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& what now & what’s next

Kevin O’Donnell, Toshiba Medical Research Inst . Co-Chair, DICOM Standards Cmte. Member, IHE Radiology Technical Cmte. & what now & what’s next. Presenter perceives no conflict of interest with this presentation but discloses being an employee of:

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& what now & what’s next

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  1. Kevin O’Donnell, Toshiba Medical Research Inst. Co-Chair, DICOM Standards Cmte.Member, IHE Radiology Technical Cmte. & what now & what’s next

  2. Presenter perceives no conflict of interest with this presentation but discloses being an employee of: Toshiba Medical Research Institute USA, a division of Toshiba Medical Systems Corp. disclosure

  3. DICOM is the standard for medical imaging. • Widely implemented; basis of DI marketplace • Managed process (NEMA/MITA) • International scope (ISO-12052) • and many pages of detail information…

  4. IHE in One Slide • IHE helps vendors implement & test functions that span multiple systems • Profiles are implementation guides • how to use existing standards • to address a specific problem scenario • Connectathons are test events • managed testing of Profile implementations • IHE helps users purchase & integrate multi-system solutions • list required IHE Profile support in RFPs

  5. Communication Standards X X x X X ? Y ? X X X ? X Y

  6. Communication Standards X X !

  7. product-registry.ihe.net • Integration Statement Database • IS = specific version of specific product • connectathon-results.ihe.net • Vendor Participation Database Level of Implementation

  8. What Now… • IHE Scheduled Workflow • DICOM Modality Worklist • DICOM Images • DICOM MPPS (Performed Procedure Step) • Unscheduled or Modified Procedures • DICOM Storage Commit (turn it on) • IHE Mammography Image Imaging Workflow

  9. What’s Next… • DICOM Enhanced CT, MR, XA, PET, 3D US • Faster • Better Processing • DICOM Multiframe Converted Legacy • Supplement 157 • Addresses Mixed Environment Imaging Workflow

  10. DICOM Multi-frame Conversion Advanced Modality Advanced Workstation Enhanced View & & Classic View Legacy Modality Legacy Workstation

  11. What’s Next… • IHE Scheduled Workflow.b • HL7 2.5.1 • Replaces 2.5.1 Option in SWF • RadLexPlaybook (RSNA) • Standard codeset for orderables • Code: RPID7 • Short Name: CT HEAD ANGIO WO & W IVCON • Long Name: CT HEAD ANGIOGRAPHY WITHOUT THEN WITH IV CONTRAST • playbook.radlex.org Imaging Workflow

  12. Standard Procedure Codes Confidential P7 P7 P7 P7 some text: # Numerical Details 12.2 14.5 11.8 7.6 9.5 10.9 RSNA some text: # Numerical Details 12.2 14.5 9.5 10.9 Sdfkljslkjreljwerkljwe Lksdflkjsdfljksdflkjsdf sdllksjlksjdflkjsdlfkj 12.2 14.5 9.5 10.9 Sdfkljslkjreljwerkljwe Lksdflkjsdfljksdflkjsdf sdllksjlksjdflkjsdlfkj EMR some text: # Numerical Details 12.2 14.5 11.8 7.6 9.5 10.9 Templates Guidelines Registry P7 P8 Radlex Playbook :RPID7- CT HEAD ANGIO WO & W IVCON P7 CDA PACS RIS P7 P7 P7 P7->Protocol

  13. What’s Next… • DICOM Protocol Storage (CT) • Supplement 121 (WIP) • DICOM Contrast Administration Record • Supplement 164 (WIP) Imaging Workflow

  14. Protocol Storage Defined & Planned Protocol SOURCES APPLICATIONS Device=Aquilion Series … Pat. Pos. : Feet First / Supine Pat. Instruct : Single Breath Hold / Full Inspiration … kVp : 80~140 Slice Thickness : 1.0~2.5mm Recon. Kernel : Std. … Semi-auto Scan Setup Prior Scan Prior Comparability Modality Patient Positioning Protocol Library Vendor SharingBest Practice Clinical Trial Protocol or Clinical Trial Performed Protocol Protocol Backups Device=Aquilion ONE Version=3.0.4 … Pat. Pos=Feet First / Supine Pat. Instruct=Given … kVp=120 Slice Thickness=1.0mm Recon. Kernel=FC12 … Local Standard Acquisition Validation Hospital Best Practice Scan QA / Troubleshooting ACR / RSNA AAPM

