Scheduled Workflow 2.0 - Brief Proposal

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IHE Profile Proposal (Brief)

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1. Proposed Profile: Imaging Acquisition Workflow - Radiology

  • Proposal Editor: Chris Lindop/Tony Palmer/Herve Hoehn
  • Date: N/A (Wiki keeps history)
  • Version: N/A (Wiki keeps history)
  • Domain: Radiology and Other Imaging Acquisition Domains

2. The Problem

The Scheduled Workflow Integration Profile pioneered the use cases for integrating Systems which specialized in Order Placement/Department Scheduling Image Management and Image Acquisition Systems (i.e. CT, MR, US, etc) with DICOM MPPS. At this time, it was the current “state of integration” for integration order placers with order fillers. While with Image Managers, the value proposition is clear. PPS provides a mechanism for Image Managers to associate images acquired by modalities with procedures scheduled by Radiology Information Systems. The value for Radiology Information Systems is less clear. The value provided is minimal and insufficient for a RIS to fully automate workflow based solely on a MPPS message coming from a RIS.

3. Key Use Case

This Integration profile leverages the same use cases as scheduled workflow at a high level. Some of the key information not addressed by MPPS includes some basics; exam Start, Exam Complete, Technologist performing the acquisition to name a few. The current workflow in SWF is only focused on the acquisition of the images only and not the clinical elements of the image acquisition. Also missing is key feedback with actionable items for a tech to perform while the study is in session. This would include re-takes, additional protocols, etc. The current use cases cover this level of interoperability in a generic sense (i.e append). But they do not address the specific needs and is not clearly defined. Error conditions are not handled effectively and are in most cases optional. This revision of scheduled workflow needs to be an upgrade to the existing transactions, making the interfaces truly interoperable.

4. Standards & Systems

The existing systems include Radiology Information Systems, Diagnostic Imaging Devices and PACS. Standards: DICOM

5. Discussion

Uptake of SWF Order Filler actor is low or in-effective due to the missing capabilities described above. The goal of this Integration Profile is to focus on the interoperability of RIS and Modalities. To make this interface robust and, most important, effectively usable by Order fillers. It will also need to be decoupled with the order filler. In many cases, order fillers in an out-patient setting receive referrals or include the order filler and ADT role embedded in their application. By decoupling the Order filler role from the order placer role, the implementing system can focus on only transactions associated with managing the fulfillment of an order and not necessarily how the order was received.