Transcript SINR and KIN Profiles - IHE Product Registry

Integrating the Healthcare Enterprise
Key Image Notes
Simple Image & Numeric Report
Evidence Documents
Sanjay Jain
Co-Chair, Radiology Planning Committee
February 8, 2005
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IHE Europe Educational Event
Value Proposition
Share diagnosis, reports and images
Standard mechanism to communicate with the
referring physicians
Enable Automated handling based on coded data
 E.g. Routing
 Mammo Follow-up and checking
 Clinical trials
Avoid dependence only on memory
Paper, audio ..
Data mining
February 8, 2005
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IHE Europe Educational Event
Don’t Call Us, We’ll Call You
“Dave, you read that 3000 slice MR study last
night. Can you highlight the 5 most important
images for me”
 Thinking… “#$@%!%# You”, says “Sure”
“Dr. Channin, I just reviewed 40 cases and
marked my questions on yellow stickies. Can you
review those”
Tech to radiologist: “The patient wouldn’t hold
still”
The solution is……
February 8, 2005
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IHE Europe Educational Event
IHE Radiology Integration Profiles
Charge
Posting
Scheduled Workflow
-
Patient
Info.
Reconciliation
Presentation
of Grouped
Procedures
NM
Image
Consistent
Presentation of
Images
PostProcessing
Workflow
Evidence
Docs
Reporting
Workflow
Key
Image
Notes
Simple
Image &
Numeric
Reports
Access to Radiology Information
Portable Data for Imaging
Basic Security
February 8, 2005
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IHE Europe Educational Event
for referring physician
Here you can
see the renal
osteopathy.
For teaching
Fibroosteoclasia
February 8, 2005
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Note2
Note3
for referring physician
for referring physician
for
physician
Here you can
seereferring
the
This is the hematoma.
renal rupture.
Hematoma everywhere
Note1
Different notes on different images
Note1
for refering physician
Here you can see the
renal rupture.
Note2
for refering physician
This is the hematoma.
Same note on different images
Note3
for refering physician
Hematoma everywhere
Note3
for refering physician
Hematoma everywhere
February 8, 2005
Note3
for refering physician
Hematoma everywhere
Note3
for refering physician
Hematoma everywhere
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IHE Europe Educational Event
Key Image Notes Titles are Coded
Defined by DICOM Supplement 59. May be extended
Codes
The note title defines the semantics
of the reason of significance.
Of Interest
Rejected for Quality Reasons
For Referring Provider
For Surgery
Key Image Notes can be queried by
code.
For Teaching
For Conference
For Therapy
For Patient
The user comments are meant to be
informal.
For Peer Review
For Research
Quality Issue
Reporting (CP in ballot)
February 8, 2005
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IHE Europe Educational Event
Key Image Notes
There is more to teamwork than images and reports
With IHE, it is possible to attach « electronic post-it™ » to
images to increase informal but critical communication
between:
 The Technologist and the Radiologist about specific examination events
 The Radiologist and the Technologist about image quality issues
 The Radiologist and other department clinicians (surgeon, orthopedist,..)
 The Radiologist and collegues about selecting images for conferences
 The Radiologist to the Referring Provider, …..etc.
Query for the Images/Studies using the codes
This IHE Integration Profile is the cost effective solution
(increases radiology and overall efficiency)
February 8, 2005
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IHE Europe Educational Event
Evidence Documents
Header:
Report Type:
Findings:
OB / Gyn
…..
BPD
...
…..
Query / Retrieve
Image Refs.:
Evidence Document Stored
Storage Commitment
February 8, 2005
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IHE Europe Educational Event
Evidence Documents
Measurements and coded data
 DICOM SR document
Created by either Acquisition Modality or
Evidence Creator
Produced during acquisition or postprocessing workflows
Interpreted along with the images
February 8, 2005
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Evidence Documents
Examples
Mammography CAD
Chest CAD
OB-Gyn Ultrasound Measurements
Vascular Ultrasound Measurements
Vascular Intervention Results
Echocardiography Measurements
February 8, 2005
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IHE Europe Educational Event
Evidence
Documents
Simple Image &
Numeric Report
Header:
Header:
Report Type:
Findings:
Radiology Report
Report Type:
OB / Gyn
…..
