1. Feb. 07-10, 2005IHE Europe Workshop 1 Integrating the Healthcare Enterprise – Radiology – Established IHE Integration Profiles: Dr. Nikolaus Wirsz –Siemens Medical Solutions IHE Europe Committee IHE Radiology Planning Committee Post-Processing Workflow (PPWF)

2. Feb. 07-10, 2005IHE Europe Workshop 2 IHE Radiology Integration Profiles Patient Info. Recon- ciliation Access to Radiology Information Consistent Present- ation of Images Basic Security - Evidence Docs Key Image Notes Simple Image & Numeric Reports Presentation of Grouped Procedures Post- Processing Workflow (PPWF) Reporting Workflow Charge Posting Scheduled Workflow Portable Data for Imaging NM Image

3. Feb. 07-10, 2005IHE Europe Workshop 3 Summary Extension to the Scheduled Workflow to Support Typical Post-Processing Workflow Procedures:  Image Processing  Image Reconstruction  Computer Aided Detection Ability to Schedule and Track the Status of Post- Processing Tasks

4. Feb. 07-10, 2005IHE Europe Workshop 4 IHE Post-Processing Workflow Overview Post-Processing Worklist Retrieve Images StoreReports Measurements CAD Reports ……....……… ArchiveImages Post-Processing Procedure Step STARTED Work Item Claimed Post-Processing Procedure Step STARTED Post-Processing Procedure Step COMPLETED Post-Processing Procedure Step COMPLETED Image & Post-Proc. Manager PACS & Archive 3D Workstation RIS Departmental System Scheduler Order Filler Completed

5. Feb. 07-10, 2005IHE Europe Workshop 5 Acquisition Modality Modality and Post-Processing Steps ORDER A request for Radiological Service Radiology Department Set of Codifiable, Billable Acts One or more series of images M-Perf. Procedure Step P1 Requested Procedure 1 Scheduled Procedure Step B Scheduled Procedure Step A Report DICOM Modality Worklist DICOM Post-Processing Worklist Post- Processing One or more series of images PP-Perf. Procedure Step P2

6. Feb. 07-10, 2005IHE Europe Workshop 6 PPWF Actors & Transactions Additional Actor:  Post-Processing Manager Transactions:  Worklist Provided  Workitem Claimed  Workitem PPS In Progress  Workitem PPS Completed  Workitem Completed  Performed Work Status Update  Evidence Documents Stored  Query Evidence Documents  Retrieve Evidence Documents

7. Feb. 07-10, 2005IHE Europe Workshop 7 Post-Processing Manager Grouping Either with Image Manager (PACS) Post-Processing Manager IM/IA DSS/OF Performed Work Status Update (optional)

8. Feb. 07-10, 2005IHE Europe Workshop 8 Post-Processing Manager Grouping Or with Departmental System Scheduler / Order Filler (RIS) IM/IA Performed Work Status Update Post-Processing Manager DSS/OF

9. Feb. 07-10, 2005IHE Europe Workshop 9 Actors and Transactions Post-Processing Manager DSS/OF Image Display Evidence Creator Image Availability Query Performed Work Status Update Worklist Provided Workitem Claimed Workitem PPS In Progress Workitem PPS Completed Workitem Completed Retrieve Images Query Evidence Documents Retrieve Evidence Documents Images Stored Storage Commitment Evidence Documents Stored IM/IA Query Images

10. Feb. 07-10, 2005IHE Europe Workshop 10 Worklist Provided Evidence Creator finds out what post-processing tasks have been scheduled or assigned to it by the Post-Processing Manager Worklist provided for workitem codes e.g. Image Processing or Computer Aided Detection. Evidence Creator includes received information in the resulting instances

11. Feb. 07-10, 2005IHE Europe Workshop 11 Worklist Provided General Purpose Worklist SOP Class Explicit definition of required matching and return keys for both Post-Processing Manager and Evidence Creator Evidence Creator shall implements at least one of 3 query cases:  PatientOriented Query:Worklist for a specific patient / procedure  StationOriented Query:Broad Worklist for a particular workstation  ClassOriented Query:Broad Worklist for a class of workstations (e.g. workstations for CT 3D Reconstructions) Post-Processing Manager Evidence Creator C-FIND-RQ C-FIND-RSP

