Scheduled Workflow 2.0 - Detailed Proposal

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Proposed Profile: Scheduled Workflow II

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

Summary

The Scheduled Workflow Integration Profile for the Radiology Domain was first introduced in the IHE Technical Framework Version 1 over 8 years ago. Since the introduction, IHE Radiology has added several options to make it more operable. Additionally, some of the early technology did not address all of the interoperability needs due to limitations of the technology. As such, the level of uptake is not consistent with all actors.

The Problem

HL7 2.3.1 is obsolete

  • SWF is based on HL7 v2.3.1. The current balloted version is HL7 v2.5.1. The current SWF utilizes overloaded fields and Z segments which make SWF incompatible with later HL7 versions.

Some specific features relevant to SWF that are lacking in 2.3.1 include:

  • SWF overloads the OBR field for specimen with views.
  • ORC segment may include the JJ1017 Code (Japanese master code for Radiology)
  • V2.5.1 provides increased Order Granularity in the fields added to the OBR in v2.4
  • Result Study UID: ORR can't normally provide the Study UID to reference. SWF added a custom ZDS Segment to handle Study Instance UID in Transactions RAD-4 and RAD-13. HL7 v2.5 formally defines it in the OMI

Poor utility of MPPS with Order FIllers

  • MPPS does not identify the operator.
  • MPPS can not be relied on for completing the study on the modality.

Obsolete Messaging Transaction for Change Order

  • Current Requires Cancel/New Order in order to perform the Modify Order.

Patient Administration Management Adoption

  • The PAM Integration Profile from the ITI domain provides a common approach for all domains for patient management.
  • SWF includes patient management because it wasn't' profiled at the time of SWF development.
  • SWF II could reduce variation by factoring out patient management and referencing PAM instead.
  • PAM effectively replaces SWF transactions RAD-1 and RAD-12.

Patient Information Reconcilliation Tranactions and use cases for this profile will be part of this profiel workscope.

Key Use Case

The existing use cases defined in SWF and PIR are applicable. The current use cases will require clarification of how to utilize the additional transactions.

Only Use Cases which address Radiology Acquisition will be part of the workscope.

Standards & Systems

HL-7 v2.5.1 (Released)

HL-7 v 2.5.1 is the most currently balloted and relevant version of HL-7 to SWF II. HL-7 v 2.5.1 is identified as a critical need by the Japan National Committee and the Spain National Committee.

HL-7 v2.6 (In Ballot)

The initial assessment by the Rad TC is that v2.6 has no additional features useful or relevant to SWF II.

HL-7 v2.7 (In Development)

The initial assessment by the Rad TC is that v2.7 has no additional features useful or relevant to SWF II.
The initial assessment by the Rad TC is that SWF II will not define any additional requirements relevant to v2.7 development.

HL-7 v3.x (In Development)

The initial assessment by the Rad TC is that the impact of HL-7 v3.x is so significant that it warrants a separate profile.

Regional HL-7 Version Requirements

see strawman process described in open issues section


DICOM

5. Technical Approach

Existing Actors

Order Placer

Order Filler

Evidence Creator

Acquisition Modality

Image Manager

New Actors

None proposed.

Existing Transactions

The following changes are proposed for each tranaction:

  • RAD-1 Patient Registration - Remove PAM tranactions superseed
  • RAD-2 Orders Management - Replace with Enhanced Orders Management V2.5 based on the OMG message.
  • RAD-3 Order Filler Management Replace with Enhanced Order Filler Management using the specific V2.5 OMI message.
  • RAD-4 Procedure Scheduled - Replace with Enhanced Procedure Scheduld using the specific V2.5 OMI message.
  • RAD-5 Query Modality Worklist - no change
  • RAD-6 Modality Procedure Step In Progres - Add operator ID
  • RAD-7 Modality Procedure Step Complete - Add operator ID
  • RAD-8 Modality Images Stored - no change
  • RAD-10 Storage Commitment - no change
  • RAD-11 Image Availability Query - remove
  • RAD-12 Patient Update - Remove PAM tranactions superseed
  • RAD-13 Procedure pdate - Replace with Enhanced Procedure Update using the specific V2.5 OMI message.
  • RAD-14 Query Images - no change
  • RAD-16 Retrieve Images - no change
  • RAD-18 Creator Images Stored - no change
  • RAD-19 Creator Procedure Step In Progres - Add operator ID
  • RAD-20 Creator Procedure Step Complete - Add operator ID
  • RAD-26 Query Reports - remove, reporting workflow not included
  • RAD-27 Retrieve Reports - remove, reporting workflow not included
  • RAD-42 Performed Workstatus Update - remove. Post-processing workflow not included
  • RAD-46 Query Reporting Worklist - remove. reporting workflow not included
  • RAD-48 Appoinment Notification - remove. scheduling not icluded.
  • RAD-50 Instance Availability Notification - no change.


New Transactions

  • RAD-x2 Enhanced Orders Management - Replaces RAD-2 with Enhanced Orders Management V2.5 based on the OMG message.
  • RAD-x3 Order Filler Management Replaces RAD-3 with Enhanced Order Filler Management using the specific V2.5 OMI message.
  • RAD-x4 Procedure Scheduled - Replaces RAD-4 with Enhanced Procedure Scheduld using the specific V2.5 OMI message.
  • RAD-x13 Procedure pdate - Replaces RAD-13 with Enhanced Procedure Update using the specific V2.5 OMI message.
  • RAD-xx1 Study Complete - New Tranaction to identify when the operator thinks they are done with the stucy and the next step in the departmental worklow may be initiated

New Integration Profiles Needed

Create Radiology Acquisition Workflow


Support & Resources

The resource support committed to this profile are high. Commitment of resources from National Committees, the Radiology Subcomittees and other Domain Committees have all expressed their commitment for a new SWF.

Specifcally:

  • The Japan and Spain National Committees both have expressed interest in seeing SWF updated to HL7 v2.5.
  • The Mammography Subcommittee has expressed their need for some of the departmental workflow enhancements identified and their willingness to work with the re-factoring to support their needs.


Risks

  1. PAM requirements may be too extensive for outpatient imaging centers.
  2. Limiting the HL7 workscope to the porting of the SWF Transactions and fields from 2.3.1 to 2.5.1 may not be sufficient to meet current needs of the systems today.
  3. Operator identiy may not match between systems without the common sharing of operator identities without the use of PWP or other IT technique to synconize operator personell identity.
  4. Domains outside of Radiology will need to consider which version/s of SWF to use. This step may introduce scope creep.


Tech Cmte Evaluation

Effort Evaluation (as a % of Tech Cmte Bandwidth):

  • 35% for ...

Responses to Issues:

See italics in Risk and Open Issue sections

Candidate Editor:

Chris Lindop


Radiology_Proposals_2008-2009

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