Rad Plan Minutes 07.06.13

Participants:

• Chris Carr – RSNA
• Dr. David Mendelson - RSNA
• Dr. Peter Mildenberger - Univ. of Mainz
• Kevin O'Donnell - Toshiba (Vendor Co-Chair)
• Chris Lindop - GE (Vendor Co-Chair)
• Niki Wirsz - Siemens
• Cor Loef - Philips
• Andrei Leontiev - Dynamic Imaging
• Ellie Avraham - Kodak
• Dave Robaska - Cerner
• Paul Morgan - Fuji
• Rita Noumeir - Softmedical
• John Paganini - Guardian Technology
• Charles Parisot – GE Healthcare
• David Heaney - McKesson
• Anne Finnlay - McKesson
• Julie Rose - iCAD
• Takashi Nakashima - Hitachi Medical, IHE Japan
• Hitoshi Yoshimura - Konica-Minolta IHE Japan
• Takeshi Ozeki - Toshiba Medical Systems, IHE Japan

Topics

RIC feedback: Concern over "low adoption" of Radiology Profiles

• is it in products?
• why don't people ask for it?
• is it not being used?
  • not turning on Storage Commitment
    • partly the cost to turn the switch
    • partly the fear that other brittle parts of the system (legacy) will break
    • partly lack of awareness
• is it "just a matter of time"?
• should we put more effort into "gardening" the existing profiles
• is there a need for a concerted push on targeted profiles?
  • by vendors?
  • by professional societies?
  • who's job is it to nudge consumers to "best" solutions?
  • who will consumers be willing to listen to?
    • professional societies, but the message has been pitched "too broadly"
• need a document outlining what we're doing and what the dynamics seem to be?
• is there a role for surveys of deployment at sites to "measure progress"

RIC feedback: Web Services in Radiology

• are we "being left behind"
• are there things that ought to be done with Web Services
  • what about amalgamated displays (ways to reduce screens/boxes)
  • continuously adapt displayed information to the task
• what things are Web Services good at?
• what's hype, what's useful
• what are concrete steps we could take? should take?
• where are there opportunities to introduce Web Services with minimal disruption
• What would Rads like to consume from other sources?
  • lab results
• What would Referrings like to consume from Radiology
  • access to schedule for a current patient
  • communication of emergent results, driven by Rad, responded to by Referring
• Bring such questions to RIC, to SIIM, to Practice Management groups
  • we already have strong representation from the informaticists
• Should parts of reporting use WS protocols?
• Paul Nagy's receipt/audit log for communicating emergent results
• Coordinate with the DICOM WG10 activities

Annual Calendar/Cycle Planning

• Set Dates - Done
• Call for Profiles (review Wiki Tools page)
  • Will accept either Wiki or Word doc by email

• Mammography
  • Need to decide - Part of Radiology, or Separate Domain
  • Must handle by time of Domain Application
  • lets make the calendar assuming Mammo is Radiology
  • solicit feedback from Mammo cochairs

IHE Governance

• Headsup for Membership
  • Application to join IHE (includes signing IP Policy)
  • Send Notification to join any Committee
  • Need to reapply IHE Radiology

IHE USA

• July 25, New York initial meeting
• contact Chris to get on the mailing list

Profile Registry Progress

• need use case / query review
• Plan a Conference Call with DCC
• Eric P is driving
• should we consider collecting information from sites on what they have/use?
• would SIIM be a good partner to start collecting this
• We also need some better metrics of success for deployment
  • Current "Is there a site using all of SWF" isn't the best

Radiology Roadmap

• do we need one yet - Yes
• what's it for?
  • parking lot for stuff not done yet
  • planning tool to see all the pieces
  • PR value to show things are not forgotten
  • logistics value to recognize the pre-requisites
    • another flavor of this is multi-year projects
    • should be careful to break it into useful subpieces
  • show some long term goals/themes
  • link to other domains for logistics/consistency
• Start with a "vision" statement - high level goals
  • Chris will get RSNA to take a shot.
  • should be ready for the matrix work
• Do the exercise of pasting brief proposals onto a matrix
  • Ought to be F2F
  • We should be doing more international meetings
  • October - HIMSS World of HIT in Vienna, Oct 22-25 Proposed - Need to Confirm
  • might like to coordinate with other international committees
  • try to do one mtg per year alternating between Asia and Europe with main meeting base in U.S. (where the secretariat is)
• Review other domain roadmaps for ideas/context
  • Kevin can collect we can discuss with above.
  • Ask DCC to work on a common format/flavor
• Should we add to the proposal process endorsements of professional societies and vendors?

