Transcript Introducing SESCAM's Serendipia Project: Scope and Technologies Speakers: José Sacristán París (SESCAM, Serendipia Project Director) Juan de Dios García (SATEC, Bussiness Development Engineer) http://sescam.jccm.es.

Introducing SESCAM's
Serendipia Project:
Scope and Technologies
Speakers:
José Sacristán París (SESCAM, Serendipia Project Director)
Juan de Dios García (SATEC, Bussiness Development Engineer)
http://sescam.jccm.es
Presentation objective
I+D+i IT Model of Sescam. Engine of ideas.
We are introducing a SESCAM step towards
telepathology: Serendipia.
Geographical extension of the project, and its hardware
related supplies. (Serendipia I)
Information systems, image acquisitors, image
viewers, image and data repositories: how they all are
integrated.
Serendipia project
OBS & main roles
Sponsoring
Ambrosio Rodriguez
IT Manager
High level Management
Ismael Moreno
Systems
José Sacristán París
Serendipia Projet Director
Juan Pedro de Ruz
Jaime Jimenez
I+D+i
Dr. Marcial García
Carlos Peces Mateos
Key Stakeholders
Technical coaching
Architectural design
SATEC PMO
Project Management and
Support
HW Providers/
Manufactures
Aurora MSC
Image procesing and
web viewers
Web Image Viewer
Image searching and
forwarding for archiving
Detailed specifications
VITRO
PIS development and
integration
SATEC Development team
Web Portals and Integration
PIS development
PIS support and training
HIS and Image
Integration
Techincal Management
Specifications design
Web Portals development
Components integration
Techincal Support
“Nobody can whistle alone a Symphony. To be
Halford. E. Luccock (1943)
needed an orchestra.”
Serendipia objectives
Unifying PIS/SIAP over the selected hospitals.
Integration with MAMBRINO XXI (our HIS, in Sescam).
Storing, displaying and exchanging images for
diagnosis.
Encouraging pathologist’s collaboration
In the end, enhancing the accuracy of pathology
diagnosis in the region
Working with standards
HL7 messaging
DICOM image wrapping and messaging. Digital Imaging and
Communications in Medicine (DICOM)
DICOM WG-26 Pathology
JPEG2K and JPIP image format and services
PACS services. (PixelDataProviderURL )(UDIAT V.5.6.)
IHE Pathology technical framework. Pathology
Pathology Workflow (PWF) establishes the continuity and integrity of
basic pathology data acquired for examinations being ordered for an
identified inpatient or outpatient.
Geographical situation in Serendipia I
Alcazar
SESCAM Central Services
Alcazar’s General Hospital
* Tomelloso Hospital
Ciudad Real General Hospital
(only prototype)
* Manzanares Hospital
Albacete’s General Hospital
* Virgen del Perpetuo Socorro
Hospital
* Villarrobledo Hospital
* Almansa Hospital
Key features
Attaching macro pictures, micro pictures and
virtual slides to a study
Allowing distributed report query, with clinical and
image information
Public forums, second opinion and educational
library
Components and communication
Patólogo externo
Patólogo/
Especialista SESCAM
Datos Portal (Colaborativos)
Imágenes JPEG/JPEG2000
Datos demográficos
Datos Portal (Colaborativos)
PRESENTACIÓN GRÁFICA Selene
PRESENTACIÓN GRÁFICA Portal
Imágenes JPEG/JPEG2000
Datos demográficos
HIS
Técnico
Portal
Datos demográficos /
Registro de estudios
Solicitud de técnicas
Administrativo
PRESENTACIÓN GRÁFICA NovoPath
Registro de estudios
Imágenes JPEG
Informes de los estudios
Publicación de estudios
SIAP
Notificación de finalización
Imágenes JPEG2000/SVS
Servidor de
Imágenes
Patólogo
PACS
Almacenamiento
Ingestor de
Imágenes
Imágenes JPEG2000/SVS
Solicitud de técnicas
Almacenamiento
Almacenamiento de JPEG
SAN
Almacenamiento de JPEG2k
Solicitud de técnicas
Estación de macroscopía,
microscopía de foto fija y de autopsias
Estación microscopía
System Architecture
Publicación de informes
e imágenes.
Publicación y anonimización
de informes, DICOM y JP2K
Publicación de informes
e imágenes.
