Managing the Acquisition Workflow

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Managing the Acquisition Workflow

• Nikolaus Wirsz, PhD
• Siemens HealthcareMember of the DICOM Standards
  Committee and Working Group Ten Strategic
  Advisory

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Managing theAcquisition Workflow

• Introduction
• Modality Worklist
• Modality Performed Procedure Step
• Storage Commitment
• Instance Availability Notification
• Conclusions

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Introduction

• DICOM Constructs
• Information Object Definitions (IOD) Images,
  Evidence Documents
• Service Class Specifications Storage,
  Query/Retrieve,
• Data Structures and Semantics
• Message Exchange
• to support
• User Tasks
• Interactions Between Systems
• Process Steps in the Diagnostic Chain
• and improve clinical processes
• Acquisition Workflow
• Post-Processing Workflow
• Reporting Workflow

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The Acquisition Workflow

• Sustain Optimize Process Tasksin the Radiology
  / Imaging Department
• Data Entry
• Procedure Scheduling
• Image Acquisition
• Procedure Tracking
• Image Storage Management
• Unobstructed Information FlowAssembling the
  Puzzle
• Key DICOM Services forAcquisition Workflow
  Support
• Modality Worklist
• Modality Performed Procedure Step
• Storage with Storage Commitment
• Instance Availability Notification

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Modality Worklist (MWL)

• Provide Demographics, Procedure and Schedule
  Details to the Modality
• Modality (SCU) Queries the RIS (SCP)
• Query Matching Key Attributes
• Date / Time of Procedure
• Modality Type (e.g. CT)
• Station AE Title (a specific Device)
• Patient Name / ID
• Accession (identifies an Imaging Order)
• Requested Procedure ID
• Query Examples
• Todays Worklist
• CT Procedures Worklist
• CT Room 1 Worklist
• John Does Procedures of a Chest Imaging Order

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Modality Worklist (MWL)

• RIS (SCP) Returns Query Results to Modality (SCU)
• Null (No Match)
• One or More Worklist Entries
• Worklist Entry (Unit of Service) Scheduled
  Procedure Step (SPS)
• Query Return Key Attributes
• Patient Data
• Name, ID, Demographics
• Allergies, Special Conditions
• Scheduling Information
• Date / Time
• Procedure Information
• Description, Protocol Codes
• Contrast Medication Administration
• Order Information
• Accession , Study UID
• Requesting Physician
• ...

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Modality Worklist (MWL)

• Deployment of the Modality Worklist Service
• Modalities Query Receive Worklists from RIS
• Modality Displays Worklist to Operator
• Operator Selects a Worklist Entry (SPS) to
  Perform
• Acquisition of Images(Based on SPS Details)
• Insert Patient Procedure Datainto the Image
  Header
• Benefits of Using the Modality Worklist
• Eliminate Redundant Data Capture
• Avoid Error-Prone Manual Tasks
• Facilitate Data ConsistencyUnambiguous
  Association of Images to Proper Patient /
  Procedure

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Modality Performed Procedure Step (MPPS)

• Feedback Acquisition Data to Scheduling System
  (RIS)
• Modality (SCU) Sends Acquisition Information to
  the RIS (SCP)
• Tracking of Modality Procedure Status
• IN PROGRESS MPPS N-CREATE
• COMPLETED MPPS N-SET
• DISCONTINUED MPPS N-SET(incl. Reason for
  Discontinuation)
• Logging of Procedure Related Data
• Identification Attributes
• Accession
• SPS ID
• Patient Name / ID / Demographics
• ...
• List (Series) of Images
• Protocol Codes for the Actually Performed
  Acquisition
• Materials Used (Chemicals, Supplies)
• Radiation Dose Exposure Values

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Modality Performed Procedure Step (MPPS)

• MPPS Use Cases (according to IHE)
• Benefits of Using MPPS
• Keeping Schedules Up-to-date
• Better Management of Resources
• Gather Information Required for Billing
• Trigger for Subsequent Processes
  Post-Processing, Reporting

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Storage with Storage Commitment

• Secure Ownership and Safekeeping of Clinical
  Results
• Modality (SCU) RequestsStorage Commitment from
  PACS (SCP)
• Modality Transmits Images (or other Objects) to
  PACS
• C-STORE Operations for Images
• Modality Issues Storage Commitment Request to
  PACS
• N-ACTION including List of Instances to Retain
• PACS Notifies Modality of Success (or Failure)
• N-EVENT-REPORT

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Storage with Storage Commitment

• Benefits of Using Storage Commitment
• Confidence in a Dependable Storage of Clinical
  Evidence
• Eliminate Double-Check / Manual Confirmation Time
• Avoid Loss of Clinical Information due to
• Network Troubles
• Storage Breakdowns
• Avoid Unnecessary Re-Examinations(Reduce
  Radiation Exposure)
• Modality can Remove Images from Local Storage
  andRe-Use Available Space for Exams to Follow

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Instance Availability Notification (IAN)

• Inform about Availability of Image Data
• PACS (SCU) Notifies the RIS (SCP) thatImages are
  Available for Retrieval Use
• List of Instances (Images)
• Location (Retrieve SCP) of Images
• Availability Status
• Online
• Nearline
• OffLine
• Unavailable
• Use of IAN to InitiateSubsequent Processes
• Post-Processing
• Interpretation / Reporting
• Distribution of Images to Other Locations

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Instance Availability Notification (IAN)

• Benefits of Using Instance Availability
  Notification
• In-Time Notification Avoids Excessive Queriesfor
  the Whereabouts of Images
• Completion of Acquisition WorkflowReady-to-Use
  Results
• Enable Transition to the Next ProcessSteps of
  the Imaging Workflow
• Allow for Timely Preparations ofTasks Resource
  Allocation for
• Additional Procedures
• Post-Processing
• Reporting
• Patient Transfer / Discharge

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Integrating the Healthcare Enterprise

• Forum (Organization) for AdvancingIntegration in
  Clinical Practice
• Interoperability Frameworks forImplementing and
  DeployingStandards-Based (HL7
  DICOM)Integrated Solutions
• IHE Integration Profiles
• Interoperability Building Blocks toSolve
  Specific Integration Issuese.g. Workflows
• Packages of DICOM / HL7 Servicese.g. Scheduled
  (Acquisition) Workflow(SWF) Integration Profile
• Refer to IHE Radiology Technical Framework
  Vol. I Scheduled Workflow (SWF) Integration
  Profile http//www.IHE.net/Technical_Framework/

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Conclusions

• DICOM Services for Acquisition Workflow
  Management
• Improve Interoperability of Imaging Equipment
• Ensure Data Consistency
• Facilitate Reliable Data Management
• Improve Process Efficiency
• Better Quality ofImaging Services

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References
http//medical.NEMA.org/
http//www.HL7.org/
http//www.IHE.net/
Thank you for your attention !