Profile Retirement

• do we want to do more this year
• Paul C two years ago
  • SWF needs to make the return channel more robust.
  • MPPS gets dropped on the floor. No one past the RIS benefits from the procedure details provided by the modality, it doesn't fix billing. Charge Posting needs to work better.
• are there places where we should reduce requirements
• schedule another round and work on pushing to resolution.

Profile Granularity

• Plan a discussion about profile granularity

TCE Demo Planning for RSNA 2007

• RSNA will do up a 1 page brief on TCE business case for pitching to participants - will go to mailing list
• Education/Demo will encompass MIRC, and more
  • Catalog/matrix to incent people to register in the Profile Registry
• Specific Education on fleshing out usage of existing stuff with demonstratable benefits
• Mostly to be picked up by IHE USA

IHE-J Appendix Handling

• IHE-J will submit a proposal to the planning cmte for AWF profile (refactor SWF including HL7 V2.+) in July
  • HL7 Versioning...
  • SWF Restructuring
• IHE-J will submit the updated "easy part" of National Extension by July 15 to Rad TC
• Rad TC will review for final text (TCon) by July 31
• IHE-J will use in the Feb 2008 Connectathon
• Clarification
  • IHE-J Connectathon tests contents of offical IHE Technical Frameworks
  • it is possible for other specifications to also be tested, but they should not be called IHE
  • IHE-USA does this too. HITSP Specification corner, Enhanced DICOM corner etc.

Post Mortem on the Workshop

• 150 total, people came and went, more targetted attendance
• about 80 people first day
• about 115 start of day two
• Maybe 50 IT, 24 PCC, 15-20 Rad, 4-6 Rad-Onc, Card ??

Goal: Educate Users about value of the profiles/deployment

• Consultants
  • not well attended, but they get good value and contribute to the discussions
  • don't know how to reach them.
    • CHIMES - goes right to the CIOs
  • seem to like AHRA, RBMA.org (Radiology Business Management Association)
  • HIMSS Consultant list -

• Decision Makers
  • want to get the purchasing decision makers
  • do they need a different kind of event
  • try to get them at RSNA, etc.
  • needs to be plush, nice venues, spoon feed info, undistracted
  • can't "waste their time", confuse them with technology details
  • needs to be what they can do NOW, practical advice
  • probably needs to be cross-domain??
    • hard because there are political battles
    • if we did cross-domain, we'd bring the battle here

• Actual Users
  • few here
  • IHE Canada had a huge turnout of actual users
    • positive experience
    • presented a bit better as mapping actors/profiles to your problems
    • a number of users presenting to users

Goal: Convince Marketing/Product Managers to put in product/test

• what's new that I don't know/need to pay attention to
• does my product need to do this (or my colleagues)
• want profiles mapped to products
  • Actual Users want profiles mapped to organization

Goal: Educate Engineering about effort estimate, implementation strategy, detailed questions/advice

• want more nuts and bolts of implementation and tools

Goal: OEM/Product Networking?

• people looking to expand their product line/feature set
• part marketing/part engineering
• looking for promising IHE features that are mature and well supported
• then make contact with people who might provide the OEM piece
• Sometimes the group 2 and group 3 person from a company team up to do this.

General Comments

• Didn't distribute feedback forms - DO next year
• Enhance registration form with a few details like are you newbie, what domains are you interested in, what role do you play (user/mktg/eng/etc)
  • might even use this to tweak presentations
• It's nice if we distribute PPT in advance so they can use for notes
• Announcement was a little late this year

• a few logistics - poor mikes, lack of laser pointer

• Explicitly identify the audience for each presentation (User/Marketing/Eng)
  • Maybe split by days
• Could we do these as separate conferences on the web
  • Lose networking and hallway tutorials
  • probably lower attendance
  • how about hiring presenters

