1. Post Acquisition Workflow (PAWF) Kevin O’Donnell Toshiba Medical Research Institute

2. Problem Statement Post-processing volumes continue to grow; needs management IHE Post-Processing Workflow (PPWF) is based on DICOM GP-Worklist –GPWL is complex to implement –DICOM recently retired GPWL in favor of UPS –Unified Procedure Step is both simpler and more flexible –IHE Radiation Oncology adopted UPS for managing treatment workflow Need a profile refresh based on UPS Also need a framework for deploying Plug-in DICOM apps for processing

3. Example “Workitem” Tasks: 3D View Generation Computer Aided Detection Clinical Applications Pre-fetching Image Routing CD Burning Image Importing …

4. Value Proposition Clinical Use Cases: –Manage CAD, 3D or Clinical Image Lab –Integrate 3 rd Party applications Systems it would impact: –RIS, PACS, CAD, 3D, Clinical Apps Value proposition: –Efficient queue-based work management –Exact task description & accurate data list –Monitor workitem completion to drive reading worklist & billing –Collect performance metrics –Add PACS functions with plug-in apps some text: # Numerical Details 12.2 14.5 11.8 7.6 Outlier: # Performin g Phys. Over Target: 12.2% Worklist Images Status Re-designs PPWF Profile to use new features of DICOM

5. IHE Post-Acquisition Workflow IHE PAWF Profile builds on DICOM UPS Essential Profile Features: Worklist managed processing –Automated & manual Progress notifications –Any interested system (RIS, Billing, Reading Worklist, Dashboards, Analytics) –Subscription-based Cancelation requests –With reason & contact Hosted applications (“DICOM plugins”) Workitem Manager Workitem Performer Watcher Image Manager Workitem Creator Hosting System Hosted App DSS / Order Filler

6. UPS Object Sched. Task Details Progress Performed Task Details Relationship A Workitem has its attributes grouped into 4 Modules: (this does not affect processing; just for logical organization) UPS Workitem Structure

7. UPS Object 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… UPS Workitem Structure

8. UPS Object Sched. Task Details Progress Performed Task Details Relationship Scheduled Proc. Info. Module - Priority - Requested perform/completion time - Requested resources/location - Requested Procedure descrip./codes - Requested Processing parameters - List of Input data IDs & Location - Input Data Availability Flag - etc… UPS Workitem Structure

9. UPS Object Sched. Task Details Progress Performed Task Details Relationship Progress Module - UPS State (Scheduled, In-Progress, Completed, Canceled) - Progress Status – Numerical (e.g. % complete) - Progress Status – Description (e.g. Annealing phase complete) - Contact information for performer (e.g. phone #) - etc… UPS Workitem Structure

10. UPS Object Sched. Task Details Progress Performed Task Details Relationship Performed Proc. Info. Module - Time Performed/completed - Performing resources/location - Performed Procedure descrip./codes - Performed Processing parameters - List of Output data IDs & Location - etc… UPS Workitem Structure

11. Perform UPS Workitems Typical Pull Workflow - Query, Claim, Update, Complete Input / Output References - Local to Performer; Local Image Manager; Other Image Manager Hosted applications (plugins) - Performer may choose to be a Hosting System - Apps may be 3 rd party Workitem Manager Workitem Performer Image Manager Hosting System Hosted App Query Get Claim Retrieve Store Update Complete Start App Start Task Finalize Task

12. Create UPS Workitems By Workitem Manager - Internal logic - Triggered by DSS/Order Filler scheduling - Triggered by Image Manager Data By Workitem Creator - Explicit create request - Can be grouped with any relevant system By Workitem Performer - Explicit create request - “Unscheduled”/Self-scheduled/Ad Hoc Workitem Manager Workitem Performer Image Manager Workitem Creator DSS / Order Filler Create Procedure Scheduled Availability Query Procedure Updated Availability Notification Create

13. Monitor UPS Workitems Subscribe / Unsubscribe - Globally or for Individual Workitems Applications/Usage - Schedule subsequent tasks - Report progress - Bill for performed tasks - Populate reading worklist - Drive dashboard - Analyze dept. performance - Claim assigned workitems Workitem Manager Workitem Performer Watcher Workitem Creator Query Manage Subscriptions Send Notification… Created Claimed Progress Updated Completed Created for WP1

14. Cancel UPS Workitems Workitem Manager - Can directly cancel unclaimed workitems - Otherwise notifies Performer Workitem Performer - Cancels at its own discretion Watcher - Waits for Notification task was either Completed or Canceled Workitem Manager Workitem Performer Watcher Workitem Creator Request Cancel Send Notification… Canceled Cancel Requested Canceled

15. Unix, Mac, PCInternet ServerCommercial Vendor #2 … Commercial Vendor #1 Standard API Application Hosting Portable applications that ‘ plug into ’ any host that implements the standardized ‘ socket ’ = DICOM Part 19

16. Application Hosting Separate provision of infrastructure from applications. - Hosting Systems (Infrastructure) provide data retrieval, storage, and workflow management. - Applications provide data processing/analysis and return results to the infrastructure. Minimize the ‘reinvention of the wheel’. Support/Combine multiple applications on a single workstation. Deploy applications across multiple platforms

17. Application Hosting Based on DICOM Part 19 DICOM Plugin Interface & Architecture Web service between “Host” & “Application” - WS end-points on same machine - WSDL definitions in PS 3.19 - language neutral (C++, C#, Java, etc.) Application launch, progress/status, suspend/cancel, complete Access to components of DICOM objects, or entire objects XML Model of DICOM Header - choose to access file, native XML model, abstract XML model See also: openxip.org for open source tools, reference implementation

18. Next Steps Review Trial Implementation of PAWF: –http://www.ihe.net/Technical_Framework/index.cfm#radiologyhttp://www.ihe.net/Technical_Framework/index.cfm#radiology Sign-up to participate in 2014 IHE Connectathons