Cross-enterprise Document Sharing for Imaging

Cross-enterprise Document Sharing for Imaging (XDS-I.b) extends XDS to share images, diagnostic reports and related information across a group of care sites.

Summary

XDS-I.b provides a solution for publishing, finding and retrieving imaging documents across a group of affiliated enterprises.

Affiliated Enterprises such as radiology departments, private physicians, clinics, long term care, and acute care centers can contribute and access imaging documents of interest.

Imaging documents include:

• Imaging studies (images, measurements, results from analysis packages, presentation states);
• Diagnostic reports for imaging studies;
• Key Image selections associated with the report content for their diagnostic significance.

Benefits

Imaging component of the Electronic Health Record

• Shared imaging Record, in a community, region, etc.

Effective means to contribute and access imaging documents across health enterprises

• Without XDS-I.b, access to the radiology report across health enterprises is difficult

Scalable sharing of imaging documents

• Sharing imaging documents between radiology departments, private physicians, clinics, long term care, acute care with different clinical IT systems.

Easy access to imaging documents

• Care providers are offered means to query and retrieve imaging documents (images and reports) of interest using the same mechanisms used to query other documents

Details

An Imaging Document Source that wants to share a set of images and/ or imaging information objects such as a presentation state constructs a DICOM manifest that references the DICOM instances that are to be published. The manifest along with metadata is submitted to the Document Repository. The metadata describes the information that is shared. Besides information about the patient and information required by the XDS profile, the Imaging Document Source provides metadata information that is image specific such as the type of imaging procedure, the modality and the anatomic region. Images and/ or imaging information objects that are made available are not transferred to the Document Repository. Instead, the Imaging Document Source is required to make them available to be retrieved.

An Imaging Document Consumer that is interested in retrieving previously published imaging information, queries the registry ( i.e. find all CT of the Head of patient John Doe for the last 2 years) and retrieves the manifest of interest. The Imaging Document Consumer decodes the manifest to extract the identifiers that uniquely identifies the available imaging information. The Imaging Document Consumer retrieves the images and/ or imaging information objects from the Imaging Document Source.

An Imaging Document Source that wants to share an imaging report constructs a document that is shared either in a PDF and /or CDA (containing only text) format. The report is submitted to the Document Repository.

A Document Consumer (any Document Consumer and not only Imaging Document Consumer) that is interested in retrieving previously published imaging report, queries the registry and retrieves the report from the Document Repository.

Systems Affected

PACS and Workstations might implement an Imaging Document Source to provide and submit images and/ or imaging reports.

RIS might implement an Imaging Document Source to provide and submit imaging reports.

PACS, Workstation, RIS and non-radiology workstations might implement an Imaging Document Consumer to retrieve and display images and imaging reports.

Actors & Transactions:

Specification

Profile Status: Trial Implementation

Documents:

IHE Radiology Technical Framework:

• Supplement for Trial Implementation Rev1-2

Underlying Standards:

• DICOM
• ebXML (ebRS v3.0, ebRIM v3.0)
• HL7 CDA Release 2.0
• PDF/A ISO 19005-1
• MTOM
• XOP

See Also

Related Profiles

• Cross-Enterprise Document Sharing (XDS) provides the basic document registration and query capabilities that this profile builds on.
• Cross-enterprise Sharing of Scanned Documents (XDS-SD) provides the CDA-wrapper for plain text reports

Consumer Information

The XDS-I FAQ answers typical questions about what the Profile does.

The XDS-I Purchasing describes considerations when purchasing equipment to deploy this Profile.

Implementer Information

The XDS-I Implementation provides additional information about implementing this Profile in software.

There are a variety of additional pages with XDS Implementation Information:

• XDS Implementation Notes
• XDS.a Implementation Notes
• XDS Implementation
• XDS.b Implementation
• Cross-Enterprise Document Sharing Implementation
• NIST XDS Implementation FAQ

Reference Articles

• Grid-based implementation of XDS-I as part of image-enabled EHR for regional healthcare in Shanghai, Zhang, j. et al, INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY, 2011link

• Image Exchange: IHE and the Evolution of Image Sharing, DS Mendelson et al, Radiographics, 2008 link

• Research of Related Issues in Regional Sharing for IHE XDS and Medical Imaging, ZHENG X., WU Y., XIA X., Chinese Medical Equipment Journal, July, 2009 link

• PACS: Beyond Radiology, S. Storkson, A. Aslaksen, International Journal of Computer Assisted Radiology and Surgery, Volume 4, Supplement 1 / June, 2009 link

• Image Distribution, P. Chang, Practical Imaging Informatics, 2009 link

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