• Are we satisfied? Serving a purpose?
  • Yes
  • details of freeware toolkits
  • sample implementations are useful because it's new/relevant
    • try to get people to share experiences (eng audience)
  • It's about the questions
• Do we keep pressing it as a user meeting?
• Are there better ways to communicate the repeated content?
  • Would webinar be good?
• Do we break it up so repeat is on one day, new on another
  • need to coordinate with other domains to be effective
• Problems
  • growth in IHE means more repetition of previous years

Publicity/Presentations

• Forward to IHE-USA for targeting the Radiology Audience
• AHRA
  • July 27-31, 2008, Denver
• RBMA
  • May 6-9, 2007, St. Louis
  • Sep 16-18, 2007, Nashville
  • Nov 2-3, 2007, Phoenix (Imaging Center & Interventional Radiology)
  • May 4-7, 2008, Las Vegas
  • Sep 14-16, 2008, San Antonio
• Suggest coordinating with HIMSS XDS outreach to RHIOs to also mention XDS-I

Reporting 2.0

• Goal is to understand The Reporting Problem so we can take productive, concrete profile steps

• Note that lots of the WS applications/value are inside Reporting
• Important to include evaluation of the available technologies
  • Should we pull in the other Domains early to re-energize?
  • Can we find a couple "Best Practices" sites to learn from?
    • what are the key metrics for best?
    • RTT? RVUs?
    • Does ACR or RSNA,etc have a candidate?
  • Should we approach Steve Horii, Paul Chang, etc.
  • Should we schedule a dedicated Face to Face
  • Literature search?
  • Is there a subpiece that can't be screwed up?
  • Need more domain people - Nuance, Reporting folks
• Would harvesting some WG20 output help?
  • at least get their minutes
• Pull in the WG10 diagrams from Baltimore

• • Lets try a Webex with interactive editing as a first step
    • John P, David R., (Commisure), (McK- Critical Event Rpt Catherine Forrester?),
    • July 9 7-9am Pacific

New Work

• Adoption of compression and DVD in PDI (Cardiology)
  • Need to ask Card if they will tackle again, else put in a Rad Proposal

• Enhanced CT/MR Profile? Creation and Display?
  • Consider at least an Enhanced Testing Corner at the Connectathon?

• IHE Endoscopy should run their Profile through Radiology?
  • (work in DICOM to finalize Acquisition Context)
  • (Top three vendors are Japanese, Olympus, Fujino, Pentax)
  • (Note JAHIS is the secretariat since JIRA is literally Radiology)
  • (Consider pulling the Surgeons in from Intervention)
  • There is already some Workflow definition done, need to engage them.

• Hanging Protocol Attributes - Done as separate modality objects
• Factor out Display Image transaction - Work Item
• Propose CiA Injector Protocol Interface?
• Teleradiology - regional radiologist resource sharing - workflow

• Consider putting names on TF, Listing Rosters

Issues from Cindy

1. As you know, OFFIS, a Germany Medical Society has extended PDI based upon what is seen as "Quality" issues. Last year we dealt with a number of CPs from OFFIS. Some we accepted and others were returned to OFFIS for them to deal with locally.

The goal would be to develop an IHE Germany National Extension which includes these

extra things. Christoph has volunteered to focus this effort. Unfortunately Marco is busy and the IHE Germany is dormant. So the goal would be to get their buy-in, but we would probably need to do the work.

• OFFIS presented CPs. IHE Rad accepted some, rejected some
• expectation is that GMS/OFFIS will review updated PDI and probably abandon local differences

1. Compression on PDI continues to be a question. OFFIS is trying to promote it even through DICOM does not currently support it as valid DICOM.???

• • Get Cindy to clarify, probably it is valid DICOM. We chose to leave out Compression in PDI for compatibility

Should we be putting together a Proposal on the implementation of DICOM Image Compression on a CD? This would require some interaction with DICOM in order to develop a valid DICOM Media Format to support this.

1. Guilliame and Christoph have been having a conversation. Apparently Guilliame has put together a whitepaper to deal with the RTC discussion from last year. My guess is that this should either be published as a whitepaper or used as the basis for the Profile Proposal (I haven't seen it). Should I go ahead and get Guilliame to pass it on to the Planning Committee?

• • A profile proposal sounds like an excellent next step
  • Don't publish externally
    • next steps will depend on where Mammo ends up (Rad or new Domain)