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IHE-J Endoscopy in Clinical Practice

IHE-J Endoscopy in Clinical Practice. Hideto Yokoi, MD, PhD IHE-J Endoscopy Planning Committee, Kagawa University Hospital. Two methods of standardization. Standardization of contents Terminologies, Classifications… SNOMED, ICD-10… Data models, Ontology… MST

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IHE-J Endoscopy in Clinical Practice

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  1. IHE-J Endoscopy in Clinical Practice Hideto Yokoi, MD, PhD IHE-J Endoscopy Planning Committee, Kagawa University Hospital DICOM WG13 in Kyoto

  2. Two methods of standardization • Standardization of contents • Terminologies, Classifications… • SNOMED, ICD-10… • Data models, Ontology… • MST (Minimal Standard Terminology) • Standardization of communication. • Protocols for communication between systems • HL7, DICOM, TCP/IP, SSL… • Integrating the Healthcare Enterprise (IHE)Making concrete guidelines for HL7 and DICOM usage Endoscopy has the international terminology. OMED (World Organisation of Digestive Endoscopy) supporting DICOM WG13 in Kyoto

  3. Our Target Flexible Endoscope Main targets: Digestive tracts Bronchial tubes… Biopsy Forceps DICOM WG13 in Kyoto

  4. Result Ｐｔ Ｐｔ Ｐｔ Ｐｔ The Workflow of Endoscopy Pathology Dpt. Pathology System Ordering System Endoscopy System Report DB PACS Order of Pathological Study Order for Study Nurse Physician Endoscopist Order and Reservation Outpatient Service after the study Endoscopy Study Pre-medication DICOM WG13 in Kyoto

  5. What is a workflow fitting endoscopy procedure? • The workflow needs an interaction with pathology department system. • Decided to have transactions for the linkage information between Endoscopy order/report and Pathology order/report. • The interaction needs data of endoscopy procedure report describing where specimens were gotten. • Included reporting procedure in the “Endoscopy SWF”. DICOM WG13 in Kyoto

  6. Report of endoscopy There is “Ulcer” in the stomach. stage: A1 Bleeding: (+) … biopsy:1. from the side of ulcer :2. oral side of 1. Endoscopy Image 1. 2. 1. 2. Pathology results GUI image that endoscopists want Window of EMR 1. Group 1: ulcer • Group 3: anomaly • of some cells… DICOM WG13 in Kyoto

  7. Trial Implementation in Kagawa University Hospital EMR system (Fujitsu) EMR Client (Fujitsu) Pathology Department System (JR west) Endoscopy Order Resistration Pathology order DICOM MWM Endoscopy report Pathology order （HL-7） Images and report retrieve （URL） Endoscopy Order （HL-7） Endoscopy Order retrieve DICOM Storage Non-Rad PACS KonicaI-PACS Capacity ：2.5TB DICOM Storage Oto-system (3Z) DICOM Gateway (Olympus) Secondary capture system(3Z) EzCAP2×５ DICOM Storage Images and report retrieve （URL） Oto-Endoscope×5 GI Endoscope×3 US (GE-YMS) Logic3×1 EMR Client (Fujitsu) GI Endoscopists can create reports

  8. Trial Implementation Workflow Conventional Electronic Medical Record (Fujitsu) PACS (Konica) ⑦Endoscopy report and order for pathology study ②Patient Information ③Endoscopy Study Information【OMI】 EMR / Order-Entry-System Server Endoscopy Department System Report Server ①Endoscopy Order ④Endoscopy order Acknowledge ⑥Order for Pathology Study Endoscopy Department System Client Software Report Client Software Client Machine ⑤Creating Report Pathology Department system ⑤Entry the Endoscopy Procedure Result for finance Start from Department Client software Japan Railway West Endoscopy PACS Legacy messages ②Patient Information ③Endoscopy Study Information【OMI】 HL7 messages

  9. Actors, Transactions and Master Tables Conventional Master Table for Pathology Order ←ES-3 Endoscopy report and order for pathology study（MDM） P Conventional Master Table for Endoscopy Order P M E E E Order Placer EndoscopyOrder Filler Report Manager →ES-1 Endoscopy Order （OMG） →ES-2 Endoscopy Order （OMI） P ↓ES-4 Order for Pathology Study（OML） MST Master Table of Endoscopic Findings PathologyOrder Filler

  10. “MST” Reporting system (structured) Terminology of organ & site Terminology for endoscopy study DICOM WG13 in Kyoto

  11. “MST” Reporting system DICOM WG13 in Kyoto

  12. Okayama University Hospital Yamaguchi University Hospital Kagawa University Hospital Ehime University Hospital Active cases Four University Hospitals share the RFP (Request For Proposal) Based on IHE endoscopy workflow Easy connectivity High reliability Low cost for integration Diagnostic accuracy with pathology as a gold standard can be accounted quickly. DICOM WG13 in Kyoto

  13. Look!!! “Fifth” University Hospital Coming soon!!! <Tohoku University Hospital> Hearing from endoscopists. Revealing clinical demands DICOM WG13 in Kyoto

  14. Thank you. DICOM WG13 in Kyoto

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