Sanjay Jain Cerner Corporation Co-Chair Radiology Planning Committee

1. Post Processing Workflow Reporting Workflow Sanjay Jain Cerner Corporation Co-Chair Radiology Planning Committee

2. IHE Radiology Integration Profiles Post-Processing Workflow Manage worklists, track status, perform & notify image processing & CAD steps Reporting Workflow Manage worklists, track status, perform & notify diagnostic reporting steps NM Image Create, store, manage, retrieve & use NM image objects Charge Posting Scheduled Workflow Admit, Order, Schedule Patient Information Reconciliation Collect and post timely billable procedure details Manage worklists, track status, perform & notify acquisition related step, Presentation of Grouped Procs Teaching Files & Clinical Trials Export Manage individual procedure image subsets from a multi-procedure acquisition for viewing & reporting Reconcile worklists, status, and data objects for unknown patients and demographics changes create, store, manage, retrieve & use images Consistent Presentation of Images Simple Image and Numeric Reports Evidence Documents Key Image Notes Manage, retrieve & use objects to record study evidence Create, store, manage, retrieve & use objects to flag significant images Manage simple diagnostic reports with optional images, measurements Manage, retrieve & use objects for hardcopy and softcopy grayscale presentation states XDS for Imaging - Sharing of Imaging Information across health enterprises Access to Radiology Information -Consistent access to images and reports Portable Data for Imaging - Consistent access to images and reports on CD Media ITIATNA – Radiology Option (Replaces Basic Security) Interoperability Strategy Workshop

3. Post-processing WorkflowAbstract / Scope • Schedule, distribute and track post-processing workflow steps using standardized mechanisms • Manage worklists, track status, perform & notify image processing & CAD steps • Worklists for each task are generated and can be queried • Workitems can be performed and the resulting status known and shared Interoperability Strategy Workshop

4. Post-processing WorkflowValue Proposition • Schedule, distribute and track the status of typical post-processing workflow steps • such as Computer-Aided Detection • Image Processing. Interoperability Strategy Workshop

5. Post-processing WorkflowActors • Post-Processing Manager • transactions: • Worklist Provided • Workitem Claimed • Workitem PPS In Progress • Workitem PPS Completed • Workitem Completed • Performed Work Status Update • Evidence Documents Stored • Query Evidence Documents • Retrieve Evidence Documents • Standards Used • DICOM 3.0 Interoperability Strategy Workshop

6. Post-Processing Manager Grouping – option 1 Groupedwith Image Manager Performed Work Status Update (optional) DSS/OF Post-Processing Manager PWF Profile IM/IA SWF Profile Interoperability Strategy Workshop

7. Post-Processing Manager Grouping – option 2 Grouped with DSS/OF Performed Work Status Update Post Processing Manager IM/IA DSS/OF SWF Profile PWF Profile Interoperability Strategy Workshop

8. Post-processing WorkflowPost-Processing Manager grouped with Image Manager Workitem Claimed Worklist Post-ProcessingWorklist Measurements CAD report ……………………………… PP-Performed Step Started Store ImagesStore SR OF/DSS 3-D Workstation StorageCommitment List of Images/SR Storage Commitment Post-Processing Performed Procedure Step Workitem Completed PP-Performed Step: Performed Status = Started PP-Performed Step: Pat Name/ID Accession #, Study UID Performed Status = Completed Complete List of Images/SR PP-Performed Step Completed Image Manager/Archive & Post Processing Manager Interoperability Strategy Workshop

9. Modality and Post-Processing Steps DICOMModality Worklist ScheduledProcedure Step A Report ScheduledProcedure Step B One or more series of images One or more series of images DICOMPost-Processing Worklist PP-Perf.Procedure Step P2 M-Perf.Procedure Step P1 AcquisitionModality Post-Processing Radiology Department ORDER A request for RadiologicalService Set of Codifiable, Billable Acts Requested Procedure 1 Interoperability Strategy Workshop

10. Patient Oriented Query Worklist for a specific patient/procedure SCU shall support all combinations of the matching keys Patient's Name Patient ID Referenced Request Sequence >Accession Number >Requested Procedure ID Scheduled Workitem Code Sequence >Code Value >Coding Scheme Designator Interoperability Strategy Workshop

