1. Title “syngo” and ”we speak syngo” are registered trademarks of Siemens AG. helmut.koenig@siemens.com Relevant Patient Information Queries: Extending the scope beyond DICOM San Antonio WG Meeting, January 2003 Helmut König, Siemens Medical Solutions

2. 2 DICOM Relevant Patient Information Query Service Class Characteristics Document-oriented Constraints on contents by templates

3. 3 Scenarios where enterprise wide access to patient information may be needed Order Entry Perform examination / procedure Information conveyed by order message is incomplete Support for selection of appropriate examination / procedure Different procedure / examination than initially intended is performed … Reporting Making up diagnosis may require additional clinical information Support for justification of performed acts Post-processing Interpretation of results Previous findings may ease interpretation

4. 4 Extending the scope of relevant patient information queries

5. 5 Extension of RPI Query Scope DICOM Query as trigger for the DIS to send HL7 query to the Clinical Information System Clarification of scenarios Clinical / Departmental Information Systems involved as provider Matching of DICOM Information model and HL7 RIM Response containing: CDA documents (EHR extracts as compound documents) Observation-oriented response Non-textual data What are useful constraints for patient clinical history / EHR extracts? Definition/matching of DICOM and HL7 templates

6. 6 Objectives Completeness: Make sure that all relevant patient information is available I.e. for reporting additional relevant information, not available by limiting the scope to the local DIS, may be needed E.g. new problem-oriented request sent by DIS Use of up-to-date information Locally cached data may be out-dated Preservation of context Common hierarchy of contextual data E.g. Patient, Encounter, Patient Diagnosis, Clinical Problem… Period of time

7. 7 Patient Clinical History Information Model Subset of DICOM Information Model: Modules SOP Common Specific Character Set Patient Module Patient IDs and Demographic Data Patient Study Admitting diagnosis … Patient Medical Medical alerts, allergies, pregnancy status … SR Document Content Template and code attributes … SR Document General Content Date, Content Time

8. 8 Patient Clinical History Information Model Role of SR documents and templates Categories: Diagnosis / problem oriented Medication Previous procedures...

9. 9 Matching the DICOM Information Model to the RIM for Relevant Patient Information Queries We have to look at: Message RIM Class Clones Associations Attributes Data Types Vocabulary Document Constraints Templates For specification of HL7 Query Making sure that the correct interpretation of EHR extracts is possible

10. 10 Potential Role of II SIG / DICOM WG20 Cooperation with EHR, O&O and other groups for message specification Document-oriented Query esponse Mapping HL7 CDA / DICOM SR is work in progress Definition of R-MIMs for DICOM-specific Relevant Patient Information Query

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