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June 28-29, 2005. IHE Interoperability Workshop. 2. Scheduled Workflow Options. Multiple options Scheduled Workflow Profile allow certain degree of workflow ?tune-up"Managing Workflow: Patient-based or Broad Worklist Queries, Assisted Protocol Setting, Exception Management, Billing and Material Man
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1. SWF Options/Charge Posting
2. June 28-29, 2005 IHE Interoperability Workshop 2 Scheduled Workflow Options Multiple options Scheduled Workflow Profile allow certain degree of workflow “tune-up”
Managing Workflow: Patient-based or Broad Worklist Queries, Assisted Protocol Setting, Exception Management, Billing and Material Management
Notifications of Performed Work Status or Availability of Results: Images, Other Evidence documents, Appointments
3. June 28-29, 2005 IHE Interoperability Workshop 3 Modality Options in SWFTransaction Diagram
4. June 28-29, 2005 IHE Interoperability Workshop 4 Assisted Protocol OptionValue Proposition Gives the Department System Scheduler an option to directly control protocol settings on the Modality.
Reduces variance on how procedures are performed
Centralizes configuration effort
5. June 28-29, 2005 IHE Interoperability Workshop 5 Assisted Protocol OptionDefinition Actors Affected
Modality
Order Filler/DSS
Image Manager/Archive
Report Manager
Transactions Affected
PPS In-Progress
Standards Used
DICOM (Modality Worklist and MPPS)
6. June 28-29, 2005 IHE Interoperability Workshop 6 Assisted Protocol OptionMechanism Mechanism
Order Filler/DSS passes Scheduled Protocol Codes to the Acquisition Modality inside the Modality Worklist Item (DICOM)
Modality configuration is set accordingly either automatically or manually accepted/modified by operator
Modality populates Performed Protocol Code information in MPPS
The Protocol Code tables in all actors have to be synchronized
7. June 28-29, 2005 IHE Interoperability Workshop 7 PPS Exception Management OptionValue Proposition
8. June 28-29, 2005 IHE Interoperability Workshop 8 PPS Exception Management Option Definition Actors Affected
Modality
Order Filler/DSS
Image Manager/Archive
Report Manager
Transactions Affected
PPS Completed
Standards Used
DICOM (MPPS)
9. June 28-29, 2005 IHE Interoperability Workshop 9 Exception Management OptionMechanism Mechanism
Provision of Discontinue Reason Code in PPS Completed transaction:
Doctor cancelled procedure
Equipment failure
Incorrect procedure ordered
Patient allergic to media/contrast
Patient died
Patient refused to continue procedure
Patient taken for treatment or surgery
Patient did not arrive
Patient pregnant
Change of procedure for correct charging
Duplicate order
Nursing unit cancel
Incorrect side ordered
Discontinued for unspecified reason
Incorrect worklist entry selected
Patient condition prevented continuing
10. June 28-29, 2005 IHE Interoperability Workshop 10 Appointment NotificationValue Proposition Provides a mechanism for the Order Placer to keep track of appointments scheduled for a patient within Radiology Department
Includes notifications of scheduling, re-scheduling and cancellation events
Helps synchronization of scheduling processes between enterprise and radiology
11. June 28-29, 2005 IHE Interoperability Workshop 11 Appointment Notification Option Definition Actors Affected
Order Filler/DSS
Order Placer
Standards Used
HL7 v. 2.4 SIU messages
Transactions affected
Appointment Notification
12. June 28-29, 2005 IHE Interoperability Workshop 12 Appointment Notification OptionMechanism Mechanism
One appointment corresponds to one or more Scheduled Procedure Steps
Department System Scheduler/Order Filler generates Appointment Notification messages and sends them to the corresponding Order Placer actor.
One message may convey multiple appointments corresponding to a single order
Order Placer receives Appointment Notification messages and internally processes them.
13. June 28-29, 2005 IHE Interoperability Workshop 13 Appointment Notification OptionDetails Specifies common information for one or more appointments associated with single order
Appointment timing is defined on the per Scheduled Procedure Step level
One message can have multiple appointments (procedure steps)
No patient identification information is required, thus Order Numbers are required
Specifies Procedure Code and Description
Not all steps of the procedure may be included
Date/Time of an appointment is expected to be in UTC
If local, UTC offset is required
14. June 28-29, 2005 IHE Interoperability Workshop 14 What is not in the option Departmental Appointment Notification Option does not allow Order Placer to request re-scheduling – it only can do it by cancel and re-order
Transaction does not require AIL segment – thus notifications on re-scheduling of the service from one location to another may not be sent
This option does not address needs of enterprise-wide scheduling
15. June 28-29, 2005 IHE Interoperability Workshop 15 Instance Availability NotificationValue Proposition Enhances mechanism that allows to obtain information about availability of newly-acquired images and other evidence objects, for further use in workflow.
