Stress Testing Workflow: Difference between revisions

Latest revision as of 14:25, 4 November 2019

This integration profile defines ordering and collecting multi-modality data during diagnostic Stress testing procedures

Summary

The Stress Testing Workflow Profile defines a means of ordering and performing cardiac stress tests involving both ECG and imaging (echocardiographic or nuclear) procedure components. All the acquired data is collected in a uniform format (DICOM). The profile is aligned with the Actors and Transactions of the Echocardiography Workflow and Scheduled Workflow Integration Profiles, so that a common infrastructure can be used in an integrated manner.

Benefits

Cardiac stress testing with both ECG and imaging has traditionally be performed almost as two independent procedures due to the technical interoperability limitations of the equipment. This integration profile establishes an industry consensus position that the clinically desirable unified approach should be based on the DICOM standard, and leverage the DICOM workflow management and object management/archiving capabilities available in the cardiology department.

Details

The Stress Testing Workflow Integration Profile describes the workflow associated with cardiac stress test procedures. This profile deals with patient identifiers, orders, scheduling, status reporting, multi-stage exams, and data storage. It specifies the scheduling and coordination of procedure data across a variety of imaging, ECG acquisition, measurement, and analysis systems, and its reliable storage in an archive from where it is available to support subsequent workflow steps, such as reporting.

This profile has much in common with the Echocardiography Workflow and the Radiology Scheduled Workflow Profiles, but deals more explicitly with the multi-modality coordination, and with stress-specific data requirements. In fact, stress echo acquisition modalities should claim compliance to the Echo Workflow Profile and nuclear acquisition modalities should claim compliance to the Radiology Scheduled Workflow and Nuclear Medicine Image (Cardiology Opiton) Profiles.

One requirement is that a workstation (Image Display actor) claiming compliance to this profile must be truly multi-modality capable; it must support display of ECGs, echo images, and nuclear images. A workstation that does not support all three modalities could still claim compliance to the Echo Workflow or Nuclear Medicine Image Profile, but not Stress Workflow.

Systems Affected

Cardiovascular Information Systems (CVIS) manage the multi-modality stress testing workflow.
Stress ECG, stress echo, and nuclear medicine (SPECT) acquisition modalities acquire data during the procedure, and appropriately annotate it for the stress protocol.
PACS systems receive, store, and manage the multi-modality acquired data.
Display workstations query, retrieve and display the acquired data in a manner conducive to stress test analysis and reporting.
Acquisition modalities or workstations may perform measurements or analysis of the data, and store those results in DICOM Structured Report evidence documents.

Actors & Transactions:

The actor-transaction diagram is identical to that for the Echocardiography Workflow Profile.

Specification

Profile Status: Trial Implementation

Documents:

Stress Testing Supplement for Trial Implementation

Underlying Standards:

