Sept 13-15, 2004IHE Interoperability Workshop 1 Integrating the Healthcare Enterprise Access to Radiology Information Cor Loef Co-chair IHE Radiology Technical Committee

Sept 13-15, 2004IHE Interoperability Workshop 2 IHE Integration profiles Patient Informa- tion Reconci- liation Access to Radiology Information Consistent Presentation of Images Scheduled Workflow Basic Security - Evidence Documents Key Image Notes Simple Image and Numeric Reports Presentation of Grouped Procedures Post- Processing Workflow Reporting Workflow Charge Posting

Sept 13-15, 2004IHE Interoperability Workshop 3Overview Context Access Transactions Actor Requirements Multiple Sources Option

Sept 13-15, 2004IHE Interoperability Workshop 4 Access to Radiology Information Profile Radiology Department – Images and Reports Emergency Department Referring Physician Other Departments: - Oncology - Surgery - Neurology - Pediatrics - etc. Remote Clinics Electronic Medical Record

Sept 13-15, 2004IHE Interoperability Workshop 5 Access to Radiology Information Access to Information Generated in Radiology: Radiological Results ( Reports ) Radiological Images Image Presentations ( Display Consistency, Layout, Graphics,... ) Key Image Notes ( Flagged Significant Images, Physician Notes ) Providing Easy Access Throughout the Healthcare Enterprise: Internally to Radiology, but also From Other Departments Such As: Cardiology Oncology Operating Room / Surgery... Consistent Information Access: DICOM Query/Retrieve Provides the Premises for Enabling EMR Solutions ( Electronic Medical Record )

Sept 13-15, 2004IHE Interoperability Workshop 6 Access to Radiology Information Query and Retrieve Images Image Archive Image Manager Image Display Report Reader Report Repository Query and Retrieve Presentation States Query and Retrieve Key Image Notes External Report Repository Query and Retrieve Reports

Sept 13-15, 2004IHE Interoperability Workshop 7 Query Retrieve of Images r Defines Matching keys for response filtering by Image Archive r Defines Return keys to be requested by Image Display r Defines Returned attributes by Image Archive in query responses r Defines Returned attributes required to be displayed on Image Display C-FIND-RQ (with matching and return keys) C-FIND-RSP (matches with return keys) Image Display Image Archive

Sept 13-15, 2004IHE Interoperability Workshop 8 IHE Generic Keys for Query Retrieve of: - Images - GSPS - SR R = Required and the SCU shall be able to display R+ = IHE Requirement on top of DICOM

Sept 13-15, 2004IHE Interoperability Workshop 9 Image Specific Query Keys

Sept 13-15, 2004IHE Interoperability Workshop 10 Presentation State Specific Query Keys

Sept 13-15, 2004IHE Interoperability Workshop 11 Key Image Note Specific Query Keys

Sept 13-15, 2004IHE Interoperability Workshop 12 Report Specific Query Keys

Sept 13-15, 2004IHE Interoperability Workshop 13 Access to Radiology Information The relevant Query Matching and Return key are required to enable an easy search for the pertinent objects in the Radiology domain Access to this Radiology information may also be achieved by means of these DICOM methods from other departments. However, it’s likely that web distribution standards will have an impact here. This IHE Integration Profile is the cost effective solution for finding the pertinent information for the patient in the Radiology domain.

Sept 13-15, 2004IHE Interoperability Workshop 14 Multiple Sources Option  Describes how both Image Displays and Report Readers can query multiple information sources.  Allows user access to distributed Radiology information  This is not prohibited by current ARI definition, this option just calls out specific support for a particular feature.

Sept 13-15, 2004IHE Interoperability Workshop 15Motivation  Historical tight coupling between Image Displays and Image Manager/Archive  Information stored in other systems was either ignored or simply unavailable  Ultrasound mini-PACS  Cardiology PACS  Another Radiology PACS  “Legacy” Archive  …

Sept 13-15, 2004IHE Interoperability Workshop 16 Actor Requirements To claim support for this profile option…  Image Display shall be able to query and retrieve from multiple Image Manager / Image Archives.  Report Reader shall be able to query and retrieve from multiple Report Repositories.

Sept 13-15, 2004IHE Interoperability Workshop 17 Actor Requirements, cont’d To claim support for this profile option…  Image Manager and Report Manager shall support the Patient Information Reconciliation integration profile. This profile option assumes all actors are members of the same ADT domain.

Sept 13-15, 2004IHE Interoperability Workshop 18 The Details For Image Display or Report Reader  Query to multiple other remote information stores shall be triggered with only one user request.  In the event of failed communications with remote information store, successfully received results from other stores shall be displayed to the user along with indication of having potentially incomplete results.  Differences in handling duplicates in study-level and series-level queries vs. object-level queries.  Shall manage duplicate instances in manner that avoids redundant retrieval.

Sept 13-15, 2004IHE Interoperability Workshop 19 More information…. IHE Web sites: Technical Frameworks: ITI V1.0, RAD V5.5, LAB V1.0 Technical Framework Supplements - Trial Implementation May 2004: Radiology August 2004: Cardiology, IT Infrastructure Non-Technical Brochures : Calls for Participation IHE Fact Sheet and FAQ IHE Integration Profiles: Guidelines for Buyers IHE Connect-a-thon Results Vendor Products Integration Statements