1. Integrating the Healthcare Enterprise
Teaching File and Clinical Trial Export
John Perry
Fujifilm Medical Systems
IHE Planning Committee
June 28-29, 2005
IHE Interoperability Workshop

2. Teaching File and Clinical Trial Export TCE
Teaching files are vital tools in medical education
Many institutions participate in clinical trials
TCE provides a simple, DICOM-based mechanism for connecting clinical systems to external teaching file or clinical trial systems
One implementation: two key features requested by almost every educational institution
June 28-29, 2005
IHE Interoperability Workshop

3. Teaching File and Clinical Trial Export Example Teaching File Scenario
A radiologist is viewing images for primariy diagnosis on an Image Display grouped with an Export Selector. The Export Selector allows images, series and studies to be selected “For Teaching File Export”.
The Export Selector may also provide a UI allowing the user to enter text notes and to select additional items (SR, KIN, GSPS, etc.) for inclusion in the exported objects.
June 28-29, 2005
IHE Interoperability Workshop

4. Teaching File and Clinical Trial Export Example Teaching File Scenario
The user action triggers the Export Selector to send the objects and a KIN manifest to the Export Manager. The Document Title of the KIN specifies “For Teaching File Export”.
The Export Manager collects all the objects selected and sends them to the Receiver which may be part of a Teaching File system.
The TF system receives the objects and the manifest and stores them for later use by the radiologist while authoring the teaching file case.
…other scenarios are in the Technical Framework
June 28-29, 2005
IHE Interoperability Workshop

5. IHE Interoperability Workshop
Teaching File and Clinical Trial Export Example Clinical Trial Scenario
A clinical trial administrator at an acquisition site is viewing images on an Image Display or Acquisition Modality grouped with an Export Selector. The Export Selector allows images, series and studies to be selected “For Clinical Trial Export”.
The user action triggers the Export Selector to send images and a KIN manifest to the Export Manager. The Document Title of the KIN specifies “For Clinical Trial Export”.
There may be multiple trials in progress, and a single patient may be a participant in more than one trial. To allow the user to identify the clinical trial for which the images are intended, a free text field or a pre-configured pull down list is provided, which is encoded as the disposition in the text value of the KIN.
June 28-29, 2005
IHE Interoperability Workshop

6. IHE Interoperability Workshop
Teaching File and Clinical Trial Export Example Clinical Trial Scenario
The Export Manager collects all the objects selected and sends them to the Receiver which may be part of a Clinical Trial communication system.
The CT system receives the objects and the manifest and forwards the relevant data to the central facility of the Clinical Trial.
…other scenarios are in the Technical Framework
June 28-29, 2005
IHE Interoperability Workshop

7. Teaching File and Clinical Trial Export Value Proposition
MIRC
Teaching File and Clinical Trial system
Developed, supported and promoted by the RSNA
Selected by the NCI for clinical trial image transport
Free & open source
Acts as a TCE Receiver
Supported by other CT and TF systems
You can add TF and CT capability to your products just by implementing the CTE profile
June 28-29, 2005
IHE Interoperability Workshop

8. Teaching File and Clinical Trial Export
Export Selector
a system that identifies information to be sent to a teaching file or clinical trial system
example: a user at a PACS diagnostic workstation
Export Manager
de-identifies and re-identifies the image, reports, evidence documents, presentation states and additional information with pseudonymous values
supports the Remap Identifiers option to pseudonymize the images with the trial-specific identifiers and to populate the clinical trial specific attributes.
sends the pseudonymized DICOM objects and an updated manifest to a Receiver.
Receiver
a local teaching file or clinical trial system
a clinical trial system responsible for transferring images to the central review facility
June 28-29, 2005
IHE Interoperability Workshop

9. Teaching File and Clinical Trial Export
Export Selector
Image
Display
Evidence
Creator
Report
Creator
Acquisition
Modality
Store Instances [Rad 50]
Store Export Selection [Rad 51]
Store Additional teaching File Information [Rad 52]
Export Manager
Image
Manager/
Archive
Report
Manager
Report
Repository
Export Instances [Rad 53]
Receiver
Image
Archive/
Manager
Portable
Media
Creator
June 28-29, 2005
IHE Interoperability Workshop

10. Teaching File and Clinical Trial Export
Export Selector
Export Manager
Receiver
Store Instances [Rad 50]
Store Export Selection [Rad 51]
Store Additional TF Info [Rad 52]
Delay for pathology
De-identify attributes
De-identify pixel data
Re-map identifiers
Export Instances [Rad 53]
June 28-29, 2005
IHE Interoperability Workshop

11. Teaching File and Clinical Trial Export Export Selection
Key Image Note used as a manifest of exported objects:
List of images and other DICOM objects
Coded Document Title “For Clinical Trial Export”
Text “disposition”
Information about the requesting user
Sent via conventional C-STORE
Not a new SOP Class
June 28-29, 2005
IHE Interoperability Workshop

12. IHE Interoperability Workshop
More information….
IHE Web site:
Technical Frameworks
Technical Framework Supplements – Trial Implementation
Non-Technical Brochures :
Calls for Participation
IHE Fact Sheet and FAQ
IHE Integration Profiles: Guidelines for Buyers
IHE Connect-a-thon Results
Vendor Products Integration Statements
Questions?
June 28-29, 2005
IHE Interoperability Workshop