1. September, 2005What IHE Delivers 1 Stefan Claesen – Medflow Inc In partnership with Visbion Ltd IHE Eye Care Webinar Requirements for PACS\IMS vendors for IHE Eye Care June 6~7, 2006

2. 2 Actors in Motion

3. 3 Actors Performed Procedure Step Manager Performed Procedure Step Manager A system that re-distributes the Modality Performed Procedure Step information from the Acquisition Modality to the Department System Scheduler/Order Filler and Image Manager. Image Manager Image Manager A system that provides functions related to safe storage and management of evidence objects. It supplies availability information for those objects to the Department System Scheduler. Image Archive Image Archive A system that provides long-term storage of evidence objects such as images, presentation states, Key Image Notes and Evidence Documents. Image Display Image Display A system that offers browsing of patients’ studies. In addition, it may support the retrieval and display of selected evidence objects including sets of images, presentation states, Key Image Notes, and/or Evidence Documents. Evidence Creator Evidence Creator A system that creates additional evidence objects such as derived images or measurements (Evidence Documents), and transmits them to an Image Archive (for instance, acquisition modalities, image displays, post processing systems, EHR, etc.).

4. 4 Dicom Communication Overview 1. An association is negotiated  SOP Classes proposed\accepted  Transfer syntaxes proposed\accepted 2. A request message is sent. Messages are made up of a command object followed by an optional data payload 3. A response message containing a status code is returned 4. Multiple messages request\response pairs may be transferred across one association 5. The association is terminated Based on OSI 7 layer model Dicom 3.0 is layered on top of TCP\IP

5. 5 Images \ Evidence Stored Ability to receive Dicom C-Store messages from modalities and evidence creators  The archive will act as Service Class Provider (SCP). The archive will be able to receive unsolicited connections containing one or more image or evidence objects.  Must have the ability to store one or more of the following image types (SOP classes) Ultrasound Image Storage Ultrasound Multi-frame Image Storage Ophthalmic 8-bit Photography Image Storage Ophthalmic 16-bit Photography Image Storage Stereometric Relationship Storage Encapsulated PDF Storage

6. 6 Images \ Evidence Stored  The archive should be able to negotiate the following syntaxes Implicit VR Little Endian transfer syntax JPEG Baseline (Process 1) – Lossy 8-bit JPEG JPEG Lossless, Non-hierarchical (Process 14)  Well behaved archives will be able to convert between these transfer syntaxes

7. 7 Image Query\Retrieve Step 1 - Image query  Image Display must be able to generate a C-Find - RQ message containing a set of matching keys  Image Archive must be able to receive C-Find-RQ messages and generate a set of C-Find-RSP messages  The Study root model must be implemented, the patient root model is optional C-Find-Rq C-Find-Rsp 12 LiteBox C-Find-Rsp n

8. 8 Image Query\Retrieve Step 2 – Image Retrieval  The Image Archive shall accept C-Move-RQ messages and will be able to initiate a second association to send images back to the Image Display actor using C-Store.  The Image Display actor needs to be able to request images for display be generating C-Move-RQ messages and be ready to receive a second association with the images.  The same SOP classes and Transfer syntaxes apply for the Image Display actors as for

9. 9 Dicom C-Move messages Image Retrieval using Dicom C-Move  2 Embedded associations  Slightly misnamed – copies images, does not move them. C-Move-Rq 1 C-Move-Rsp 4 LiteBox 2 C-Store-Rq 3 C-Store-Rsp Image Display Image Archive

10. 10 Storage Commitment A requestor (typically the acquisition modality) requests that the Image Manager confirms ownership for the specified Dicom objects (images or evidence objects)

11. 11 Modality Performed Procedure Steps Modality Procedure Step In Progress Modality Procedure Step In Progress An Acquisition Modality notifies the Performed Procedure Step Manager of the start of a new Procedure Step and the PPS Manager informs the Department System Scheduler/Order Filler and Image Manager. [RAD-6] DICOM MPPS N-Create is accepted by the associated actors. Modality Procedure Step Completed Modality Procedure Step Completed An Acquisition Modality notifies the Performed Procedure Step Manager of the completion of a Procedure Step and the PPS Manager informs the Department System Scheduler/Order Filler and Image Manager. [RAD-7] DICOM MPPS N-Set Status= COMPLETED DICOM MPPS N-Set Status= DISCONTINUED

12. 12 House Keeping Transactions Patient Update Patient Update The ADT Patient Registration System informs the Order Placer and the Department System Scheduler/Order Filler of new information for a particular patient. The Department System Scheduler may then further inform the Image Manager. [RAD-12] A08: patient update A40: patient ID update A03: patient discharge A06: patient changed from Outpatient to Inpatient A07: patient changed from Inpatient to Outpatient A02: patient transfer from one physical location to another

13. 13 House Keeping Transactions Procedure Scheduled Procedure Scheduled Schedule information is sent from the Department System Scheduler/Order Filler to the Image Manager. [RAD-4] ORM: Order Message with a Control Code of NW Order Status = SC (scheduled) Procedure Update Procedure Update The Department System Scheduler/Order Filler sends the Image Manager updated order or procedure information. [RAD-13] ORM: Order Cancel Message with a ORC-5 = CA ORM: Order Change Message with a ORC-5 = XO ORM: Order Stop (already started) Message with a ORC-5 = DC (CA Will be used commonly for undone Generic Eye Care Orders)

14. 14 Important Reference Links EYE CARE TECHNICAL FRAMEWORK http://www.ihe.net/Technical_Framework/upload/ihe_eyecare_tf_rev1.0pc_vol1_2006_ 03_14.pdf http://www.ihe.net/Technical_Framework/upload/ihe_iti_tf_2.0_vol2_FT_2005-08- 15.pdf RADIOLOGY TECHNICAL FRAMEWORK http://www.ihe.net/Technical_Framework/upload/ihe_tf_rev6.0ft_vol2_2005-05-18.pdf http://www.ihe.net/Technical_Framework/upload/ihe_tf_rev6.0ft_vol3_2005-05-12.pdf

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