1. DICOM WG13 22/04/2009 Update, IHE-J Endoscopy Committee Activity 22/04/2009 IHE Japan Endoscopy Committee

2. DICOM WG13 22/04/2009 Contents Relationship between IHE-J & JAHIS IHE document & JAHIS document JAHIS Endo Data Exchange Protocol Transactions Endo Specific Transaction1: Notification of the Report Status Endo Specific Transaction2: Pathology Order Current Activity Future Activity

3. DICOM WG13 22/04/2009 Relationship between IHE-J & JAHIS JAHIS (Japanese Association of Healthcare Information Systems Industry) is one of member groups that established IHE-Japan. JAHIS/IHE-J studied the contents of IHE Endoscopy Vol Ⅱ (Transaction) after publishing Vol Ⅰ ( trial implementation version). JAHIS/IHE- J determined to proceed HL7 part of IHE Endoscopy as JAHIS data exchange protocol. Ver1.0 has been published last summer.

4. DICOM WG13 22/04/2009 IHE document &JAHIS document ＜ IHE Endoscopy ＞ HL7 Part DICOM Part Order Transaction Execution Data Transaction (Billing) JAHIS Endo Data Exchange Protocol Ver1.0 Ver2.0 We categorized the scope of IHEVol Ⅱ from technical point of view and determined to complete each part one by one. IHE Endoscopy Vol Ⅰ Profile IHE Endoscopy Vol Ⅱ Transaction Done Future Work Working ＜ JAHIS Endo Data Exchange Protocol ＞

5. DICOM WG13 22/04/2009 JAHIS Endo Data Exchange Protocol In the latest Guide-Line for Healthcare Information Security Management that Japanese government (the Ministry of Health, Labour and Welfare) published, “JAHIS Endo Data Exchange Protocol” was adopted one of the recommended Standards.

6. DICOM WG13 22/04/2009 Transactions ＨＩＳ ＥＩＳ ＰＡＣＳ ＲＥＰＯＲＴ ⑨ Observation report notification ② Patient Information notification ④ Endoscopy order ⑥ Endoscopy result query ① Patient Information Query ③ Endoscopy order query ⑦ Patient arrival notification ⑤ Endoscopy notification ② Patient Information notification Image Status etc. ⑧ Observation report status notification

7. DICOM WG13 22/04/2009 Transactions Message DefinitionMessage TypeTrigger EventEvent Type 1) Patient information queryQRY→ ←ADR Patient queryA19 2) Patient information notification ADT→ ←ACK Admit/visit notificationA01 Transfer a patientA02 Discharge/end visitA03 Patient goes on a “ leave of absence ” A21 Patient returns from a “ leave of absence ” A22 Cancel admit/visit notificationA11 Cancel transferA12 Cancel discharge/end visitA13 Cancel leave of absence for a patientA52 Cancel patient return from a leave of absence A53 Update patient informationA08 3) Endoscopy order queryOSQ→ ←OSR Query for order statusQ06

8. DICOM WG13 22/04/2009 Transactions Message DefinitionMessage Type Trigger EventEvent Type 4) Endoscopy order （ HIS － EIS ） OMG→ ←ORG General clinical orderO19/O20 5) Endoscopy notification （ EIS － PACS/REPORT ） OMI→ ←ORI Imaging orderO23/O24 6) Endoscopy result queryQRY→ ←ORF Query for results of observationR02, R04 7) Patient arrival notification （ EIS － HIS ） ORU→ ←ACK Unsolicited transmission of an observation message R01 8) Observation report status notification （ REPORT － EIS ） MDM→ ←ACK Original document notificationT01 9) Observation report notification （ REPORT － HIS ） MDM→ ←ACK Original document notification and content T02

9. DICOM WG13 22/04/2009 Order Placer Pathology Label Printer Endoscope HL7 Message DICOM Message Patient Information Endoscopy Order Patient Information Order Information Patient Information Order Information Patient Information Order Information Endo Specific Transaction1: Notification of the Report Status ADT/Order Information Observation Report Complete!

10. DICOM WG13 22/04/2009 Endo Specific Transaction2: Pathology Order Original Idea  Endoscopy to have Order Placing function Current Idea  Endoscopy Department System has no OP.  HIS to place a Path-Order  HIS generates a Path-Order on the observation report that Report system provided.  JAHIS is also studying Path-Order protocol. How many OP in the system? What if HIS to place a path-order?

11. DICOM WG13 22/04/2009 Order Placer Pathology Label Printer Endoscope HL7 Message DICOM Message Patient Information Endoscopy Order Patient Information Order Information Patient Information Order Information Patient Information Order Information Endo Specific Transaction2: Pathology Order Here is a Label Printer Sending Observation Report to notice OP for Pathology Order

12. DICOM WG13 22/04/2009 Current Activity We are studying to establish execution information exchange (for billing) as JAHIS Endo data exchange protocol Ver2.0  Defining Z segment for execution data Japanese insurance system is complicated and requires not only Diagnosis Code and Procedure Code, but also Complementary Procedure Code and Material information.  Z segment to be sent to HIS by OMI message. For US and EU, OBR-13 and OBR-44 may be used as ICD and CPT code container.

13. DICOM WG13 22/04/2009 Messaging Route  Report→ ① →EIS→ ② →HIS  Route ① should be optional, route ② should be required so that the system allows user to enter execution data from either EIS or Report. Current Activity

14. DICOM WG13 22/04/2009 Future Activity Completion of JAHIS Endo Data Exchange Protocol Ver2.0 Completion of IHE Endo Vol Ⅰ & Vol Ⅱ  Including Lower GI (Currently Upper GI only)  Refining “Endo” Profile for conectathon  Completion of Vol Ⅱ within the scope of HL7. Attending IHE-J annual Connectathon from Endo domain  Connectathon is the event where venders together check interoperability.  Not only Endoscopy system vender but HIS vender to implement IHE Endoscopy.

15. DICOM WG13 22/04/2009 Thank You.