RAD TF Maintenance 2019-2020

Target Dates:

• Publish 3+ CP Ballots (one shortly after each face-to-face meeting in November, January, April)
  • Candidate CPs and assignees should be identified early and have enough time to work on the CPs so that the committee can review during the F2F meeting
• Incorporate FT CPs into updated TF released July 2020

Prioritize TI profiles:

• There are current a large number of Radiology profiles remain in TI for a long time. Sometimes new profiles reference transactions in these TI profiles, making understanding these new profiles challenging, involving reviewing multiple documents and find the relevant sections. To address this problem, we need to review them to determine if the profile should be promoted to Final Text or deprecated.
• Review Questionnaire Template for decision making (EP: 1)
• Assign selected TI profiles to someone to lead the evaluation (EP: 1)
• Create a new process trigger to mandate a review of a TI supplement after x (3-5?) years since first publication (EP: 1)
  • Schedule a TC meeting to assign the top x TI profile review candidates so that we can review the questionnaire at the kickoff meeting.

Profile	Last Published	Review / FT Candidate / Deprecate
Image Fusion (FUS) Integration Profile	2006-04-13
Nuclear Medicine Image Integration Profile (NMI) with Cardiac Option	2007-05-17
MR Diffusion Imaging (DIFF)	2009-06-21	Eval - Wim
Extensions to the Portable Data for Imaging (PDI) Integration Profile	2009-06-21
Chest X-Ray CAD Display (CXCAD)	2010-06-17
Post-Acquisition Workflow (PAWF)	2012-06-15
Multiple Image Manager/Archive (MIMA) Note: Tracked in CP-RAD-228	2012-07-24	Dep Eval - Kinson - Decompose
CT/MR Perfusion Imaging with Contrast (PERF)	2015-04-21
Radiology Remote Reading Workflow (RRR-WF)	2015-12-14
Radiation Exposure Monitoring for Nuclear Medicine (REM-NM)	2016-04-22	FT Eval - Wim / Jeff
Import Reconciliation Workflow (IRWF.b)	2016-09-09
Invoke Image Display (IID)	2016-09-09	FT Eval - Andrei
Mammography Acquisition Workflow (MAWF)	2016-09-09	Dep Eval - Antje
Basic Image Review (BIR)	2016-09-09
Digital Breast Tomosynthesis (DBT) Extension	2016-09-09	FT Eval - Andrei
Cross-Enterprise Remote Read Workflow Definition (XRR-WD)	2017-01-13
Management of Acquisition Protocols (MAP)	2017-07-14
Web-based Image Access (WIA)	2018-03-22
Management of Radiology Report Templates (MRRT)	2018-07-27
Standardized Operational Log of Events (SOLE)	2018-07-27
Stereotactic Mammography Image (SMI)	2018-07-27
Clinical Decision Support Order Appropriateness Tracking (CDS-OAT)	2019-04-25
Encounter-Based Imaging Workflow (EBIW)	2019-05-13
Import and Display of External Priors (IDEP)	2019-05-30
Cross-Enterprise Document Reliable Interchange of Images (XDR-I)	2019-08-09
Imaging Object Change Management Extension (IOCM Extension)	2019-08-09
Results Distribution (RD)	2019-08-09
Scheduled Workflow.b (SWF.b)	2019-08-09	FT eval - Kinson (or Charles)
Web-based Image Capture (WIC)	2019-08-09

CPs

Number of outstanding CPs: 81 (Assigned by end of 2018-19 cycle), 81 (Assigned by end of 2017-18 cycle), 75 (2016-17), 68, 59

List of "non-trivial" CPs:

List of outstanding items not yet submitted as CPs:

List of "priority" CPs:

• Completed the 4 remaining SWF.b CPs that were identified in 2018-19 cycle but have not yet completed
  • CP-RAD-356 (Charles, Steve)
  • CP-RAD-378 (Charles, Steve)
  • CP-RAD-379 (Kinson)
  • CP-RAD-382 (Kinson)
• Repeat TOP TEN CPs process

• note that the list of CPs is increasing, not decreasing
• CP author distribution
• Consider which might help a profile go to FT
• Consider organizing batches of CPs around themes (Profile or topic) so we can get relevant domain experts on that call and keep them engaged

• How to more effectively use the regular scheduled CP tcons? (Wim)
  • Observation: some CPs can be effective done in tcons and leave the f2f time for more important work.
  • Write up a proposal for how many regular CP tcons.

