Difference between revisions of "SWF.b Assisted Protocol Option Extension"

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''This template is for one or two page IHE workitem proposals for initial review. To create a new proposal, first log in to the Wiki (or create an account if you don't already have one). Then create an appropriately named new Wiki page (see the editing instructions linked to "Help" at left. Then come back to this page, click "edit" above, select and '''copy''' the contents of this page and paste the contents into your newly created page.''
 
 
 
''<Delete everything in italics and angle brackets and replace with real text.  This means delete the angle bracket character and the two quote marks too.>''
 
 
  
 
==1. Proposed Workitem: ''<initial working name for profile/whitepaper/etc>''==
 
==1. Proposed Workitem: ''<initial working name for profile/whitepaper/etc>''==
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==2. The Problem==
 
==2. The Problem==
  
In IHE Scheduled Workflow (SWF.b), Assisted Procol Option, the "assignment of acquisition protocols" is included as a function of the Order Filler/Department System Scheduler (OF/DSS) Actor.  In practice, implemented Order Filler Actors typically do not have the features necessary to properly assign protocols that would be  performed by an acquisition system. A more recent profile, "Management of Acquisition Protocols" (MAP) was introduced for managing acquisition protocols, centrally across an enterprise by the Protocol Manager (PM) Actor. 
 
  
While both the PM and the OF/DSS have key and distinct roles in Managing and assigning Acquisition Protocols, IHE has not identified transactions between these two profiles and their key actors actors. Providing this enterface will improve the efficiencies between the management, assignment and selection of acquisition protocols.
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IHE has defined two profiles regarding how acquisition protocoling is performed and managed.  They are Management of Acquisition Protocols and Scheduled Workflow, Assisted Protocol Option.  IHE has not defined how these profiles interact.
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Management of Acquisition Protocols defines actors, and a centralized process for managing Protocols across modalities, and the SWF.b Assisted Protocol Option provides for the capability to communicate to the acquisition modality, the recommended protocols for the acquisition.
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There is a natural grouping of Protocol Management and Protocol Prescription functionalities within the Protocol Manager Actor. Such systems are being developed as standalone systems apart from the traditional Radiology Information System. The RIS typically incorporates this Protocol Prescription capability along with resource (Modality) scheduling, however, the RIS may lack equipment specific knowledge to assign the correct protocol based on the manufacturer and model of the scheduled resource. These new systems include the incorporation of EMR clinical data (such as patient history and allergies) and AI algorithms, to improve the efficiencies of radiologists in prescribing acquisition protocols necessary to fulfill an order.  
  
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This proposal is to address how a Protocol Management System communicates to a Radiology Information System the prescription of the acquisition protocols that are known by the performing modality to be scheduled.
  
 
==3. Key Use Case==
 
==3. Key Use Case==
  
''<Describe a short use case scenario from the user perspective.  The use case should demonstrate the integration/workflow problem.>''
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An imaging service request is typically created by and EMR  and transferred as an imaging order to a Radiology Department Information System.
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The order received by the Radiology Information System (EMR), initiates two tasks, Scheduling and Protocolling.  These tasks happen independently.  In this use case, these tasks are performed on two separate systems, a RIS performing the scheduling and a Protocol Management System performing the protocoling.
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When the Order is received by the Protocol Management System, the order is associated with a number of radiology-specific procedures that have to be performed to satisfy the order. Each procedure prescribes a number of actions that are to be performed by Acquisition Modalities.  Actions are grouped into procedure steps.
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A Radiologist determines the procedure assignment and will recommend the protocols to be performed by the acquisition modalities to fill the order.  This includes the acquisition protocol which identifies the settings and conditions to be used by the technologist to perform the acquisition.  The Radiologist reviews the patient’s medical history, typically hosted on an EMR, to assist in this assignment.  This task is performed on a Protocol Management System.
  
''<Feel free to add a second use case scenario demonstrating how it “should” workTry to indicate the people/systems, the tasks they are doing, the information they need, and hopefully where the information should come from.>''
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A Department Scheduler will assign the time slots and performing resource (modality) for the procedure stepsThe procedure steps includes the protocol assignments by the Radiologist.
  
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See also
  
 
==4. Standards and Systems==
 
==4. Standards and Systems==
  
''<List existing systems that are/could be involved in the problem/solution.>''
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'''Systems'''
  
''<If known, list standards which might be relevant to the solution>''
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:# Protocol Management System
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:# Electronic Medical Record Order Management System
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:# Radiology Information System
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:# Protocol Management System
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:# Acquisition Modality
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'''Standards'''
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:# DICOM
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:# HL7 v2
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:# HL7 FHIR
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:# IHE Scheduled Workflow, Assisted Protocol Option
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:# [https://www.ihe.net/uploadedFiles/Documents/Radiology/IHE_RAD_Suppl_MAP.pdf IHE Management of Acquisition Protocols]
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:## Section 44.4.1.13 Protocolling Ordered Patient Studies.
  
