Remote Radiology Reporting Workflow (RRR-WF) IHE Radiology Domain Kevin O’Donnell, Toshiba
Remote Radiology Reporting Workflow (RRR-WF) Manage & Track Distributed Reporting Workflow Create reporting tasks Pre-assigned or open worklists Convey inputs Notify progress/completion Convey outputs Simple state control Academic Specialist Reporting Worklist Hospital A “Nighthawk” Radiologist Repository Hospital B You have common access to images, e.g. an XDS repository, so with a worklist you could share reporting. Central Hospital Clinic
Remote Radiology Reporting Workflow (RRR-WF) Tasks on Worklists RESTful interface (UPS-RS) Create, Claim, Update Cancel, Complete WebSockets (Notifications) ATNA Node Security Data flow (3 Options) XDS, XDS-I DICOMweb WADO-RS, STOW-RS DICOM C-STORE, C-MOVE Academic Specialist Reporting Worklist Hospital A “Nighthawk” Radiologist Repository Hospital B You have common access to images, e.g. an XDS repository, so with a worklist you could share reporting. Central Hospital Clinic
UPS Workitem Structure Unified Procedure Step Sched. Task Details Progress Performed Task Details Relationship Relationship Module Patient demographics Admission details Order details Requested Procedure Accession # - Reason for Requested Procedure Requesting physician/department etc…
Create Task Patient’s Name: John Doe Patient ID: 31445679 Issuer of Patient ID: Mercy Hospital Accession Number: A5590847 Issuer of Accession Number: Scheduled Workitem Code Sequence: Neuroradiology Imaging Specialty Sched. Processing Parameters Seq.: Modality to Read = Report Requested = MR Preliminary Report, Final Report Input Information Sequence: References & Retrieval Path = images, priors, dose objects, etc. Highlight Issuer of Pat ID, Queriable tags
Some Additional Attributes Expected Completion Date Time: 2015.12.15 21:00:00 Scheduled Procedure Step Priority: HIGH Requested Procedure Code Seq.: MR Head w/wo Admitting Diagnoses Description: Non-traumatic intracerebral hemorrhage Requesting Service: ER Requesting Physician: Marcus Welby, MD
UPS-RS API Summary See DICOM PS3.18 for details Action Type Section Method & Resource CreateUPS 6.9.1 POST {+SERVICE}/workitems{?AffectedSOPInstanceUID} UpdateUPS 6.9.2 POST {+SERVICE}/workitems/{UPSInstanceUID}{?transaction} SearchForUPS 6.9.3 GET {+SERVICE}/workitems{?query*} RetrieveUPS 6.9.4 GET {+SERVICE}/workitems/{UPSInstanceUID} ChangeUPSState 6.9.5 PUT {+SERVICE}/workitems/{UPSInstanceUID}/state RequestUPSCancellation 6.9.6 POST {+SERVICE}/workitems/{UPSInstanceUID}/cancelrequest CreateSubscription 6.9.7 POST {+SERVICE}/workitems/{UPSInstanceUID}/subscribers/{AETitle}{?deleti onlock} {additional methods omitted for brevity} SuspendGlobalSubscription 6.9.8 POST {+SERVICE}/workitems/1.2.840.10008.5.1.4.34.5/ DeleteSubscription 6.9.9 DELETE {+SERVICE}/workitems/{UPSInstanceUID}/ subscribers/{AETitle} OpenEventChannel 6.9.10 GET {+WSSERVICE}/subscribers/{AETitle} SendEventReport 6.9.11 N/A See DICOM PS3.18 for details
Reporting Workstation Open Worklist Example Requester (SCU) Worklist Manager (SCP) Create UPS Subscribe UPS Query Performer (SCU) UPS State Event Get UPS Contents Get UPS Contents UPS UPS State “In-Progress” Set UPS Contents UPS State “Complete” Reporting Workstation Watcher (SCU) Q. Not sure if this slide adds much Subscribe Global UPS State Event Dashboard System