Servicios Centrales
Repositorio imágenes
anónimas
Segunda opinión
y biblioteca pedagógica
(incluyendo imágenes)
Usuario Externo
Repositorio
JPEG2K
Portal
Portal
SESCAM
Aurora Image
Server
PÚBLICO
PACS de Backup
PRIVADO
JP2K: backup
Consulta Worklist WS
ÁREA CLÍNICA 1
ÁREA
PACS: envío backup.
Consulta proxy.
CLÍNICA 2
Centro
Hospitalario 1
Repositorio imágenes
Aperio
Foro, segunda opinión,
biblioteca pedagógica y
escaneos remotos.
Inventario e incidencias.
Aurora Image
Server
Centro
Hospitalario 2
HIS
Repositorio imágenes PACS
Aperio
Ingestión Imágenes,
escaneos locales, consulta de
estudios online.
Usuario SESCAM
HIS
Repositorio imágenes
Aperio
PACS
Repositorio imágenes
Aperio
Hospital Dependiente 1.1
PIS
PIS
Hospital Dependiente 2.1
Usuario SESCAM
Repositorio imágenes
Aperio
Hospital Dependiente 1.2
Portal
Portal
Hospital Nodriza 2
Repositorio imágenes
Aperio
Repositorio imágenes
Aperio
Aurora Image
Server
Aurora Image
Server
Hospital Nodriza 1
(Edificio2) Repositorio
JPEG2K
Repositorio
JPEG2K
Hospital Dependiente 2.2
Storage commitment
de digitalizaciones remotas
Architecture Reference
Solaris 9
Ldap Server
Application
server/web
Linux RH
4.0/ias
Environment
J2EE/Aurora
Environment
SIAP
IAS/
WEB
Secondary Hospital Secondary Hospital
DB
W2003.Sql
Server 2005
Db Server
Linux RH 4.0.
Oracle
Services
Linux
Server
RH4.0
Linux
Server
RH4.0
Environment
PACS/APERIO
Tapes
Librar
y
Tapes
Librar
y
Environment
Aperio
W2003.Sql
Server 2005
Linux
Server
RH4.0
Tapes
Librar
y
Environment
Backup
Environment
Backup
Environment
Backup
Principal Hospital
Sanitel
Central Services
network
Solaris 9
Ldap Server
Servidor
LDAP
Solaris 9
Application
Entorno
server/web
Linux
J2EE/Aurora
RH 4.0/ias
Serv. Aplicaciones/Web
Linux RH 4.0/iAS
Serv. Aplicaciones/Web
Environment
Linux RH 4.0/iAS
J2EE/Aurora
BD
DB
J2EE/Aurora
Db Servers Linux
RH 4.0. Oracle
Services
SERVICIOS
Servidores PACS
W2003
SQL Server 2005
Servidor
2Gb
Librería de
cintas
Tapes
Librar
y
2Gb
Environment
Entorno
Backup
Backup
Dispositivo de Almacenamiento
Entorno
Environment
PACS/SIAP
PACS/APERIO
Servidores W2003
SQL Server 2005
W2003.Sql
Aperio Server 2005
DB
W2003.Sql
Server 2005
Linux
Server
RH4.0
W2003.Sql
Server 2005
IAS/
WEB
Db Server
Linux RH 4.0.
Oracle
Environment
PACS/APERIO
Cluster
Cluster
Linux
Backup
Linux RH
Server
RH4.0
Environment
J2EE/Aurora
Services
Servidor de BBDD
Linux RH 4.0
Oracle
Servidor de BBDD
Linux RH 4.0
Oracle
Application
server/web
Linux RH
4.0/ias
Environment
SIAP
IAS/
WEB
iAS/WEB
Public
Entorno
Público
Environment
J2EE/Aurora
Solaris 9
Ldap Server
Tapes
Librar
y
Environment
Backup
Principal Hospital
Data base Schema. Oracle 10g
Features of Sw.
User Interface
The user interface of the portal telepatología is purely
web. On the client side, HTML + AJAX technology will
be used to improve the user experience.
Regarding the Server, will use the paradigm of ModelView-Controler through the framework of Struts
through JSP & Java classes. For the presentation of
images and tasks auxiliaries perform at the team
clients, the portal embedded in a Java applet that will
run
on
JRE
1.5
or
higher.
