Ihe endoscopy should be a formal domain of the ihe
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“ IHE Endoscopy ” should be a formal domain of the IHE. May 2007 Endoscopy IHE-WG JAHIS (Japanese Association of Healthcare Information System Industry) Masaru Ikeda ( OPLYMPUS MEDICAL SYSTEMS Corp.). DOMAINS. There is no Endoscopy domain yet. Radiology. Cardiology. IT Infrastructure.

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Ihe endoscopy should be a formal domain of the ihe

“IHE Endoscopy” should be a formal domain of the IHE

May2007

Endoscopy IHE-WG

JAHIS (Japanese Association of Healthcare Information System Industry)

Masaru Ikeda

( OPLYMPUS MEDICAL SYSTEMS Corp.)


Ihe endoscopy should be a formal domain of the ihe

DOMAINS

There is no Endoscopy domain yet.

Radiology

Cardiology

IT Infrastructure

Laboratory

Pathology

Radiation therapy

Endoscopy

Ophthalmology


What i want to say

What I want to say…

A new domain of the IHE for the endoscopy should be assumed to be made, and the domain to be formal.

Because

  • The IHE work flow of radiology doesn't meet endoscopy.

    Workflow of endoscopy is different from radiology’s examination.

    But

  • Some people who not relate to endoscope think that endoscope is same as radiology’s modality .

  • Doesn’t it need to make new domain for endoscope, do it?

    Therefore

  • The WG that can be discussed by member who relate to the endoscope gathering is necessary.

    “IHE Endoscopy WG” in U.S.A.It becomes our partner


Out of scope in today s discussion

Out of scope in today’s discussion

  • Progress report of our activity

    Of course, evaluating the progress of the specified vender also

  • Have the difference between the radiology examination and the endoscopy understood.

    It is difficult to explain to the people who don’t relate to endoscopy like radiologist.

    Even if it is an explanation in Japanese by the same Japanese.

    I want you to understand there is the difference,

    not understood detailed differences.

    However, explains difference only a little next.


Difference between radiology and endoscopy

Difference between Radiology and Endoscopy

For instance,

  • Who does use modality ? Who does examine?

  • Difference of working range done by examination once.

    • until the image is acquired?

    • until writing a paper?

  • Are there any order to pathology for the inspection of the specimen material?

    Use-case is not the same as radiology’s


Radiology scheduled workflow

Pt.Registration

ADT

Pt.Registration

Order

Filler

Order

Placer

Order Management

Procedure

Scheduled

Creator PPS

Image

Creator

Storage

Commitment

Image

Stored

PPS

PPS

Manager

Image

Manager

Image

Archive

Q/R Images

Image

Display

PPS

Storage

Commitment

Image

Stored

Modality PPS

Acquisition

Modality

Modality Worklist

Radiology Scheduled Workflow

Blue: HL7 Messages

Green: DICOM Messages


Scheduled workflow for endoscopy 2007 01 25

2007/01/26

Scheduled Workflow for Endoscopy2007/01/25

Defined in

Pathology field

ADT

6 Pre-procedure PPS

7 Modality PPS in Progress

8 Specimen PPS

9 Modality PPS Completed

18 GPPPS report finished

24 Post-procedure PPS

1 Pt.Registration

21 Pt.Update

1 Pt.Registration

21 Pt.Update

Placer Order Management

e-Order

Filler

Order

Placer

Pathology

Order Filler

2 Placer Order Management

3 Filler Order Management

23 Demand for Path. Order

State of Filler show demand for pathology

Filler Order Management

OP confirms state of OF and order to

Pathology’s OF

4 Procedure Scheduled

25 PtUpdate

26 Procedure Update

4 Procedure Scheduled

e-PPS

Manager

Pre/Post

Procedure

Terminal

Image

Manager

Image

Archive

13 Image Availability Query

7 Modality PPS in Progress

9 Modality PPS Completed

10 Modality Image Stored

(11 Modality Presentation State Stored)

12 Storage Commitment

5 Modality Worklist Provided

Acquisition

Modality

7 Modality PPS in Progress

9 Modality PPS Completed

5 Modality Worklist Provided

Specimen

Manager

Specimen

Label Printer

8 Specimen PPS (return by DICOM instance number)

7 Modality PPS in Progress

8 Specimen PPS

9 Modality PPS Completed

5 Modality Worklist Provided

Report

Creator

Image

Display

14 Query Images

(15 Query Presentation State)

16 Retrieve Images

(17 Retrieve Presentation State)

22 GPPPS report finished/Order to Path.

  (Endoscope report completion notification/pathology inspection request notification)

(define at GPPPS Part16; it may be UPPPS?)

