Basic Image Review - Brief Proposal

1. Proposed Workitem: Basic Image Review Profile

• Proposal Editor: Kevin O'Donnell
• Editor: David Clunie
• Domain: Radiology (incl. all image viewing subspecialties)

2. The Problem

It is common practice for imaging facilities to distribute images on CDs and for receiving physicians to review those images with the viewer often bundled onto the CD.

Physicians have increasingly been expressing frustration that all too often:

• the viewer does not successfully run and load the images
• functions critical to review are missing from the viewer
• the CD has Yet Another Viewer in which the operation of basic functions is non-obvious

The impact is delayed care, inaccessible information, and poor use of valuable clinician time.

3. Key Use Case

Patient Viewing

<Feel free to add a second use case scenario demonstrating how it “should” work. Try to indicate the people/systems, the tasks they are doing, the information they need, and hopefully where the information should come from.>

4. Standards & Systems

Relevant Systems:

• Media Creators
• Basic Image Review Applications

Relevant Standards:

• DICOM Media
• IHE PDI

5. Discussion

• The AMA, ACR, ACC, AANS, DRG, and RANZCR have all specifically identified this as a significant issue for them
  • Several members of those organizations have been identified to participate in the meetings where the profile is developed
  • AMA, ACR, ACR and AANS are preparing to declare IHE PDI as being the Standard of Care and look forward to further productive work with IHE

• In some ways the work would be similar to what was done in Mammography Image to specify basic display behaviors and control

• Potentially the solution is a Basic Image Review Profile which places requirements on Media Creators and Image Display actors.

• Issue: Specifying what to achieve VS how to do it
  • Some would like to specify icons and GUI elements
    • Problem: May unnecessarily disallow valid implementations, which might be better
  • Others would like to specify broad behaviors and things like "must be readily apparent"
    • Problem: May requires human evaluation which may be subjective
• There is some interest in ACR to be involved in the evaluation of systems implementing the profile

• Issue: Should we address office review workflow
  • E.g. provide recommendations to set up your own viewer and have office staff pre-load images from patients