Enterprise Scanner Protocol Management - Proposal

1. Proposed Workitem: Enterprise Scanner Protocol Management

• Proposal Editor: Krishna Juluru
• Editor: <Name of candidate Lead Editor for the Profile, if known>
• Domain: Radiology

2. The Problem

Although imaging protocols in different scanners may have the same name and are intended to achieve the same diagnostic outcome, the contents of the protocols often differ in details such as:

• procedure step name (series name)
• procedure step sequence
• procedure step parameters

This has consequences in both clinical and research settings. Inconsistent series names can lead to failures of hanging protocols and failures of image processing pipelines in research. Wrong procedure step sequence can lead to scan delays and incorrect timing of post-contrast phases. Variability in scan parameters can lead to difficulties in following lesions over time, and variability in image quantification, not to mention unnecessary radiation.

There is a need to standardize imaging protocols within an institution, and between institutions. Currently, at most institutions, this standardization is performed manually by a lead technologist who visits every scanner and checks the uniformity the protocols.

Value Statement: Manual management of imaging protocols involves a visit to every scanner in an institution and is a time-consuming and error prone process. The problem is exacerbated when scanner software is upgraded and existing protocols are deleted. The institution’s ability to implement desirable changes to protocols is also limited due to this manual process.

A better solution would be a system and process that could manage all scanner protocols within an institution from a central access point. This would enable standardization across scanners, quick updates of protocols, and monitoring of protocols for quality assurance purposes.

3. Key Use Case

Rather than an ad hoc manual process that involves physically visiting each device in an institution or group of institutions and on each device reviewing dozens or hundreds of protocols, using tools and doing much of this remotely would have a tremendous benefit. The following use case is an example. The tech cmte is expected to explore variants.

Protocol Review

• Lead tech or radiologist visits a protocol management workstation
• The workstation pulls the full set of protocols from all the scanners in the institution or group of institutions
• Features on the workstation let the tech

• organize the protocols by device model, clinical purpose, patient type, etc.
• see what protocols have been added or changed recently or since the last review
• compare parameter values across selected protocols, e.g. to find undesired differences, or confirm necessary differences are in place

• The workstation allows the tech to push the appropriate protocol sets out to specific devices or groups of devices
• The tech might be allowed to make certain simple edits to protocols

• E.g. when a "correct" version of the protocol is not available on another scanner to be simply copied.
• Edits might include aligning names or descriptions, or setting dose thresholds for a group of protocols.

• Some edits will require the user interface and business logic of the scanner itself to perform correctly.

• The workstation may help the tech generate and print a list of such changes to visit

4. Standards and Systems

• Modalities, Protocol Management System

• DICOM Sup121 - CT Protocol Storage

5. Discussion

<Include additional discussion or consider a few details which might be useful for the detailed proposal>

<Why IHE would be a good venue to solve the problem and what you think IHE should do to solve it.>

<What might the IHE technical approach be? Existing Actors? New Transactions? Additional Profiles?>

<What are some of the risks or open issues to be addressed?>