Reporting Workflow Rita Noumeir, Ph.D. IHE Technical Committee

HIMSS/RSNAVendor Workshop, April 2003 IHE Integration Profiles Scheduled Workflow Admit, order, schedule, manage worklists, track status, perform & notify acquisition related steps, create, store, manage, retrieve & use images Simple Image and Numeric Reports Create, store, manage, retrieve & use simple diagnostic reports with optional image links & measurements Evidence Documents Create, store, manage, retrieve & use objects to record study evidence Reporting Workflow Manage worklists, track status, perform & notify diagnostic reporting steps Required for workflow management Required for content Images or ED required for content Charge Posting Collect and post timely billable procedure details triggers

HIMSS/RSNAVendor Workshop, April 2003 Reporting Workflow Objectives Schedule, distribute and track the status of reporting workflow tasks using standardized mechanisms – Worklists for each task are generated and can be queried – Workitems can be performed and the resulting status known and shared

HIMSS/RSNAVendor Workshop, April 2003 Diagnostic report workflow Reporting Workflow Acquisition Modality Image Manager & Archive images stored acquisition completed images available OF/DSS work status update Output: DICOM SR Objects

HIMSS/RSNAVendor Workshop, April 2003 Actors & Transactions No new actors One new transaction: – Reporting Worklist Provided

HIMSS/RSNAVendor Workshop, April 2003 Actors & Transactions Report Manager Report Creator/ Reader IM/IA PPS Manager DSS/OF Reporting Worklist Provided Workitem Claimed Workitem PPS in Progress Workitem PPS Completed Workitem Completed MPPS Completed Image Availability Procedure Scheduled Procedure Update P. Work Status Update

HIMSS/RSNAVendor Workshop, April 2003 Grouping Report Manager grouped with Image Manager Report Manager IM/IA DSS/OF Performed Work Status Update (optional) RWF Profile SWF Profile

HIMSS/RSNAVendor Workshop, April 2003 Grouping Report Manager grouped with DSS/OF Report Manager IM/IADSS/OF RWF Profile SWF Profile Performed Work Status Update, if needed

HIMSS/RSNAVendor Workshop, April 2003 Grouping Report Manager not grouped with neither IM nor DSS Report Manager IM/IA DSS/OF Performed Work Status Update RWF Profile SWF Profile Performed Work Status Update, if needed

HIMSS/RSNAVendor Workshop, April 2003 Reporting Tasks The process of report creation is composed of multiple tasks: – Interpretation – Interpretation and dictation – Transcription – Verification – Review – Comparison – Coding

HIMSS/RSNAVendor Workshop, April 2003 Verification vs Signature Verification is considered to be different from Signature Verification may trigger a Signature Signature has policies attached to it. Signature is not part of the Reporting Workflow profile

HIMSS/RSNAVendor Workshop, April 2003 Reporting Worklist Provided Report Creator finds out what tasks have been scheduled or assigned to it by the Report Manager

HIMSS/RSNAVendor Workshop, April 2003 Reporting Worklist Provided General Purpose Worklist SOP Class Explicit definition of required matching and return keys for both Report Manager and Report Creator Report Creator implements at least one of Patient Oriented or User Oriented queries Report Manager Report Creator C-Find-RQ C-Find-RSP

HIMSS/RSNAVendor Workshop, April 2003 Patient Oriented Query Worklist for a specific patient/procedure SCU shall support all combinations of the matching keys Patient's Name Patient ID Referenced Request Sequence >Accession Number >Requested Procedure ID Scheduled Workitem Code Sequence >Code Value >Coding Scheme Designator

HIMSS/RSNAVendor Workshop, April 2003 User Oriented Query Broad worklist for a particular user being logged in on a particular station SCU must support all combinations of the matching keys General Purpose Scheduled Procedure Step Status Scheduled Station Name Code Sequence >Code Value >Coding Scheme Designator Scheduled Procedure Step Start Date and Time Scheduled Workitem Code Sequence >Code Value >Coding Scheme Designator Scheduled Human Performers Sequence >Human Performer Code Sequence >>Code Value >>Coding SchemeDesignator >Human Performers Name

HIMSS/RSNAVendor Workshop, April 2003 Reporting Workitem Codes DCMR CID 9231

HIMSS/RSNAVendor Workshop, April 2003 Reporting Workitem Codes What is scheduled – GP Worklist: scheduled workitem code sequence What is performed – GP PPS: Performed Work Item Code Sequence What is next – GP PPS: requested subsequent workitems code sequence Update – what is performed, what is next

HIMSS/RSNAVendor Workshop, April 2003 Input Availability Report Manager uses Image Availability Query to know when images are available. Report Manager and Report Creator must be able to handle workitems with PARTIAL Image Availability in a stable way.