18 Report Submission

Report

Manager

4 Procedure Scheduled

25 PtUpdate

26 Procedure Update

Blue: HL7 Messages

Green: DICOM Messages

19 Report Issuing

Human’s action

Report

Repository

Report

Reader

20 Query Report

21 Retrieve Report


About real system

About Real system

  • Though you might say that you want to see a real system, to know about them.

  • We are at the stage where WG should be made for defining Technical Framework to make a real machine.

    • As for saying as the discussion based on a real machine, the step is reverse.

  • If you wants to understand the image of the information system for endoscopy,

    it is possible to see present system

    that isn’t on the IHE.


  • Ihe endoscopy should be a formal domain of the ihe

    As for a system now at the time of not being in IHE, the requirements of the endoscopy is included.

    Therefore, If you want to understand workflow and differences, It‘s better to study present system than halfway system.

    It is thought that the disadvantage where extra confusion is caused is larger even if it

    examines it based on a halfway evaluation system.


    The present conditions

    The present conditions

    • There is “Endoscopy IHE Working Group” only in Japan.

      It is acting in the industry association of the JAHIS.

    • We can discuss about use-case of Japan.

    • But we don’t do them about other country.

    • Then, also we can’t decide baseline of TF “Endoscopy IHE” for International .

      If there would be partner of another country, our progress will advance earlier.

      Present : Local activity – in Japan

      Future : International activity

      there will be partners in many country


    What should we do

    What should we do?

    • make WG in U.S.A

    • invite Endoscopists, Venders and other specialists of the IHE

    • Who have to do them?

    • How should it advance?

    • What Organization should be a base?

      • DICOM International Committee

      • IHE Inc.

      • Other

        We need your help and advice.


    Conclusion

    Conclusion

    The following is necessary to evaluate “Endoscopy IHE” as an official domain of the “IHE”.

    • Stand and put up working group to argue about “endoscopy IHE” in U.S.A.

      (also in Europe)

    • Endoscopists, experts of medical information and related vendors in U.S.A. should be member of the “endoscopy IHE working group”in U.S.A.

      (Even WG for preparations is good)

    • Japan and U.S.A., each WG cooperates and works on a new endoscopy domain in the “IHE”, and widen activity worldwide.

    • Advice and backup of the IHE Inc. are necessary.


    The current result

    The current result

    • Review and renewal of Volume1

      • Examination of lower digestive tract

      • The above part digestive organs and lower digestive organs are integrated as digestive organs, and it reflects it in the work flow.

      • Adjustment with pathology IHE-WG

      • Materialization of mechanism of specimen material inspection request to pathology section

    • Technical framework Volume2 examination begins.

      • Examination of message for order by HL7

    • Enlightenment to digestive organs endoscope society

      • Route securing for thesis submission

      • Thesis submission


    For instance

    for instance

    • Show Defining HL7 message for request of examination of specimen next page.

      It is progressing now.


    Ihe endoscopy should be a formal domain of the ihe

    Order information exchange that centers on HIS case of Japan

    Order is done by HIS.

    Order to the other department passes HIS.

    Department system

    Department system

    Order

    Filler

    Order

    Filler

    HIS

    There is specimen

    ADT

    Endoscopy system

    Pathology system

    Order to pathology

    Order

    Filler

    Order

    Filler

    Order

    Placer

    There is specimen

    There is specimen

    HIS controls the flow of information in the hospital.

    Department system

    Department system

    Order

    Filler

    Order

    Filler


    Ihe endoscopy should be a formal domain of the ihe

    next

    • We will make Endoscopy TF Volume2.

      • HL7 message for Endoscopy IHE

        It will makes from the industry association of the JAHIS, and it provides.

      • DICOM message for Endoscopy IHE

        Basic idea will make from the industry association of the JIRA, and it propose.

      • Get Public comments

      • Public

    • Volume1

      • Update Ver.2

      • Translate to English

    • World wide

      • DDW, Other meeting

      • Enlightenment for spread

    • Related society

      • support contribution of thesis etc.


