Import Reconciliation Workflow

Import Reconciliation Workflow (IRWF) is an integration profile that manages importing images from CDs, hardcopy, etc. and reconciling identifiers to match local values.

Summary

Import Reconciliation Workflow Integration Profile establishes a flow of information that supports the efficient importation of DICOM patient data from an external enterprise. It provides specifies transactions that maintain the use of consistent patient/procedure information between the data being imported and the local enterprise, while maintaining the integrity of the original data. DICOM Patient data imported into the local enterprise can be used in the same manner as DICOM data created by the local enterprise, such as reporting.

Benefits

Reduce Errors and Enhance Patient Care

• Prevents missing data from other sites because the PACS is able to import data sent on interchange media and integrate it with the patient’s record
• Prevents mismatched patient identifiers in data imported from interchange media from other institutions because the PACS reconciles this information to local values at import time

Improve Data Accessibility

• Improves access to other sites’ data—the PACS can import and reconcile patient and diagnostic information on interchange media from other institutions and clinics

Details

The Import Reconciliation Workflow Integration Profile:

• Specifies both the data and workflow requirements for importing existing DICOM Evidence Objects and importing Hardcopy from an external Enterprise.
• Provides a process to reconcile imported patient and procedure information with local patient and procedure information through the use of Worklists and Patient Demographics Query.
• Specifies critical patient demographics (e.g. Patient Name, Patient ID) and order/procedure Information (e.g. Accession Number) which is important since the local Enterprise will typically have different identifiers (for patient, orders, etc.) from the Enterprise that created the Evidence Objects or Hardcopy being imported.
• Specifies a mechanism for preserving a copy of the original values inside the imported DICOM Composite Objects when attribute values must be changed.
• Ensures that DICOM images, reports and other evidence objects associated with a particular import have been archived.
• Ensures that the status of importation workflow steps are known throughout the department by specifying the use of DICOM Performed Procedure Step to convey that status from the Evidence Creator to the RIS and the PACS.

Systems Affected

Systems which are expected to have implemented actors from this profile include:

• Enterprise-wide information systems that manage patient registration and service ordering (Hospital information system (HIS))
• Radiology departmental information systems that manage department scheduling (i.e., radiology information system (RIS))
• Radiology image management/archiving (i.e. picture and communication systems (PACS)
• Importation Workstations that manage the reading and reconciliation of the data to be imported (e.g. CDs, digitized films, cross-enterprise networks).

Actors and Transactions

Specification

Profile Status: Final Text

Documents:

IHE Radiology Technical Framework:

• Vol. 1 - Section 21
• Vol. 2 - Section 4.10 and Appendix A.5
• Vol. 3 - Sections 4.59, 4.60 and 4.61

IHE IT Infrastructure Technical Framework:

• Vol. 1 Section 8
• Vol. 2 Section 3.21

Underlying Standards:

• DICOM
• HL7

See Also

Related Profiles

• Scheduled Workflow is the foundation upon which IRFW is based. IRFW uses the existing workflow mechanisms for notification and storage of imported Evidence Objects.
• Patient Demographics Query [PDQ] retrieves local Patient Demographics for use in the Patient Information importation.
• Portable Data for Imaging [PDI] specifies CDs that are particularly suited to importing.

Several "content profiles" specify DICOM data that may be imported, including:

• Nuclear Medicine Image [NM] specifies Nuclear Medicine images and result screens.
• Mammography Image [MAMMO] specifies Mammography images and evidence.
• Evidence Documents [ED] specifies digital measurements.
• Key Image Note [KIN] let users flag images as significant (e.g. for referring, for surgery, etc.) and add notes.
• Simple Image and Numeric Report [SINR] specifies Diagnostic Radiology Reports.

References

• ACR–AAPM–SIIM Technical Standard for Electronic Practice of Medical Imaging. J.T. Norweck, et al., SIIM & ACR Publication, Sept. 2012

• van Ooijen, P.M.A, et al, Evaluation of the Use of CD-ROM Upload into the PACS or Institutional Web Server, Journal of Digital Imaging, Vol 19, Suppl 1, 2006, pp 72-77

• Discusses experiences with a process similar to the Scheduled Import Option of IRWF.

• Lu, M.T, et al, Reducing the Rate of Repeat Imaging: Import of Outside Images to PACS, American Journal of Roentgenology, Vol 198(3), March 2012, pp 628-634 - Abstract - Commentary in CMIO

• "When outside images were not available, 72% (13/18) of patients underwent repeat imaging; when outside images were available but not imported, 52% (14/27); when outside images were imported to PACS, 11% (9/79)"

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