Contrast Administration Management - Proposal

1. Proposed Workitem: Contrast Administration Monitoring

• Proposal Editor: IHE-J/Tomoyuki Araki/Nemoto-Kyorindo
• Proposal Contributors: Shiokawa, O'Donnell
• Editor: Tentative: Tomoyuki Araki / Salt
• Contributors:
• Domain: Radiology

Summary

The DICOM Sup164 is developed to record information associated with administration of imaging agent. The information is expressed as Planned and Performed Imaging Agent Administration Structured Report (IAA SR) and is stored in the IM/IA for later retrieval to meet various needs. Work flow, Contrast Agent Administration Reporting (CAAR), to support handling of selection of imaging agent, its use according to usage protocol, record of adverse event and infusion related events, generation and storage of IAA SR, and retrieval of reports is developed.

2. The Problem

Administration of contrast is often requested and performed in imaging studies. Information generated during the administration usually is recorded manually because IHE integration profile and a base standard for this purpose is lacking, which makes important medical records prone to be missed.

Now DICOM Supplement 164 is published, it becomes possible to automatically report and store information regarding imaging agent administration in an integrated workflow.

<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

• An order for imaging study is placed by a clinician and transmitted to DSS/OF via Placer Order Management [RAD-2].
• A radiologist checks the order to select an imaging protocol that fits the order. When the protocol includes contrast, he determines whether to modify it or not.
• The imaging protocol and the resultant contrast usage protocol is recorded in the RIS.
• A radiologic technologist uses Query Modality Worklist [RAD-5] to select the order to process.
• A power injector, which is composed of grouped Infusion Manager and Infusion Pump, has stored user-defined contrast usage protocols in it.
• The radiologic technologist selects one protocol from the stored protocols in the injector that corresponds to the ordered usage protocol. If the contrast usage is modified from the pre-defined protocol, the radiologic technologist makes appropriate changes and confirms the protocol on the injector console.
• After finishing the injection, a contrast SR is sent to the IM/IA triggered by receipt of end signal of the administration by the infusion manager.

4. Standards and Systems

• IHE REM/REM-NM Profiles - provide a framework for this profile and example transactions
• DICOM Sup 164 (expect Final Text in October) - provides format for contrast administration data

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?>