1September, 2005 What IHE Delivers
Key Image NotesKey Image Notes
Evidence DocumentsEvidence Documents
Simple Image & Nume...
2September, 2005 What IHE Delivers
Key Image NotesKey Image Notes
3
Key Image NotesKey Image Notes
Value PropositionValue Proposition
There is more to teamwork than images and reportsThere...
4
Don’t Call Us, We’ll Call YouDon’t Call Us, We’ll Call You
““Dave, you read that 3000 slice MR study last night. CanDave...
5
for referring physician
Here you can
see the renal
osteopathy.
For teaching
Fibroosteoclasia
6
Different notes on different images
Same note on different images
for referring physician
Here you can see the
renal rup...
7
Key Image Notes Titles are CodedKey Image Notes Titles are Coded
Defined by DICOM. May be extendedDefined by DICOM. May ...
8September, 2005 What IHE Delivers
Evidence DocumentsEvidence Documents
9
Evidence DocumentsEvidence Documents
Value PropositionValue Proposition
Measurements and coded dataMeasurements and code...
10
Evidence DocumentsEvidence Documents
…..
Findings:
Image Refs.:
Header:
Report Type: OB / Gyn
BPD
...
…..
Evidence Docu...
11
Evidence DocumentsEvidence Documents
ExamplesExamples
Mammography CADMammography CAD
Chest CADChest CAD
OB-Gyn Ultrasou...
12
InterpretationInterpretation
…..
ndings:
Image Refs.:
eader:
eport Type: OB / Gyn
BPD
...
…..
Simple Image &Simple Imag...
13September, 2005 What IHE Delivers
Simple Image & NumericSimple Image & Numeric
ReportReport
14
Can You Make A Report Like This?Can You Make A Report Like This?
Institution IdentificationInstitution Identification
P...
15
(We can’t either). What about?(We can’t either). What about?
DiscussionDiscussion
Comparison is made to the prior study...
16
Simple ImageSimple Image
andand
Numeric ReportsNumeric Reports
17
Simple Image & Numeric ReportsSimple Image & Numeric Reports
Value PropositionValue Proposition
Reports’ content is mor...
18
Pattern –Pattern – Simple Image ReportSimple Image Report
• Minimal Structure : Coded Title and HeadingsMinimal Structu...
19
Pattern –Pattern – Simple Image &Simple Image &
Numeric ReportNumeric Report
Simply adds Measurements to Simple Image R...
20
AnAn
illustrationillustration
21September, 2005 What IHE Delivers
Access to Radiology InformationAccess to Radiology Information
22
Access to Radiology InformationAccess to Radiology Information
Abstract / ScopeAbstract / Scope
Provides access to radi...
23
Multiple Sources OptionMultiple Sources Option
Allows user access toAllows user access to distributeddistributed Radiol...
24
Access to Radiology InformationAccess to Radiology Information
Value PropositionValue Proposition
Improves data accessi...
25
Access to Radiology InformationAccess to Radiology Information
Value Proposition (2)Value Proposition (2)
Improves effi...
26
Access to Radiology InformationAccess to Radiology Information
Standards UsedStandards Used
DICOM Query/ RetrieveDICOM ...
27
Access to Radiology InformationAccess to Radiology Information
Actors/ Actor RequirementsActors/ Actor Requirements
Ima...
28
Access to Radiology InformationAccess to Radiology Information
Multiple Sources OptionMultiple Sources Option
Actors/ A...
29
More information….More information….
IHE Web site:IHE Web site: http://www.ihe.nethttp://www.ihe.net
http://www.himss.o...
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Key Image Notes Evidence Documents

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  • When Querying, get only the images with notes. Also referred as money shots. Don’t need to get all the images of a study at first.
  • Is there a way to associate a few choice words with an image? How about a way to associate one comment with a bunch of images? Can I tag images for QA purposes? Can technologists tag images in order to explain why images have artifacts
  • I should be able click on anything that is underlined or in color and get more info or images (green).
  • 1st bullet on Accessibility:
    Querying multiple sources also provides an opportunity for an Image Display to access objects stored in a “legacy” archive that has been replaced by, and is possibly having its information migrated to, a new Image Manager/Image Archive.
  • Detailed specs for DICOM Q/R:
    Defines Matching keys for response filtering by Image Archive
    Defines Return keys to be requested by Image Display
    Defines Returned attributes by Image Archive in query responses
    Defines Returned attributes required to be displayed on Image Display
  • Image Managers and Report Managers shall also support the Patient Information Reconciliation integration profile in order to ensure that the information gathered from them is as accurate as possible. Since having actors in different ADT (patient identifier) domains could result in unpredictable query results, this option assumes that all actors are members of the same ADT domain (i.e., it can be assumed that a given patient identifier uniquely refers to a single patient).
