Import Reconciliation Workflow Enhancement - Brief Proposal
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1. Proposed Workitem: Import Reconciliation Workflow Enhancement
- Proposal Editor: Peter Kuzmak
- Editor: <Name of candidate Lead Editor for the Profile, if known>
- Domain: Radiology
2. The Problem
<Summarize the integration problem. What doesn’t work, or what needs to work.>
<Now describe the Value Statement: what is the underlying cost incurred by the problem, what is to be gained by solving it>
3. Key Use Case
The classic problem is how to deal with the prior study that was performed while the patient was being treated at another facility. The patient brings the CD containing the prior study when the patient went to the local institution for treatment. The patient’s clinician (provider) determined that the outside images/studies are clinically significant and need to be included in the patient’s EHR as reference images. The solution involves importing an outside study that is unknown to the local system.
Importing prior studies is performed by creating a new order on the institution’s imaging system and then associating the DICOM objects from the prior study with it.
Currently, the user loads the media into the drive and then waits for the commercial importer product to read all the DICOM files. The user then has to work on one study at a time. First, the user has to review the study on the commercial importer. The user then has to go to the institution’s RIS and place an order for an equivalent radiology study. Then, the user would has to go back to the commercial importer and use DICOM Modality Worklist to retrieve the order, have the commercial importer update the DICOM images with the institution’s patient and order information, and have them sent to the institution’s imaging system. Finally, the user has to go back to the institution’s RIS to update the study status to indicate that it is completed. The user has to repeat this effort for each study on the portable media that needs to be imported.
The process to import prior DICOM studies can be automated to eliminate many of the manual steps.
The workflow of the import process can be designed to operate like an online merchandise ordering application where the user adds items to a shopping cart and then proceeds to checkout.
All of the interactive item selection is done first and then is followed by an automatic database update commit transaction. First the HIS/RIS patient and equivalent radiology procedure are manually identified for each prior study. Then the DICOM importer process automatically places the order on the RIS for each the equivalent radiology study, uses the order information for import reconciliation, sends the images to the institution’s imaging system, and then updates the status of the study on the RIS to indicate that it was completed.
4. Standards and Systems
<List existing systems that are/could be involved in the problem/solution.>
<If known, list standards which might be relevant to the solution>
5. Discussion
<Include additional discussion or consider a few details which might be useful for the detailed proposal>
- <Why IHE would be a good venue to solve the problem and what you think IHE should do to solve it.>
- <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?>
<This is the brief proposal. Try to keep it to 1 or at most 2 pages>