Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Integrating the Healthcare Enterprise Presentation of Grouped Procedures Charles Parisot, GE Healthcare IHE IT Radiology Planning and Technical Committees February 8, 2005 1 IHE Europe Educational Event IHE Integration profiles Patient Information Reconciliation Scheduled Workflow Charge Posting - Presentation PostReporting of Grouped Processing Workflow Procedures Workflow Consistent Evidence Presentation Documents of Images Key Image Notes Simple Image and Numeric Reports Access to Radiology Information Basic Security February 8, 2005 2 IHE Europe Educational Event IHE Integration profiles Scheduled Workflow Patient Information Reconciliation Charge Posting - Presentation PostReporting of Grouped Processing Workflow Procedures Workflow Consistent Evidence Presentation Documents of Images Key Image Notes Simple Image and Numeric Reports Access to Radiology Information Basic Security February 8, 2005 3 IHE Europe Educational Event IHE Scheduled Workflow Patient Registration/Update Order Management Worklist RIS Modality Worklist Procedure Scheduled Store Images Storage Commitment List of Images Storage Commitment A Closed Loop Performed Step: Modality Performed Procedure Step •Update IS Scheduling •Match Procedure with Order •Support Billing Based on MPPS •Avoid Reading incomplete Procedures Status = Completed Performed CT Head Pat Name/ID, Dose, Accession #, Study UID Complete List of Images February 8, 2005 PACS & Archive 4 IHE Europe Educational Event IHE Workflow Concepts IHE identifies four fundemental workflow information units : ORDER : REQUESTED PROCEDURE : A request for radiologic service A Unit of Reporting Work with associated codified, billable acts Procedure Steps : The smallest unit of work in the workflow: SCHEDULED PROCEDURE STEP: ‘A unit of work to do’ PERFORMED PROCEDURE STEP: ‘A unit of work done’ February 8, 2005 5 IHE Europe Educational Event IHE Workflow is User Driven Information Unit has its Prime User ORDER: A request for imaging service (Accession Number) CLINICIAN OR REFERING DOC: The Imaging Dept Customer REQUESTED PROCEDURE : Units of work resulting in one Report RADIOLOGIST : In Charge of producing the Report with associated codified, billable acts (Requested Procedure ID) TECHNOLOGIST (and RADIOLOGIST) In charge of acquiring images, etc. PROCEDURE STEP : The smallest unit of work in the workflow (modality worklist entry) February 8, 2005 6 IHE Europe Educational Event IHE Workflow is User Driven Information Unit has its Prime User ORDER: A request for imaging service (Accession Number) CLINICIAN OR REFERING DOC: The Imaging Dept Customer REQUESTED PROCEDURE : Units of work resulting in one Report RADIOLOGIST : In Charge of producing the Report with associated codified, billable acts (Requested Procedure ID) TECHNOLOGIST (and RADIOLOGIST) In charge of acquiring images, etc. PROCEDURE STEP : The smallest unit of work in the workflow (modality worklist entry) February 8, 2005 7 IHE Europe Educational Event Normal Workflow Typical workflow: One Order – One Procedure – One Report ORDER Radiology Department A request for Radiologic Requested Service Procedure Report Acquisition Modality Set of Codifiable, Billable, Acts One or more series of images February 8, 2005 8 IHE Europe Educational Event Multiple Modality Steps ORDER A request for Radiologic Service DICOM Modality Worklist Radiology Department Scheduled Procedure Step A Performed Procedure Step P1 Requested Procedure One or more series of images 1 Scheduled Procedure Step B Report Set of Codifiable, Billable, Acts Performed Acquisition Procedure Step P2 Modality DICOM Modality Worklist One or more series of images Acquisition Modality February 8, 2005 9 IHE Europe Educational Event Multiple Modality Steps (Append) ORDER A request for Radiologic Service DICOM DICOM Modality ModalityWorklist WorklistRadiology Department Scheduled Procedure Step A Performed Procedure Step P1 Requested Procedure Report One or more series of images 1 Set of Codifiable, Billable, Acts Performed Procedure Step P2 One or more series of images Acquisition Modality February 8, 2005 10 IHE Europe Educational Event Discontinued Procedure Step ORDER A request for Radiologic Service DICOM Modality Worklist Radiology Department Requested Procedure 1 Report Scheduled Procedure Step A Set of Codifiable, Billable, Acts Performed Procedure Step P1 One or more series of images Acquisition Modality Requested Procedure 2 Scheduled Procedure Step C February 8, 2005 No Performed Procedure Step 11 IHE Europe Educational Event February 8, 2005 12 IHE Europe Educational Event The Group Case Approach One Order – Two Procedures – One Acquisition - Two Reports Step Radiology Department ORDER A request for Radiologic Requested Service Procedure CT