Transcript Imaging Integration for HL7 SDTC 2004-09-28.00.ppt

Integrating Imaging and
Reporting using DICOM SR
and HL7 CDA
DICOM WG20 / HL7 IISIG
Loosely Integrated Reporting
 This updates and extends a written report to WG10 in April 2004.
 Further detail is in the WG20/IISIG minutes, 2004.
• Image viewing and reporting done in different appli-cations,
on same or different (adjacent) platforms
• Reports may reference images (individual or groups)
– Linkage is no finer-grained than the report level
• References may include overlays of graphical or text
annotation
********************************************************************************
UNIVERSITY OF CHICAGO HOSPITALS
RADIOLOGY CONSULTATION
********************************************************************************
342 02/05/96
UNIVERSITY OF CHICAGO HOSPITALS
BHIS #: 1234567
INPATIENT
201-23-90
RADIOLOGY CONSULTATION
Hematology
/ Oncology
CHANDLER, CAROLYN
342 02/05/96
Mitchell-6NE
49
FEMALE 201-23-90
BHIS #: 1234567
INPATIENT
Hematology / Oncology
Admitting
Diagnosis: NEUTROPENIC FEVER; HYPERBILIRUBEMIA
Mitchell-6NE
Clinical data: Biliary tube check.
Carl
M. Gompers,
MD
Admitting
Diagnosis:
NEUTROPENIC FEVER; HYPERBILIRUBEMIA
Clinical data: Biliary tube check.
Change Perc
Drainage
CarlBiliary
M. Gompers,
MD Cath Proced
********************************************************************************
UNIVERSITY OF CHICAGO HOSPITALS
RADIOLOGY CONSULTATION
********************************************************************************
342 02/05/96
UNIVERSITY OF CHICAGO HOSPITALS
BHIS #: 1234567
INPATIENT
201-23-90
RADIOLOGY CONSULTATION
Hematology
/ Oncology
CHANDLER, CAROLYN
342 02/05/96
Mitchell-6NE
49
FEMALE 201-23-90
BHIS #: 1234567
INPATIENT
Hematology / Oncology
Admitting
Diagnosis: NEUTROPENIC FEVER; HYPERBILIRUBEMIA
Mitchell-6NE
Clinical data: Biliary tube check.
Carl
M. Gompers,
MD
Admitting
Diagnosis:
NEUTROPENIC FEVER; HYPERBILIRUBEMIA
Clinical data: Biliary tube check.
Change Perc
Drainage
CarlBiliary
M. Gompers,
MD Cath Proced
--
Change Perc Biliary Drainage Cath Proced
COMPARISON: 07/23/95 and 06/27/95
Exam #46 on 01/08/96
--
Exam #46 on 01/08/96
FINDINGS:
After the
procedure
was explained to the patient and informed
COMPARISON:
07/23/95
and 06/27/95
& Int -- Exam #47 on 02/05/96
FINDINGS: After the procedure was explained to the patient and informed
& Int -- Exam #47 on 02/05/96
FINDINGS: As above.
IMPRESSION:
FINDINGS: As above.
Successful
biliary tube change, and findings consistent with interval tumor
IMPRESSION:
growth.
Successful biliary tube change, and findings consistent with interval tumor
Simon
A. Templar, MD / Richard Nixon, MD (R19)
growth.
Signed 02/9/96 at 8:48 AM
3
Simon A. Templar, MD / Richard Nixon, MD
Signed 02/9/96 at 8:48 AM
3
(R19)
--
Change Perc Biliary Drainage Cath Proced
COMPARISON: 07/23/95 and 06/27/95
CHANDLER, CAROLYN
49
FEMALE
Exam #46 on 01/08/96
--
Exam #46 on 01/08/96
FINDINGS:
After the
procedure
was explained to the patient and informed
COMPARISON:
07/23/95
and 06/27/95
& Int -- Exam #47 on 02/05/96
FINDINGS: After the procedure was explained to the patient and informed
& Int -- Exam #47 on 02/05/96
FINDINGS: As above.
IMPRESSION:
CHANDLER, CAROLYN
49
FEMALE
FINDINGS: As above.
Successful
biliary tube change, and findings consistent with interval tumor
IMPRESSION:
growth.
Successful biliary tube change, and findings consistent with interval tumor
Simon
A. Templar, MD / Richard Nixon, MD (R19)
growth.
Signed 02/9/96 at 8:48 AM
3
Simon A. Templar, MD / Richard Nixon, MD
Signed 02/9/96 at 8:48 AM
3
(R19)
Loosely Integrated Reporting
Image Viewing
Application
Reporting
Application
Image
selection
Annotation
Dictated
report
********************************************************************************
UNIVERSITY OF CHICAGO HOSPITALS
RADIOLOGY CONSULTATION
********************************************************************************
342 02/05/96
UNIVERSITY OF CHICAGO HOSPITALS
BHIS #: 1234567
INPATIENT
201-23-90
RADIOLOGY CONSULTATION
Hematology
/ Oncology
CHANDLER, CAROLYN
342 02/05/96
Mitchell-6NE
49
FEMALE 201-23-90
BHIS #: 1234567
INPATIENT
Hematology / Oncology
Admitting
Diagnosis: NEUTROPENIC FEVER; HYPERBILIRUBEMIA
Mitchell-6NE
Clinical data: Biliary tube check.
