1 / 20

Evidence Documents Profile (ED)

Evidence Documents Profile (ED). Harry Solomon GE Healthcare Co-chair, IHE Cardiology Technical Committee. What are Evidence Documents?. Intermediate products between acquisition and clinical reporting Data derived from primary evidence (images, waveforms), such as measurements

maeve
Download Presentation

Evidence Documents Profile (ED)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Evidence Documents Profile (ED) Harry Solomon GE Healthcare Co-chair, IHE Cardiology Technical Committee

  2. What are Evidence Documents? • Intermediate products between acquisition and clinical reporting • Data derived from primary evidence (images, waveforms), such as measurements • Manually and/or automatically derived • Data associated with performance of acquisition steps • Procedure logs • Created by either Acquisition Modality or Evidence Creator (workstation or automated process) • Produced during acquisition or post-processing workflows • Interpreted along with the images and other acquired data in the production of the clinical report Interoperability Strategy Workshop

  3. The State of the Kludge The State of the Art • Measurements made on modality or workstation, and written onto a paper worksheet, then transcribed into a report • Measurements output to a printer port, intercepted by an application that scrapes the values • Screen capture of measurements sent to a reporting system, which uses OCR (optical character recognition) to reconstruct the original measurement names and numbers • Error-prone, inefficient, hard to configure, hard to manage Interoperability Strategy Workshop

  4. Evidence Documents Profile Abstract / Scope • Management of DICOM Structured Report (SR) formatted measurements, logs, CAD results • Creation, storage, and review • Inclusion of measurements into reports Interoperability Strategy Workshop

  5. DICOM SR ExampleMeasurement Echocardiography Measurement Patient: Doe, John Technologist: der Payd, N Measurements: Mitral valve diameter 3.1cm - shown in image at [ ] Ventricular length, diastolic 5.97 cm - shown in image at [ ] Ventricular volume, diastolic 14.1 ml - inferred from [ ] - inferred from VLZ algorithm Interoperability Strategy Workshop

  6. DICOM SR ExampleProcedure Log Catheterization Procedure Log Patient: Doe, John Technologist: Logger, H. Moe 11:15:37 Patient admitted 11:18:39 Physician arrived - ver Payd, O 11:20:46 Patient prepped and draped 11:22:07 Drug administered - Agent: D51/2NS - Volume: 400 ml - Rate: 30 ml/hr - Route: IV 11:22:13 Vital signs - NIBP Systolic: 105 mm(Hg) - NIBP Diastolic: 59 mm(Hg) - HR: 101 /min - Resp: 21 /min 11:23:16 Consumable: 7Fr sheath 11:24:11 Sheath inserted - Right Femoral Artery ... 11:41:08 Catheter placed - Left Ventricle 11:41:21 Waveform acquired [ ] - Modality: HD - Technique: Aortic valve pullback 11:43:11 Drug administered - Agent: Omnipaque - Volume: 30 ml - Rate: 20 ml/s - Route: power injection 11:43:29 Image acquired [ ] - Modality: XA - Number of frames: 77 - Positioner primary angle: 30 deg - Positioner secondary angle: 60 deg ... Interoperability Strategy Workshop

  7. DICOM SR ExampleComputer Aided Detection Mammography CAD Results Patient: Doe, Jane Overall Findings: Successful analysis - Suspicious abnormality, biopsy should be considered - Follow-up immediately Feature: Mass Scope: Detected on multiple images Algorithm: Lesion Analyzer V.1.3 Pathology: Lobular carcinoma in situ Image: [ ] Feature: Calcification ... Interoperability Strategy Workshop

  8. DICOM SR Features • Structured content • Lists, hierarchies and relationships • Numeric measurements, coded values • Automatically extractable for database, data mining • References to images, waveforms, other objects • Explicit contextual information • Unambiguous documentation of meaning Interoperability Strategy Workshop

  9. The SR Content Treeand SR Templates • Data structured in hierarchical Content Item Tree • Structure of tree, relationships between items, and concepts and values encoded in items are constrained by Templates Root Content Item Document Title Content Item Content Item Content Item Content Item Content Item Content Item Content Item Interoperability Strategy Workshop

  10. Evidence Documents Profile Value Proposition • DICOM SR provides a standard interface for measurements, procedure logs, and CAD results • Eliminates manual recording/transcribing steps • Minimizes vendor-specific configuration • DICOM Templates define semantically interoperable measurement names and consistent hierarchical structuring • Allows automated processing on creator and receiver • The Evidence Documents Profile specifies actors and transactions for exchanging measurements leveraging the image exchange data flow • Consistent with Scheduled Workflow, Cath, and Echo Profiles Interoperability Strategy Workshop