Chest & CT Chest Abdomen Report Acquisition Modality Requested Procedure CT Abdomen February 8, 2005 CT Chest Report One or more series of images 13 CT Abdo Set of Codifiable, Billable, Acts Set of Codifiable, Billable, Acts IHE Europe Educational Event Group Case DICOM Modality Worklist ORDER A request for Radiologic Service Requested Procedure 1 Requested Procedure 2 Radiology Department Report Scheduled Procedure Step A Performed Procedure Step P1 Scheduled Procedure Step B One or more series of images Report Set of Codifiable, Billable, Acts Set of Codifiable, Billable, Acts Acquisition Modality February 8, 2005 14 IHE Europe Educational Event Is Grouping of Procedures a common need ? CT Chest/Abdomen/Pelvis Neuroradiology: CT Neck & CT Chest MR Imaging of different sections of the spine MRI and MRA of vessels acquired together MRI of the head and neck with specialized coils Direct radiography (DR) in a trauma patient: AP images, then move the patient once to acquire a set of orthogonal images, and then regroup by body part Sonographic evaluation of the kidneys and of the abdomen CT of the pelvis with CT angiographic runoff Angiographic studies of multiple vessels mixed with therapeutic interventions on selected segments. February 8, 2005 15 IHE Europe Educational Event Why is the Grouping of Procedures a significant need ? • Optimize patient comfort • Optimize time of image acquisition. But, there is the need to: Maintain the link back to each one of the grouped procedures without breaking the acquisition apart. Ensure that each image subset related to a requested procedure is identified and ready to be presented. This is key for quick display of new and prior studies. In the film world, images are manually sorted. In the filmless world, images should be sorted automatically when displayed February 8, 2005 16 IHE Europe Educational Event Grouping of Procedures in IHE Group Case support is required by the IHE Scheduled Workflow Integration Profile on Image Managers (PACS) and Order Fillers (RIS). Its support is optional on Modalities. February 8, 2005 17 IHE Europe Educational Event IHE Integration profiles Patient Information Reconciliation Scheduled Workflow Charge Posting - Presentation PostReporting of Grouped Processing Workflow Procedures Workflow Consistent Evidence Presentation Documents of Images Key Image Notes Simple Image and Numeric Reports Access to Radiology Information Basic Security February 8, 2005 18 IHE Europe Educational Event IHE Integration profiles Patient Information Reconciliation Scheduled Workflow Charge Posting - Presentation of Grouped Procedures PostReporting Processing Workflow Workflow Consistent Evidence Presentation Documents of Images Key Image Notes Simple Image and Numeric Reports Access to Radiology Information Basic Security February 8, 2005 19 IHE Europe Educational Event IHE Integration profiles Patient Information Reconciliation Scheduled Workflow Charge Posting - Presentation of Grouped Procedures PostReporting Processing Workflow Workflow Consistent Evidence Presentation Documents of Images Key Image Notes Simple Image and Numeric Reports Access to Radiology Information Basic Security February 8, 2005 20 IHE Europe Educational Event IHE Integration Profiles Scheduled Workflow Admit, order, schedule, acquire images, notify of completed steps + Consistent Presentation of Images Softcopy grayscale and presentation state Presentation of Grouped Procedures Required for Presentation of Subsets of a Single Acquisition February 8, 2005 21 IHE Europe Educational Event IHE – Presentation of Grouped Procedures Requested Procedure: CHEST Report: CHEST ABDOMEN Requested Procedure: Chest View ABDOMEN Scheduled Procedure Step Chest Scheduled Procedure Step Abdo Report: Abdomen View RIS / PACS MODALITY Performs a single exam Chest View Abdomen View Operator groups 2 procedures February 8, 2005 22 IHE Europe Educational Event Presentation of Grouped Procedures Improves workflow, overall efficiency of care and reduces costs of providing services: Lowers barriers to migration to digital radiology practice Optimizes use of newer & faster acquisition devices Improves clarity and access to Radiology results Simplifies and facilitates billing of grouped procedures Enhances softcopy interpretation throughput February 8, 2005 23 IHE Europe Educational Event February 8, 2005 24 IHE Europe Educational Event More information…. IHE Web sites: http://www.rsna.org/IHE Technical Frameworks: • RAD V5.5 Technical Framework Supplements - Trial Implementation • May 2004: Radiology Non-Technical Brochures : • • • • • Calls for Participation IHE Fact Sheet and FAQ IHE Integration Profiles: Guidelines for Buyers IHE Connect-a-thon Results Vendor Products Integration Statements February 8, 2005 25 IHE Europe Educational Event