Difference between revisions of "Resting ECG Workflow"

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==Summary==
 
==Summary==
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''<Describe the profile in about a paragraph using user-oriented language.  Focus on what it accomplishes for a user (i.e. the Use Cases).  Don't get into how it works, leave that to the Details section.>''
 
  
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''<Insert a simple graphic that, at a glance, visually summarizes what the profile is about.  Do not use an actor/transaction diagram here.  Show your graphic to someone for 5 seconds (literally) and ask them what it's about.  If what they say hits the main points in your summary paragraph, you have succeeded. E.g. a graphic of a hospital, a clinic, and a lab with patient records moving between them.  .>''
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Resting Electrocardiograms (ECGs) are a widely prescribed diagnostic test in Cardiology. Current workflows are based on proprietary communication protocols, which hamper interoperability and clinical workflows.
  
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''<See [[Help:Contents#Tips_.26_Tricks| Help - Tips and Tricks]] for details on inserting an image/graphic.>''
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The profile describes workflows associated with digital electrocardiography. Similar to the Cath and Echo Workflow integration profiles, this profile deals with patient identifiers, orders, scheduling, status reporting, and data storage.  It also addresses the issues of acquisition modality devices that are intermittently connected to the network, such as portable electrocardiograph machines, as well as ECG-specific data requirements. The Resting ECG Profile will handle the cases of unordered and urgent ECG tests and ECGs acquired in both hospital and office settings.  It also handles ECGs acquired for the purposes of clinical trials and research.
  
 
==Benefits==
 
==Benefits==
  
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''<List the key benefits the profile provides (e.g. error reduction, increased throughput) and how they come about (e.g. SWF reduces patient errors due to mistyped demographics at the modality by transfering demographics electronically from the Order Filler).  Consider using a bullet list for readability.  If possible, identify benefits that help users and vendors make the business case for the profile.>''
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* An “Integrated ECG Manager” actor makes it easier for traditional ECG management products to adopt this profile
  
 
==Details==
 
==Details==
  
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''<A few paragraphs, if appropriate, providing more details (mostly in user-speak, not tech-speak) on what the profile does and how it works.>''
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The Resting ECG Workflow (REWF) Integration Profile:
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* Establishes the continuity and integrity of basic departmental ECG data by profiling specific usage of HL7 messaging across multiple systems including: Patient registration (ADT), Order Placing (CPOE) and Order Scheduling (CVIS) systems.
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* Bridges the gap between HL7-based systems (like CVIS) and DICOM-based systems (like ECG carts and PACS) within the cardiology department by specifying the semantic mappings between messages.
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* Maintains the consistency of patient demographic and ordering information across multiple systems by making that information available to ECG carts via the DICOM Modality Worklist (MWL) Service.
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* Allows storage and management of ECG evidence documents and final report creation and storage
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* Ensures that acquired ECGs are not inadvertently lost by specifying that the DICOM Storage Commitment Service is used to transfer the custodianship of images from the modality to the PACS.
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* Ensures that the status of acquisition workflow steps are known throughout the department by specifying the use of the DICOM Modality Performed Procedure Step (MPPS) Service to convey that status from the modality to the CVIS and the PACS.
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* Allows multi-vendor interoperability between major subsystems:
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** Registration and ordering (HIS, CVIS)
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** ECG archive (PACS, ECG Management)
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** Acquisition devices (Electrocardiographs)
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** ECG analysis and reporting workstations (ECG or PACS Workstations)
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** ECG report consumers (EMR)
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* Uses HL7 transactions for HIS and EMR
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* Uses DICOM transactions for acquisition devices and workstations
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** ECG waveforms stored as DICOM General ECG Waveform objects
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** ECG measurements and interpretations stored as DICOM Structured Reports
  
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''<If the user might be familiar with the mechanisms used by the profile, you can mention them here.  E.g. Evidence Documents is based on DICOM Structured Report (SR) Templates.>''
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==Systems Affected==
  
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''<If the user might have an appreciation for the problems addressed in the profile, you can mention them here, but keep it short.  E.g. Mapping HL7 Order fields to DICOM Modality Worklist attributes can be inconsistent in the marketplace, so Scheduled Workflow provides vendors with more detailed instructions.>''
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Systems involved in this profile are:
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==Systems Affected==
 
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''<List (in user terms) the types of systems they might expect to have implemented actors from this profile, e.g. RIS, PACS, HIS, CAD Workstation, etc. and for each, how it would participate.>''
 
  
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* ''PACS systems may store, manage, and/or display Evidence Documents.''
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* Enterprise-wide information systems that manage patient registration and services ordering (i.e., admit-discharge-transfer (ADT)/registration system and hospital information system)
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* ''Display systems may query, retrieve and display Evidence Documents.''
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* Cardiology information systems that manage department scheduling and report creation
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* ''Reporting workstations may retrieve, process and include details from Evidence Documents in reports
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* Picture Archiving and Communication Systems that manage storage of images, waveforms and evidence documents.
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* Review workstation that allow for querying, retrieving and displaying images, waveforms (ECG) and evidence documents
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* ECG carts for the acquisition of waveform data and evidence documents.
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* In order to allow legacy systems easier transition, the Cardiology Information System and PACS can be grouped into an integrated ECG Manager.
  