BPD
...
…..
OB / Gyn
…..
Findings:
BPD
...
…..
Impressions:
Gestational
Age
Interpretation
...
Image Refs.:
Image Refs.:
Key Image Notes
February 8, 2005
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IHE Europe Educational Event
Can You Make A Report Like This?
Institution Identification
Patient Identification
Study Identification
Technique Identification
Discussion
The liver is normal. There is a focal area of
decreased attenuation adjacent to the falciform
ligt., likely representing focal fat (image 22). The
spleen, both kidneys, the … are normal.
Impression
CT of the abdomen within normal limits
Signature
February 8, 2005
The solution is……
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IHE Europe Educational Event
(We can’t either). What about?
Discussion
Comparison is made to the prior study of 4/11/99.
The left paratracheal lymph node (image 8, image
11) now measures 2.5x2.7x3.1 cm increasing from
2.0x2.1x2.6 previously. No other mediastinal,
upper abdominal or axillary adenopathy is
identified. No focal pulmonary lesions are seen.
The yadda, yadda, yadda are normal.
Impression
Worsening L Paratracheal adenopathy.
Signature
February 8, 2005
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IHE Europe Educational Event
IHE Radiology Integration Profiles
Charge
Posting
Scheduled Workflow
-
Patient
Info.
Reconciliation
Presentation
of Grouped
Procedures
NM
Image
Consistent
Presentation of
Images
PostProcessing
Workflow
Evidence
Docs
Reporting
Workflow
Key
Image
Notes
Simple
Image &
Numeric
Reports
Access to Radiology Information
Portable Data for Imaging
Basic Security
February 8, 2005
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IHE Europe Educational Event
Simple Image
and
Numeric Reports
February 8, 2005
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Simple Image
& Numeric
Reports
• Based on DICOM SR
• Allows to include
without transcription:
- measurements
- image links
- structured content
• Integrated with the
imaging workflow
• Friendly to XML
implementations
• Easy to export to the
EPR (HL7)
February 8, 2005
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IHE Europe Educational Event
Pattern – Simple Image Report
1
Observation
Context
(See section
5.3.2.3)
0-1
Observation
Context
(See section
5.3.2.3)
Document Title
1-n
CONTAINS
Section Heading
CONTAINS
0-n
0-n
Report Text
Image Reference
INFERRED
FROM
0-n
0-n
Coded Entry
INFERRED
FROM
0-n
Image Reference
Image Reference
• Minimal Structure : Coded Title and Headings
• Full image links from specific sections of report
• Observation Context (who, what, when) may be section specific
February 8, 2005
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Pattern – Simple Image &
Numeric Report
HAS OBS
CONTEXT
Document Title
1
Observation
Context
(See section
5.3.2.3)
0-1
Observation
Context
(See section
5.3.2.3)
CONTAIN
S
HAS OBS
Section Heading
CONTEXT
1-n
0-n
0-n
Report Text
0-n
Image Reference
INFERRED
FROM
Image Reference
CONTAIN
S
0-n
0-n
Measurement
0-n
Measurement
Image Reference
0-n
Coded Entry
INFERRED
FROM
0-n
Measurement
Simply adds Measurements to Simple Image Reports
February 8, 2005
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IHE Europe Educational Event
An Illustration
Chest, PA & Lateral (GCS,T78)
Dr Andrew Smith
…….
George Jones
…...
Procedure
PA and Lateral radiographs were …….
Findings
The PA demonstrates ... A small opacity
is visible in the base of lung in lateral
view. Image 32
CT recommended.
Conclusions
Possible Mass (ICD,XXX)
February 8, 2005
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IHE Europe Educational Event
Simple Image and Numeric Report
Reports’ content is more than words…..
SINR is the Output of Interpretation, while Evidence
documents are Input for Interpretation
With IHE, it is possible to add value to
reports/preliminary reports by organizing content
This IHE Integration Profile is the cost effective
solution to sharing reports and enabling content
processing applications (increases radiology
efficiency)
February 8, 2005
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IHE Europe Educational Event
More information….
IHE Web sites:
http://www.himss.org/IHE
http://www.rsna.org/IHE
http://www.acc.org/quality/ihe.htm.
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
February 8, 2005
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