1. Remote Radiology Reporting Workflow (RRR-WF)
IHE Radiology Domain
Kevin O’Donnell, Toshiba

2. 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

3. 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

6. 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…

7. Create Task Patient’s Name: John Doe Patient ID: 31445679
Issuer of Patient ID:
Mercy Hospital
Accession Number: A
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

8. Some Additional Attributes
Expected Completion Date Time:
: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

9. 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/ /
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

10. 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

11. 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

12. 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

13. 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

14. title Example: Claim Assigned
participant Task Requester
Task Manager->+Task Manager: Workitem \nScheduled Station Name="Performer1“
Task Manager->-Task Performer: WebSocket Event: UPS Assigned\n AffectedSOPInstanceUID= \n Scheduled Station Name="Performer1“
activate Task Performer
Task Performer->+Task Manager: GET {+SERVICE}/workitems/
Task Manager-->-Task Performer: workitem
Task Performer->+Task Manager: PUT {+SERVICE}/workitems/ /state\n Procedure Step State=IN PROGRESS\n Transaction UID=
Task Manager->-Task Requester: WebSocket Event:UPS State Report\n AffectedSOPInstanceUID= \n Procedure Step State=IN PROGRESS

15. title Example: Reject Assigned
participant Task Requester
Task Manager->+Task Manager: Workitem \nScheduled Station Name="Performer1“
Task Manager->-Task Performer1: WebSocket Event: UPS Assigned\n AffectedSOPInstanceUID= \n Scheduled Station Name="Performer1“
activate Task Performer1
Task Performer1->+Task Manager: GET {+SERVICE}/workitems/
Task Manager-->-Task Performer1: workitem
Task Performer1->+Task Manager: POST {+SERVICE}/workitems/ /cancelrequest\n Discontinuation Reason Code=\n(110530,DCM,"Assignment Rejected")\n
deactivate Task Performer1
Task Manager->Task Manager: Workitem \nScheduled Station Name="Performer2“
Task Manager->-Task Performer2: WebSocket Event: UPS Assigned\n AffectedSOPInstanceUID= \n Scheduled Station Name="Performer2“
activate Task Performer2
Task Performer2->+Task Manager: GET {+SERVICE}/workitems/
Task Manager-->-Task Performer2: workitem
Task Performer2->+Task Manager: PUT {+SERVICE}/workitems/ /state\n Procedure Step State=IN PROGRESS\n Transaction UID=
Task Manager->-Task Requester: WebSocket Event:UPS State Report\n AffectedSOPInstanceUID= \n Procedure Step State=IN PROGRESS

16. Thank you for attending!
Questions?
Thank you for attending! 16