DICOM%20SR%20and%20CDA%20Rel%202 - PowerPoint PPT Presentation

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DICOM%20SR%20and%20CDA%20Rel%202

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Images = Structured Info. Object reference. Use/create info content. 4. Strategic process ... [ 1. Breast Imaging Report, 2. Echo] ... – PowerPoint PPT presentation

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Title: DICOM%20SR%20and%20CDA%20Rel%202


1
DICOM SR and CDA Rel 2
2
DICOM SR and CDA Rel 2
3
DICOM SR and CDA Rel 2
  • Summary Imaging Report (SIR)
  • Patient Personal Record
  • Back to Referring Physician

SIR
SIR is extract of Imaging Report
Specialized Diagnostics Intervention
  • Mammo
  • US
  • Cardiac
  • Ophthalmology

Imaging Reports
Images
Evidence Docs
  • Specialist
  • Evidence Structured Info
  • Images Structured Info

Object referenceUse/create info content
4
Strategic process
  • We had a closer look at one of our main topics
  • Structured reporting objects and templates,
    relationship with CDA Release 2
  • Actions
  • Update the Policy Paper on Structured Documents,
    also including IHE in discussion.Kevin, Niki,
    Charles, Cor. Review by Lloyd, John, Joel.
  • Have telcon with WG20/WG10/WG6 about Radiology
    report workitem scope, purpose, DICOMs help in
    adoption process, collaboration with HL7.Also
    DICOM encapsulated CDA, sup 114

5
Strategic Insights
  • 1. Today in the clinical practice we hardly see
    any application of structured and coded reporting
    beyond the evidence documents. The expectation
    and vision is that the need for structured and
    coded reporting will emerge the coming years to
    facilitate decision support, full integration in
    the patients EHR, data mining and analysis to
    improve the theoretical foundation and practice
    of medicine.
  • 2. The workload for creation of structured and
    coded reports is the most significant acceptance
    criteria for the reporting clinician. There
    should be a direct link between the guidelines
    and practice protocol and the template/document
    structure.
  • 3. The expectation is that given the broad range
    of clinical domains, broad scope of the use cases
    that need to be supported, and IT infrastructures
    and applications that are in place today, there
    will be a coexistence of both DICOM SR and HL7
    CDA for encoding structured semantics.

6
Strategic Insights
  • 4. The reporting use cases identify the need to
    exactly capture the report layout. This is
    legally required in certain jurisdictions, and
    because of human perception and readability, and
    business presentation and reimbursement. PDF is
    well suited to support these requirements.
  • 5. The assumption is that in some/many reporting
    use cases the reference to the evidence documents
    and images from the report is an important
    element in the report.
  • 6. The assumption is that the report and the
    referenced evidence documents and images have to
    be incorporated in the patient's electronic
    health record.
  • 7. Reaching agreement on clinical templates for
    specific applications is a significant challenge
    to the adoption of structured and coded
    reporting, both for the professional societies to
    generate and the IT infrastructure in the
    practice to be flexible enough to deal with these.

7
Proposed Actions
  • a. In the DICOM community we need to find and
    document at least one typical clinical use case
    where we believe DICOM SR is ideally suited to
    encode the structured report, and efficiently
    supports the whole scope of the use case
    including the verification, distribution and
    medical research. The DICOM standard has all the
    elements in place to support such an "all DICOM"
    structured reporting use case. 1. Breast Imaging
    Report, 2. Echo
  • b. DICOM should communicate to the IHE community
    its acceptance of the coexistence of DICOM and
    HL7 constructs for the purpose of structured and
    coded reports.

8
Proposed Actions
  • c. WG20 is on the right track with the ongoing
    effort to harmonize the structured report content
    between DICOM SR and HL7 CDA, because in practice
    it may well be that it is more the hospital's IT
    and application infrastructure that is the
    decisive factor for the choice of structured
    report encoding, rather than the clinical use
    case. WG20 will be supported in their activity
    to define a Diagnostic Report template by the
    activity defined in action a.
  • d. Because DICOM has a method for encapsulating
    PDF, IHE is encouraged to incorporate into the
    reporting workflow a mechanism by which DICOM SR
    is complemented by an equivalent encoding of the
    report in PDF.
  • e. Advise to the DICOM Committee to set-up a
    liaison with Physicians EHR Coalition for the
    topic of clinical guidelines and the relationship
    to structured and coded reporting.
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