 
'''Actors & Transactions:'''
 
'''Actors & Transactions:'''
  
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''<Insert an actor-transaction diagram, and or list of Content Definitions>''
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[[Image:Rewf_act_trans.jpg|900px]]
  
 
==Specification==
 
==Specification==
  
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'''Profile Status:''' [[Comments| Final Text]] 
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'''Profile Status:''' ''Trial Implementation''
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''<Replace "Final Text" with "Trial Implementation" or "Public Comment" as appropriate.>''
 
  
 
'''Documents:'''  
 
'''Documents:'''  
  
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''<Provide direct links to the specific volumes or supplements, and list the volume sections relevant to this profile.  This is a simple inventory of official normative and informative text. If you would like to provide a reading guide or walkthrough of what is in each of the different sections for implementers or users, do that in the Profile FAQ or the Profile Implementation Page linked below. If the profile uses transactions from multiple Tech. Frameworks, repeat the structure below.>''
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:* [http://www.ihe.net/Technical_Framework/upload/IHE_CARD_Suppl_REWF_Rev1-1_TI_2010-07-30.pdf Resting ECG Supplement]
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:* [http://www.ihe.net/Technical_Framework/index.cfm#cardiology IHE Cardiology Technical Framework:]
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:** [http://www.ihe.net/Technical_Framework/upload/IHE_CARD_TF_Rev3-0_Vol2_2010-10-15.pdf Vol. 2] - Sections 4.1 and 4.3
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:* [http://www.ihe.net/Technical_Framework/index.cfm#radiology IHE Radiology Technical Framework:]
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:** [http://www.ihe.net/Technical_Framework/upload/ihe_tf_rev8-2.pdf Vol. 2] - Sections 4.1 to 4.3, 4.12, 4.20 to 4.21
  
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[http://www.ihe.net/Technical_Framework/index.cfm#radiology IHE Radiology Technical Framework:]
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:* [http://www.ihe.net/Technical_Framework/upload/IHE_CARD_Suppl_DRPT_Rev48_TI_2010_07_30.pdf Displayable Reports Supplement] - Section 4.7
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:* [http://www.ihe.net/Technical_Framework/upload/ihe_tf_rev8.pdf Vol. 1] - Section 5 (SWF Profile)
 
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:* [http://www.ihe.net/Technical_Framework/upload/ihe_tf_rev8-2.pdf Vol. 2] - Sections 4.8 to 4.10, 4.14 to 4.19, and 4.23
 
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:* [http://www.ihe.net/Technical_Framework/upload/ihe_tf_rev8-3.pdf Vol. 3] - Appendix E
 
  
 
'''Underlying Standards:'''
 
'''Underlying Standards:'''
  
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''<list all the standards on which the profile is based; if possible with links to sources>''
 
 
:* [http://dicom.nema.org DICOM]
 
:* [http://dicom.nema.org DICOM]
 
:* [http://www.hl7.org HL7]
 
:* [http://www.hl7.org HL7]
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==See Also==
 
==See Also==
  
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''<The following sections can be left out if there is nothing to point to.  This is just to show where such information can go.>''
 
  
  
 
'''Related Profiles'''
 
'''Related Profiles'''
  
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''<List profiles this one depends on, profiles that depend on this one, profiles that are synergistic with this one.  Start with the name of the other profile as a link and then explain the relationship.>''
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* [[Displayable Reports]] [DRPT] for storage and managements of reports.  
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* [[Consistent Time]] [CT] to allow exact timestamps during ECG acquisition
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* ''[[Reporting Workflow]] [RWF] may use Evidence Documents as inputs to the reporting process.''
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* [[Patient Demographics Query]] [PDQ] to obtain patient demographics for unscheduled patients
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* ''[[Simple Image & Numeric Reports]] [SINR] may include data copied from Evidence Documents.''
 
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* ''[[Cross-enterprise Document Sharing for Imaging]] [XDS-I] can be used to share Evidence Documents between sites over a network.''
 
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* ''[[Portable Data for Imaging]] [PDI] can store Evidence Documents on media such as CDs.''
 