 
==5. Discussion==
 
==5. Discussion==
  
''<Include additional discussion or consider a few details which might be useful for the detailed proposal>''
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This proposal is to bridge two existing IHE profiles, IHE SWF.b, Assisted Protocol Option with the IHE MAP.  The Protocol Manager defined in MAP will require the Order created in SWF.b by the Order Placer.  This is an existing transaction [RAD-2].  The protocol assigned by the protocol Manager needs to be communicated to the Order Filler in SWF.b.  This transaction is not defined in IHE. RSNA is demonstrating this capability at the RSNA 2021 IAIP demonstration and could serve as a model on how this can be achieved.
:''<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?>''
 
 
 
  
''<This is the brief proposalTry to keep it to 1 or at most 2 pages>''
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The Protocol Manager may need to know what protocol is performed by the Modality.  This feedback is provided by the existing Modality in the MPPS transaction.  A Protocol Manager could receive the MPPS directly from the ModalityWhile access to the Patient’s medical record is important to the protocoling, IHE IT has defined several profiles which should be considered as a cross profile consideration.
  
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The Protocol Management system will require access to the list of local procedures for the department.  This need can be supported by IHE ITI Shared Value Set profile as a cross profile consideration. 
  
''<Delete this Category Templates line since your specific Profile Proposal page is no longer a template.>'' [[Category:Templates]]
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[[File:RIS-writeback graphic.jpg]]

Latest revision as of 16:11, 18 August 2021


1. Proposed Workitem: <initial working name for profile/whitepaper/etc>

  • Proposal Editor: Chris Lindop
  • Editor: <Name of candidate Lead Editor for the Profile, if known>
  • Date: N/A (Wiki keeps history)
  • Version: N/A (Wiki keeps history)
  • Domain: Radiology


2. The Problem

IHE has defined two profiles regarding how acquisition protocoling is performed and managed. They are Management of Acquisition Protocols and Scheduled Workflow, Assisted Protocol Option. IHE has not defined how these profiles interact.

Management of Acquisition Protocols defines actors, and a centralized process for managing Protocols across modalities, and the SWF.b Assisted Protocol Option provides for the capability to communicate to the acquisition modality, the recommended protocols for the acquisition.

There is a natural grouping of Protocol Management and Protocol Prescription functionalities within the Protocol Manager Actor. Such systems are being developed as standalone systems apart from the traditional Radiology Information System. The RIS typically incorporates this Protocol Prescription capability along with resource (Modality) scheduling, however, the RIS may lack equipment specific knowledge to assign the correct protocol based on the manufacturer and model of the scheduled resource. These new systems include the incorporation of EMR clinical data (such as patient history and allergies) and AI algorithms, to improve the efficiencies of radiologists in prescribing acquisition protocols necessary to fulfill an order.

This proposal is to address how a Protocol Management System communicates to a Radiology Information System the prescription of the acquisition protocols that are known by the performing modality to be scheduled.

3. Key Use Case

An imaging service request is typically created by and EMR and transferred as an imaging order to a Radiology Department Information System.

The order received by the Radiology Information System (EMR), initiates two tasks, Scheduling and Protocolling. These tasks happen independently. In this use case, these tasks are performed on two separate systems, a RIS performing the scheduling and a Protocol Management System performing the protocoling.

When the Order is received by the Protocol Management System, the order is associated with a number of radiology-specific procedures that have to be performed to satisfy the order. Each procedure prescribes a number of actions that are to be performed by Acquisition Modalities. Actions are grouped into procedure steps.

A Radiologist determines the procedure assignment and will recommend the protocols to be performed by the acquisition modalities to fill the order. This includes the acquisition protocol which identifies the settings and conditions to be used by the technologist to perform the acquisition. The Radiologist reviews the patient’s medical history, typically hosted on an EMR, to assist in this assignment. This task is performed on a Protocol Management System.

A Department Scheduler will assign the time slots and performing resource (modality) for the procedure steps. The procedure steps includes the protocol assignments by the Radiologist.


See also

4. Standards and Systems

Systems

  1. Protocol Management System
  2. Electronic Medical Record Order Management System
  3. Radiology Information System
  4. Protocol Management System
  5. Acquisition Modality

Standards

  1. DICOM
  2. HL7 v2
  3. HL7 FHIR
  4. IHE Scheduled Workflow, Assisted Protocol Option
  5. IHE Management of Acquisition Protocols
    1. Section 44.4.1.13 Protocolling Ordered Patient Studies.

5. Discussion

This proposal is to bridge two existing IHE profiles, IHE SWF.b, Assisted Protocol Option with the IHE MAP. The Protocol Manager defined in MAP will require the Order created in SWF.b by the Order Placer. This is an existing transaction [RAD-2]. The protocol assigned by the protocol Manager needs to be communicated to the Order Filler in SWF.b. This transaction is not defined in IHE. RSNA is demonstrating this capability at the RSNA 2021 IAIP demonstration and could serve as a model on how this can be achieved.

The Protocol Manager may need to know what protocol is performed by the Modality. This feedback is provided by the existing Modality in the MPPS transaction. A Protocol Manager could receive the MPPS directly from the Modality. While access to the Patient’s medical record is important to the protocoling, IHE IT has defined several profiles which should be considered as a cross profile consideration.

The Protocol Management system will require access to the list of local procedures for the department. This need can be supported by IHE ITI Shared Value Set profile as a cross profile consideration.

RIS-writeback graphic.jpg