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DICOM Strategic Direction for Image Distribution

DICOM Strategic Direction for Image Distribution. Cor Loef co-chair DICOM Strategic Advisory Committee. Scope of DICOM Standards Committee Trends in Imaging-IT Standards in Imaging-IT Objects , Information, EPR, Web-distribution, Desktop. Contents. Mission of DICOM

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DICOM Strategic Direction for Image Distribution

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  1. DICOM Strategic Direction for Image Distribution Cor Loef co-chair DICOM Strategic Advisory Committee

  2. Scope of DICOM Standards Committee Trends in Imaging-IT Standards in Imaging-IT Objects, Information, EPR, Web-distribution, Desktop Contents

  3. Mission of DICOM Create and maintain international standards for communication of bio-medical diagnostic and therapeutic information Goals of DICOM Achieve compatibility and improve workflow efficiency between imaging systems and other information systems Scope of DICOM Standards Committee

  4. Sup 23: Structured Reporting (Pre-reports, image measurements, analysis results, diagnostics reports with qualified image links) Sup 30: Waveform (sound, ECG, Electr. Physio.) synchronized with images Sup 31: Network Security (node authentication and transport encryption) Sup 33: Softcopy Presentation State 42 Correction Items, Including: JPEG-LS, Thai & Korean, Time zones, Case Insensitive Name Queries New:published in DICOM 2000

  5. Sup 40 DVD RAM Application Profiles Sup 50 Mammography Comp. Aided Detect. Reports Sup 52 General Purpose Worklist Reporting workflow management, image postprocessing, computer aided detection, filming, quality control, etc. Sup 53 Content Mapping Resource codes and templates for Structured Reporting Sup 54 MIME Content Type for e-mailing DICOM persistent objects (images reports, presentation states, key object selection, etc. Sup 59 Key Object Selection Supplements approvedin 2001

  6. New generations of image objects: Revised Secondary Capture Images (specific applications) Multiframe MR and CT (large number of dynamic dimensions) Sup 41 Digital Signature secure transformation of images and reports Security on Storage Media (confidentiality) Attribute Level Confidentiality (de-identification) New Work Items

  7. Present focus is to meet new end-user needs, adopt complementary and proven standards. Key areas are: Security, New imaging technology, and Image Distribution in the enterprise. Current Direction

  8. Good liaison since April 99. Cross-representation may be the effective next step beyond TC 215 DICOM Task Force. Procedure TC 215 has agreed to rely on DICOM for Medical Imaging Standardization DICOM offers expertise in medical imaging, with world-wide users and vendors representation. Need to ensure coherence with other ISO standards group on imaging related issues (e.g. ISO JTC1 SC9 on JPEG 2000) DICOM is ready to further develop its relationship with TC 215. Liaison with TC 215

  9. 1. Horizontal Integration HIS 2. Vertical Integration RIS Cardiology PACS VL, US, NM PACS Radiology PACS Trends in Imaging-IT: Other Clinical System 3. Elect. Patient Record Electronic Patient Record At the desktop

  10. Image management system supports archiving/retrieving of all types of images (incl. visible light) and Structured Reports 1. Horizontal Integration

  11. HIS HIS IMAGING: IMAGING: ADT Patient Registration • • PACS / Archives PACS / Archives Patient Registration • • Workstations Workstations Image Creator • • Modalities Modalities Order Placer Image Display New Order Q /R Images Department System Scheduler – Order Filler – Image Archive Procedure Scheduled Image Manager Images Stored Storage Commit PPS In-Progress / Completed Acquisition Modality RIS RIS Modality Worklist 2. Vertical Integration The Healthcare Enterprise

  12. Back-Office Clinical Information System Clinical Information System messages Integrated Clinical Viewing at the desktop Front Office Integration: not only back-office! Efficiency Improve Clinical Decisions

  13. Image Management system and Departmental Information System must be EPR-prepared (Queries) EPR: emphasis today on desktop integration, should become the integrated, secure, patient centric, source of health information Web front-end: viewing not only of images but also waveforms, measurements, reports, etc always need the capability to access the original medical images support for DICOM Structured Reporting 3. Electronic Patient Record

  14. Ultimate goal: All the information the user needs through one common and simple user interface

  15. Other Clinical Information Systems Multi-Media Report with references Clinical Question RIS PACS 4. Order and Results Management

  16. RIS data Header: Thorax Report Type: ….. ….. ….. Report Creator application Findings: Mass (DICOM) SR Object ….. ….. Daim. Conclusions: Infiltr. ….. ….. Image Refs.: From DICOM standard: Report Templates DICOM SR Creation - Example -Radiology Image data (Pointer) from PACS select Coding Schemesbehind pop-up menus

  17. Great opportunities for IHE. Important roles for HL7 Clinical Document Architectureand DICOM Structured Reporting One should not consider DICOM SR as the only possibility to integrate multi-speciality information. Especially XML-based implementations should be considered. 4. Orders and Results Management

  18. 5. Security Web Viewer Webserver Security PACS Viewing Station At Modality

  19. NEMA and COCIR address some major issues as a result of HIPAA, e.g. remote service. Security remains a challenge with connected systems, and is of course dependent on hospitals ensuring policies and procedures Use of Audit trial standards in a multi-vendor environment needs further detailing 5. Security

  20. PACS Viewing Station At Modality 6. Freedom of Application Workspot Web Viewer Webserver

  21. 1. Horizontal Integration DICOM 2. Vertical Integration IHE, DICOM, HL7 3. Electronic Patient Record ISO/CEN,DICOM,HL7,XML 4. Orders and Results IHE, DICOM, HL7Management 5. Security IHE,IETF,DICOM,HL7,ASTM 6. Freedom of Application ISO/CEN, CCOW, IETF, Workspot DICOM, XML Standards in Imaging-IT

  22. The (multi-vendor) Integrated Imaging Solution Structured Documents (XML) Numeric report QCA, LVA General Purpose Worklist Hanging Protocols secure transport digital signature Email attachment DICOM URL Connection to other Network and/or TeleCardiology Image Archive Image Server Department Info Server CD Exchange Diagnostic Workstation

  23. Header: Thorax Report Type: ….. ….. ….. Findings: Mass ….. ….. Radiology PACS Daim. Conclusions: Infiltr. ….. ….. (Pointer) Image Refs.: The distribution problem HIS Other Clinical System RIS Cardiology PACS VL, US, NM PACS Electronic Patient Record URL/URI? Webserver Web Viewers

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