Maintenance of Radiology Profiles Published in 2017 and earlier

Supporting documentation

• A Powerpoint presentation with an overview of this work item proposal.
• An Excel Spreadsheet with supplementary data behind this proposal; more details on CPs and published RAD TF documents
• This proposal in Word document format

1. Proposed Workitem: Maintenance of Radiology Profiles Published in 2017 and earlier

• Proposal Editor: Lynn Felhofer (felhofer.lynn@gmail.com), IHE Radiology Technical Project Manager
• Editor: current members of the RAD Technical Committee, and hopefully additional recruits
• Date: N/A (Wiki keeps history)
• Version: N/A (Wiki keeps history)
• Domain: Radiology

Summary

<Summarize in a few lines the existing problem . E.g. "It is difficult to monitor radiation dose for individual patients and almost impossible to assemble and compare such statistics for a site or a population.">

<Demonstrate in a line or two that the key integration features are available in existing standards. E.g. "DICOM has an SR format for radiation dose events and a protocol for exchanging them.">

<Summarize in a few lines how the problem could be solved. E.g. "A Radiation Dose profile could require compliant radiating devices to produce such reports and could define transactions to actors that collect, analyze and present such information.">

<Summarize in a line or two market interest & available resources. E.g. "Euratom and ACR have published guidelines requiring/encouraging dose tracking. Individuals from SFR are willing to participate in Profile development.">

<Summarize in a line or two why IHE would be a good venue to solve the problem. E.g. "The main challenges are dealing with the chicken-and-egg problem and avoiding inconsistent implementations.">

2. The Problem

A dedicated but finite number of Radiology Technical Committee members is responsible for both creating new work items and maintaining the growing list of existing Technical Framework documents. The Radiology Domain applies some Technical Committee resources to processing Change Proposals, primarily during face-to-face meetings. Progress in reducing the backlog has slowed. The RAD Domain is publishing more new TI supplements every year than we move to Final Text, and some TI Supplements are kept from moving to Final Text due to unresolved CPs.

PUBLISHED DOCUMENTS: In Summer 2017, the Radiology Domain has:

• 19 Final Text Profiles in the Radiology Technical Framework
• 22 Trial Implementation (TI) Profiles

• 3 of these are new for 2018 Connectathons (SOLE, MAP, RD) (Note: At the time of this proposal, RD is in Public Comment prior to TI publication)
• Approximately 6 Trial Implementation Profiles are still TI because of open CPs or are pending update because they’re out-of-date (BIR, CDS-OAT, XDR-I, MRRT, MHD-I, SWF.b)
• 6 of these have never been tested at a Connectathon (CXCAD, XRR-WD, MHD-I, PAWF, RRR-WF, SMI)

• 5 additional Trial Implementation Supplements that modify existing profiles (extensions for DBT, IOCM, MAWF, SWF (MIMA), and NMI)
• (white papers are not accounted for in this proposal)

CHANGE PROPOSALS: Entering the 2017-18 publication cycle, as of July 1, 2017, there are:

• 12 Submitted CPs (awaiting assessment)
• 75 Assigned CPs (awaiting completion, committee review, and balloting)

• 24 CPs are currently assigned to someone who is no longer active on the Radiology Technical Committee.
• Assigned CPs broken into rough categories look like this:

Category	Num of CPs
XDS-I / XDR-I / Metadata	21
HL7v2	13
HL7 <-> DICOM	6
DICOM	6
MRRT	3
MHDI	1 (large)
REM	4
Other (TCE, IID, PGP)	5
Editorial	12
Assess for possible cancellation	5

Recent CP Ballot / Technical Framework history:

• 2013-14: 2 CP ballots, 8 Final Text CPs, 1 Profile (IOCM) moved to Final Text Rev 13.0
• 2014-15: 3 CP ballots, 28 Final Text CPs, 0 Profiles moved to Final Text Rev 14.0
• 2015-16: 0 CP ballots, 1 Profile (DBT) moved to Final Text Rev 15.0
• 2016-17: 1 CP ballot, 13 Final Text CPs, 0 Profiles moved to Final Text Rev 16.0

Some recent barriers to CP progress:

• Some profiles have taken more Technical Committee time than anticipated (XRR-WD, RRR-WF)
• MHD-I is being treated as a “large CP”
• Too few active Technical Committee members with deep HL7v2 expertise
• Active Technical Committee members have been editors of new work items (and wear lots of other standards development hats)
• Failure to recruit enough new, active Technical Committee members
• Others??

The audience for this proposal already knows the value of Radiology Technical Framework documentation. The Radiology domain should set aside Technical Committee resources to improve quality in existing documentation.

4. Discussion

I am proposing that the RAD Planning and Technical Committees explicitly identify maintenance as a work item to evaluate against other work item proposals for new profiles. While maintenance is always given a nod and factored in during work item selection, during the year when the Technical Committee faces a choice between spending efforts on new items vs maintenance, new items win. In recent years, we under-estimated the effort for several items, so there was scant time for CPs. Technical Committee members are asked to be one or more of: supplement editor, or a key contributor, or a reviewer to one or more work items, leaving less time for them to spend on CPs.

I am asking:

• that the Planning Committee take the backlog of maintenance into account when making work item selections this year. When selecting work items, consider who the editors are, what existing document they maintain, and what CP work they will defer in order to work on something new. If the Planning Committee de-prioritizes maintenance, OK, but at least it will be an explicit choice.
• that Technical Committee members be polled at the beginning of the 2017-18 cycle to identify whether they are both willing and available to contribute to CP work in Radiology. If this “RAD TF Maintenance” work item is selected by the Planning Committee, it won’t help much if RAD TC members are not available in the coming year to work on CPs. This assessment could be made as part of the ‘Detailed Work Item Proposal’ if the Planning Committee selects this as a work item.

5. Technical Approach

Breakdown of tasks

<As the basis for the effort estimation, enumerate the tasks to develop the Profile text. E.g.>

• <Discuss/Confirm use case list (currently 5) to decide in/out of scope and details>
• <Analyze/choose which report guidelines to use>
• <Resolve open issue on the degree of computer parsability>
• <Draft/Review content definition for Oncology Report (profile use of CCDA)>
• <Draft/Review transaction for Retrieve Report>

6. Support & Resources

<List groups that have expressed support for the proposal and resources that would be available to accomplish the tasks listed above.>

<Identify anyone who as indicated an interest in implementing/prototyping the Profile if it is published this cycle.>

7. Risks

<List technical or political risks that will need to be considered to successfully field the profile. Demonstrate to the TC/PC your understanding/appreciation of the problem space>

8. Open Issues

<Point out any key issues or design problems. This will be helpful for estimating the amount of work and demonstrates thought has already gone into the candidate profile.>

9. Tech Cmte Evaluation

<The technical committee will use this area to record details of the effort estimation, etc.>

Effort Evaluation (as a % of Tech Cmte Bandwidth):

• 35% for ...

Candidate Editor:

TBA

<Delete this Category Templates line since your specific Profile Proposal page is no longer a template.>

3. Key Use Case

Not applicable

4. Standards and Systems

Not applicable