  • Key Image Notes Evidence Documents

    1. 1. 1September, 2005 What IHE Delivers Key Image NotesKey Image Notes Evidence DocumentsEvidence Documents Simple Image & Numeric ReportSimple Image & Numeric Report Access to Radiology InformationAccess to Radiology Information IHE Vendors Workshop 2006IHE Vendors Workshop 2006 Rita Noumeir, Ph.D.,Rita Noumeir, Ph.D., SoftmedicalSoftmedical
    2. 2. 2September, 2005 What IHE Delivers Key Image NotesKey Image Notes
    3. 3. 3 Key Image NotesKey Image Notes Value PropositionValue Proposition There is more to teamwork than images and reportsThere is more to teamwork than images and reports With IHE, it is possible to attach « electronic post-it™ » toWith IHE, it is possible to attach « electronic post-it™ » to images to increase informal but critical communicationimages to increase informal but critical communication between:between:  The Technologist and the Radiologist about specific examination eventsThe Technologist and the Radiologist about specific examination events  The Radiologist and the Technologist about image quality issuesThe Radiologist and the Technologist about image quality issues  The Radiologist and other department clinicians (surgeon,The Radiologist and other department clinicians (surgeon, orthopedist,..)orthopedist,..)  The Radiologist and collegues about selecting images for conferencesThe Radiologist and collegues about selecting images for conferences  The Radiologist to the Referring Provider, …..etc.The Radiologist to the Referring Provider, …..etc. Query for the Images/Studies using the codesQuery for the Images/Studies using the codes This IHE Integration Profile is the cost effective solutionThis IHE Integration Profile is the cost effective solution (increases radiology and overall efficiency)(increases radiology and overall efficiency)
    4. 4. 4 Don’t Call Us, We’ll Call YouDon’t Call Us, We’ll Call You ““Dave, you read that 3000 slice MR study last night. CanDave, you read that 3000 slice MR study last night. Can you highlight the 5 most important images for me”you highlight the 5 most important images for me”  Thinking… “Thinking… “#$@%!%# You#$@%!%# You”, says “Sure””, says “Sure” ““Dr. Channin, I just reviewed 40 cases and marked myDr. Channin, I just reviewed 40 cases and marked my questions on yellow stickies. Can you review those”questions on yellow stickies. Can you review those” Tech to radiologist:Tech to radiologist: “The patient wouldn’t hold still”“The patient wouldn’t hold still” The solution is……The solution is……
    5. 5. 5 for referring physician Here you can see the renal osteopathy. For teaching Fibroosteoclasia
    6. 6. 6 Different notes on different images Same note on different images for referring physician Here you can see the renal rupture. Note1 for referring physician This is the hematoma. Note2 for refering physician Here you can see the renal rupture. Note1 for refering physician This is the hematoma. Note2 for refering physician Hematoma everywhere Note3 for refering physician Hematoma everywhere Note3 for refering physician Hematoma everywhere Note3 for refering physician Hematoma everywhere Note3 for referring physician Hematoma everywhere Note3
    7. 7. 7 Key Image Notes Titles are CodedKey Image Notes Titles are Coded Defined by DICOM. May be extendedDefined by DICOM. May be extended The note title defines the semanticsThe note title defines the semantics of the reason of significance.of the reason of significance. Key Image Notes cKey Image Notes can be queried byan be queried by code.code. The user comments are meant to beThe user comments are meant to be informalinformal.. 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 Quality Issue For Reporting
    8. 8. 8September, 2005 What IHE Delivers Evidence DocumentsEvidence Documents
    9. 9. 9 Evidence DocumentsEvidence Documents Value PropositionValue Proposition Measurements and coded dataMeasurements and coded data  DICOM SR documentDICOM SR document Created by either Acquisition Modality orCreated by either Acquisition Modality or Evidence CreatorEvidence Creator Produced during acquisition or post-Produced during acquisition or post- processing workflowsprocessing workflows Interpreted along with the imagesInterpreted along with the images
    10. 10. 10 Evidence DocumentsEvidence Documents ….. Findings: Image Refs.: Header: Report Type: OB / Gyn BPD ... ….. Evidence DocumentEvidence Document StoredStored Storage CommitmentStorage Commitment Query / RetrieveQuery / Retrieve