11. Station Oriented Query Broad worklist for a particular workstation SCU must support all combinations of the matching keys General Purpose Scheduled Procedure Step Status Scheduled Station Name Code Sequence >Code Value >Coding Scheme Designator Scheduled Procedure Step Start Date and Time Scheduled Workitem Code Sequence >Code Value >Coding Scheme Designator Interoperability Strategy Workshop

12. Class Oriented Query Broad worklist for a particular class of workstations SCU must support all combinations of the matching keys General Purpose Scheduled Procedure Step Status Scheduled Station Name Code Sequence >Code Value >Coding Scheme Designator Scheduled Procedure Step Start Date and Time Scheduled Workitem Code Sequence >Code Value >Coding Scheme Designator Interoperability Strategy Workshop

13. IHE Radiology Integration Profiles Post-Processing Workflow Manage worklists, track status, perform & notify image processing & CAD steps Reporting Workflow Manage worklists, track status, perform & notify diagnostic reporting steps NM Image Create, store, manage, retrieve & use NM image objects Charge Posting Scheduled Workflow Admit, Order, Schedule Patient Information Reconciliation Collect and post timely billable procedure details Manage worklists, track status, perform & notify acquisition related step, Presentation of Grouped Procs Teaching Files & Clinical Trials Export Manage individual procedure image subsets from a multi-procedure acquisition for viewing & reporting Reconcile worklists, status, and data objects for unknown patients and demographics changes create, store, manage, retrieve & use images Consistent Presentation of Images Simple Image and Numeric Reports Evidence Documents Key Image Notes Manage, retrieve & use objects to record study evidence Create, store, manage, retrieve & use objects to flag significant images Manage simple diagnostic reports with optional images, measurements Manage, retrieve & use objects for hardcopy and softcopy grayscale presentation states XDS for Imaging - Sharing of Imaging Information across health enterprises Access to Radiology Information -Consistent access to images and reports Portable Data for Imaging - Consistent access to images and reports on CD Media ITIATNA – Radiology Option (Replaces Basic Security) Interoperability Strategy Workshop

14. Reporting WorkflowAbstract / Scope • Workflow Profile addresses the need to schedule, distribute and track the status of the reporting workflow tasks such as • Interpretation • Transcription • Verification. • Worklists for each of these tasks are generated and can be queried Interoperability Strategy Workshop

15. Reporting Workflow Actors • Report Manager • Report Creator • Report Reader • Department System Scheduler/Order Filler • PPS Manager • Image Manager/Image Archive Interoperability Strategy Workshop

16. Reporting WorkflowTransaction Diagram Procedure Scheduled Procedure Update DSS/OF Reporting Worklist Provided Report Creator/ Reader Report Manager P. Work Status Update PPS Manager Workitem Claimed Workitem PPS in Progress MPPS Completed IM/IA Workitem PPS Completed Workitem Completed Image Availability Interoperability Strategy Workshop

17. Reporting Workflow Grouping • Report Manager not grouped with neither IM nor DSS Performed Work Status Update DSS/OF Report Manager RWF Profile Performed Work Status Update, if needed SWF Profile IM/IA SWF Profile Interoperability Strategy Workshop

18. Reporting Workflow Grouping • Report Manager grouped with Image Manager Performed Work Status Update (optional) DSS/OF Report Manager RWF Profile IM/IA SWF Profile Interoperability Strategy Workshop

19. Reporting Workflow Grouping • Report Manager grouped with DSS/OF Performed Work Status Update, if needed Report Manager RWF Profile DSS/OF IM/IA SWF Profile Interoperability Strategy Workshop

20. Diagnostic Reporting Use Cases • Predefined report • Workitem deferred • Direct report creation • Interpretation and dictation • Transcription • Partial completion • Verification Interoperability Strategy Workshop

21. Predefined report The results are normal I will also verify the report • The user chooses a report from a list of pre-configured draft reports Interoperability Strategy Workshop

22. Task deferred Put this task back on the worklist. • The user selects the task and decides not to perform it Interoperability Strategy Workshop

23. Partial Completion Bad data quality! New acquisition is required • The user begins the task and then decides that this task cannot be completed at this moment Interoperability Strategy Workshop

24. Verification Send report back to the transcriptionist for correction • The user may need to correct the report's content by dictation Interoperability Strategy Workshop

25. More information…. • IHE Web sites: www.ihe.net • Technical Frameworks, Supplements • Fill in relevant supplements and frameworks • 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 Questions? Interoperability Strategy Workshop