1. DICOM Structured Reporting Workshop - March 2000 Structured Reporting and the IHE Year 2 Technical Framework Simon Wail, PhD Marconi Medical Systems

2. DICOM Structured Reporting Workshop - March 2000 What is IHE? IHE is Integrating the Healthcare Environment by: Continuity & Integrity of Patient Information Clinical Workflow Optimization Foster Communication Among Diverse Healthcare Information Systems Avoid Repeating Tasks Eliminate Data Redundancy Eliminate Rigid & Costly Proprietary Solutions Show Evolving Capabilities of Standards Promote Emerging Standards

3. DICOM Structured Reporting Workshop - March 2000 What is IHE? (cont.) Sponsored by RSNA (Radiological Society of North America) and HIMSS (Healthcare Information and Management Systems Society) 5 year program of Incremental Capability & Demonstration Growth Demonstrations at each RSNA and HIMSS Annual Meetings IHE Technical Framework: Flexible solutions Defines information model Defines vendor and product neutral architecture based on actor definitions and transactions Promotes the use of industry standards: DICOM and HL7 Is NOT a standard

4. DICOM Structured Reporting Workshop - March 2000 IHE Year 1 Integration of IS and Image equipment Demonstrated at RSNA 99 and HIMSS 00 (23 vendors)

5. DICOM Structured Reporting Workshop - March 2000 IHE Year 2 Report Creation and Access Images Available Information Query Softcopy/Hardcopy Consistency Unidentified Patient Management

6. DICOM Structured Reporting Workshop - March 2000 Structured Reporting Transaction Chart

7. DICOM Structured Reporting Workshop - March 2000 Structured Reporting Actors and Transactions Report Creator Report Submission (C-STORE SCU) Report Repository and External Report Repository Access Report Manager Report Reader Report Submission (C-STORE SCP) Report Issuing (C-STORE SCU) Report Issuing (C-STORE SCP) Query Report (C-FIND SCP) Retrieve Report (C-MOVE SCP and C-STORE SCU) Query Report (C-FIND SCU) Retrieve Report (C-MOVE SCU and C-STORE SCP)

8. DICOM Structured Reporting Workshop - March 2000 Report Actor Grouping Any actors may be grouped together depending on implementation specification Must still support all external transactions and individual actor requirements according to the IHE Technical Framework For example - group Report Creator and Report Manager Must support Report Submission as SCU AND SCP Must support Report Issuing as SCU Must support creating new reports (Report Creator) and managing/modifying existing reports (Report Manager)

9. DICOM Structured Reporting Workshop - March 2000 Report Creator Provides user interface to create new reports including setting status flags - Completion Flag and Verification Flag Configurable coded entries Must support evidence sequences to specify referenced objects Must support Identical Documents Sequence if necessary Creates Basic Text SR object OR Creates Enhanced SR object Stores report in Report Manager using: Basic Text SR Storage SOP class; OR Enhanced SR Storage SOP class; OR both

10. DICOM Structured Reporting Workshop - March 2000 Report Manager Receives reports from Report Creator Supports Basic Text SR objects Supports Enhanced SR objects (optional) May forward reports to Report Repository at any time Must allow users to set status flags - Completion Flag and Verification Flag Other modifications and report manipulation is possible Amending reports Merging reports Additional content etc. All changes require new SOP Instance UID Must send final reports to Report Repository

11. DICOM Structured Reporting Workshop - March 2000 Identical Documents Sequence Ask user if modify all documents If all, then must set Predecessor Documents Sequence and Identical Documents Sequence appropriately

12. DICOM Structured Reporting Workshop - March 2000 Report Repository Receives reports from Report Manager Supports Basic Text SR objects Supports Enhanced SR objects Responds to Query and Retrieve requests from Report Reader Sends reports to Report Reader

13. DICOM Structured Reporting Workshop - March 2000 Report Query Keys

14. DICOM Structured Reporting Workshop - March 2000 External Report Repository Access Allows access to reports from outside radiology department, for example, Laboratory Converts external report to DICOM SR objects Supports Basic Text SR objects Supports Enhanced SR objects (optional) Must provide consist Patient ID with radiology May create Study, Series, and Instance UIDs and must conform to DICOM UID rules Must provide consist UIDs - if same report is queried and retrieved several times, then the same UIDs shall be used Must support same Instance level query keys as Report Repository but reduced set of keys for Patient, Study, and Series levels

15. DICOM Structured Reporting Workshop - March 2000 Report Reader Provides user interface to view reports Allows user to select report from either Report Repository or External Report Repository Access via DICOM Query/Retrieve mechanisms Must support SCU query keys in previous table - allows user to filter for particular reports Supports Basic Text SR objects Supports Enhanced SR objects (optional) Must show any object references May retrieve and display image objects if grouped with Image Display

16. DICOM Structured Reporting Workshop - March 2000 Report Pattern - Key Image Note Required for Report Creator, Report Manager and Report Reader Optional for External Report Repository Access

17. DICOM Structured Reporting Workshop - March 2000 Report Pattern - Simple Image Report Required for Report Manager, Report Reader and External Report Repository Access Optional for Report Creator

18. DICOM Structured Reporting Workshop - March 2000 Report Pattern - Simple Image and Numeric Report Required if actor supports Enhanced SR object

19. DICOM Structured Reporting Workshop - March 2000 Report Pattern - Observation Context Required for: Report Creator Report Manager External Report Repository Access Report Reader

20. DICOM Structured Reporting Workshop - March 2000 Participation Timeline April 26-27Vendor Workshop (Chicago) June 1Applications due July 10-11Vendor participants Workshop (Chicago) September 20Test and simulation logs due October 2-6Connect-a-thon (Chicago) October 9Final commitment and payment due Nov 26-Dec 1RSNA 2000 (Chicago) February 10-15HIMSS 2001 (New Orleans)

21. DICOM Structured Reporting Workshop - March 2000 Questions? IHE Technical Framework V4.0 available from: http://www.rsna.org/IHE