Carl
M. Gompers,
MD
Admitting
Diagnosis:
NEUTROPENIC FEVER; HYPERBILIRUBEMIA
Clinical data: Biliary tube check.
Change Perc
Drainage
CarlBiliary
M. Gompers,
MD Cath Proced
--
Change Perc Biliary Drainage Cath Proced
COMPARISON: 07/23/95 and 06/27/95
CHANDLER, CAROLYN
49
FEMALE
Exam #46 on 01/08/96
--
Exam #46 on 01/08/96
FINDINGS:
After the
procedure
was explained to the patient and informed
COMPARISON:
07/23/95
and 06/27/95
& Int -- Exam #47 on 02/05/96
FINDINGS: After the procedure was explained to the patient and informed
& Int -- Exam #47 on 02/05/96
FINDINGS: As above.
IMPRESSION:
FINDINGS: As above.
Successful
biliary tube change, and findings consistent with interval tumor
IMPRESSION:
growth.
Successful biliary tube change, and findings consistent with interval tumor
Simon
A. Templar, MD / Richard Nixon, MD (R19)
growth.
Signed 02/9/96 at 8:48 AM
3
Simon A. Templar, MD / Richard Nixon, MD
Signed 02/9/96 at 8:48 AM
(R19)
3
GSPS
KO
“For Report”
Image Archive
Pointers to KO
“For Report” objects
Report
(SR or CDA)
Reporting System
Image Viewing
Application
Reporting
Application
Image
selection
Dictated
report
Annotation
GSPS
DICOM Query/Retrieve for
all KO objects matching
Accession Number
DICOM references
to Images & GSPSs
WADO
Server
Hematology / Oncology
Admitting
Diagnosis: NEUTROPENIC FEVER; HYPERBILIRUBEMIA
Mitchell-6NE
Clinical data: Biliary tube check.
Carl
M. Gompers,
MD
Admitting
Diagnosis:
NEUTROPENIC FEVER; HYPERBILIRUBEMIA
Clinical data: Biliary tube check.
Change Perc
Drainage
CarlBiliary
M. Gompers,
MD Cath Proced
--
Change Perc Biliary Drainage Cath Proced
COMPARISON: 07/23/95 and 06/27/95
CHANDLER, CAROLYN
49
FEMALE
Exam #46 on 01/08/96
--
Exam #46 on 01/08/96
FINDINGS:
After the
procedure
was explained to the patient and informed
COMPARISON:
07/23/95
and 06/27/95
& Int -- Exam #47 on 02/05/96
FINDINGS: After the procedure was explained to the patient and informed
& Int -- Exam #47 on 02/05/96
FINDINGS: As above.
IMPRESSION:
FINDINGS: As above.
Successful
biliary tube change, and findings consistent with interval tumor
IMPRESSION:
growth.
Successful biliary tube change, and findings consistent with interval tumor
Simon
A. Templar, MD / Richard Nixon, MD (R19)
growth.
Signed 02/9/96 at 8:48 AM
3
Simon A. Templar, MD / Richard Nixon, MD
Signed 02/9/96 at 8:48 AM
(R19)
3
Transcribed
narrative
KO
“For Report”
Image Archive
********************************************************************************
UNIVERSITY OF CHICAGO HOSPITALS
RADIOLOGY CONSULTATION
********************************************************************************
342 02/05/96
UNIVERSITY OF CHICAGO HOSPITALS
BHIS #: 1234567
INPATIENT
201-23-90
RADIOLOGY CONSULTATION
Hematology
/ Oncology
CHANDLER, CAROLYN
342 02/05/96
Mitchell-6NE
49
FEMALE 201-23-90
BHIS #: 1234567
INPATIENT
SR
Report
WADO URI references
to Images & GSPSs
Reporting System
Validation Functions
Reporting
Integration
Functions
CDA
Report
Verification Process
The verifying radiologist will either:
• Send the report back to Transcription
for correction, or
• Complete and verify the report.
– Make corrections as necessary
– Sign it
Verification Process
The verifying radiologist will either:
• Send the report back to Transcription
for correction, or
• Complete and verify the report.
– Make corrections as necessary
– Select image references (using check
boxes)
– Sign it
Deliverables
• DICOM CP451: Add “For Report” code to KO
• DICOM Supplement 101: HL7 Structured
Document Object References
– Report template to Part 16
– CDA Reference from within DICOM Documents
– Informative Annex describing translation to CDA
for this SR object
• Release 1
• Release 2
Schedule
• CP451:
• Supplement 1xx:
–
–
–
–
–
–
–
–
–
WG6 first read
WG20 review, prepare PC Draft
WG6 review
Public Comment
WG20 Review
WG6 review for LB
Letter Ballot
Wg20 Review
WG6 Final Text
 Candidate for IHE at RSNA 2006
Done.
Sept. 2004
Sept. 2004
Nov. 2004
Nov.-Dec. 2004
Jan. 2005
Mar. 2005
Apr-May 2005
May 2005
June 2005
Open Issues
• Terminology: HD or HMD?
• H(M)D OID without extension needed
• XFRM relationship in CDA R1
– need to do in Local Markup?
– any recommendations how?
• Why no Title in external document
references?
• Details of Image Reference from CDA R2