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Extending the Scope of Relevant Patient Information Queries

This article discusses the extension of the Relevant Patient Information Query service class in DICOM, focusing on scenarios where enterprise-wide access to patient information is needed. It explores different use cases, such as order entry, reporting, and post-processing, and examines the potential role of II.SIG/DICOM WG20 in the development of this query service.

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Extending the Scope of Relevant Patient Information Queries

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  1. Title Relevant Patient Information Queries: Extending the scope beyond DICOM San Antonio WG Meeting, January 2003 Helmut König, Siemens Medical Solutions helmut.koenig@siemens.com “syngo” and ”we speak syngo” are registered trademarks of Siemens AG.

  2. DICOM Relevant Patient Information Query Service Class Characteristics • Document-oriented • Constraints on contents by templates

  3. Scenarios where enterprise wide access to patient information may be needed • Order Entry • Perform examination / procedure • Information conveyed by order message is incomplete • Support for selection of appropriate examination / procedure • Different procedure / examination than initially intended is performed … • Reporting • Making up diagnosis may require additional clinical information • Support for justification of performed acts • Post-processing • Interpretation of results • Previous findings may ease interpretation

  4. Extending the scope of relevant patient information queries

  5. Extension of RPI Query Scope • DICOM Query as trigger for the DIS to send HL7 query to the Clinical Information System • Clarification of scenarios • Clinical / Departmental Information Systems involved as provider • Matching of DICOM Information model and HL7 RIM • Response containing: • CDA documents (EHR extracts as compound documents) • Observation-oriented response • Non-textual data • What are useful constraints for patient clinical history / EHR extracts? • Definition/matching of DICOM and HL7 templates

  6. Objectives • Completeness: Make sure that all relevant patient information is available • I.e. for reporting additional relevant information, not available by limiting the scope to the local DIS, may be needed • E.g. new problem-oriented request sent by DIS • Use of up-to-date information • Locally cached data may be out-dated • Preservation of context • Common hierarchy of contextual data • E.g. Patient, Encounter, Patient Diagnosis, Clinical Problem… • Period of time

  7. Patient Clinical History Information Model Subset of DICOM Information Model: Modules • SOP Common • Specific Character Set • Patient Module • Patient IDs and Demographic Data • Patient Study • Admitting diagnosis … • Patient Medical • Medical alerts, allergies, pregnancy status … • SR Document Content • Template and code attributes … • SR Document General • Content Date, Content Time

  8. Patient Clinical History Information Model Role of SR documents and templates Categories: • Diagnosis / problem oriented • Medication • Previous procedures ...

  9. Matching the DICOM Information Model to the RIM for Relevant Patient Information Queries We have to look at: • Message • RIM Class Clones • Associations • Attributes • Data Types • Vocabulary • Document Constraints • Templates • For specification of HL7 Query • Making sure that the correct interpretation of EHR extracts is possible

  10. Potential Role of II SIG / DICOM WG20 • Cooperation with EHR, O&O and other groups for message specification • Document-oriented Query esponse • Mapping HL7 CDA / DICOM SR is work in progress • Definition of R-MIMs for DICOM-specific Relevant Patient Information Query

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