12. Feb. 07-10, 2005IHE Europe Workshop 12 Workitem Claimed Evidence Creator takes ownership of the workitem Post-Processing Manager updates its worklist and permits other worklist users to detect that this SPS has been claimed

13. Feb. 07-10, 2005IHE Europe Workshop 13 Workitem Claimed General Purpose Scheduled Procedure Step SOP Class N-ACTION (SPS in Progress) Post-Processing Manager Evidence Creator

14. Feb. 07-10, 2005IHE Europe Workshop 14 Workitem Performed Procedure Step In Progress Evidence Creator starts work on claimed SPS Notifies Post-Processing Manager to create a Performed Procedure Step

15. Feb. 07-10, 2005IHE Europe Workshop 15 Workitem Performed Procedure Step In Progress General Purpose Performed Procedure Step SOP Class SPS and PPS relationships (Appendix III-D):  Simple Case  Unscheduled Case  Append Case  Abandoned Case N-CREATE (PPS in Progress) Post-Processing Manager Evidence Creator

16. Feb. 07-10, 2005IHE Europe Workshop 16 Workitem Performed Procedure Step Completed Evidence Creator notifies Post-Processing Manager of the PPS completion Evidence Creator references any results created e.g. images, evidence documents

17. Feb. 07-10, 2005IHE Europe Workshop 17 Workitem Performed Procedure Step Completed General Purpose Performed Procedure Step SOP Class Evidence Creator shall send to the Post-Processing Manager a list of all Composite SOP Instances in the Output Information Sequence (0040,4033) N-SET (PPS Completed) Post-Processing Manager Evidence Creator

18. Feb. 07-10, 2005IHE Europe Workshop 18 Workitem Completed Evidence Creator notifies the Post-Processing Manager when it completes the scheduled workitem Post-Processing Manager updates its worklist

19. Feb. 07-10, 2005IHE Europe Workshop 19 Workitem Completed General Purpose Scheduled Procedure Step SOP Class No further PPS will be created for this SPS N-ACTION (SPS Completed) Post-Processing Manager Evidence Creator

20. Feb. 07-10, 2005IHE Europe Workshop 20 Performed Work Status Update Department System Scheduler and Image Manager inform each other of the status of performed post-processing work Allows the system not managing the performed work to stay in sync

21. Feb. 07-10, 2005IHE Europe Workshop 21 Performed Work Status Update General Purpose Performed Procedure Step SOP Class IM/IA DSS/OF N-CREATE (PPS in Progress) N-SET (PPS Completed) DSS/OF IM/IA N-CREATE (PPS in Progress) N-SET (PPS Completed)

22. Feb. 07-10, 2005IHE Europe Workshop 22 Wrap Up Post-Processing Workflow (Multiple Steps) with Post-Processing Manager grouped with Image Manager RIS PACS Modality DICOM MWL DICOM Image Storage DICOM Storage Commitment DICOM MPPS DICOM MPPS CAD Station Post-Processing Station DICOM PP-WL DICOM PP-SPS DICOM PP-WL DICOM PP-SPS DICOM PP-PPS DICOM PP-PPS DICOM PP-PPS DICOM Storage & Commitment DICOM Q/R DICOM Storage & Commitment

23. Feb. 07-10, 2005IHE Europe Workshop 23 Value Proposition Improve Post-Processing Workflow Efficiency – Use of Worklists to Manage Post-Processing Tasks Eliminate Errors Associated with Paper and Film Handling Close the Information Loop:  Integrating Post-Processing Results with Acquired Images  Associate Post-Processing Results with Correct Order Enable Sub-sequent Workflow Steps:  Initiate Reporting Workflow  Support for Billing Based on Post-Processing Results

24. Feb. 07-10, 2005IHE Europe Workshop 24 References: IHE Europe:http://www.IHE-Europe.org IHE Main Web Site:http://www. IHE.net Questions ?