Effort to Split Technical Framework

List of other maintenance tasks (proposed priority):

• Split technical framework Vol 1-3 into multiple smaller documents (come up with a low risk mechanical method, and volume editors and Mary will work through the details)
  • Some thought about how to do this: (Kinson)
    • Speaking of breaking up the TF, my thought is that can we do something slightly different from ITI? That means can we create the break up Vol1-3. For example, Vol 2 to 2a, 2b, 2.. and Vol 3 to 3a, 3b, 3… (e.g. by number of transactions that we want to keep in one document), but we DO NOT change the section references to reference 2a or 3b, but stay with referencing just Vol 2 and 3 as today. I think the readers will know that when referencing Vol 3, it is inside one of 3a, 3b, 3… Then in the document title page, it can include also the transaction number range. Therefore someone trying to find TF Vol 3: 3.74 will immediately know which TF Vol 3x should read. No hunting necessary. Also we don’t change any of the references, which is the scary part because we need to make sure there is no dangling references or old references to nowhere. With this plan, then we can easily break up the TF Vol 2 and 3 now into smaller documents. If we agree with the plan, I am in fact leaning towards do it now than pushing to another cycle.
    • In Vol 3, we should put all of the ‘content module’ sections into one document. This is RAD TF-3: 6. None of this content is Final Text yet (eg RAD TF-3: 6.1 in XDR-I).
    • For the Vol 2 and Vol 3 documents that contain transactions, the cover page could contain the starting and ending transaction number.
    • We will have to consider what to do about appendices. Maybe all Vol 2 appendices in one Vol 2 document, and all Vol 3 appendices into one Vol 3 document.

Decisions:

• Break up TF vol1 into 1a, 1b, 1c, ... (10 profiles per document)
  • Update the IHE website, Resources > Technical Framework page, and include specific profiles under corresponding vol1.x documents
• Put vol1 appendices into '1x'
• Break up TF vol2 into 2a, 2b, 2c, ... (~20? transaction per document - TBD)
• Put all appendices into one single document '2x' (consistent with ITI)
  • All appendices currently in TF vol3 will also be merged to '2x'
    • Require renumbering of the appendices and update all corresponding references
• Break up TF vol3 into 2d (or whatever the next continuation of 2?), 2e, ...
• Extract the content modules in vol3 into 3 (e.g. XDR-I)
  • Volume 3 will have content modules, audit triggers,
• Each file name (2a, 2b, 2c, ...) and the title page will include the range of transaction numbers in that document
• Throughout the TF, any references to TF-3 (not content modules) will be changed to TF-2
  • Any references to TF-2 will remain unchanged
• Review the new supplement template

Proposed breakdown - initial proposal from Lynn

Mary says about 200 pages max is a good target. Diagrams included affect this number.

Vol 1a

• 1 Introduction
• 2 Integration Profiles Overview
  • Include the complete list incl. summary
• 3 Scheduled Workflow (note SWF.b is in Chapter 34)
• ... PIR, CPI, PGP, ARI, KIN
• 9 - SINR
• 10 SEC (dep)

Vol 1b

• 11 CHG,
• ...PWF, RWF, ED, PDI, NM, TCE, XDS-I
• 19 MAMMO
• 20 FUS

Vol 1c

• 21IRWF,
• ...REM, MAWF, DIFF, PERF, BIR, CXCAD, IOCM
• 29 XCA-I
• 30 PAWF

Vol 1d

• 31 XDR-I
• ...,SMI, MRRT, SWF,b, IID, DBT WIC, CDS-OAT
• 39 CDS-OAT

Vol 1e

• 40 REM-NM
• ... XRR-WD, WIA, SOLE, MAP, RD, EBIW
• 48 IDEP

Vol 1x

• Appx A - I ... from current Vol 1
• Appx J - DICOM Attributes and Relevancy ... from IDEP
• Appx K - IDEP Deployment Models ... from IDEP

Vol 2a

• RAD-1 Patient Registration
• ...
• RAD-13 Procedure Update

Vol 2b

• RAD-14 Query Images
• ...
• RAD-28 Structured Report Export

Vol 2c

• RAD-29 Key Image Note Stored
• ...
• RAD-67 Media Information Stored (...from PDI extensions)

Vol 2d

• RAD-68 Provide and Register Imaging Document Set – MTOM/XOP
• ...
• RAD-75 Cross Gateway Retrieve Imaging Document Set
• ...more to be added to this volume as supplements go to FT. Start of Vol 2e is tbd.