HIMSS/RSNAVendor Workshop, April 2003 Input Information Report Creator may retrieve Input Objects using Input Information Sequence provided in the worklist response. Report Manager Report Creator C-Find-RQ C-Find-RSP IM/IA Retrieve Images, Evidence Documents

HIMSS/RSNAVendor Workshop, April 2003 Workitem Claimed Report Creator takes ownership of the workitem Report Manager updates its worklist and permits other worklist users to detect that this SPS has been claimed General Purpose Scheduled Procedure Step SOP Class Report Manager Report Creator N-ACTION, SPS in Progress

HIMSS/RSNAVendor Workshop, April 2003 Workitem Performed Procedure Step In Progress Report Creator starts work on claimed SPS General Purpose Performed Procedure Step SOP Class SPS and PPS relationships – Simple Case- Unscheduled Case – Append Case- Abandoned Case Report Manager Report Creator N-CREATE, PPS in Progress

HIMSS/RSNAVendor Workshop, April 2003 Workitem Performed Procedure Step Completed General Purpose Performed Procedure Step SOP Class Report Creator notifies Report Manager of the PPS completion Report Creator references any created results Report Manager Report Creator N-CREATE, PPS Completed

HIMSS/RSNAVendor Workshop, April 2003 Tasks Performed Report Creator may carry out several steps at once. Performed Work Item Code Sequence General Purpose Performed Procedure Step N-SET message.

HIMSS/RSNAVendor Workshop, April 2003 Output Generated Report Creator sends the list of all SOP Instances in the Output Information Sequence (0040,4033) or identifies non-DICOM output in the Non-DICOM Output Code Sequence (0040,4032). General Purpose Performed Procedure Step N-SET message.

HIMSS/RSNAVendor Workshop, April 2003 Next Workitem The Report Creator may suggest subsequent workitems to the Report Manager. It is a suggestion, a hint The requested subsequent workitems code sequence General Purpose Performed Procedure Step N-SET message.

HIMSS/RSNAVendor Workshop, April 2003 Workitem Completed General Purpose Scheduled Procedure Step SOP Class No further PPS will be created for this SPS Report Creator notifies the Report Manager when it completes the scheduled workitem Report Manager updates its worklist Report Manager Report Creator N-ACTION, SPS Completed

HIMSS/RSNAVendor Workshop, April 2003 Performed Work Status Update Report Manager informs other actors of the creation and status update of the performed reporting task Allows the systems not managing the performed work to stay in sync

HIMSS/RSNAVendor Workshop, April 2003 Performed Work Status Update General Purpose Performed Procedure Step SOP Class Performed Workitem Code Sequence Requested Subsequent Workitem Code Sequence Report Manager DSS/OF IM/IA N-CREATE, PPS in Progress N-SET, PPS Completed

HIMSS/RSNAVendor Workshop, April 2003 Diagnostic Reporting Use Cases Predefined report Workitem deferred Direct report creation Interpretation and dictation Transcription Partial completion Verification Double reading, Comparison, Review, Over read

HIMSS/RSNAVendor Workshop, April 2003 Predefined report The user chooses a report from a list of pre-configured draft reports The results are normal I will also verify the report

HIMSS/RSNAVendor Workshop, April 2003 Workitem deferred The user starts to work on the workitem and decides not to complete it. Put this workitem back on the worklist.

HIMSS/RSNAVendor Workshop, April 2003 Partial Completion The user begins the task and then decides that this task cannot be completed at this moment. Bad data quality! New acquisition is required

HIMSS/RSNAVendor Workshop, April 2003 Verification This use case has an extension when the user needs to correct the report's content by dictation Send report back to the transcriptionist for correction

HIMSS/RSNAVendor Workshop, April 2003 Questions?