XDR-I - Detailed Proposal

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1. Proposed Workitem: XDR-I

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

2. Summary

Currently, Imaging has no payload which would allow for the push of images outside of an enterprise environment. IHE ITI has a transport protocol called XDR which serves well for non-imaging payloads. It is compatible with the Security and Privacy protocols developed by the IHE ITI domain. The XDS-I.b protocol breaks the content profile into 2 components. The first component is designed essential as a notification of where to pull the content. Usage of the XDR transport protocol should not require this notification/pull architecture, but just the push model. It should remove the requirement for a source to be a cross enterprise source of Images.

The value for this capability would allow for a less sophisticated system to be a source of images. An XDR-I image source could be as low cost as a workstation. Additional value could be to use the XDR-I webservices as an XDS-I.b proxy with a regional XDS-I.b source. Currently, when an XDS-I.b Image Document Source provides & register images on behalf of a local facility, there is no mechanism to provide feedback to the originating source. This would allow for an XDS-I.b Image document source to use the response of the XDR transport services to provide success or failure status back to the originatting source of the images.

3. Key Use Case

The potential use cases can be fairly robust.

1) A Clinical outpatient facility providing images to a shared image repository.
This is the case where a clinical facility with diagnostic imaging systems would like to provide an acquired image set to a shared image repository via reliable webservices messaging.
2 Sending images and other clinical documents to a referring clinician without the use of CD media.
In this case, a clinical facility with diagnostic imaging systems may have additional documents (a Radiology Report, for example)and would like to provide the images and documents to a a referring physician via reliable webservices messaging.
3 Connecting a Hospital or Clinical practice PACS to a Regional Repository that is an XDS-I.b Image Document Source.
As in the Canadian National Health Infoway Blueprint and other regional projects around the globe, the hospitals and other clinical institutions share a regional image repository that also functions as an XDS-I.b Image Document Source. The source which aquires the images, provides the images to the regional image repository with a reliable message transaction. The regional imge repository would provide and register the manifest to an XDS.b Registry/Repository. As part of the response back to the source. the regional repositoy would include the XDS-I.b transaction results.
4 Submitting images for a clinical trial
A clincal facility enrolled in a clinical trial would transfer the images and additional clinical information using reliable messaging.
5 Submitting Dose reports to a National registry.
A clincal facility enrolled in a National Dose Registry would transfer the dose reports and additional clinical information using reliable messaging.

4. Standards and Systems

Existing Standards

  1. ITI XDR
  2. RAD XDS-I.b
  3. RAD REM
  4. RAD TCE

Existing Systems

  1. Workstations
  2. Acquisition Modalities
  3. PACS and Enterprise Archives
  4. Regional PACS and Archives
  5. Regional and Enterprise RIS
  6. Dose and Clinical Trial Registries

5. Discussion

Another group which would be interested in the development of this profile is WG 27. However, the expertise with the ITI profiles is with IHE. I do reccomend that IHE develops this profile for the Web services "push" of images in collaboration with WG 27.

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5. Technical Approach

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Existing actors

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New actors

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Existing transactions

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New transactions (standards used)

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Impact on existing integration profiles

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New integration profiles needed

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Breakdown of tasks that need to be accomplished

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6. Support & Resources

This fullfills a gap in the XDS-I.b current Canadian Health Inforway Blueprint. provides synergy

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7. Risks

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8. Open Issues

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9. Tech Cmte Evaluation

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

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Responses to Issues:

See italics in Risk and Open Issue sections

Candidate Editor:

Chris Lindop

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