Cross-enterprise Document Sharing for Imaging
Cross-enterprise Document Sharing for Imaging (XDS-I.b) is an interoperability profile that extends XDS to share images, diagnostic reports and related information across a group of care sites.
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.
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
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.
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:
Differences between WADO-URL [RAD-55] and Retrieve Imaging Document Set [RAD-69]
|Category||WADO-URL [RAD-55]||Retrieve Imaging Document Set [RAD-69]|
|Technology Stack||Simple HTTP. Usually no additional library required for implementation.||SOAP over HTTP. Usually require some kind of library to handle SOAP messages.|
|Request||Simple HTTP parameterized URL||Specific SOAP envelop format|
|Response||Simple DICOM Part 10 object by default||DICOM Part 10 objects returned in MTOM/XOP|
|Request content||Only a single object per request. Always fully references study/series/image UID||Allow one or more objects per request.|
|Optional behavior||Supports rendering (e.g. retrieve DICOM images as jpeg or DICOM SR as HTML). This is included in the base DICOM WADO-URL specification, not additional specification in XDS-I.b.||Only supports retrieving DICOM objects as Part 10 object. No rendering support (Note: WADO-WS as defined in DICOM (now deprecated) has additional rendering and retrieve metadata capabilities, but these are not defined in RAD-69)|
|Authentication||Supports ATNA bi-directional certifcate authentication||Supports ATNA bi-directional certifcate authentication|
|Additional Security||None||Supports same set of security related functionality as the rest of XDS. e.g. XUA \ XUA++ using SAML token, optional asynchronous response using WS-Addressing, BPPC \ APPC, etc.|
In XDS-I.b, the Imaging Document Source covers all the retrieve protocols supported at the time when it was defined (DICOM DIMSE, Simple HTTP URL, SOAP over HTTP) to cover all the bases. If you also want to support the new DICOMweb WADO-RS, then one can group the Imaging Document Source with an Imaging Document Source in WIA Web-based Image Access too.
Profile Status: Final Text
- Vol. 1 - Section 18 (XDS-I.b Profile)
- 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
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.
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
- ACR–AAPM–SIIM Technical Standard for Electronic Practice of Medical Imaging. J.T. Norweck, et al., SIIM & ACR Publication, Sept. 2012
- 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
- 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
- Image Exchange: IHE and the Evolution of Image Sharing, DS Mendelson et al, Radiographics, 2008 link
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