The user interface of SIAP will be MS Access in a first
phase, this being migrated to an architecture J2EE
homogeneous with the rest of the settlement at a later
stage.
Hardware supplies
Ciudad Real Hospital
(Project Prototype)
Albacete’s Reference Hospital
x2
Alcazar’s Reference Hospital
x4
Estación Tallado
x3
Nikon
D200
Lectores
x2
x4
Microscopio
Estación Diagnostico
Impresora
portaobjetos
Estación Tallado
Estación Consulta
Impresora
puesto
Estación Consulta
Macropath
Kit camara
microscopio
Videoconferencia
x11
ScanScope XT
x8
Lectores
x3
x19
Impresora
puesto
Impresora
etiquetas
ScanScope XT
Estación Autopsias
x6
Kit camara
microscopio
Impresora
cassettes
Videoconferencia
Nikon
D200
Impresora
cassettes
Macropath
Impresora
portaobjetos
Impresora
etiquetas
Virgen del Perpetuo
Socorro Hospital
Estación Diagnostico
Microscopio+camara
Villarrobledo Hospital
Nikon
D200
v
Lectores
x2
Tomelloso Hospital
Lectores
Manzanares Hospital
Impresora
puesto
Impresora
puesto
ScanScope CS
Impresora
etiquetas
x2
v
Lectores
Macropath
ScanScope CS
Estación Tallado
Kit camara
microscopio
x4
Macropath
x3
Lectores
ScanScope CS
Estación Consulta
Nikon
D200
Estación Autopsias
Impresora
cassettes
Impresora
puesto
Nikon
D200
Microscopio+camara
x3
x3
Estación Consulta
Kit camara
microscopio
ScanScope CS
v
Lectores
Estación Consulta
Estación Tallado
Impresora
etiquetas
Impresora
portaobjetos
Impresora
puesto
Almansa Hospital
Estación Diagnostico
Estación Consulta
ScanScope CS
Macropath
Estación Tallado
Estación Autopsias
Impresora
etiquetas
x2
Estación Consulta
x2
v
Lectores
Estación Tallado
Impresora
puesto
Estación Tallado
Lectores
Hardware supplies
Account
Equipment
Images Device
5 Wireless photo cameras for autopsy rooms: NIKON D200
5 Macroscopy capture station: Macropath
11 Optical microscopy devices: Nikon DS-Fi-L2 + Nikon Eclipse 50i/55i
3 Optical microscopy devices
7 Virtual slide scanners: Aperio ScanScope XT 2+ Aperio ScanScope CS 5
Printers
5 Label printer: Zebra TLP 2844-Z
3 Cassette printer: OLYMPUS SAKURA Tissue-Tek® Auto Write
3 Slide printer: OLYMPUS SAKURA Tissue-Tek® Auto Write
27 Printers
Handheld scanners
39 Handheld scanners: DATALOGIC GRYPHON D432_2D
Workstations
5 High resolution diagnosing monitors: Barco 4Mpx
14 Workstations with 19 ' monitors
7 Workstations for registration and Sculpting
5 Autopsy workstations
Audiovisual equipment
2 Videoconferences for clinic sessions
Others
1 Rfid project
20 Tools for change photografs
Allocation in a hospital
Sculpting/Tissue processing room
Conference room
Hospital Local IT infraestructure
Workstation
USB
Macroscopic Image
Serial
Web Server
PIS DB
Web Services
USB
Codebar
reader
Cassette printer
Codebar
reader
Videoconferencing
station
Microscope + camera
PACS/JP2
HIS
(Present)
Hospital Local Area Network
Pathologist office
Autopsy room
Registration
USB
USB
Microscope + camera
Bar code
label printer
Workstation
Laser
printer
USB
Nikon
D200
Autopsy Workstation
PC
USB
USB
Codebar
reader
Laser
Printer
Codebar
reader
Hospital Local Area Network
Diagnostic room
SESCAM Network (SANITEL)
Laboratory
SESCAM Central Services
Serial
Slide printer
Diagnostic Workstation
Virtual Microscope
Aperio ScanScope
Laboratory PC
HIS
LDAP Server
Web Server
Logical Pathology Workflow
Registration, Order in Mambrino XXI
Implemented Pathology Workflow (1)
1.- Registering the study
3.- Listing the gross image worklist
2.- Requesting a gross image (generating worklist item)
4.- Capturing the gross images and uploading (attached to WLI)
Implemented Pathology Workflow (2)
5.- Study detail
4.- Distributed study query (over the region)
6.- Study image series
Physical Pathology Workflow (1)
Physical Pathology Workflow (2)
HL7 messaging: MDM^T01
The SIAP
encode and
send a
message HL7
v2.5 MDM ^
T01 in XML
format to
mark the
XMLSchema
MDM_T01.xs
d. For its part,
the web
SSCC return
a message
HL7 v2.5
ACK to mark
the
XMLSchema
ACK.xsd.
