Mobile access to Health Documents for Imaging - Brief Proposal
1. Proposed Workitem: Mobile access to Health Documents for Imaging (MHD-I)
- Proposal Editor: Brad Genereaux
- Editor: Brad Genereaux
- Domain: Radiology
XDS-I provides a method to share imaging documents across enterprises by a query and retrieve mechanism, but the technology is burdensome for lightweight web and mobile clients. This proposal calls for the creation of a profile to mimic the Mobile access to Health Documents (MHD) profile for Cross Document Sharing (XDS) for XDS-I, by defining a simple HTTP interface.
Unlike MHD, however, creation of Health Documents for Imaging via a mobile interface is intentionally not in scope.
2. The Problem
Participating as a client in XDS-I is straightforward in a controlled, robust, server or desktop configuration. Libraries exist that can make MTOM/XOP requests for manifests with DICOM KOS parsers for SOP instance retrieval.
However, in a resource or bandwidth constrained environment, the XDS mechanisms do not work effectively. There needs to be a lightweight mechanism to simply request, retrieve, and parse the manifest without putting undue pressure on the client. The client, in this case, is browser-based and capable of making HTTP requests and parsing web-friendly formats, like XML and JSON.
3. Key Use Case
A physician, away from the hospital, is asked to provide a preliminary review of a patient in crisis.
- He launches the electronic health record (EHR) web site on his mobile device
- He authenticates, and then opens the patient record
- He reviews documents stored in his facility’s XDS repository using MHD, and notes that imaging data is available.
- Using MHD-I, the EHR web page makes a query for studies available for the patient
- A list of studies are returned with WADO-RS locations to retrieve the relevant instances
- He selects a study
- The EHR website retrieves and renders for the physician
4. Standards and Systems
Systems include XDS-I servers and clients, web and mobile clients
Standards include XDS-I, DICOM, WADO-RS, REST, JSON, XML, HTTP
This is a logical extension of MHD.
New MHD-I Profile
- Existing actors: Imaging Document Consumer
- New actors: Imaging Document Responder
- New transactions
- Find Imaging Document Dossiers (standards used?)
- Get Imaging Document Dossier (standards used?)
This would supplement XDS-I with a RESTful web friendly methodology
This would complement MHD with an imaging-centric retrieval methodology
Breakdown of Tasks:
- Review MHD profile to ensure coverage of imaging paradigms
- Account for possible changes with FHIR enhancements
- Draft two new transactions and one new profile
- confirm the need/business case does exist
- Lack of Participation from vendors is a risk.
- There is a possibility that the proposed DICOM JSON may change.
- MHD is being reviewed and may be updated due to enhanced FHIR integration