    11. 11. 11 Evidence DocumentsEvidence Documents ExamplesExamples Mammography CADMammography CAD Chest CADChest CAD OB-Gyn Ultrasound MeasurementsOB-Gyn Ultrasound Measurements Vascular Ultrasound MeasurementsVascular Ultrasound Measurements Vascular Intervention ResultsVascular Intervention Results Echocardiography MeasurementsEchocardiography Measurements
    12. 12. 12 InterpretationInterpretation ….. ndings: Image Refs.: eader: eport Type: OB / Gyn BPD ... ….. Simple Image &Simple Image & Numeric ReportNumeric Report EvidenceEvidence DocumentsDocuments ….. Findings: Image Refs.: Header: Report Type: OB / Gyn BPD ... ….. Radiology Report Impressions: Gestational Age ... Key Image NotesKey Image Notes
    13. 13. 13September, 2005 What IHE Delivers Simple Image & NumericSimple Image & Numeric ReportReport
    14. 14. 14 Can You Make A Report Like This?Can You Make A Report Like This? Institution IdentificationInstitution Identification Patient IdentificationPatient Identification Study IdentificationStudy Identification Technique IdentificationTechnique Identification DiscussionDiscussion The liver is normal. There is a focal area ofThe liver is normal. There is a focal area of decreased attenuation adjacent to the falciformdecreased attenuation adjacent to the falciform ligt.,ligt., likely representing focal fatlikely representing focal fat ((image 22image 22). The). The spleen, both kidneys, the … are normal.spleen, both kidneys, the … are normal. ImpressionImpression CT of the abdomen within normal limitsCT of the abdomen within normal limits SignatureSignature
    15. 15. 15 (We can’t either). What about?(We can’t either). What about? DiscussionDiscussion Comparison is made to the prior study of 4/11/99Comparison is made to the prior study of 4/11/99. The. The leftleft paratracheal lymph nodeparatracheal lymph node ((image 8image 8,, image 11image 11) now) now measuresmeasures 2.5x2.7x3.1 cm2.5x2.7x3.1 cm increasing fromincreasing from 2.0x2.1x2.62.0x2.1x2.6 previously. No other mediastinal, upper abdominal orpreviously. No other mediastinal, upper abdominal or axillary adenopathy is identified. No focal pulmonaryaxillary adenopathy is identified. No focal pulmonary lesions are seen. The yadda, yadda, yadda arelesions are seen. The yadda, yadda, yadda are normal.normal. ImpressionImpression Worsening L Paratracheal adenopathy.Worsening L Paratracheal adenopathy. SignatureSignature The solution is……The solution is……
    16. 16. 16 Simple ImageSimple Image andand Numeric ReportsNumeric Reports
    17. 17. 17 Simple Image & Numeric ReportsSimple Image & Numeric Reports Value PropositionValue Proposition Reports’ content is more than words…Reports’ content is more than words… Based on DICOM SRBased on DICOM SR Allows to include without transcription:Allows to include without transcription:  measurementsmeasurements  image linksimage links  structured contentstructured content Integrated with the imaging workflowIntegrated with the imaging workflow Friendly to XML implementationsFriendly to XML implementations Easy to export with HL7Easy to export with HL7
    18. 18. 18 Pattern –Pattern – Simple Image ReportSimple Image Report • Minimal Structure : Coded Title and HeadingsMinimal Structure : Coded Title and Headings • Full image links from specific sections of reportFull image links from specific sections of report • Observation ContextObservation Context (who, what, when)(who, what, when) may be section specificmay be section specific 0-n CONTAINS 1 CONTAINS 0-n 0-n INFERRED FROM Report Text Image Reference Observation Context (See section 5.3.2.3)1-n Section Heading Document Title Image Reference 0-1 Observation Context (See section 5.3.2.3) 0-n Coded Entry 0-n INFERRED FROM Image Reference
    19. 19. 19 Pattern –Pattern – Simple Image &Simple Image & Numeric ReportNumeric Report Simply adds Measurements to Simple Image ReportsSimply adds Measurements to Simple Image Reports 0-n CONTAIN S HAS OBS CONTEXT 1 CONTAIN S 0-n Report Text Image Reference Observation Context (See section 5.3.2.3)1-n Section Heading Document Title HAS OBS CONTEXT 0-1 Observation Context (See section 5.3.2.3) 0-n Coded Entry 0-n 0-n INFERRED FROM Image Reference Measurement 0-n Measurement 0-n INFERRED FROM Image Reference Measurement 0-n
    20. 20. 20 AnAn illustrationillustration
    21. 21. 21September, 2005 What IHE Delivers Access to Radiology InformationAccess to Radiology Information
    22. 22. 22 Access to Radiology InformationAccess to Radiology Information Abstract / ScopeAbstract / Scope Provides access to radiology informationProvides access to radiology information within the rest of the hospital (e.g., ER, OR,within the rest of the hospital (e.g., ER, OR, cardiology, oncology, etc)cardiology, oncology, etc)  Images, evidence documents, presentation states, keyImages, evidence documents, presentation states, key image notes, structured radiology reportsimage notes, structured radiology reports Query and retrieve based modelQuery and retrieve based model
