Transcript REQUESTED PROCEDURE - IHE Product Registry

Integrating the Healthcare Enterprise
Presentation of Grouped Procedures
Charles Parisot, GE Healthcare
IHE IT Radiology Planning and Technical Committees
February 8, 2005
1
IHE Europe Educational Event
IHE Integration profiles
Patient
Information
Reconciliation
Scheduled Workflow
Charge
Posting
-
Presentation
PostReporting
of Grouped Processing
Workflow
Procedures Workflow
Consistent
Evidence
Presentation
Documents
of Images
Key Image
Notes
Simple
Image and
Numeric
Reports
Access to Radiology Information
Basic Security
February 8, 2005
2
IHE Europe Educational Event
IHE Integration profiles
Scheduled Workflow
Patient
Information
Reconciliation
Charge
Posting
-
Presentation
PostReporting
of Grouped Processing
Workflow
Procedures Workflow
Consistent
Evidence
Presentation
Documents
of Images
Key Image
Notes
Simple
Image and
Numeric
Reports
Access to Radiology Information
Basic Security
February 8, 2005
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IHE Europe Educational Event
IHE Scheduled Workflow
Patient Registration/Update
Order Management
Worklist
RIS
Modality Worklist
Procedure Scheduled
Store Images
Storage
Commitment
List of Images
Storage Commitment
A Closed Loop
Performed Step:
Modality
Performed
Procedure
Step
•Update IS Scheduling
•Match Procedure with Order
•Support Billing Based on MPPS
•Avoid Reading incomplete Procedures
Status = Completed
Performed CT Head
Pat Name/ID, Dose,
Accession #, Study UID
Complete List of Images
February 8, 2005
PACS &
Archive
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IHE Europe Educational Event
IHE Workflow Concepts
IHE identifies four fundemental workflow information units :
ORDER :
REQUESTED PROCEDURE :
A request for radiologic service
A Unit of Reporting Work
with associated codified, billable acts
Procedure Steps : The smallest unit of work in the workflow:
SCHEDULED PROCEDURE STEP:
‘A unit of work to do’
PERFORMED PROCEDURE STEP:
‘A unit of work done’
February 8, 2005
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IHE Europe Educational Event
IHE Workflow is User Driven
Information Unit
has its
Prime User
ORDER:
A request for imaging service
(Accession Number)
CLINICIAN
OR REFERING DOC:
The Imaging Dept Customer
REQUESTED PROCEDURE :
Units of work resulting in one Report
RADIOLOGIST :
In Charge of producing
the Report
with associated codified, billable acts
(Requested Procedure ID)
TECHNOLOGIST
(and RADIOLOGIST)
In charge of acquiring
images, etc.
PROCEDURE STEP :
The smallest unit of work
in the workflow
(modality worklist entry)
February 8, 2005
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IHE Europe Educational Event
IHE Workflow is User Driven
Information Unit
has its
Prime User
ORDER:
A request for imaging service
(Accession Number)
CLINICIAN
OR REFERING DOC:
The Imaging Dept Customer
REQUESTED PROCEDURE :
Units of work resulting in one Report
RADIOLOGIST :
In Charge of producing
the Report
with associated codified, billable acts
(Requested Procedure ID)
TECHNOLOGIST
(and RADIOLOGIST)
In charge of acquiring
images, etc.
PROCEDURE STEP :
The smallest unit of work
in the workflow
(modality worklist entry)
February 8, 2005
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IHE Europe Educational Event
Normal Workflow
Typical workflow: One Order – One Procedure – One Report
ORDER
Radiology Department
A request for
Radiologic Requested
Service
Procedure
Report
Acquisition Modality
Set of
Codifiable,
Billable,
Acts
One or more
series of
images
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IHE Europe Educational Event
Multiple Modality Steps
ORDER
A request for
Radiologic
Service
DICOM
Modality Worklist Radiology Department
Scheduled
Procedure
Step A
Performed
Procedure
Step P1
Requested
Procedure
One or
more series
of images
1
Scheduled
Procedure
Step B
Report
Set of
Codifiable,
Billable, Acts
Performed
Acquisition
Procedure
Step P2 Modality
DICOM
Modality Worklist
One or
more series
of images
Acquisition
Modality
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IHE Europe Educational Event
Multiple Modality Steps (Append)
ORDER
A request for
Radiologic
Service
DICOM
DICOM
Modality
ModalityWorklist
WorklistRadiology Department
Scheduled
Procedure
Step A
Performed
Procedure
Step P1
Requested
Procedure
Report
One or
more series
of images
1
Set of
Codifiable,
Billable, Acts
Performed
Procedure
Step P2
One or
more series
of images
Acquisition
Modality
February 8, 2005
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IHE Europe Educational Event
Discontinued Procedure Step
ORDER
A request for
Radiologic
Service
DICOM
Modality Worklist Radiology Department
Requested
Procedure
1
Report
Scheduled
Procedure
Step A
Set of
Codifiable,
Billable, Acts
Performed
Procedure
Step P1
One or
more series
of images
Acquisition
Modality
Requested
Procedure
2
Scheduled
Procedure
Step C
February 8, 2005
No
Performed
Procedure
Step
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IHE Europe Educational Event
February 8, 2005
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IHE Europe Educational Event
The Group Case Approach
One Order – Two Procedures – One Acquisition - Two Reports
Step
Radiology Department
ORDER
A request for
Radiologic
Requested
Service
Procedure
CT Chest & CT Chest
Abdomen
Report
Acquisition Modality
Requested
Procedure
CT
Abdomen
February 8, 2005
CT Chest
Report
One or more
series of
images
13
CT Abdo
Set of
Codifiable,
Billable,
Acts
Set of
Codifiable,
Billable,
Acts
IHE Europe Educational Event
Group Case
DICOM
Modality Worklist
ORDER
A request for
Radiologic
Service
Requested
Procedure
1
Requested
Procedure
2
Radiology Department
Report
Scheduled
Procedure
Step A
Performed
Procedure
Step P1
Scheduled
Procedure
Step B
One or
more series
of images
Report
Set of
Codifiable,
Billable, Acts
Set of
Codifiable,
Billable, Acts
Acquisition
Modality
February 8, 2005
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IHE Europe Educational Event
Is Grouping of Procedures a common need ?
