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Product Experiences. Cor Loef Philips Healthcare. Contents The challenge of implementing DICOM The product in the clinical environment Software design rules Examples of typical misinterpretations Verification and validation of products Conclusion. The challenge of implementing DICOM.

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product experiences

Product Experiences

Cor Loef

Philips Healthcare

slide2
Contents
  • The challenge of implementing DICOM
  • The product in the clinical environment
  • Software design rules
  • Examples of typical misinterpretations
  • Verification and validation of products
  • Conclusion
slide3

The challenge of implementing DICOM

Part 1 - Introduction and Overview

Part 2 - Conformance

Part 3 - Information Object Definitions

Part 4 - Service Class Definitions

Part 5 - Data Structures & Semantics

Part 6 - Data Element Listing and Typing

Part 7 - Message Exchange Protocol

Part 8 - Network Support for Message Exchange

Part 10: Media Storage and File

Format for Media Interchange

Part 11: Media Storage Application Profiles

Part 12: Media Formats and Physical Media for Media Interchange

Part 14: Grayscale Standard Display Function

Part 15: Security and System Management Profiles

Part 16: Content Mapping Resource

Part 17: Explanatory Information

Part 18: Web Access to DICOM Persistent Objects (WADO)

slide4

The product in the clinical environment

Patient Centric Workflow and Dataflow

slide5

The product in the clinical environment

"Interoperability" means the ability of ICT systems, and of the business processes they support, to exchange data and to enable the sharing of information and knowledge1.

1. “Draft Recommendation of the Commission on Union-wide interoperability of Electronic Health Record Systems”

slide6

Collect, organize and distribute clinical imaging data in- and outside the hospital

MR Scanner

Radiology

CT Scanner

Orthopedics

Data acquisition by modalities

UltraSound

Results viewing & distribution

NuclearMedicine

Operating

Room

Storage & Archive

X-ray

Web Distribution

EmergencyDepartment

Film

Digitizer

Internet/Intranet

WardReferring Physician

Patient

The product in the clinical environment

slide8
Software design rules
  • Be tolerant and robust on received input, and correct, flexible and comprehensive on produced output
  • Consider the receiving application’s needs when filling optional DICOM fields (Application Profiles)
  • Create a fall-back scenario when implementing new SOP Classes
  • Consider the consequences for the receiver when using private extended SOP class
  • Be efficient in protocol resource utilization
  • Always remember: DICOM is enabler for interoperability, but no guarantee
slide10
Software Design Rules: Fall-Back Scenario
  • Create multiple rendered images with Overlays when Presentation State is not supported by receiving system
  • Use multiple instances of the existing MR SOP Class when Enhanced multi-frame MR SOP Class is not supported by the receiving system
slide11
Software Design Rules: Be Tolerant
  • Accept leading zeros in de components of an UID
  • Handle PN attribute values with more than 5 components (HL7 syntax)
slide12
Examples of typical misinterpretations
  • Misunderstanding meaning of PDU size = 0 (unlimited)
  • Overlooking that a Modality Worklist SCP has to include all requested type 1 and type 2 attributes, and is prohibited to provide any additional not requested attributes
  • Overlooking requirement to include and/or use correct values for Specific Character Set attribute
  • Too limited implementation: Study description field not exported
  • Incorrect assumptions on Image number, Study ID, Series ID and Instance ID and its use for display order
slide13

DICOM import module

Re-order

Default Display Protocol

Misinterpretation:

Use of Image number to determine display order

PACS

slide14
Examples of typical misinterpretations
  • Overlooking consequences of changing Series and Study UID, this will break references from GSPS and SR
  • Incorrect assumptions about maximum attribute tag being the Pixel Data (7FE0,0010), some implementation ignore the remainder
  • Overlooking consequences of queries with key such as Patient Name having wildcards
  • Overlooking the reverse role in the Storage Commitment Association
slide15

SCU

SCP

A-Associate Request

Association 1

A-Associate Accept

N-Action- Request

Archive

N-Action- Response

A-Release Request

A-Release Response

A-Associate Request

Modality

A-Associate Accept

SCP

SCU

N-Event-Report-Request

Association 2

N-Event-Report-Response

A-Release Request

A-Release Response

Storage Commitment: Asynchronous

slide16

Verification and validation of products

  • Audited Quality Assurance Procedure
  • Published Conformance Claims
  • Tools
  • In-house conformance testing of products
  • Cross-vendor interoperability testing
    • Bilateral vendor agreements and activities
    • IHE connectathon process and tools
  • Feedback to DICOM Standards Committee when common issues arise in the field
slide17
Conclusion

A viable common sense approach exists that vendors should use for the creation of healthcare products that use the DICOM Standard for the communication of medical information.

This will achieve interoperability for the connected products in the healthcare enterprise.