Avoids “performance penalty” of Instance Availability query mechanism that forces “managers” to poll Image Manager/Archive for availability of evidence objects.
Provides this information to all workflow management actors.
16. June 28-29, 2005 IHE Interoperability Workshop 16 Instance Availability Notification Option Definition Actors Affected
Image Manager/Archive
Order Filler/DSS
Post-Processing Manager
Report Manager
Standards Used
DICOM (Instance Availability Notification SOP Class; Supplement 93 Final Text)
Transactions affected
Instance Availability Notification
17. June 28-29, 2005 IHE Interoperability Workshop 17 Instance Availability Notification OptionMechanism Mechanism
Image Manager/Image Archive generates an Instance Availability Notification message and send it to the DSS/Order Filler and optionally to other workflow managing actors (Post-Processing Manager, Report Manager).
DSS/Order Filler, Post-Processing Manager, Report Manager receive an Instance Availability Notification message and internally process it..
18. June 28-29, 2005 IHE Interoperability Workshop 18 Instance Availability Values “ONLINE”
the instances are immediately available from the Retrieve AE Title, and if a C-MOVE were to be requested, it would succeed in a reasonably short time
“NEARLINE”
the instances need to be retrieved from relatively slow media such as optical disk or tape, and if a C-MOVE were to be requested from the Retrieve AE Title, it would succeed, but may take a considerable time
19. June 28-29, 2005 IHE Interoperability Workshop 19 Instance Availability Values “OFFLINE”
manual intervention is needed before the instances may be retrieved, and if a C-MOVE were to be requested from the Retrieve AE Title, it would fail (e.g., by timeout) without such manual intervention.
“UNAVAILABLE”
the instances cannot be retrieved from the Retrieve AE Title, and if a C-MOVE were to be requested, it would fail. Note that SOP Instances that are unavailable from this AE may be available from other AEs, or may have an alternate representation that is available from this AE.
20. June 28-29, 2005 IHE Interoperability Workshop 20 Instance Availability Notification OptionDetails Image Manager shall send only one IAN message for each MPPS referencing at least one evidence object.
Image Manager shall sent IAN when it received ALL instances referenced in MPPS
Timing of a message can vary significantly depending on timing of MPPS and object storage
No message may be sent if complete object set never arrives
No message may be sent if objects arrive without corresponding MPPS
Even when objects are included in IAN, the retrieval request may fail due to errors
21. June 28-29, 2005 IHE Interoperability Workshop 21 Instance Availability Notification OptionDetails Actors receiving IAN message are expected to use its content for workflow management.
Examples of internal actions:
The Department System Scheduler/Order Filler may update the procedure status internally, indicating that images for the procedure have been stored.
The Post-Processing Manager may add or re-arrange items to a corresponding worklist.
The Report Manager may add items to a corresponding worklist.
22. June 28-29, 2005 IHE Interoperability Workshop 22 What is not in the option This option only addresses the use case when MPPS referencing evidence objects has been received by Image Manager.
Image Manager generates Instance Availability Notification upon receiving of all objects referenced in particular MPPS.
Cross-referencing of MPPS in IAN may compensate for MPPS missed by OF
23. June 28-29, 2005 IHE Interoperability Workshop 23 Charge PostingAbstract / Scope The Department System Scheduler/Order Filler provides the procedure data that is used by the Charge Processor to generate claims and submit them to payors.
Fees associated with the procedures may be defined by the Department System Scheduler/Order Filler or by the Charge Processor.
Claim/Bill creation from charges and communication with payors is out of scope of the profile
24. June 28-29, 2005 IHE Interoperability Workshop 24 Charge PostingValue Proposition Standardizes data exchange of charges from radiology to the financial systems
Reduces the need of the billing system to have knowledge of the radiology internals.
Charge Processor receives more complete, timely and accurate data.
25. June 28-29, 2005 IHE Interoperability Workshop 25 Charge PostingTransaction Diagram
26. June 28-29, 2005 IHE Interoperability Workshop 26 Charge PostingStandards Used Health Level Seven, Version 2.3.1: Chapter 6 - Financial Management
DFT^P03 message
DICOM 2003 PS 3.4 Modality Performed Procedure Step SOP Class
Billing and Materials Management module – allows Modality specify billing information, including material consumption (contrast, film, etc.)
27. June 28-29, 2005 IHE Interoperability Workshop 27 More information…. 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