  11. Evidence Documents ProfileTransaction Diagram Report Evidence Creator Image Display Creator RAD-10: Storage ¯ RAD-43: Evidence ¯ RAD-44: Query Evidence Documents ¯ Commitment Documents Stored ¯ RAD-45: Retrieve Evidence Documents Image Image Manager Archive RAD-43: Evidence RAD-10: Storage ­ Documents Stored ­ Commitment Acquisition Modality Interoperability Strategy Workshop

  12. Evidence Documents ProfileActors • Acquisition Modality – A system that acquires and creates medical images or waveforms while a patient is present, and that may also create other evidence objects such as measurements. • Evidence Creator – A system that creates additional evidence objects, such as derived images or measurements. • Image Manager / Image Archive – A system that provides long term storage and management of images and other evidence objects. • Image Display – A system that offers browsing of patients’ studies, and the retrieval and display of selected images and other evidence objects. • Report Creator – A system that generates and transmits clinical reports. Must be grouped with Image Display in this Profile. Interoperability Strategy Workshop

  13. Evidence Documents ProfileStandards Used • DICOM Services • Structured Report Storage • Enhanced • Comprehensive • Procedure Log • CAD • Storage Commitment • Query • Retrieve • DICOM SR Templates Interoperability Strategy Workshop

  14. Evidence Documents Profile Options • Cath Evidence option – Modality / Evidence Creator must support at least one specified Cath Template • 3001 Procedure Log • 3202 Ventricular Analysis • 3213 Quantitative Arterial Analysis • 3250 Intravascular Ultrasound • 3500 Hemodynamics • Echo Evidence option – Modality / Evidence Creator must support at least one specified Echo Template • 5100 Vascular Ultrasound • 5200 Echocardiography Interoperability Strategy Workshop

  15. Image Display Issues • Image Display actors must follow DICOM SR display rules • Render complete content tree of SR object, regardless of Template • ED Report Creator actor is the product assertion that it uses data from Evidence Documents in the clinical report • Report Creator must be grouped with Image Display to retrieve documents from the Image Manager/Archive • Report Creator also appears in Simple Image and Numeric Report Profile (SINR), and in Displayable Reports Profile (DRPT) to create clinical report • Workstation that revises Evidence Documents should claim Image Display and Evidence Creator actors • E.g., for updating preliminary measurements and storing updates back to the Image Manager/Archive Interoperability Strategy Workshop

  16. Relationship to Workflow Profiles • Evidence Creator actor also appears in Scheduled Workflow, Cath Workflow, and Echo Workflow Profiles • Performance of evidence creation reported through Modality Performed Procedure Step in those Profiles • Scheduled Procedure Step identified in the analyzed images may be used as the referenced SPS for the evidence documents created • Evidence Creator actor also appears in Post-Processing Workflow Profile • Performance of evidence creation managed through General Purpose Worklist and General Purpose Performed Procedure Step in that Profile Interoperability Strategy Workshop

  17. Cath Templates Scope • 3001 Procedure Log • Time stamped event log, with codes defined for common events, and free text entries allowed • 3202 Ventricular Analysis • Quantitative measurements of heart chambers, including wall motion by any of three types of analysis • 3213 Quantitative Arterial Analysis • Angiographic arterial measurements and findings organized by vessel • 3250 Intravascular Ultrasound • IVUS arterial measurements and findings organized by vessel • 3500 Hemodynamics • Pressure and flow measurements organized by procedure phase and measurement location Interoperability Strategy Workshop

  18. Echo Templates Scope • 5100 Vascular Ultrasound • Vascular measurements and findings organized by anatomic region • 5200 Echocardiography • Measurements of heart chambers, valves, and adjacent vessels; and assessment of wall motion Interoperability Strategy Workshop

  19. More information…. • IHE Web sites: www.ihe.net • Technical Frameworks, Supplements • Radiology Technical Framework • Cardiology Technical Framework • Cath and Echo Options for Evidence Documents Supplement • 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 Interoperability Strategy Workshop

  20. Providers and Vendors Working Together to Deliver Interoperable Health Information Systems In the Enterprise and Across Care Settings W W W . I H E . N E T Interoperability Strategy Workshop

More Related