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* ''[[Import Reconciliation Workflow]] [IRWF] can fix patient ids, etc. of Evidence Documents when importing.''
 
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'''Consumer Information'''
 
'''Consumer Information'''
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The [[Profile FAQ Template]] answers typical questions about what the Profile does.  ''<Replace the link with a link to the actual FAQ page for the Profile>''
 
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The [[Profile Purchasing Template]] describes considerations when purchasing equipment to deploy this Profile.  ''<Replace the link with a link to the actual Purchasing page for the Profile>''
 
  
 
'''Implementer Information'''
 
'''Implementer Information'''
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The [[Profile Implementation Template]] provides additional information about implementing this Profile in software.  ''<Replace the link with a link to the actual Implementation page for the Profile>''
 
  
 
'''Reference Articles'''
 
'''Reference Articles'''
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''<List References (good and bad) (with link if possible) to Journal Articles that mention IHE's work (and hopefully include some analysis).  Go ahead, Google: IHE <Profile Name> abstract  or Google: IHE <Profile Name> and under the "more" select "Scholar".  You might be surprised. >''
 
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[[Category:Profiles]]
 
[[Category:Profiles]]
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[[Category:Cardiac Profile]]
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<noinclude>''<'''Delete this Category Templates line''' since your Profile page is no longer a template.>'' </noinclude>
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[[Category:DICOM]]

Latest revision as of 14:28, 4 November 2019

Summary

Resting Electrocardiograms (ECGs) are a widely prescribed diagnostic test in Cardiology. Current workflows are based on proprietary communication protocols, which hamper interoperability and clinical workflows.

The profile describes workflows associated with digital electrocardiography. Similar to the Cath and Echo Workflow integration profiles, this profile deals with patient identifiers, orders, scheduling, status reporting, and data storage. It also addresses the issues of acquisition modality devices that are intermittently connected to the network, such as portable electrocardiograph machines, as well as ECG-specific data requirements. The Resting ECG Profile will handle the cases of unordered and urgent ECG tests and ECGs acquired in both hospital and office settings. It also handles ECGs acquired for the purposes of clinical trials and research.

Benefits

  • An “Integrated ECG Manager” actor makes it easier for traditional ECG management products to adopt this profile

Details

The Resting ECG Workflow (REWF) Integration Profile:

  • Establishes the continuity and integrity of basic departmental ECG data by profiling specific usage of HL7 messaging across multiple systems including: Patient registration (ADT), Order Placing (CPOE) and Order Scheduling (CVIS) systems.
  • Bridges the gap between HL7-based systems (like CVIS) and DICOM-based systems (like ECG carts and PACS) within the cardiology department by specifying the semantic mappings between messages.
  • Maintains the consistency of patient demographic and ordering information across multiple systems by making that information available to ECG carts via the DICOM Modality Worklist (MWL) Service.
  • Allows storage and management of ECG evidence documents and final report creation and storage
  • Ensures that acquired ECGs are not inadvertently lost by specifying that the DICOM Storage Commitment Service is used to transfer the custodianship of images from the modality to the PACS.
  • Ensures that the status of acquisition workflow steps are known throughout the department by specifying the use of the DICOM Modality Performed Procedure Step (MPPS) Service to convey that status from the modality to the CVIS and the PACS.
  • Allows multi-vendor interoperability between major subsystems:
    • Registration and ordering (HIS, CVIS)
    • ECG archive (PACS, ECG Management)
    • Acquisition devices (Electrocardiographs)
    • ECG analysis and reporting workstations (ECG or PACS Workstations)
    • ECG report consumers (EMR)
  • Uses HL7 transactions for HIS and EMR
  • Uses DICOM transactions for acquisition devices and workstations
    • ECG waveforms stored as DICOM General ECG Waveform objects
    • ECG measurements and interpretations stored as DICOM Structured Reports

Systems Affected

Systems involved in this profile are:

  • Enterprise-wide information systems that manage patient registration and services ordering (i.e., admit-discharge-transfer (ADT)/registration system and hospital information system)
  • Cardiology information systems that manage department scheduling and report creation
  • Picture Archiving and Communication Systems that manage storage of images, waveforms and evidence documents.
  • Review workstation that allow for querying, retrieving and displaying images, waveforms (ECG) and evidence documents
  • ECG carts for the acquisition of waveform data and evidence documents.
  • In order to allow legacy systems easier transition, the Cardiology Information System and PACS can be grouped into an integrated ECG Manager.

Actors & Transactions:

Rewf act trans.jpg

Specification

Profile Status: Trial Implementation

Documents:

Underlying Standards:

See Also

Related Profiles

Consumer Information

Implementer Information

Reference Articles


This page is based on the Profile Overview Template

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