Reporting Whitepaper - Section 5
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| Artifact | Encoding | Transaction | Transport | Dir | Input/Output |
|---|---|---|---|---|---|
| Patient Account | HL7 PV1 | Patient Update | (HL7 Msg) | Push | Patient Account |
| Patient Summary | HL7 CDA-MS | ??? | ??? | Pull | History/Allergies/Problems/Meds |
| Order | HL7 ORM | Placer Order Management | (HL7 Msg) | Push | Order |
| Worklist | DICOM MWL IOD | Modality Worklist Provided | DICOM MWM C-Find | Pull | Acquisition Worklist |
| DICOM UPS IOD | (Query Worklist) | DICOM UPS C-Find | Pull | Post-Proc Worklist Reading Worklist Overread Worklist Verification Worklist | |
| (Push Workitem) | DICOM UPS N-Create | Push | Overread Worklist Verification Worklist | ||
| Images | DICOM Image IODs | Images Stored | DICOM C-Store | Push | Acquired Images Processed Images 3D Views |
| Retrieve Images | DICOM C-Store | Pull | Acquired Images Processed Images 3D Views | ||
| Performed Proc. | DICOM MPPS IOD | Modality Procedure Performed | DICOM N-Set | Push | Acquisition |
| DICOM UPS IOD | (D-Store Performed Proc) | DICOM UPS N-Get | Pull | ||
| HL7 DFT? | (H-Store Performed Proc) | (HL7 Msg) | Push | ??? | |
| Radiation Dose | DICOM SR Dose IOD | (Store Dose) | DICOM C-Store | Push | Acquisition Dose |
| Procedure Log | DICOM SR PLog IOD | (Store Procedure Log) | DICOM C-Store | Push | |
| Audio | ??? | (Store Audio) | ??? | Push | Dictation |
| Radiology Report | HL7 CDA | (D-Store Report) | DICOM C-Store | Push | Proto Report Draft Report Signed Report |
| (H-Store Report) | (HL7-Msg) | Push | Draft Report Signed Report | ||
| Lab Results | HL7 CDA | (H-Retrieve Report) | (HL7-Msg) | Pull | |
| Path Results | HL7 CDA | (H-Retrieve Report) | (HL7-Msg) | Pull | |
| Staff Schedule | HL7 ??? | Out of scope? | ??? | ???? | Staff Schedule |
| Staff Details | HL7 ??? | <PWP> | ??? | Pull | Certifications |
Patient History Sheet
Tech Interview Sheet
Bill X12
CDA in Imaging
<Material from Section 3 to go in Section 5>
- Investigate CDA as an authoring and distribution format for diagnostic reports
- Two gaps are:
- the lack of CDA report templates for a broad set of Radiology reports
- the lack of deployed implementations using CDA
Push vs Pull
Currently most data transfer transactions are either Push or Pull, not both.
Mostly, the preference is for clients to be in control, so client inputs are Pulled (from Servers) and outputs are Pushed (to Servers). Configuration issues also favour this approach.
When bandwidth limitations cause client response times to be unacceptable to users, this is sometimes addressed by having inputs Pushed (to the client), sometimes at the cost of needing more local storage.
When explicit workflow control is "overkill", implicit workflow is sometimes implemented by having inputs Pushed (to the client). The presence of the input implies that some action should be performed on it.
When the client needs to know promptly when an (infrequently and unpredictably updated) piece of information has been updated, that input may be Pushed (to the client) to avoid excessive polling. When there is also a desire to avoid excessive broadcasts, the data push can be expanded to Publish-Subscribe.
<<Should continue to flesh out the cases where it makes sense to push inputs and pull outputs so we can add such transactions when it's appropriate and not complicate the architecture when it's not>>
<<We should start working out which nodes would prefer to pull it's inputs or have them pushed, and which would like to push it's outputs or have them pulled. It depends somewhat on the overall workflow architecture. Not sure if it goes in Section 3, Section 5, or Section 6.>>