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Presentation of Grouped Procedures Profile. Ellie Avraham Kodak Health Group IHE Planning and Technical Committees. Presentation of Group Procedures. Grouping of Procedures – Use case. CT Chest/Abdomen/Pelvis Neuroradiology : CT Neck & CT Chest

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Presentation of Grouped Procedures Profile

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Presentation of grouped procedures profile

Presentation of Grouped Procedures Profile

Ellie Avraham

Kodak Health Group

IHE Planning andTechnical Committees


Presentation of group procedures

Presentation of Group Procedures


Presentation of grouped procedures profile

Grouping of Procedures – Use case

  • 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.


Presentation of grouped procedures profile

Presentation of Group ProceduresScope

One Order – Two Procedures – One Acquisition - Two Reports

Step

Requested

Procedure

CT Chest

Requested

Procedure

CTAbdomen

One or more series of images

Radiology Department

ORDER

A request for RadiologicService

CT Chest & Abdomen

Set of Codifiable,

Billable, Acts

Report

CT Chest

Acquisition Modality

Report CT Abdo

Set of Codifiable,

Billable, Acts


Presentation of grouped procedures profile

Grouping of Procedures – Value Proposition

  • 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 film-less world, images should be sorted automatically when displayed


Presentation of grouped procedures profile

DICOMModality Worklist

Requested

Procedure

1

ScheduledProcedure

Step A

Requested

Procedure

2

ScheduledProcedure

Step B

One or more series of images

PerformedProcedure

Step P1

Group Case

Radiology Department

Set of Codifiable,

Billable, Acts

ORDER

A request for RadiologicService

Report

Set of Codifiable,

Billable, Acts

Report

AcquisitionModality


Presentation of grouped procedures profile

Grouping of Procedures in IHE

Group Case support is required by the IHE Scheduled Workflow Integration Profile:

  • On Image Managers (PACS)

  • On Order Fillers (RIS).

    Group Case support is optional on Modalities.

    PGP requires support of the “Group Case Option” on Modalities.


Presentation of grouped procedures profile

Scheduled Workflow

Group Case

Admit, order, schedule, acquire images, notify of completed steps

Presentation ofGrouped Procedures

Presentation of Subsets of a Single Acquisition

Required for

ConsistentPresentation of Images - GSPS

Softcopy grayscale and presentation state

Presentation of Grouped Proceduresbuilds upon SWF and CPI

+


Presentation of grouped procedures profile

Report:CHEST

Report:ABDOMEN

Abdomen View

ScheduledProcedure

Step Chest

ScheduledProcedure

Step Abdo

Chest View

Chest View

Abdomen View

Performs a single acquisition

MODALITY

Operator

groups

2 procedures

IHE – Presentation of Grouped Procedures

Requested Procedure:CHEST

Requested Procedure:ABDOMEN

RIS / PACS


Presentation of grouped procedures profile

Report:CHEST

Report:ABDOMEN

CPI only Actor

Abdomen View

Abdomen View

ScheduledProcedure

Step Chest

ScheduledProcedure

Step Abdo

Image

Display

Chest View

Chest View

Chest View

Abdomen View

MODALITY

Operator

groups

2 procedures

IHE PGP - Implementation Example Image Display Constraints

SWF/PGP Actors

Requested Procedure:CHEST

Requested Procedure:ABDOMEN

Image Mgr

(Incl. Display)

Order Filler

Image Displayhas no access to fullRequested Procedure

Information

Performs a single acquisition


Presentation of grouped procedures profile

Presentation of Grouped Procedures Value Proposition

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


Presentation of grouped procedures profile

Implementing PGP made easy !

Feedback from early implementors has resulted in significant improvement for the Technical Framework:

  • Appendix A has been entirely restructured to provide a thorough and unambiguous specifications of all SWF+PGP workflow cases.

  • The NewAppendix A defines precisely every details for information mappings in modalities between MWL, Images/Presentation States, Modality PPS. This is critical information for PACS and RIS implementations of SWF and PGP.


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