Success of DICOM standard

Transcription

1 International Telecommunication Union Success of DICOM standard Cor Loef Industry Co-Chair DICOM Strategic Advisory Committee Workshop on Standardization in E-health Geneva, May 2003

2 Success of DICOM standard ITU-T o o o o Mission and goal of the DICOM standard Some recent new developments View on the future of DICOM Summary 2

3 Mission and goal of DICOM o Mission of DICOM Create and maintain international standards for communication of bio-medical diagnostic and therapeutic information o Goals of DICOM Achieve interoperability and improve workflow efficiency between imaging systems and other information systems 3

4 Some recent new developments o 16 parts of official DICOM 2003 edition available at: o Security De-identification, Clinical Trials o Applications of structured reporting (DICOM SR) Evidence documents: Chest CAD Cath Lab Reporting OB-GYN, Vascular US, Echocardiography 4

5 Some recent new developments o New Media DVD-R, attachments, large capacity MODs o New Objects Multi-frame MR New CT, XA, VL o JPEG 2000 o Configuration Management 5

6 Multi-frame MR ITU-T o New object definition supporting latest advancements in MR technology o Support for very large data sets, split of an acquisition between several multi-frame objects o New concepts functional groups 6

7 Ultrasound Procedure Reporting ITU-T o A number of supplements covering different areas of US procedure reporting: OB-GYN Vascular Echocardiography o Further advances the concept of Evidence Documents objects generated by machine, that are not images but are carrying the supplemental coded information for the procedure to aid in diagnosis 7

8 DICOM Object Access via Net o In addition to the distribution of DICOM objects, DICOM recently spearheaded a joint Work Item with ISO TC215 WADO Web Access to DICOM Persistent Objects In currently prototype phase Will allow for web-access to images in different formats utilizing standardized URL (HTTP-GET) In conjunction with standardized MIME type allows for access using a Web Browser 8

9 Charter of Strategic Advisory Committee o To develop and maintain the long-term strategic plan of the DICOM Standards Committee; o To review standards and technology trends in healthcare, biomedical imaging, commerce, telecommunications, and informatics; o To consider issues and opportunities related to the strategic evolution of DICOM; o To provide liaison to other standards developing organizations: ISO, HL7, JIRA, CEN. 9

10 Quality of care improved by information and IT All relevant information the care giver and patient need, anywhere and anytime, for the best clinical decisions, through one common and simple user interface, adapted for the task. 10

11 All relevant info accessible 11

12 Trends in Imaging-IT ITU-T Other Clinical System Cardiology PACS HIS RIS Radiology PACS o Horizontal Integration o Vertical Integration o Active workflow o Data explosion o Web based PACS VL, US, NM PACS Web distribution At the desktop 12

13 Vertical Integration ITU-T HIS ADT Patient Registration IMAGING: Patient Registration PACS / Archives Order Placer Workstations Modalities Image Display Image Creator New Order The Healthcare Enterprise Q /R Images Department System Scheduler Order Filler Procedure Scheduled Image Archive Image Manager RIS Modality Worklist PPS In-Progress / Completed Storage Commit Acquisition Modality Images Stored 13

14 Active Workflow ITU-T 14

15 Workflow in Radiology ITU-T Registration Preparation Examination Post Examination Referral Digital Radiology Archiving Reviewing Image Distribution Demonstration Transcription Reporting 15

16 User s default display protocol 16

17 Paradigm shift in PACS: Clinical Applications to PACS 17

18 Multi-slice CT: images 18

19 Post-processing everywhere ITU-T o Viewing and Advanced Image Processing: clinical SW packages move towards modalities, PACS and web 3D Spine Endo3D Cardiac MR 19

20 Post-processing everywhere ITU-T o Analysis tools to enhance clinical decisions: Echo measurements & calculations Left Ventricular Analysis Quantitative Coronary Analysis Vascular X-Ray Analysis Vascular X-Ray Post-Processing 20

21 Horizontal Integration ITU-T Hospital Information System, Master Person Index Radiology Cardiology Ultrasound Pathology workflow workflow workflow workflow Radiology PACS Cardiology PACS Ultrasound PACS Visible Light PACS One Image Management Infrastructure 21

22 Horizontal Integration o Image (information) management system supports archiving/retrieving of all types of clinical objects (incl. visible light) and Structured Reports 22

23 DICOM SR Creation - Example - Radiology RIS data Report Creator application Image data from PACS Header: Report Type: Findings: Conclusions: Image Refs.: Thorax Mass.... (Pointer) Diam. Infiltr..... (DICOM) SR Object select Report Templates Coding Schemes behind pop-up menus 23

24 Web based PACS Web Viewer Webserver At Modality PACS Viewing Station 24

25 Web and Security Web Viewer Webserver Security At Modality PACS Viewing Station 25

26 Electronic Health Record ITU-T o Image Management system and Departmental Information Systems must be EHR-prepared (Query/Retrieve) o EHR: emphasis today on visual integration on the desktop, will become the integrated, secure, patient centric, source of health information o Need for coded vocabularies to represent medical knowledge and the patient s health condition 26

27 Electronic Health Record ITU-T o Web front-end: viewing not only of images but also waveforms, measurements, reports, lab results, etc need the capability to access the original medical images Support for (DICOM) Structured Reporting XML and XML Schema for the exchange of clinical documents 27

28 Clinical Information System EHR: Visual Integation Back-Office messages Clinical Information System Efficiency Integrated Clinical Viewing at the desktop Front Office Improve Clinical Decisions 28

29 Summary o DICOM is well positioned to continue to serve integration needs of medical imaging, including workflow, evidence information recording, effective access to imaging results in the enterprise o Active cooperation with other standards assures DICOM objects integration into future EHR whether by reference, or through well-defined trans-coding mechanisms. 29