IHE RRR-WF Actors Task Requester A repository Task Manager Watcher Open Event Channel [RAD-Y1] Send UPS Notification [RAD-87] Query UPS Workitems [RAD-81] Get UPS Workitem [RAD-83] Claim UPS Workitem [RAD-82] Update UPS Workitem [RAD-84] Complete UPS Workitem [RAD-85] Request UPS Cancelation [RAD-88] Manage UPS Subscription [RAD-86] Task Requester Create UPS Workitem [RAD-80] Request UPS Cancelation [RAD-88] Manage UPS Subscription [RAD-86] Get UPS Workitem [RAD-83] Open Event Channel [RAD-Y1] Send UPS Notification [RAD-87] Task Performer ← Open Event Channel [RAD-Y1] → Send UPS Notification [RAD-87] ← Manage UPS Subscription [RAD-86] A consumer → Retrieve Imaging Data → Store Report → Retrieve Report A creator
Variations Re-assignment Managers may reassign if initial assignment “times out” Assignees Assignment can be to an Organization, a Station or a Person Filtered Subscriptions Performers can be notified of new items created with certain characteristics (e.g. matching their specialty and STAT) Addendum Performers create a self-assigned task for a post-completion addendum and the original requester is notified
Variations Gateway Performer The “Performer” may be the local RIS/Reporting System acting as a gateway and splicing external reporting into radiologists work Cancellation Depending on the Reason For Cancellation, the performer, manager or requester may choose to create a replacement workitem with details copied or revised from the original Missing/non-diagnostic images: Requester might create replacement with reference to additional inputs Expected Completion Time not met: Manager might create replacement assigned to another site per SLA Performing resource called away: Performer might create and open-assignment replacement to minimize disruption Replaced Procedure Step Sequence (0074,1224) can link the new replacement task and the original cancelled task
title Example: Claim Assigned participant Task Requester Task Manager->+Task Manager: Workitem 1.2.3.4.8987\nScheduled Station Name="Performer1“ Task Manager->-Task Performer: WebSocket Event: UPS Assigned\n AffectedSOPInstanceUID=1.2.3.4.8987\n Scheduled Station Name="Performer1“ activate Task Performer Task Performer->+Task Manager: GET {+SERVICE}/workitems/1.2.3.4.8987 Task Manager-->-Task Performer: workitem 1.2.3.4.8987 Task Performer->+Task Manager: PUT {+SERVICE}/workitems/1.2.3.4.8987/state\n Procedure Step State=IN PROGRESS\n Transaction UID=9.8.7.55413 Task Manager->-Task Requester: WebSocket Event:UPS State Report\n AffectedSOPInstanceUID=1.2.3.4.8987\n Procedure Step State=IN PROGRESS
title Example: Reject Assigned participant Task Requester Task Manager->+Task Manager: Workitem 1.2.3.4.8987\nScheduled Station Name="Performer1“ Task Manager->-Task Performer1: WebSocket Event: UPS Assigned\n AffectedSOPInstanceUID=1.2.3.4.8987\n Scheduled Station Name="Performer1“ activate Task Performer1 Task Performer1->+Task Manager: GET {+SERVICE}/workitems/1.2.3.4.8987 Task Manager-->-Task Performer1: workitem 1.2.3.4.8987 Task Performer1->+Task Manager: POST {+SERVICE}/workitems/1.2.3.4.8987/cancelrequest\n Discontinuation Reason Code=\n(110530,DCM,"Assignment Rejected")\n deactivate Task Performer1 Task Manager->Task Manager: Workitem 1.2.3.4.8987\nScheduled Station Name="Performer2“ Task Manager->-Task Performer2: WebSocket Event: UPS Assigned\n AffectedSOPInstanceUID=1.2.3.4.8987\n Scheduled Station Name="Performer2“ activate Task Performer2 Task Performer2->+Task Manager: GET {+SERVICE}/workitems/1.2.3.4.8987 Task Manager-->-Task Performer2: workitem 1.2.3.4.8987 Task Performer2->+Task Manager: PUT {+SERVICE}/workitems/1.2.3.4.8987/state\n Procedure Step State=IN PROGRESS\n Transaction UID=9.8.9.16675 Task Manager->-Task Requester: WebSocket Event:UPS State Report\n AffectedSOPInstanceUID=1.2.3.4.8987\n Procedure Step State=IN PROGRESS
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