Mammography Reporting Workflow - Brief Proposal

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) Screening mammography recall examination abnormality demarcated on the 5 MP monitor should be automaticality transferred back to the breast imaging reporting system and the technologist's patient recall sheet without requiring the radiologist to demarcate the same abnormality again within these two reporting/information systems;
• b) if no abnormality is identified at the conclusion of the hanging protocol review and final screening mammography iterpretation, an automatic normal report should be generated instead of requiring the manual development of a normal screening mammography report within the breast imaging reporting system; and
• c) upon completion of an interpreted normal screening mammography examination, the next screening mammography case within the screening mammography worklist should be automatically loaded on the 5 MP monitors for interpretation without requiring the manual selection of the next case from the screening mammography worklist.

3. Key Use Case

• a) Once a screening mammography recall examination abnormality is demarcated on the 5 MP monitor, the abnormality and its corresponding locations should be automatically transferred back via a bidirectional interface to the breast imaging reporting system and the technologist's patient recall sheet either as a thumbnail print or information uploaded into a universal breast diagram;
• b) if not abnormality is identified at the conclusion of the hanging protocol review and final screening mammography iterpretation, an automatic normal report should be generated instead of requiring the manual development of a normal screening mammography report within the breast imaging reporting system by using a normal templated report, and
• c) upon completion of the interpreted normal screening mammography examination, the next screening mammography case which is in CASHS within the screening mammography worklist is automatically loaded on the 5 MP monitors for interpretation, eliminating the need to manually select the next case for review from the worklist.

4. Standards & Systems

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

Standards: <TBA>

5. Discussion

The purpose of a bidirectional interface amongst the breast imaging clinical workstation, reporting system, and PACS is to increase the end user (ie, radiologists, breast imaging support staff) efficiency and performance metrics within screening mammmography. Anticipated in the future is greater centralization of screening mammography interpretation resulting in a larger volume of examinations per radiologist for interpretion each year.

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 techhologists could help establish the requirements for bidirectional interface amongst the clinical workstation, reporting sytem, and PACS so that a universal bidirectional interface profile could be created. This requested profile 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?>