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DICOM General Purpose Worklist

DICOM General Purpose Worklist. The next major political battle in PACS Dr David Harvey. Why a DICOM Talk today ?. DICOM General Purpose worklist is to reporting workstations what basic DICOM is to a CT Scanner You wouldn’t (I hope!) since 1995 buy a CT without checking the DICOM conformance

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DICOM General Purpose Worklist

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  1. DICOM General Purpose Worklist The next major political battle in PACS Dr David Harvey

  2. Why a DICOM Talk today ? • DICOM General Purpose worklist is to reporting workstations what basic DICOM is to a CT Scanner • You wouldn’t (I hope!) since 1995 buy a CT without checking the DICOM conformance • You shouldn’t buy a reporting station (or PACS) in 2004 without doing the same

  3. “Traditional” DICOM Queries • Concerned with “static” data, which once generated is never altered. • Images • RT plans etc. • Provides excellent methods for creating, storing, querying and retrieving such data, if your starting point is a particular patient or study

  4. Why original DICOM Queries are not suitable for workstations • No information or reporting status(unreported / reported / in progress) • No way of querying for “things to do” • If patient IDs etc. are entered by hand, then there is a delay while images are actually retrieved. Radiologists need a “NEXT” button

  5. Key Features of GP Worklist Provides: • A vendor independent method of interfacing efficient reporting stations to a PACS • A mechanism to simulate the “reporting pile”(but in multiple places simultaneously) • A Locking mechanism to prevent accidental double reporting • Wide range of query and priority fields to support chosen working practices. • Sufficient information to allow images to be pre-fetched.

  6. Why Have a DICOM Interface? • Is the best RIS/PACS supplier also the best workstation supplier? • Is the best workstation supplier also the best RIS/PACS supplier • Or do you compromise?

  7. Hot it works (the technical bit) • Modelled on the existing modality worklist (MWL) and modality performed procedure step (MPPS) services • Workstation first queries for items of a requested type • Then it selects and locks an item • Then marks it compeleted

  8. GP Worklist Query for Work Items Query for Examinations List of those available Lock (In Progress) GPWL GPWL Lock OK Mark Complete OK MWL/MPPS Overall Data Flow MWL/MPPS SCU (Client) MWL/MPPS SCP (Server)

  9. Worklist Data Source • Exactly the same options as used by proprietary systems: • RIS • PACS • Broker

  10. Vendors have no technical excuses • Data sources already exist (used for their proprietary systems) • DICOM mechanisms already exist(used for MWL/MPPS) • So where is it ?

  11. Can I use it Now? At present, NO – because: • It has only been in DICOM for 3 years (short time by development scales) • Like all such protocols, it requires support from both SCP (server/PACS) and SCU (client/workstation) • PACS suppliers don’t like it’s potential to eat into the very lucrative proprietary workstation market • Only a few independent workstations support it yet • Users haven’t yet learnt about it and demanded it!

  12. Will it become available? Perhaps ? • Negative Features • Not all DICOM features become adopted widely • Arguments from major PACS vendors: • Responsibility, Reliability etc. • User ignorance • May become an expensive retrofit option • Positive Features • Adoption into IHE will push implementation by vendors • Some smaller vendors are already using it • Like original DICOM, a few knowledgeable users may be sufficient to push the market

  13. But won’t the national Program make this obsolete? • Life of your RIS ~7-10 yrs • Life of Government Initiatives ~2-4 yrs • Trusts 4ys (then merged) • Information for Health – 3 yrs • NPfIT – 3 yrs ? • You will still be using your system long after the LSP has lost interest or gone bankrupt!

  14. Conclusions • In 1994, you could buy a CT scanner which worked well with it’s own expensive secondary console, but if you wanted flexibility and choice for the future, you needed to insist on DICOM C-STORE • In 2004, you can buy a PACS which works well with it’s own expensive tied reporting stations, but if you want flexibility and choice in the future, you need to insist on DICOM General Purpose Worklist • If not there yet (insist on a firm, dated commitment, with guaranteed interconnection)

  15. References • DICOM Standard Home Page • http://www.dclunie.com/dicom-status/status.html • DICOM Newsgroup • news:comp.protocols.dicom • My E-mail (Dave Harvey) • mailto:dave@medicalconnections.co.uk

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