SWF-Image Exchange option

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1. Proposed Workitem: SWF-Image Exchange option

  • Proposal Editor: Chris Lindop
  • Editor: Chris Lindop
  • Date: N/A (Wiki keeps history)
  • Version: N/A (Wiki keeps history)
  • Domain: Radiology

2. The Problem

Scheduled workflow solves the interoperability and workflow for Radiology Departmental Imaging acquisition. It does not address interoperability and workflow when cross-enterprise actors are involved.

This proposal is to address this gap.

The valus is to allow for greater flexibility with enabling cross-eneterpise worflow.

3. Key Use Case

Use Case 1

  1. A physician creates a referral and notifies an imaging service provider through Notification of Document Avalaibility of the request.
  2. The Imaging Service Provider (ISP) recieves an XDS-MS referral for an imaging service.
  3. The ISP acknowledges that it received the referral and accepts it as a workitem
  4. The ISP creates an order as an Order Place to an Order Filler.
  5. The order information is communicated back to the refferral initiator.

The XDS-MS and NAV profiles are specified appropiately to achieve steps 1 and 2. The acknowlegement and it's content is not refined for this scenario. Content required from the referral to the order is not specified.

Use Case 2

  1. The Order Filler receives the clinical order and creates an imaging procedure plan. The procedure plan contains serveral procedure steps. This procedure steps may involve one or more organisations which can be part of the same organisation. The procedure plan is made available to the referral initiator. The originator is notified via either NAV or DSUB.

There is a Clinical Care Plan Integraiton Profile in PCC. This could be the template for doing an imaging Procedure plan.

Use Case 3

  1. The procedure steps are created by the order filler as tasks to be managed Management as a minimum require the tasks to be; assigned, scheduled, and performed.
  2. The Order Filler associatesd the tasks or procedure steps with the procedure plan posted in the XDS infrastructure. By posting the tasks to be managed, it enables the fulfillment of these tasks to be completed in other institutions. Note that the procedures steps could be as simple as 1) "acquire images" and 2) "read images" with specific clinical instructions. Each task should be posted and referenced to the original procedure plan and the associated referral.
  3. Each step is assigned and scheduled for completion.

Scheduled Workflow, Post-Processing Workflow and Reporting Workflow provide for the framework within an enterise. None of these profiles handle the cross-enterprise task management workflow. There is an IHE PCC profile for Care Plan Coordination which does.

Use Case 4

  1. Once images are acquired for a task or procedure step, the task status is updated and reported to the manager of the procedure plan.
  2. Using DSUB as the enabling technology, the referral initiator is notified of the task status updates, including completion.
  3. The images are posted, using XDS-I. All of the relevant clinical acquisition information is included in the submission set as part of the acuisition workflow.
  4. The images and referenced to the original referral.
    1. Using DSUB and/or NAV, the referral originator and other relevant clincal care providers are notified of the image availability.

Use Case 5

  1. Once the report is created and finalized, the task status is updated and reported to the manager of the procedure plan.
  2. Using DSUB as the enabling technology, the referral initiator is notified of the task status updates, including completion.
  3. The report is posted, using XDS-I. All of the relevant clinical acquisition information is included in the submission set as part of the reporting workflow.
  4. The report is referenced to the images and the original referral.
  5. Using DSUB and/or NAV, the referral originator and other relaevent clincal care providers are notified of the report availability.

4. Standards and Systems

XDS-MS

XDS-I

XDS Care Plan


DICOM

HL-7

CCD


5. Discussion

What is described is currently being done today with non-standard components. SWF currently does not manage the attributes which could help facilitate the interoperability in a standards-based method. IHE

IHE needs to clearly work though the usecases to ensure better interoperability with Scheduled Workflow. For the other profiles, we may need create options to those profiles for better interoperability.