of this profile is to deal with the workflow surrounding procedural documentation for echocardiography. Specific content mapping is not addressed in this profile. Feature In/Out Key Image Notes Out Measurements and other structured data mappings (SINR) Integrated image review and documentation In Note: list functionality especially at borders of what is included/excluded – i.e., included features that could reasonably be descoped by the Technical Committee, or excluded features that could be included IHE Cardiology

Phased Approach Workflow outside of content mapping should constitute phase 1. IHE Cardiology

Open Issues Key Image Notes Nursing notes for TEE Workflow surrounding content mapping among the various documents. (e.g. evidence document on image display to physician report on report creator) Dictation vs. SR IHE Cardiology