Notification of new study: MDM^T01
HL7 messaging: RSP^Z11
Asking for detailed study (Request QBP_Q11 and Answer RSP_Z11)
DICOM messaging: worklist item
132:(0002,0000) UL #4 [30] Group Length
144:(0002,0010) UI #22 [1.2.840.10008.1.2.4.94] Transfer Syntax UID
174:(0004,0EE1) UI #14 [323.21.332.11] ?
196:(0008,0050) SH #6 [90202] Accession Number
210:(0008,0090) PN #24 [Benito Goicoechea Marta] Referring Physician's Name
242:(0008,1110) SQ #-1 Referenced Study Sequence
254:>(FFFE,E000) #-1 Item
262:>(0008,1150) UI #24 [1.2.840.10008.5.1.4.32.1] Referenced SOP Class UID
294:>(0008,1155) UI #26 [192.168.1.2_1183535626745] Referenced SOP Instance UI
328:>(FFFE,E00D) #0 Item Delimitation Item
336:>(FFFE,E0DD) #0 Sequence Delimitation Item
344:(0010,0010) PN #14 [Dolores Agudo] Patient's Name
366:(0010,0020) LO #20 [12.345.678.4.13343.2] Patient ID
394:(0010,0030) DA #8 [20070704] Patient's Birth Date
410:(0010,0040) CS #2 [M] Patient's Sex
420:(0010,1000) LO #12 [161042-MA-PO] Other Patient IDs
440:(0020,000D) UI #6 [90202] Study Instance UID
454:(0032,1032) PN #24 [González Pascual Alfonso] Requesting Physician
486:(0032,1060) LO #34 [estudio paramétrico estigmatizado] Requested Procedure
528:(0040,0100) SQ #-1 Scheduled Procedure Step Sequence
540:>(FFFE,E000) #-1 Item
548:>(0008,0060) CS #2 [XC] Modality
558:>(0040,0001) AE #12 [192.164.1.1] Scheduled Station AE Title
578:>(0040,0006) PN #20 [Perez De Oca Arturo] Scheduled Performing Physician's
606:>(0040,0007) LO #12 [macroscopía] Scheduled Procedure Step Description
626:>(FFFE,E00D) #0 Item Delimitation Item
634:>(FFFE,E0DD) #0 Sequence Delimitation Item
642:(0040,0551) UI #14 [12.313.213.44] Specimen Identifier
664:(0040,06FA) UI #2 [1] Slide Identifier
674:(0040,1001) SH #6 [90202] Requested Procedure ID
688:(0040,3001) LO #30 [No RCP. Contactar con familia.] Confidentiality Constr
The website(portal) will ask
the SIAP different lists
working catchment
photographs
Macroscopic, microscopic
photo sets and autopsy by
worklists DICOM as
The standard specifies in its
IHE workflow PAT7.
DICOM images content
Patient module
Specimen module
General study module
General series module
General equipment module
General image module
Image pixel module (GROSS AND MICRO)
Image URL provider (VIRTUAL SLIDES)
(PixelDataProviderURL )
Acquisition context module
SOP common module
Screenshots: study registering
Screenshots: gross image request
Screenshots: distributed report query
Screenshots: study detail
Screenshots: study images
Screenshots: worklist and upload
Screenshots: collaboration
Challenges and benefits
Integrating several image devices is challenging
nowadays. A comprehensive and unique point to locate
images AND reports is benefit both for the user and for
the organization
Aiming for standards implantation may be quite
challenging. Software and hardware independence is
worth it
Huge image handling and storing is challenging at
some point. Diagnosis quality image definitely pays off
Thanks!