User:Nhonda
Contrast Administration Management (CAM) Integration Profile
1. Proposed Workitem: Developing Contrast Administration Management (CAM) Integration Profile: Step 1 of two-step approach
Proposal Editor: Norinari Honda, Co-Chair, Radiology Planning Committee, IHE Japan Editor: Kevin O'Donnell
2. The Problem
Use of imaging agent is common in imaging studies with potential serious adverse reactions. Thus, detailed record of the imaging agent use should be documented in medical record. The Contrast Administration Management (CAM) Integration Profile aims automatic creation and storage of the record contributing to reduction in work burden, while it helps healthcare professionals make the record detailed and precise.
Stored record, i.e., Imaging Agent Administration Structured Report (IAASR), is used for radiology report creation, charging and management of drugs and consumables, making evidence of clinical practice, and developing guideline of imaging agent use, etc. These uses facilitate improvement of healthcare quality with reduced management cost for medical institution.
3. Key Use Case
Use case focuses on generation of the IAASR in scheduled case. Use Case begin with decision of imaging protocol and infusion protocol of imaging agent for imaging study to store in the DSS/OF.
Development Step 1 addresses the following: On the scheduled day, the worklist is queried from the Acquisition Modality. Technologist selects the order to perform and checks for infusion protocol. The corresponding infusion protocol is selected from those stored in the Infusion Manager. The technologist then starts imaging according to both imaging and administration protocol. The technologist ends the study. The technologist orders the Infusion Manger to end the infusion, which triggers the generation of Planned and Performed IAASRs. The generated IAASRs are stored to the IM/IA.
Developing Step 2 addresses followings: Worklist is queried from the Acquisition Modality and then from the Infusion Manager. Selection of an order on the Acquisition Modality triggers automatic selection of the corresponding patient on the Infusion Manager. End of the imaging study by the technologist automatically triggers both end of the infusion activity and generation of IAASRs on the Infusion Manger. The generated IAASRs are stored to the IM/IA.
4. Standards and Systems
Following Standards is referenced. DICOM Sup 164, other parts of DICOM standard used in the systems listed below.
Following existing and new systems are involved in the CAM Profile. In Development Step 1; Infusion Manager, IM/IA, and Contrast Usage Consumer In Development Step 2: DSS/OF, Acquisition Modality, Infusion Manager
5. Discussion
Development of the CAM Profile is planned to be done in two steps to reduce effort in one year. The step 1 addresses storage, query, and retrieval of IAASRs. The Step 2 aims to attain synchronized automatic selection of a patient on the Infusion Manager triggered by order selection on the Acquisition Modality, and Automatic generation of IAASR as far as possible to minimize workload of healthcare professionals. Creation of new transactions to fulfil this aim needs detailed analysis of DICOM such as whether derivation of the new transactions from existing transactions of similar function as templates work or not. Registry of the IAASRs are out of scope at present.