    Ihe endoscopy should be a formal domain of the ihe

    END


    Scheduled workflow for endoscopy 2007 01 251

    2007/01/26

    Scheduled Workflow for Endoscopy2007/01/25

    病理IHEでの

    定義範囲

    ADT

    6 Pre-procedure PPS

    7 Modality PPS in Progress

    8 Specimen PPS

    9 Modality PPS Completed

    18 GPPPS report finished

    24 Post-procedure PPS

    1 Pt.Registration

    21 Pt.Update

    1 Pt.Registration

    21 Pt.Update

    Placer Order Management

    e-Order

    Filler

    Order

    Placer

    Pathology

    Order Filler

    2 Placer Order Management

    3 Filler Order Management

    23 Demand for Path. Order

    Fillerが病理検査オーダ有りの状態を示す

    Filler Order Management

    内視鏡のFillerにおける病理検査オーダ

    有りのステートをPlacerが確認して、病理

    へ検査オーダを出す

    4 Procedure Scheduled

    25 PtUpdate

    26 Procedure Update

    4 Procedure Scheduled

    e-PPS

    Manager

    Pre/Post

    Procedure

    Terminal

    ○ 病理オーダに関する要件

    ・病理部門へのオーダは各部門からのオーダ発行でもかまわない。

     つまり、HIS上のOPからのオーダでなくとも、部門から直接OPでオーダされても良い。

    ・ただし、院内で統一的に管理されたオーダ番号である必要がある。

    ・院内で統一管理されたオーダ番号を生成機能があれば良い。

    ・各OPは、そのオーダ番号をもらってオーダを発行すればよい。

    ○ 検体番号に関する要件

    ・検体番号は、病院内で重複しないユニークなもので有れば良い。

    ・これが保証されれば各部門で管理生成されて良い。

    ・オーダ時にオーダ番号に検体番号の紐付けをして発行すればよい。

     検体番号=内視鏡へのオーダ番号+枝番

     検体番号=内視鏡へのオーダ番号+内視鏡室内シリアル附番

     検体番号=何らかの院内統一番号(+枝番orシリアル番号)

         ・

         ・

    Image

    Manager

    Image

    Archive

    13 Image Availability Query

    7 Modality PPS in Progress

    9 Modality PPS Completed

    10 Modality Image Stored

    (11 Modality Presentation State Stored)

    12 Storage Commitment

    5 Modality Worklist Provided

    Acquisition

    Modality

    7 Modality PPS in Progress

    9 Modality PPS Completed

    5 Modality Worklist Provided

    Specimen

    Manager

    Specimen

    Label Printer

    8 Specimen PPS (DICOMのインスタンスナンバーで返す)

    7 Modality PPS in Progress

    8 Specimen PPS

    9 Modality PPS Completed

    5 Modality Worklist Provided

    Report

    Creator

    Image

    Display

    14 Query Images

    (15 Query Presentation State)

    16 Retrieve Images

    (17 Retrieve Presentation State)

    オーダ番号生成機能

    Order Placerの情報源の一つ

     院内で統一管理されている

     (サーバ?)

    22 GPPPS report finished/Order to Path.

      (内視鏡レポート完了通知/病理検査依頼通知)

    GPPPS Part16 に登録して使う

    UPPPSへ変わる可能性有り)

    18 Report Submission

    Report

    Manager

    4 Procedure Scheduled

    25 PtUpdate

    26 Procedure Update

    Blue: HL7 Messages

    Green: DICOM Messages

    19 Report Issuing

    人間の端末操作による入力

    Report

    Repository

    Report

    Reader

    Modality Presentation State Stored;今のところ該当するモダリティは無いので、省略可

    同様にQuery Presentation State及びRetrieve Presentation Stateも省略可能

    20 Query Report

    21 Retrieve Report


    Scheduled workflow for endoscopy 2007 01 252

    オーダ番号

    ENDO20061211

    検体番号

    ENDO20061211-2

    2007/01/26

    Scheduled Workflow for Endoscopy2007/01/25 見直し修正案 

    病理IHEでの

    定義範囲

    ADT

    6 Pre-procedure PPS

    7 Modality PPS in Progress

    8 Specimen PPS

    9 Modality PPS Completed

    18 GPPPS report finished

    24 Post-procedure PPS

    1 Pt.Registration

    21 Pt.Update

    1 Pt.Registration

    21 Pt.Update

    Placer Order Management

    e-Order

    Filler

    Order

    Placer

    Pathology

    Order Filler

    2 Placer Order Management

    3 Filler Order Management

    23 Demand for Path. Order

    Fillerが病理検査オーダ有りの状態を示す

    Filler Order Management

    内視鏡のFillerにおける病理検査オーダ

    有りのステートをPlacerが確認して、病理

    へ検査オーダを出す

    4 Procedure Scheduled

    25 PtUpdate

    26 Procedure Update

    4 Procedure Scheduled

    e-PPS

    Manager

    Pre/Post

    Procedure

    Terminal

    Image

    Manager

    Image

    Archive

    13 Image Availability Query

    7 Modality PPS in Progress

    9 Modality PPS Completed

    10 Modality Image Stored

    (11 Modality Presentation State Stored)

