What to see at theRSNA annual meeting?RADIOLOGY IT 2011David S. Mendelson, M.D.Professor of RadiologyChief of Clinical InformaticsThe Mount Sinai Medical CenterCo-chair IHE International Board
Major Radiology IT Themes-Meaningful Use for the Radiologist Radiation Exposure Aggregating and monitoring patient and population exposure Image Sharing Quality Diminished inappropriate utilization IHE XDS; Personal Health Records as a vehicle Reporting Decision Support Teaching and Research MIRC CTP IHE- TCE Radlex as a fundamental tool Playbook Meaningful Use – ONC/CMS
Radiation Exposure Evaluating legacy dose information OCR solutions Evaluating dose today Within the institution Comparing multiple instruments Patient Site comparison IHE-REM profile ACR registry Site to Site comparison as well as within an enterprise Radlex terms
REM Actors and Transactions to move dose information stored as DICOM SR
MIRC - Teaching Files Medical Imaging Resource Center Ease of installation Brand new user interface - more intuitive, easier to operate TCE compatible - of course!! Improved conferencing capabilities Automatic conversion utility to bulk import entire static image collections into the system with a few clicks
CTP- Clinical Trials Processor Again, ease of installation and configuration Best anonymizer in the business! Audit trail repository - 21CFR11 compliance for FDA- work in progress Plug-in architecture, customizable pipelines Extremely efficient - will easily process millions of images De-facto image management tool for NCI and other large trials
TCE- Teaching File andClinical Trial Export IHE profile How to get images directly out of PACS as a part of your normal workflow
Reporting Structured reporting Standardization of content Quality Data mining Decision support Trigger events RSNA Templates Incorporation of RADLEX
RADLEX The Radlex playbook for CT orderables will be released by the annual show The ACR Dose Registry is employing the Radlex ontology for its exam dictionary ideally a site would use this exam dictionary the ACR has a tool to map other exam dictionaries to the RADLEX playbook
IMAGE SHARING • Version 1.1 is in production • Review and Update 2011
IHE-XDS (Cross-Enterprise Document Sharing) XDS.a XDS- I.a XDS.b ?? XDS-I.b a vs. b Related to web standards and transactions
NIBIB/RSNA Image SharingProject A Standards Based Solution
Goals of Contract NIBIB contract Bootstrap an IHE based network Primary emphasis is Consumer Control through PHRs Can be extended to other forms of sharing HIE Security and Confidentiality are drivers Replacement / Alternative to CD
NIBIB contract summary Consumer Control 5 Academic Institutions Mayo Clinic Employ IHE solutions Mount Sinai Medical whenever possible Center IHE generally has not University of California focused on San Francisco consumer- driven University of Chicago solutions, but rather on institutional and University of Maryland enterprise workflow Establish a clearinghouse Engage PHRs 300,000 patients over 2 years
Image Sharing/Elements ofSolution Edge Server Register a patient Listens to a Radiology Information System (RIS) - looking for a complete exam Retrieves Image set from PACS and Report from RIS Send both to clearinghouse PHI hidden; an RSNA ID and 2nd factor security token are used to identify the patient Clearinghouse (XDS-I) – functions as a secure router Transiently hold encrypted patient data PHR Consumer controls upload and future access Must have RSNA ID available and know answer to 2nd factor question Develop web based viewers Download full DICOM data set Misc Consumers
Project design assumptions Security is paramount Restrictive policy PHI is never unsecured Consumer controls the flow of information by placing it in the PHR Diminishes the need for BAAs between enterprises Imaging Site to Clearinghouse Clearinghouse to PHR
Future Directions Refine Workflow Initial workflow is to replace a CD Exam updates Download DICOM data and archive in a local PACS Edge server as a platform Radiation Monitoring Peer Review Quality Metrics
Live Q&A Session To Submit a Question: • Type your question in theDavid Mendelson white “Q and A” box.Professor of Radiology & Chief of Clinical Informatics • Hit “SUBMIT” toThe Mount Sinai Medical Center; Co-chair IHE deliver your question to theInternational Board email@example.comMary TierneyVP, Chief Content Officer, Health Imagingmtierney@healthimaging.com All presentations will be available OnDemand within 48 hours. To view this presentation again, please login into the conference and visit the Auditorium.
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