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Cross - Enterprise Screening Mammography - Workflow Definition (XSM-WD)

Cross - Enterprise Screening Mammography - Workflow Definition (XSM-WD). White Paper for 2011/2012 presented to the RAD Technical Committee, Planning Committee, Mammography Arianna Cocchiglia , Francesca Vanzo, Luca Zalunardo December, 9 th 2011. White Paper developing.

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Cross - Enterprise Screening Mammography - Workflow Definition (XSM-WD)

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  1. Cross - Enterprise Screening Mammography - Workflow Definition(XSM-WD) White Paper for 2011/2012 presented to the RAD Technical Committee, Planning Committee, Mammography Arianna Cocchiglia, Francesca Vanzo, Luca Zalunardo December, 9th 2011

  2. White Paper developing The work group started to draw up the draft version of the White Paper The main themes of the work are: • description of the most common practices in mammography screening according to several workflows and conveying them in the Mammography Screening Task Diagram • definition of the actors and transactions needed in this clinical process • definition of a common structure for the Workflow Document

  3. The Mammography Screening Task Diagram • As known, this White Paper relies on of the ITI XDW profile by using the Workflow Document which manages and gathers the details necessary about the screening process and collects: • Workflow and Tasks Information • Input Document References • Output Document References • In order to enrich the Task Diagram, Input and Output Documents items have been included

  4. The Mammography Screening Task Diagram TASK 1: RECRUITMENT • Task 1  4 INPUT …….. OUTPUT - Invitation Letter If a woman misses her scheduled appointment OR OR TASK 2a: ADMISSION TASK 2b: ADMISSION INPUT - Previous Exams - Invitation Letter INPUT - Invitation Letter …………… OUTPUT - Images (KOS Document) - AnamnesticDocument OUTPUT - “No admission” Document END TASK 4: EVALUATION 2 TASK 3: EVALUATION 1 INPUT - Images (KOS Document) - Anamnestic Document INPUT - Images (KOS Document) - Anamnestic Document OUTPUT - Report 1 OUTPUT - Report 2

  5. The Mammography Screening Task Diagram • Task 5  7 TASK 5: CS EVALUATION INPUT - Report 1 - Report 2 OUTPUT - Response Report (--,++,+-) OR OR OR TASK 6a: END (--) TASK 6b: SECOND LEVEL (++) TASK 6c: EVALUATION 3 INPUT - Response Report INPUT - Response Report INPUT - Images (KOS Document) - Anamnestic Document OUTPUT - Letter to Patient END • OUTPUT • - Letter to Patient (“Alert”) • Planning Document • END OUTPUT - Report 3 TASK 7: RESPONSE INPUT - Report 1 - Report 2 - Report 3 OR OR OUTPUT - Response Report (+-+,+--) TASK 6b: SECOND LEVEL (+-+) TASK 6a: END (+--)

  6. Actors and Transaction XSM–WD Diagram Complete Diagram

  7. Actors and Transaction XSM–WD Diagram Complete Diagram XDS Lifecycle Management Tools coordinate WorkflowDocumentupdates

  8. Actors and Transaction XSM–WD XDW SpecificActors XDS SpecificActors

  9. Actors and Transaction XSM–WD ImagingSpecificActors 1/2

  10. Actors and Transaction XSM–WD ImagingSpecificActors 2/2

  11. Actors and Transaction XSM–WD Other Actors

  12. XSM–WD in the XDS environment • The complete Actor and Transactions Digram shows several transactions and groupable actors • Since the Workflow Document is meant to be constantly updated with the information conveyed by the XDS transactions, we will consider the XSM-WD Workflow Document from this point of view

  13. Workflow Document: Creation and update • The Content Creator constitutes the first version of the Workflow Document • The Content Updater modifies and adds new data based on the tracking of the screening process • The Content Consumer retrieves the Workflow Document

  14. Workflow Document: Creation • The Content Creator constitutes the first version of a Workflow Document and places it into a new Workflow Context Folder (stored in the Document Repository) which will be a fixed reference for the Workflow Document. This actor shall: • Create a New Workflow Context Folder • Generate the First Version of the XSM-WD Workflow Document with the Description information, the Recruitment Task setting as “Completed” the Task’s status including the Input/Output Document References • Submit the Workflow Document to the Folder stored in the Document Repository

  15. Workflow Document: Update • The ContentUpdater modifies and adds new data based on the tracking of the screening process and provides it to the Document Repository and Registry by a Replace. The Content Updater shall: • Get the only “Approved” version of the Workflow Document in the Folder • Update XSM-WD Workflow Document Description elements • Include the new Task, added to the content of the latest Workflow Document version, with its own Input/Output Document References • Save all changes in a new Workflow Document, setting as “Deprecated” the last one and as “Approved” the current version) • Submit the updated Workflow Document to the Folder (stored in the Document Repository)

  16. Workflow Document: Update • Into the Folder there will be only one Workflow Document with the “Approved” status. All the previous ones are located into the same Folder will have a “Deprecated” status • The case with moreContentUpdaters which modify and add new data using a common latest version of the Workflow Document would succeed only for the first Content Updater who submits it. Infact the other(s) would submit the Workflow Document with the documentUniqueID of a “Deprecated” Workflow Document and this can not be accepted • Example Task 3-4: The second radiologist Content Consumer should always refer to the Evaluation 1 Worflow Document to avoid errors: • The second radiologist will not see the screening Images on his/her worklist until the first one will have finished his/her evaluation • Another etrieve of the “actual” Workflow Document and update of it only at the end of each Evaluation (for these two Tasks)

