Mammography Reporting Workflow - Brief Proposal

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1. Proposed Workitem: <initial working name for profile/whitepaper/etc>

  • Proposal Editor: Richard L. Ellis, M.D.
  • Editor: <TPA>
  • Version: N/A (Wiki keeps history)
  • Domain: Radiology: Mammography

2. The Problem

  • a) [Coordinate Tracking/ROI]: For a screening mammography recall examination, the radiologist is currently required to demarcate (ie, use of an arrow, circle, etc.) the abnormality on the 5 MP monitor and again demarcate the same abnormality and its location within the reporting system.
  • b) [Bidirectional Synchronization]: Currently, all screening mammography reports require a manual generation of a report, even for normal examinations; and
  • c) [Bidirectional Synchronization]: Upon completion of the current screening mammography examination, the next screening mammography examination within the screening mammography worklist must be manually selected to launch and load this examination on the clinical workstation.

3. Key Use Case

  • a) [Coordinate Tracking/ROI]: Once a screening mammography recall examination abnormality is demarcated on the 5 MP monitor, the abnormality and its corresponding location (coordinates) should be automatically transferred back via a bidirectional interface to the breast imaging reporting system;
  • b) [Bidirectional Synchronization]: If no abnormality is identified upon reaching the end of the hanging protocol and final screening mammography interpretation, an automatic normal templated report should be an option for the radiologist instead of requiring the manual development of a normal screening mammography report within the breast imaging reporting system, and
  • c) [Bidirectional Synchronization]: Upon completion of the current screening mammography examination, the next screening mammography examination (waiting in cache) should be automatically launched and loaded on the 5 MP monitors for interpretation, eliminating the need for manually selecting the next examination from the worklist.

4. Standards & Systems

Systems Affected: Breast imaging clinical workstations, reporting systems, and PACS systems.

Standards: <TBA>

5. Discussion

Two essential purposes of a bidirectional interface between the breast imaging clinical workstation and reporting systems (also require PACS involvement for later storage and retrieval of information) is to increase the end user (ie, radiologists, breast imaging support staff) efficiency and performance metrics within screening mammography. Anticipated in the future is greater centralization of screening mammography interpretation resulting in a larger volume of examinations per radiologist for interpretation each year. Appropriate integration and use of a bidirection interface could have a significant effect upon efficiency, especially in the interpretation and reporting for screening mammography.

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

Through RSNA IHE Mammography, vendor representatives, radiologists, and appropriate information technologists could help establish the requirements for bidirectional interface between the clinical workstation and reporting systems, so that a universal bidirectional interface profile could be created. This requested profile [1. Coordinated Tracking/ROI & 2. Bidirectional Synchronization] meets the mission of RSNA IHE.
<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?>
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