  15. What Now… • DICOM RDSR (CT, XA, CR, DR, MG) • IHE Radiation Exposure Monitoring • CT Now, Others appearing • Dose Analysis • ACR Dose Registry (2Mil+ studies) • Open Source (Radiance, etc.) • Commercial Packages Radiation Management

  16. some text: # Numerical Details 12.2 14.5 11.8 7.6 9.5 10.9 some text: # Numerical Details 12.2 14.5 11.8 7.6 9.5 10.9 some text: # Numerical Details 12.2 14.5 11.8 7.6 9.5 10.9 some text: # Numerical Details 12.2 14.5 11.8 7.6 9.5 10.9 some text: # Numerical Details 12.2 14.5 11.8 7.6 9.5 10.9 some text: # Numerical Details 12.2 14.5 11.8 7.6 9.5 10.9 some text: # Numerical Details 12.2 14.5 11.8 7.6 9.5 10.9 some text: # Numerical Details 12.2 14.5 11.8 7.6 9.5 10.9 some text: # Numerical Details 12.2 14.5 11.8 7.6 9.5 10.9 Numer 12.2 14.5 9.5 10.9 IHE Radiation Exposure Monitoring Profile National Registry Outlier: # Performing Phys. Over Target: 12.2% Outlier: # Performing Phys. Over Target: 12.2% some text: # Numerical Details 12.2 14.5 11.8 7.6 9.5 10.9 Outlier: # Performing Phys. Over Target: 12.2% Dose Information Reporter Archive

  17. What’s Next… • DICOM Radiopharmaceutical SR • Supplement 159 (WIP) • DICOM Patient Dose SR • Supplement TBA Radiation Management

  18. What Now… • DICOM Push/Pull (configure firewalls) • IHE PDI compliant DICOM CDs • IHE XDS-I.b • Some Canadian DIRs already using • IHE Import Reconciliation Workflow.b Image Distribution Store (Fix IDs, Codes & Demographics)

  19. What’s Next • DICOM WADO-RS • Web Access to DICOM Objects - RESTful • DICOM STOW-RS • Store Over the Web - RESTful • DICOM QIDO-RS • Query – RESTful • IHE Invoke Image Display Image Distribution

  20. What Now… • Ultrasound Measurements • OB/Gyn • Adult Echo • Fetal, Pediatric and Congenital Echo • Record & Dataflow Measurement

  21. What’s Next… • Ultrasound Measurements • (Simplified) Adult Echo Measurement

  22. What’s Next… • IHE Post-Acquisition Workflow • DICOM Unified Procedure Step • DICOM Application Hosting (“DICOM plugins”) • Worklist managed processing • Automated & manual • Progress notifications • Any interested system (RIS, Billing, Reading Worklist, Dashboard, Analytics) • Subscription-based • Cancelation requests • With reason & contact Post-Acquisition Workflow

  23. Example “Workitem” Tasks: 3D View Generation Computer Aided Detection Clinical Applications Pre-fetching Image Routing CD Burning Image Importing … IHE PAWF

  24. What Now… • IHE Consistent Presentation of Images • DICOM GSDF (Calibration) • DICOM Greyscale Presentation State Reporting

  25. What’s Next… • IHE Management of Rad. Report Templates • Format for dictation/authoring templates • Vehicle for RSNA Template Library • www.radreport.org • DICOM Radiology CDA Templates • Supplement 155 (WIP) • DICOM Multi-dimensional Presentation States • Supplement 156 (WIP) Reporting

  26. DICOM • dicom.nema.org • IHE • www.ihe.net – Technical Frameworks • wiki.ihe.net - (click “Integration Profiles”) • product-registry.ihe.net • connectathon-results.ihe.net • QIBA • qibawiki.rsna.org – Profiles, Project status Useful Links

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