1. 20/11/2009 DICOM WG13 Atsushi Amano Medical Imaging Systems Committee Japanese Association of Healthcare Information Systems Industry (JAHIS) 1 JAHIS / IHE-J Activity Update - Re: Endoscopy Domain -

2. 20/11/2009 DICOM WG13 2 JAHIS Endo Data Exchange Protocol Ver2.0 IHE Endoscopy Technical Framework About IHE Endoscopy Domain Establishment (preliminary…)Contents

3. 20/11/2009 DICOM WG13 JAHIS & IHE-J JAHIS (Japanese Association of Healthcare Information Systems Industry) is one of the 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. Now, we are about to complete Ver2.0. JAHIS Endo Data Exchange Protocol Ver2.0

4. 20/11/2009 DICOM WG13 JAHIS & IHE-J Document ＜ IHE Endoscopy ＞ HL7 Part DICOM Part Order Transaction Performed Data Transaction 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 About to be completed ＜ JAHIS Endo Data Exchange Protocol ＞ JAHIS Endo Data Exchange Protocol Ver2.0

5. 20/11/2009 DICOM WG13 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 JAHIS Endo Data Exchange Protocol Ver2.0 ⑩ Performed Data notification ② Patient Information notification ⑤ Endoscopy notification

6. 20/11/2009 DICOM WG13 How to send performed data?(1) OMI （ Event Z23)Imageing Order Message MSH Message Header [ { NTE } ] Notes and Comments (for Header) PID Patient Identification [ { NTE } ] Notes and Comments (for Patient ID) PV1 Patient Visit [ PV2 ] Patient Visit 2 [ { AL1 } ] Allergy { ORC Order Common { TQ1 Timing/Quantity [ { TQ2 } ] Timing/Quantity Order Sequence } OBR Observation Request [ { NTE } ] Notes and Comments (for Detail)) [ { OBX Observation/Result [ { NTE } ] Notes and Comments (for Results) } ] [{ ZE1 Billing Segment [ { OBX } ] Observation/Result }] { IPC } Imaging Procedure Control } JAHIS Endo Data Exchange Protocol Ver2.0

7. 20/11/2009 DICOM WG13 How to send performed data?(2) Z segment (ZE1) to send procedure data Performed Procedure Following OBX to describe the details about the procedure Performers Equipments used Materials used (medicine etc.) Performed time (start, end, biopsy execution time, etc.) Additional information for the Japanese insurance system ……. JAHIS Endo Data Exchange Protocol Ver2.0

8. 20/11/2009 DICOM WG13 Comments at previous meeting Why didn’t we use Charge Posting profile? As I noted, we are not intending to send only billing data but more comprehensive data set as performed information. What if HL7 be enhanced to describe Japanese billing situation? Some confusion may happen on the usage of z-segment. As stated above, more comprehensive data should be sent. Also if it happens, we can control Japanese domestic situation. JAHIS Endo Data Exchange Protocol Ver2.0

9. 20/11/2009 DICOM WG13 Schedule 2009 November: Completion of the draft 2009 December-2010 January: Public Comment 2010 February: To be Published English version should be prepared soon! JAHIS Endo Data Exchange Protocol Ver2.0

10. 20/11/2009 DICOM WG13 Integration Profile “Endo” IHE Endoscopy Technical Framework ↑ 10 Modality Image Stored ↑ （ 11 Modality Presentation State Stored ） → 7 Modality PPS in Progress → 9 Modality PPS Completed ← 8 Specimen PPS ↑ 12 Storage Commitment ADT e-Order Filler Acquisition Modality Image Manager Image Archive ← 1 Pt.Registration ← 21 Pt.Update → 5 Modality Worklist Provided ↓ 4 Procedure Scheduled ↓ 25 PtUpdate ↓ 26 Procedure Update ↑ 13 Image Availability Query ← 14 Query Images ← (15 Query Presentation State) ← 16 Retrieve Images ← (17 Retrieve Presentation State) ← 2 Placer Order Management → 3 Filler Order Management → Patient Arrival ／ Report Completion Report Manager Report Repository Report Reader ← 7 Modality PPS in Progress ← 9 Modality PPS Completed Pathology Order Filler Order Placer Placer Order Management → Scope of Anatomic Pathology → 6 Pre-procedure PPS → 7 Modality PPS in Progress → 8 Specimen PPS → 9 Modality PPS Completed → 24 Post-procedure PPS Specimen Manager Specimen Ｌａｂｅｌ Printer → 5 GP Worklist Provided → 4 Procedure Scheduled → 25 PtUpdate → → 26 Procedure Update ← Report Status ← 4 Procedure Scheduled Report Creator Image Display e-PPS Manager Pre/Post Procedure Terminal Blue: HL7 Messages Green: DICOM Messages Manual Input by Men → Pathology Order Message → 1 Pt.Registration → 21 Pt.Update EIS HIS PACS Report

11. 20/11/2009 DICOM WG13 Challenges and Solutions It describes everything in one profile. Not many users intend to implement all of them at a time. Small facility does not need everything described here. IHE Endoscopy Technical Framework We need a guide line about, What should be implemented the first? What level of implementation should be preferable? We determined to reconstruct integration profile. Based on implementation load map. Adoption of ITI-PAM for patient data communication.

12. 20/11/2009 DICOM WG13 Implementation Load Map IHE Endoscopy Technical Framework The 1st Step Interoperability between HIS &EIS The 2 nd Step Reporting System The 3 rd Step Image Archiving System Scope of the first draft of Endoscopy TF1&2 Goal ： actors are interoperable based on one standard…Paradise! 1.First you should define interoperability between HIS & EIS (Department System). 2. Next, you should standardize the most important function in the endoscopy suite. 3.Then you should complete the endoscopy system.

13. 20/11/2009 DICOM WG13 Endoscopy Workflow -- EWF 1. Endoscopy Order (Required) 2. Patient Arrival Notification (R) 3. Endoscopy Report Notification for Path Order (R) 4. Performed Data Notification (R) 5. Endoscopy performance Order (Optional) 6. Report Status Notification (O) IHE Endoscopy Technical Framework OP Order Trigger Manager EOF Report ①② ③ ④ HIS Endoscopy System Execution Information Creator ⑤ ⑥

14. 20/11/2009 DICOM WG13 IHE Endo Domain Establishment Who should be the domain Spons0r? JAHIS may be the domain sponsor. (Preliminary: Under discussion & negotiation in JAHIS) Expected schedule? 2009 Nov. Final decision in JAHIS 2010 Mar. Application from IHE-J/JAHIS ---- Preparation Meeting? ------ 2010 November. Starting Activity Officially How about user participation? During domain establishment, we (all of us here today!) should actively work on user association (JGES, ACG, OMED,etc) to participate IHE. About IHE Endoscopy Domain Establishment (preliminary…)

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