CT Chest/Abdomen/Pelvis
Neuroradiology: CT Neck & CT Chest
MR Imaging of different sections of the spine
MRI and MRA of vessels acquired together
MRI of the head and neck with specialized coils
Direct radiography (DR) in a trauma patient: AP images, then move
the patient once to acquire a set of orthogonal images, and then
regroup by body part
Sonographic evaluation of the kidneys and of the abdomen
CT of the pelvis with CT angiographic runoff
Angiographic studies of multiple vessels mixed with therapeutic
interventions on selected segments.
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IHE Europe Educational Event
Why is the Grouping of Procedures a significant
need ?
• Optimize patient comfort
• Optimize time of image acquisition.
But, there is the need to:
Maintain the link back to each one of the grouped
procedures without breaking the acquisition apart.
Ensure that each image subset related to a requested
procedure is identified and ready to be presented. This is
key for quick display of new and prior studies.
In the film world, images are manually sorted. In the filmless world, images should be sorted automatically when
displayed
February 8, 2005
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IHE Europe Educational Event
Grouping of Procedures in IHE
Group Case support is required by the IHE
Scheduled Workflow Integration Profile on Image
Managers (PACS) and Order Fillers (RIS).
Its support is optional on Modalities.
February 8, 2005
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IHE Europe Educational Event
IHE Integration profiles
Patient
Information
Reconciliation
Scheduled Workflow
Charge
Posting
-
Presentation
PostReporting
of Grouped Processing
Workflow
Procedures Workflow
Consistent
Evidence
Presentation
Documents
of Images
Key Image
Notes
Simple
Image and
Numeric
Reports
Access to Radiology Information
Basic Security
February 8, 2005
18
IHE Europe Educational Event
IHE Integration profiles
Patient
Information
Reconciliation
Scheduled Workflow
Charge
Posting
-
Presentation
of Grouped
Procedures
PostReporting
Processing Workflow
Workflow
Consistent
Evidence
Presentation
Documents
of Images
Key Image
Notes
Simple
Image and
Numeric
Reports
Access to Radiology Information
Basic Security
February 8, 2005
19
IHE Europe Educational Event
IHE Integration profiles
Patient
Information
Reconciliation
Scheduled Workflow
Charge
Posting
-
Presentation
of Grouped
Procedures
PostReporting
Processing Workflow
Workflow
Consistent Evidence
Presentation Documents
of Images
Key Image
Notes
Simple
Image and
Numeric
Reports
Access to Radiology Information
Basic Security
February 8, 2005
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IHE Europe Educational Event
IHE Integration Profiles
Scheduled Workflow
Admit, order, schedule,
acquire images, notify of
completed steps
+
Consistent
Presentation of
Images
Softcopy
grayscale and
presentation state
Presentation of
Grouped Procedures
Required for
Presentation of Subsets of
a Single Acquisition
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IHE Europe Educational Event
IHE – Presentation of Grouped Procedures
Requested
Procedure:
CHEST
Report:
CHEST
ABDOMEN
Requested
Procedure:
Chest
View
ABDOMEN
Scheduled
Procedure
Step Chest
Scheduled
Procedure
Step Abdo
Report:
Abdomen
View
RIS / PACS
MODALITY
Performs
a single exam
Chest
View
Abdomen
View
Operator
groups
2 procedures
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IHE Europe Educational Event
Presentation of Grouped Procedures
Improves workflow, overall efficiency of care and
reduces costs of providing services:
Lowers barriers to migration to digital radiology practice
Optimizes use of newer & faster acquisition devices
Improves clarity and access to Radiology results
Simplifies and facilitates billing of grouped procedures
Enhances softcopy interpretation throughput
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IHE Europe Educational Event
February 8, 2005
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IHE Europe Educational Event
More information….
IHE Web sites:
http://www.rsna.org/IHE
Technical Frameworks:
•
RAD V5.5
Technical Framework Supplements - Trial Implementation
•
May 2004: Radiology
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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IHE Europe Educational Event