  17. Workflow Document: Retrieve • The Content Consumer retrieves the Workflow Document, obtains informations from it,… • This actor should retrieve the latest version which coincides with the unique “Approved” version • Input/Output Document references for each Task include: • XDSDocumentEntry.uniqueId • homeCommunityId • Possible queries: • Find the Workflow Folder for a Patient • Get the Workflow Folder in which a particular Workflow Document is stored • Get one or more document referenced in a Workflow Document • …

  18. XSM–WD Workflow Document • The XDM-WD Workflow Document cutomization complies the XDW XML Schema which includes elements from the following standards: • HL7 CDA • OASIS WS-Human Task • The four part Document composition: • See XDW Profile for the detailed description of all WD elements

  19. Screening Mammography Workflow Document • Workflow Document Information: • id : documentId • title : « Screening Mammography Workflow Document » • effectiveTime : … • confidentialityCode : … • languageCode : … • patient : Jane Doe  • author : Dr.Kris  • workflowIstanceId : • workflowDocumentSequenceNumber : « 3 » • workflowStatus : « OPEN » • workflowDefinitionReference : to workflow definition template (urn: OID:…) • XDWdocumentHistory : …  XSM–WD Workflow Document • The XSM-WD Workflow Document at Task 3 “Evaluation 1”: TASK 3: EVALUATION 1 INPUT - images (KOS Document) - anamnestic doc TaskList OUTPUT - Report 1 XDWTask taskData Name : Recruitment id : Status : Completed Date/time : Input : Lists of eligible women Output : Recruitment Letter actualOwner : Dr.Smith … • The main Workflow Document Informations are located in the first three part of the structure • Some elements are updated upon on the specific Task: author, workflowDocumentSequenceNumber workflowStatus,… • The fourth part is composed by the list of the actual and the previous Tasks XSM-WD Workflow Document • Workflow Document Information: • id : documentId • title : « Screening Mammography Workflow Document » • effectiveTime : … • confidentialityCode : … • languageCode : … • patient : Jane Doe  • author : Dr.Kris  • workflowIstanceID: • workflowDocumentSequenceNumber : « 3 » • workflowStatus : « OPEN » • workflowDefinitionReference : to workflow definition template (urn: OID:…) • XDWdocumentHistory : …  taskEventHistory  XDWTask taskData Name : Admission id : Status : Completed Date/time : Input : Invitation Letter, Previous exams Output : KOS Document, Anamnestic Document actualOwner : Dr. White … TaskList  taskEventHistory  XDWTask taskData Name : Evaluation 1 id : Status : Completed Date/time : Input : KOS Document, Anamnestic Document Output : Report 1 actualOwner : Dr. Kris … taskEventHistory 

  20. XSM–WD Workflow Document • The XSM-WD Workflow Document at Task 3 “Evaluation 1”: TASK 3: EVALUATION 1 INPUT - images (KOS Document) - anamnestic doc XDWTask OUTPUT - Report 1 OUTPUT - Report 1 taskData Name : Recruitment id : Status : COMPLETED Date/time : Input : Lists of eligible women Output : Recruitment Letter actualOwner : Dr.Smith … • The taskList element includes all generated Tasks items • The last Task’s actualOwner represents the author for the general information of the Workflow Document taskEventHistory  XDWTask XDWTask taskData Name : Evaluation 1 id : Status : COMPLETED Date/time : Input : KOS Document, Anamnestic Document Output : Report 1 actualOwner : Dr. Kris … taskData Name : Admission id : Status : COMPLETED Date/time : Input : Invitation Letter, Previous exams Output : KOS Document, Anamnestic Document actualOwner : Dr. White … taskEventHistory  taskEventHistory 

  21. Example: taskData Element in XSM-DW <ns3:taskData> <ns2:taskDetails> <ns2:id>3</ns2:id> <ns2:taskType>Requested</ns2:taskType> <ns2:name>Evaluation 1</ns2:name> <ns2:status>COMPLETED</ns2:status> <ns2:createdTime>YYYY-MM-DDTHH:MM:SS.0Z</ns2:createdTime> <ns2:lastModifiedTime>YYYY-MM-DDTHH:MM:SS.0Z</ns2:lastModifiedTime> <ns2:renderingMethodExists>false</ns2:renderingMethodExists> </ns2:taskDetails> <ns2:description></ns2:description> <ns2:input> <ns2:part name="xdw"> <reference uid="urn:oid:1.2.3.4.4.3.2.2.X"/> <!– KOS Document --> </ns2:part> <ns2:part name="xdw"> <reference uid="urn:oid:1.2.3.4.4.3.2.2.Y"/> <!– Anamnestic Document--> </ns2:part> </ns2:input> <ns2:output> <ns2:part name="xdw"> <reference uid="urn:oid:1.2.3.4.4.4"/> <!– Report 1 --> </ns2:part> </ns2:output> </ns3:taskData> XDWTask taskData Name : Evaluation 1 id : Status : COMPLETED Date/time : Input : KOS Document, Anamnestic Document Output : Report 1 actualOwner : Dr. Kris … taskEventHistory  • Work in progress: The entire customization on the Screening Mammography Workflow Document

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