    23. 23. 23 Multiple Sources OptionMultiple Sources Option Allows user access toAllows user access to distributeddistributed RadiologyRadiology informationinformation  Describes how users can query multiple informationDescribes how users can query multiple information sourcessources
    24. 24. 24 Access to Radiology InformationAccess to Radiology Information Value PropositionValue Proposition Improves data accessibility by makingImproves data accessibility by making radiology information available within theradiology information available within the hospitalhospital  Makes data from different sources available with aMakes data from different sources available with a single request (Multiple Sources Option)single request (Multiple Sources Option) Improves patient safety by reducing the use ofImproves patient safety by reducing the use of incomplete imaging records (Multiple Sourcesincomplete imaging records (Multiple Sources Option)Option)
    25. 25. 25 Access to Radiology InformationAccess to Radiology Information Value Proposition (2)Value Proposition (2) Improves efficiency by eliminating the need toImproves efficiency by eliminating the need to perform multiple searches to access completeperform multiple searches to access complete imaging records (Multiple Sources Option)imaging records (Multiple Sources Option) Cost effective solution for finding the pertinentCost effective solution for finding the pertinent information for the patient in the Radiologyinformation for the patient in the Radiology domaindomain
    26. 26. 26 Access to Radiology InformationAccess to Radiology Information Standards UsedStandards Used DICOM Query/ RetrieveDICOM Query/ Retrieve  Defines Matching keys for response filtering byDefines Matching keys for response filtering by Image Manager/ArchiveImage Manager/Archive  Defines Return keys to be requested by ImageDefines Return keys to be requested by Image DisplayDisplay  Defines Returned attributes supported by ImageDefines Returned attributes supported by Image Manager/Archive in query responsesManager/Archive in query responses  Defines Returned attributes required to beDefines Returned attributes required to be displayed on Image Displaydisplayed on Image Display
    27. 27. 27 Access to Radiology InformationAccess to Radiology Information Actors/ Actor RequirementsActors/ Actor Requirements Image Display / Report Reader:Image Display / Report Reader:  Required to support the specified query matching andRequired to support the specified query matching and return keys as a “client” (DICOM SCU)return keys as a “client” (DICOM SCU) Image Manager / Report Manager:Image Manager / Report Manager:  Required to support the specified query matching andRequired to support the specified query matching and return keys as a “server” (DICOM SCP)return keys as a “server” (DICOM SCP)
    28. 28. 28 Access to Radiology InformationAccess to Radiology Information Multiple Sources OptionMultiple Sources Option Actors/ Actor RequirementsActors/ Actor Requirements Image Display / Report Reader:Image Display / Report Reader:  Must be able to query from multiple sources andMust be able to query from multiple sources and consolidate the resultsconsolidate the results Image Manager / Report Manager:Image Manager / Report Manager:  No additional query or retrieve requirements, but mustNo additional query or retrieve requirements, but must support Patient Information Reconciliation (PIR)support Patient Information Reconciliation (PIR)
    29. 29. 29 More information….More information…. IHE Web site:IHE Web site: http://www.ihe.nethttp://www.ihe.net http://www.himss.org/IHEhttp://www.himss.org/IHE http://www.rsna.org/IHEhttp://www.rsna.org/IHE http://www.acc.org/quality/http://www.acc.org/quality/iheihe..htmhtm Technical FrameworksTechnical Frameworks Technical Framework SupplementsTechnical Framework Supplements – Trial Implementation– Trial Implementation Non-Technical Brochures :Non-Technical Brochures :  Calls for ParticipationCalls for Participation  IHE Fact Sheet and FAQIHE Fact Sheet and FAQ  IHE Integration Profiles: Guidelines for BuyersIHE Integration Profiles: Guidelines for Buyers  IHE Connect-a-thon ResultsIHE Connect-a-thon Results  Vendor Products Integration StatementsVendor Products Integration Statements Questions? Questions?
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