1. Feb. 07-10, 2005IHE Europe Workshop 1 Integrating the Healthcare Enterprise – Radiology – Introduction to the New IHE Integration Profiles: Dr. Nikolaus Wirsz –Siemens Medical Solutions IHE Europe Committee IHE Radiology Planning Committee Instance Availability Notification (IAN) Option (Extension to the Scheduled Workflow)

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 Reporting Workflow Charge Posting Scheduled Workflow Portable Data for Imaging NM Image Instance Availability Notification

3. Feb. 07-10, 2005IHE Europe Workshop 3 IHE Scheduled Workflow Overview Order Placer ADT Patient Registration Image Archive Image Manager Image Display Image Creator Acquisition Modality Department System Scheduler – Order Filler – Modality Worklist Patient Registration Procedure ScheduledInstance Availability Query / Notification Images Stored Storage Commit Storage Commit Images Stored PPS In-Progress / Completed Filler Order Management Placer Order Management Q /R Images Performed Procedure Step Manager PPS In-Progress / Completed PPS In-Progress / Completed

4. Feb. 07-10, 2005IHE Europe Workshop 4 Summary Instance Availability Notification – Option within the Scheduled Workflow Integration Profile: Signals the Availability of Images or Other Evidence Objects Provides Information about the Location of Images

5. Feb. 07-10, 2005IHE Europe Workshop 5 Background Managing Actors (DSS/Order Filler, Post-Processing Manager, Report Manager) need to know when acquired evidence objects made it to the Archive  MPPS may be sent before objects are stored, and storage may fail  MPPS is not available to all “managers”  MPPS may fail or not be sent at all (media import) Existing query mechanism forces “managers” to poll Image Manager/Archive for availability of Instances

6. Feb. 07-10, 2005IHE Europe Workshop 6 Interaction Diagram Image Manager/Image Archive generates an Instance Availability Notification message and sends it to the DSS/Order Filler (optionally to other workflow managing actors: Post-Processing Manager, Report Manager) Receiving actors process the information and decide upon further course of actions

7. Feb. 07-10, 2005IHE Europe Workshop 7 IAN N-CREATE Message Structure Attribute NameTagReq. Type N-CREATE (SCU/SCP) Specific Character Set(0008,0005)1C/1C (Required if an extended or replacement character set is used) All other Attributes of SOP Common Module3/3 Referenced Performed Procedure Step Sequence(0008,1111)2/2 >Referenced SOP Class UID(0008,1150)1/1 >Referenced SOP Instance UID(0008,1155)1/1 >Performed Workitem Code Sequence(0040,4019)2/2 >>Code Value(0008,0100)1/1 >>Coding Scheme Designator(0008,0102)1/1 >>Code Meaning(0008,0104)1/1 >>All other Attributes from Performed Workitem Code Sequence3/3 …

8. Feb. 07-10, 2005IHE Europe Workshop 8 IAN N-CREATE Message Structure (cont.) Attribute NameTagReq. Type N-CREATE (SCU/SCP) … Study Instance UID(0020,000D)1/1 Referenced Series Sequence(0008,1115)1/1 >Series Instance UID(0020,000E)1/1 >Referenced SOP Sequence(0008,1199)1/1 >>Referenced SOP Class UID(0008,1150)1/1 >>Reference SOP Instance UID(0008,1155)1/1 >>Instance Availability(0008,0056)1/1 >>Retrieve AE Title(0008,0054)1/1 >>Storage Media File-Set ID(0088,0130)3/3 >>Storage Media File-Set UID(0088,0140)3/3

9. Feb. 07-10, 2005IHE Europe Workshop 9 Image Manager Behavior Image Manager shall send only one IAN message for each MPPS referencing at least one evidence object Image Manager shall sent an IAN after it received ALL instances referenced in MPPS Image Manager shall send IAN to the DSS/OF (optionally to other workflow managing actors)

10. Feb. 07-10, 2005IHE Europe Workshop 10 Receiving Actor Behavior Actors being notified are expected to use IAN message contents for workflow management Keep a list of references to instances and their location for later retrieval Examples of internal actions:  The Department System Scheduler/Order Filler may update the procedure status internally, indicating that images for the procedure have been stored  The Post-Processing Manager may add or re-arrange items in a corresponding worklist  The Report Manager adds items to a corresponding worklist

11. Feb. 07-10, 2005IHE Europe Workshop 11 Additional Considerations IAN is currently limited to the availability of a COMPLETE set of evidence objects resulting from an image acquisition  No message may be sent if complete object set never arrives  No message may be sent if objects arrive without a corresponding MPPS Timing of IAN can vary significantly depending on timing of MPPS and object storage IAN does not cover other availability statues such as:  Images pre-fetched  Non-availability status (instances moved to another location)  Report statuses

12. Feb. 07-10, 2005IHE Europe Workshop 12 Value Proposition Enhanced Mechanism to Notify Instance Availability in “Real-Time“ Information about the Location of Images and Access Time Optimized Workflow Management – Knowing where instances reside and how to retrieve

13. Feb. 07-10, 2005IHE Europe Workshop 13 References: IHE Europe:http://www.IHE-Europe.org IHE Main Web Site:http://www. IHE.net Questions ?