Integrating the Healthcare Enterprise

1. Integrating the Healthcare Enterprise Key Image Notes Evidence Documents Simple Image & Numeric Report Rita Noumeir Ph.D. University of Quebec IHE Technical and Planning Committees IHE Interoperability Workshop

2. Key Image Notes IHE Interoperability Workshop

3. Key Image NotesValue Proposition • There is more to teamwork than images and reports • With IHE, it is possible to attach « electronic post-it™ » to images to increase informal but critical communication between: • The Technologist and the Radiologist about specific examination events • The Radiologist and the Technologist about image quality issues • The Radiologist and other department clinicians (surgeon, orthopedist,..) • The Radiologist and collegues about selecting images for conferences • The Radiologist to the Referring Provider, …..etc. • Query for the Images/Studies using the codes • This IHE Integration Profile is the cost effective solution (increases radiology and overall efficiency) IHE Interoperability Workshop

4. Don’t Call Us, We’ll Call You • “Dave, you read that 3000 slice MR study last night. Can you highlight the 5 most important images for me” • Thinking… “#$@%!%# You”, says “Sure” • “Dr. Channin, I just reviewed 40 cases and marked my questions on yellow stickies. Can you review those” • Tech to radiologist: “The patient wouldn’t hold still” The solution is…… IHE Interoperability Workshop

5. for referring physician Here you can see the renal osteopathy. For teaching Fibroosteoclasia IHE Interoperability Workshop

6. Note3 Note1 Note2 for referring physician Here you can see the renal rupture. for referring physician This is the hematoma. for referring physician Hematoma everywhere Note1 Note2 for refering physician This is the hematoma. for refering physician Here you can see the renal rupture. Note3 Note3 Note3 Note3 for refering physician Hematoma everywhere for refering physician Hematoma everywhere for refering physician Hematoma everywhere for refering physician Hematoma everywhere Different notes on different images Same note on different images IHE Interoperability Workshop

7. Key Image Notes Titles are Coded Codes Of Interest Rejected for Quality Reasons For Referring Provider For Surgery For Teaching For Conference For Therapy For Patient For Peer Review For Research For Reporting Quality Issue Defined by DICOM. May be extended The note title defines the semantics of the reason of significance. Key Image Notes can be queried by code. The user comments are meant to be informal. IHE Interoperability Workshop

8. Evidence Documents IHE Interoperability Workshop

9. Evidence Documents Value Proposition • Measurements and coded data • DICOM SR document • Created by either Acquisition Modality or Evidence Creator • Produced during acquisition or post-processing workflows • Interpreted along with the images IHE Interoperability Workshop

10. Evidence Documents Header: Report Type: OB / Gyn ….. BPD Findings: ... ….. Query / Retrieve Image Refs.: Evidence Document Stored Storage Commitment IHE Interoperability Workshop

11. Evidence Documents Examples • Mammography CAD • Chest CAD • OB-Gyn Ultrasound Measurements • Vascular Ultrasound Measurements • Vascular Intervention Results • Echocardiography Measurements IHE Interoperability Workshop

12. Header: Report Type: OB / Gyn Radiology Report Header: ….. BPD BPD Report Type: OB / Gyn Findings: ... ... ….. ….. ….. Findings: Gestational Impressions: Age ... Image Refs.: Image Refs.: Evidence Documents Simple Image & Numeric Report Interpretation Key Image Notes IHE Interoperability Workshop

13. Simple Image & Numeric Report IHE Interoperability Workshop

14. Can You Make A Report Like This? Institution Identification Patient Identification Study Identification Technique Identification Discussion The liver is normal. There is a focal area of decreased attenuation adjacent to the falciform ligt., likely representing focal fat (image 22). The spleen, both kidneys, the … are normal. Impression CT of the abdomen within normal limits Signature IHE Interoperability Workshop

15. (We can’t either). What about? Discussion Comparison is made to the prior study of 4/11/99. The left paratracheal lymph node (image 8, image 11) now measures 2.5x2.7x3.1 cm increasing from 2.0x2.1x2.6 previously. No other mediastinal, upper abdominal or axillary adenopathy is identified. No focal pulmonary lesions are seen. The yadda, yadda, yadda are normal. Impression Worsening L Paratracheal adenopathy. Signature The solution is…… IHE Interoperability Workshop

16. Simple ImageandNumeric Reports IHE Interoperability Workshop

17. Simple Image & Numeric ReportsValue Proposition • Reports’ content is more than words… • Based on DICOM SR • Allows to include without transcription: • measurements • image links • structured content • Integrated with the imaging workflow • Friendly to XML implementations • Easy to export with HL7 IHE Interoperability Workshop

18. Pattern – Simple Image Report • Minimal Structure : Coded Title and Headings • Full image links from specific sections of report • Observation Context (who, what, when) may be section specific IHE Interoperability Workshop

19. Pattern – Simple Image & Numeric Report Simply adds Measurements to Simple Image Reports IHE Interoperability Workshop

20. An illustration IHE Interoperability Workshop

21. Profile References • IHE Radiology Technical Framework • Volume I, Integration Profile • Volume II for Transactions • Key Image Note • Simple Image and Numeric Report • Volume III for Transactions • Evidence Documents IHE Interoperability Workshop

22. IHE Web site: http://www.ihe.net http://www.himss.org/IHE http://www.rsna.org/IHE http://www.acc.org/quality/ihe.htm Technical Frameworks Technical Framework Supplements – Trial Implementation 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 More information…. Questions? IHE Interoperability Workshop