1. THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee, Wisconsin, USA Professor of Radiology – representing the American College of Radiology (ACR)

2. Introduction This presentation explores DICOM’s impact on clinical medical practice – today and tomorrow - Why do physicians work on DICOM? - How can DICOM improve medical practice? August 2014 DICOM Chengdu WorkshopCharles KahnDICOM and the Future of Medicine2

3. An Example Radiology Reporting An international effort Led by the Radiological Society of North America (RSNA) Soon to include the European Society of Radiology (ESR) Goals Improve the communication of radiology procedures Allow “data mining” of radiology results August 2014 DICOM Chengdu WorkshopCharles KahnDICOM and the Future of Medicine3

4. Radiology Reporting Library of “best practice” templates RadReport.org Standard for report templates Integrating the Healthcare Enterprise (IHE) “Management of Radiology Report Templates” (MRRT) profile August 2014 DICOM Chengdu WorkshopCharles KahnDICOM and the Future of Medicine4

5. radreport.org

7. Findings Heart Normal Lungs No acute disease [Mild biapical scarring is unchanged.] Bones Degenerative changes [Unchanged.] [The pacemaker is unchanged.] Findings Heart Normal Lungs No acute disease [Mild biapical scarring is unchanged.] Bones Degenerative changes [Unchanged.] [The pacemaker is unchanged.] Heart (RID1385) Observations section (RID28486) Normal (RID13173) Lungs (RID13437) Set of bones (RID28569)

8. Why Templates? Reduce variability of reports Improve completeness Encourage best practices Improve interoperability Support automation of report production Support validation of report content Promote data extraction August 2014 DICOM Chengdu WorkshopCharles KahnDICOM and the Future of Medicine8

9. Turkish Chinese 骨龄 Kemik Yaşı Impression (RID13170) Normal (RID13173) “Bone Age” template

10. Multiple layers of constraint Courtesy of H. Solomon HL7 v3 RIM Abstract Data Classes CDA r2 Refined Data Classes and structures for clinical documents DICOM (Sup 155) Additional requirements, templates, and business names for radiology reports Professional Content Specific content for specialized procedures v3 XML ITS Data Encoding

11. Clinical Knowledge Report Authoring Template Report Authoring Process Imaging Study Data Clinician Interpretation CDA Report Instance Templates Business Names Element CDA Structure Report Formatting Process Business Name Production Logic CDA Imaging Report Document Authoring Template Element Structure IHE MRRT RSNA RadReport Courtesy of H. Solomon

12. DICOM’s Role New “Work Item” Proposed to DICOM Standards Committee Assigned to Work Group 8 (Structured Reporting) –Harry Solomon (GE Healthcare), co-chair –Charles Kahn (ACR), co-chair August 2014 DICOM Chengdu WorkshopCharles KahnDICOM and the Future of Medicine12

13. Working Group 8 DICOM Supplement 155 Defines how radiology reports are exported into HL7 Clinical Document Architecture (CDA) CDA provides a universal format for clinical results –Integrates radiology results with entire health record –Allows “data mining” for research and quality improvement August 2014 DICOM Chengdu WorkshopCharles KahnDICOM and the Future of Medicine13

14. Why do physicians work on DICOM? Technical expertise Advocacy and communication with physician communities Contribution to international effort August 2014 DICOM Chengdu WorkshopCharles KahnDICOM and the Future of Medicine14

15. How can DICOM improve medical practice? Standards foster competition to create better products DICOM helps advance the worldwide adoption of new medical imaging technology August 2014 DICOM Chengdu WorkshopCharles KahnDICOM and the Future of Medicine15

16. Author Information Prof. Charles Kahn ckahn@mcw.edu Dept. of Radiology Medical College of Wisconsin 9200 W. Wisconsin Ave. Milwaukee, WI 53226 USA 谢谢 August 2014 DICOM Chengdu WorkshopCharles KahnDICOM and the Future of Medicine16