    12 Storage Commitment

    5 Modality Worklist Provided

    Acquisition

    Modality

    7 Modality PPS in Progress

    9 Modality PPS Completed

    5 Modality Worklist Provided

    Specimen

    Manager

    Specimen

    Label Printer

    8 Specimen PPS (DICOMのインスタンスナンバーで返す)

    7 Modality PPS in Progress

    8 Specimen PPS

    9 Modality PPS Completed

    5 Modality Worklist Provided

    Report

    Creator

    Image

    Display

    14 Query Images

    (15 Query Presentation State)

    16 Retrieve Images

    (17 Retrieve Presentation State)

    ○Specimen Managerに対する要件

    ・ Specimen Managerは検体ラベルプリンタと一緒にして、一つのモダリティ扱いとする。

    ・つまり、画像の代わりにバーコード及び関連テキストが印刷されたラベルが生成されると言う考え。

    ・画像発生モダリティと同じようにMWLを受けて動作する。

    ・画像番号に対して検体番号が対応する。

    ・ただし、インスタンスUIDではなく、インスタンスナンバーを用いる。

    ・生検が発生しなかった場合はラベル印刷が発生しないがDICOMとしての問題は無い。

    22 GPPPS report finished/Order to Path.

      (内視鏡レポート完了通知/病理検査依頼通知)

    GPPPS Part16 に登録して使う

    UPPPSへ変わる可能性有り)

    18 Report Submission

    Report

    Manager

    4 Procedure Scheduled

    25 PtUpdate

    26 Procedure Update

    Blue: HL7 Messages

    Green: DICOM Messages

    19 Report Issuing

    人間の端末操作による入力

    Report

    Repository

    Report

    Reader

    Modality Presentation State Stored;今のところ該当するモダリティは無いので、省略可

    同様にQuery Presentation State及びRetrieve Presentation Stateも省略可能

    20 Query Report

    21 Retrieve Report


    Scheduled workflow for endoscopy 2007 01 253

    2007/01/26

    Scheduled Workflow for Endoscopy2007/01/25 見直し修正案 

    病理IHEでの

    定義範囲

    ADT

    6 Pre-procedure PPS

    7 Modality PPS in Progress

    8 Specimen PPS

    9 Modality PPS Completed

    18 GPPPS report finished

    24 Post-procedure PPS

    1 Pt.Registration

    21 Pt.Update

    1 Pt.Registration

    21 Pt.Update

    Placer Order Management

    e-Order

    Filler

    Order

    Placer

    Pathology

    Order Filler

    2 Placer Order Management

    3 Filler Order Management

    23 Demand for Path. Order

    Fillerが病理検査オーダ有りの状態を示す

    Filler Order Management

    内視鏡のFillerにおける病理検査オーダ

    有りのステートをPlacerが確認して、病理

    へ検査オーダを出す

    4 Procedure Scheduled

    25 PtUpdate

    26 Procedure Update

    4 Procedure Scheduled

    e-PPS

    Manager

    Pre/Post

    Procedure

    Terminal

    Image

    Manager

    Image

    Archive

    13 Image Availability Query

    7 Modality PPS in Progress

    9 Modality PPS Completed

    10 Modality Image Stored

    (11 Modality Presentation State Stored)

    12 Storage Commitment

    オーダ情報では、検体番号と依頼内容の情報が含まれる

    5 Modality Worklist Provided

    Acquisition

    Modality

    7 Modality PPS in Progress

    9 Modality PPS Completed

    5 Modality Worklist Provided

    Specimen

    Manager

    Specimen

    Label Printer

    8 Specimen PPS (DICOMのインスタンスナンバーで返す)

    7 Modality PPS in Progress

    8 Specimen PPS

    9 Modality PPS Completed

    5 Modality Worklist Provided

    宿題

    オーダ時に具体的にどのような情報が送受信されるのかというサンプルを用意すること!

    Report

    Creator

    Image

    Display

    14 Query Images

    (15 Query Presentation State)

    16 Retrieve Images

    (17 Retrieve Presentation State)

    22 GPPPS report finished/Order to Path.

      (内視鏡レポート完了通知/病理検査依頼通知)

    GPPPS Part16 に登録して使う

    UPPPSへ変わる可能性有り)

    18 Report Submission

    Report

    Manager

    4 Procedure Scheduled

    25 PtUpdate

    26 Procedure Update

    Blue: HL7 Messages

    Green: DICOM Messages

    19 Report Issuing

    人間の端末操作による入力

    Report

    Repository

    Report

    Reader

    Modality Presentation State Stored;今のところ該当するモダリティは無いので、省略可

    同様にQuery Presentation State及びRetrieve Presentation Stateも省略可能

    20 Query Report

    21 Retrieve Report


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