DICOM
HL7

@@ Line 6: / Line 6: @@
 ==Summary==
- One Paragraph Description
+The Stress Testing Workflow Profile defines a means of ordering and performing cardiac stress tests involving both ECG and imaging (echocardiographic or nuclear) procedure components. All the acquired data is collected in a uniform format (DICOM).  The profile is aligned with the Actors and Transactions of the Echocardiography Workflow and Scheduled Workflow Integration Profiles, so that a common infrastructure can be used in an integrated manner.
-The Stress Profile defines a means of ordering and performing cardiac stress tests involving stress ECG, echocardiographic, and/or nuclear imaging components. The profile is aligned with the Actors and Transactions of the Echocardiography Workflow and Scheduled Workflow Integration Profiles, so that a common infrastructure can be used in an integrated manner.
-''<See [[Help:Contents#Tips_.26_Tricks| Help - Tips and Tricks]] for details on inserting an image/graphic.>''
 ==Benefits==
-''<List the key benefits the profile provides (e.g. error reduction, increased throughput) and how they come about (e.g. SWF reduces patient errors due to mistyped demographics at the modality by transfering demographics electronically from the Order Filler).  Consider using a bullet list for readability>''
+Cardiac stress testing with both ECG and imaging has traditionally be performed almost as two independent procedures due to the technical interoperability limitations of the equipment.  This integration profile establishes an industry consensus position that the clinically desirable unified approach should be based on the DICOM standard, and leverage the DICOM workflow management and object management/archiving capabilities available in the cardiology department.
 ==Details==
@@ Line 20: / Line 16: @@
 The Stress Testing Workflow Integration Profile describes the workflow associated with cardiac stress test procedures. This profile deals with patient identifiers, orders, scheduling, status reporting, multi-stage exams, and data storage. It specifies the scheduling and coordination of procedure data across a variety of imaging, ECG acquisition, measurement, and analysis systems, and its reliable storage in an archive from where it is available to support subsequent workflow steps, such as reporting.
-This profile has much in common with the IHE Radiology Scheduled Workflow and Patient Information Reconciliation Integration Profiles, but deals more explicitly with the multi-modality coordination, and with stress-specific data requirements.
+This profile has much in common with the Echocardiography Workflow and the Radiology Scheduled Workflow Profiles, but deals more explicitly with the multi-modality coordination, and with stress-specific data requirements.  In fact, stress echo acquisition modalities should claim compliance to the Echo Workflow Profile and nuclear acquisition modalities should claim compliance to the Radiology Scheduled Workflow and Nuclear Medicine Image (Cardiology Opiton) Profiles.
+One requirement is that a workstation (Image Display actor) claiming compliance to this profile must be truly multi-modality capable; it must support display of ECGs, echo images, ''and'' nuclear images.  A workstation that does not support all three modalities could still claim compliance to the Echo Workflow or Nuclear Medicine Image Profile, but not Stress Workflow.
 ==Systems Affected==
-''<List (in user terms) the types of systems they might expect to have implemented actors from this profile, e.g. RIS, PACS, HIS, CAD Workstation, etc. and for each, how it would participate.>''
-* ''PACS systems may store, manage, and/or display Evidence Documents.''
+* Cardiovascular Information Systems (CVIS) manage the multi-modality stress testing workflow.
-* ''Display systems may query, retrieve and display Evidence Documents.''
+* Stress ECG, stress echo, and nuclear medicine (SPECT) acquisition modalities acquire data during the procedure, and appropriately annotate it for the stress protocol.
-* ''Reporting workstations may retrieve, process and include details from Evidence Documents in reports
+* PACS systems receive, store, and manage the multi-modality acquired data.
+* Display workstations query, retrieve and display the acquired data in a manner conducive to stress test analysis and reporting.
+* Acquisition modalities or workstations may perform measurements or analysis of the data, and store those results in DICOM Structured Report evidence documents.
 '''Actors & Transactions:'''
-''<Insert an actor-transaction diagram, and or list of Content Definitions>''
+The actor-transaction diagram is identical to that for the [[Echocardiography Workflow]] Profile.
 ==Specification==
-'''Profile Status:''' [[Comments| Final Text]]
+'''Profile Status:''' [[Comments| Trial Implementation]]
-''<Replace "Final Text" with "Trial Implementation" or "Public Comment" as appropriate.>''
 '''Documents:'''
-''<Provide direct links to the specific volumes or supplements, and list the volume sections relevant to this profile.  This is a simple inventory of official normative and informative text.  If you would like to provide a reading guide or walkthrough of what is in each of the different sections for implementers or users, do that in the Profile FAQ or the Profile Implementation Page linked below.  If the profile uses transactions from multiple Tech. Frameworks, repeat the structure below.>''
+[http://www.ihe.net/Technical_Framework/upload/IHE_CARD_TF_Supp_Stress_TI_2007-06-08.pdf Stress Testing Supplement for Trial Implementation]
-[http://www.ihe.net/Technical_Framework/index.cfm#radiology IHE Radiology Technical Framework:]
-:* [http://www.ihe.net/Technical_Framework/upload/ihe_tf_rev8.pdf Vol. 1] - Section 5 (SWF Profile)
-:* [http://www.ihe.net/Technical_Framework/upload/ihe_tf_rev8-2.pdf Vol. 2] - Sections 4.8 to 4.10, 4.14 to 4.19, and 4.23
-:* [http://www.ihe.net/Technical_Framework/upload/ihe_tf_rev8-3.pdf Vol. 3] - Appendix E
 '''Underlying Standards:'''
-''<list all the standards on which the profile is based; if possible with links to sources>''
 :* [http://dicom.nema.org DICOM]
 :* [http://www.hl7.org HL7]
-:* ...
 ==See Also==
-''<The following sections can be left out if there is nothing to point to.  This is just to show where such information can go.>''
 '''Related Profiles'''
-''<List profiles this one depends on, profiles that depend on this one, profiles that are synergistic with this one.  Start with the name of the other profile as a link and then explain the relationship.>''
+* [[Echocardiography Workflow]] [ECHO] includes stress echo
+* Radiology [[Scheduled Workflow]] [SWF] includes nuclear medicine imaging
-* ''[[Reporting Workflow]] [RWF] may use Evidence Documents as inputs to the reporting process.''
+* Radiology Nuclear Medicine Image [NMI] with Cardiology Option
-* ''[[Simple Image & Numeric Reports]] [SINR] may include data copied from Evidence Documents.''
+* [[Evidence Documents]] [ED] includes stress measurements and analyses in the cardiology Echo Evidence Option and the Stress Test Evidence Option (see [http://www.ihe.net/Technical_Framework/upload/IHE_CARD_TF_Supp_2007ED_06_TI.pdf ED Cardiology Options Supplement for Trial Implementation])
-* ''[[Cross-enterprise Document Sharing for Imaging]] [XDS-I] can be used to share Evidence Documents between sites over a network.''
-* ''[[Portable Data for Imaging]] [PDI] can store Evidence Documents on media such as CDs.''
-* ''[[Import Reconciliation Workflow]] [IRWF] can fix patient ids, etc. of Evidence Documents when importing.''
-'''Consumer Information'''
-The [[
- Stress Testing Workflow]] answers typical questions about what the Profile does.  ''<Replace the link with a link to the actual FAQ page for the Profile>''
-The [[
- Stress Testing Workflow]] describes considerations when purchasing equipment to deploy this Profile.  ''<Replace the link with a link to the actual Purchasing page for the Profile>''
-'''Implementer Information'''
-The [[
- Stress Testing Workflow]] provides additional information about implementing this Profile in software.  ''<Replace the link with a link to the actual Implementation page for the Profile>''
-'''Reference Articles'''
-''<List References (good and bad) (with link if possible) to Journal Articles that mention IHE's work (and hopefully include some analysis).  Go ahead, Google: IHE <Profile Name> abstract   or something.  You might be surprised. >''
@@ Line 92: / Line 59: @@
 [[Category:Profiles]]
+[[Category:Cardiac Profile]]
+[[Category:DICOM]]
-[[Category:
- Domain Committee ]]