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) [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]: Currenly, 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) 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 (ie, as a thumbnail print or information uploaded into a universal breast diagram);
b) If no abnormality is identified at the conclusion of the hanging protocol review and final screening mammography iterpretation, 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) Upon completion of the current screening mammography examination, the next screening mammography examination (CASHS within the screening mammography worklist) should be automatically launched and loaded on the 5 MP monitors for interpretation, eliminating the need for manually selecting the next examination for review from the worklist.

4. Standards & Systems

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

Standards: <TBA>

5. Discussion

Two essenial purposes 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. 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 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?>