Vol 2x

• From Vol 2:
  • Appendix A - Attribute Consistency
  • Appendix B - HL7 Order Mapping to DICOM MWL
  • Appendix C - Dept access to Non-Rad Information
  • Appendix D - Clarification of Patient Identifiers for Merge Cases
  • Appendix E - HL7 v2.3.1 Message Field Replaced...
• From vol 3:
  • Appendix A - Deprecated
    • Now:
  • Appendix B - Deprecated
    • Now:
  • Appendix C - Attribute Consistency between GP Workslist, SPS, PPS.... in Post-Processing WF
    • Now:
  • Appendix D - Attribute Consistency ...in Reporting WF
    • Now:
  • Appendix E - DICOM Media Interchange - Critical DICOM Compatibility TIps
    • Now:
  • Appendix F - Example Created Media Instance Content
    • Now:
  • Appendix G - Configuration for Accessing DICOM, WADO & Webservices Retrieve
    • Now:
  • Appendix H - Example Template for Teachning File
    • Now:
  • Appendix I - De-Identification ... Clinical Trial Attributes
    • Now:
• From TI Supplements

Appendix E (Vol 3) - DICOM Media Interchange – Critical DICOM Compatibility Tips ...modified in  PDI extensions

• • Appendix F - Organization of series and images into frame sets ...from BIR
    • Now:
  • Appendix J - Clinical Decision Support (CDS) and Appropriate Use Criteria (AUC) Data Explanation ... from CDS-OAT
  • Appendix J - Multiple Identity Resolution Option ... from MIMA
  • Appendix K – Import Reconciliation Workflow Import Instruction Handling Option ... from IDEP
  • Appendix O – Reason for Procedure Codesets (Informative) .... from EBIW
  • Appendix P - Appendix P – HL7 v2 ORU for External Prior Reports Mapping ... from IDEP
  • Appendix W - Populating UPS Workitem Attributes during Creation ... from PAWFF, moving to AI Workflow
  • Appendix V - Attribute Consistency between UPS and ResultingComposite IODs ... from PAWF, moving to AI Workflow

Vol 3

• 5 Transaction Options on Other Domain Profiles
  • 5.1 ITI-20 Record Audit Event
• 6 Content Modules
  • 6.1 XDR-I Imaging Document Set
  • 6.3 SOLE Event Definitions
  • 6.4 HL7 v.2.x Content Modules
    • 6.4.1 HL7 v2.x Content Modules for CDS Information ... from CDS-OAT
• 7 Namespaces and Vocabulary ... from SOLE
  • 7.1 New codes for SOLE Profile ... from SOLE
  • XRR-WD has namespace additions; they are added to Vol 2, but s/b Vol 3
• 8 ??
  • 8.1 Report Template Structure ... from MRRT

Vol 4 - unchanged

Break-up method - Lynn's notes

• Volume 1
  • Section 1 remains the same in all Vol 1 documents
    • MARY & TECH CMTE DECISION: Sec 1 contains copyright, but there is duplication....
  • break up sections per the previous proposal above
    • TECH CMTE DECISION: Section 2.1 contains a high-level summary of all profile. we could move the subsections into the volumes that contain the actual profiles, or leave them combined in Sec 2 which is currently only in Vol 2
  • For deleted sections, maintain preceding section headings to preserve numbering.
    • Add one line underneath, eg "See Vol 1b"
    • Or, if the section is blank because it is TI, indicate that and include a hyperlink to the TI supplement
  • TO DO: Talk to Mary about how to modify the Heading 1 style so that these 'empty' sections do not force a page break.
  • Now...turn on change tracking.
  • Find all references to appendices, and add a preface RAD TF-1x: or RAD TF-2x:
  • Replace RAD TF-3 (for transactions) with RAD TF-2 because all transactions now live in Vol 2
  • Update cover page and header

To dos

• Update the existing technical framework to use the new template?
  • Need to identify what needs to be done: (Kevin)
  • Content of each profile chapter
    • New profile inside a chapter will use new template, old ones remain old template. => Should not be a problem
    • Need to fix the "intro chapters"

• Enhance outreach-ability to make the profile wiki more easier to consumer by people not already familiar with IHE

Profile Pages on Wiki

• From the face-to-face meeting in January 2019, we agreed the following catch up:

Update existing page:

• SWF to SWF.b (Steve)
• Update IRWF to IRWF.b (Kinson)

Populate empty or missing page:

• EBIW (Kevin)
• RD (Antje)
• KIN (Antje)
• MRRT (Kinson)

Risks of Work Item

• Effort underestimated for other activities, less effort spend on maintenance
• Lack of appropriate knowledge, there is a lack of expertise in HL7v2 area

. Tech Cmte Evaluation

Effort Evaluation (as a % of Tech Cmte Bandwidth): 35%

Total Maintenance load

For reference from recent cycles:

Cycle	2018-19	2017-18	2016-17	2015-16	2014-15	2013-14	2012-13
Maint Allocated	30%	40%	15%	35%	30%	30%	15%
Maint Used	38%	31% + 28% (WIA)	17% + 26% (WIA)	45%	62%	29%	19%
Outstanding CPs	87	81	75	68	59	47

Discussion

• What do we want to do in the normal time allotted.