aycan workflow HIS/RIS/PACS integration with HL7 and DICOM

Transcription

1 aycan workflow HIS/RIS/PACS integration with HL7 and DICOM Copyright aycan Digitalsysteme GmbH 2017 ayc_workflow_his_ris_pacs_integration_en_171017_ds. ID83838 aycan workflow HIS/RIS/PACS integration with HL7 and DICOM Page 1 of 12

2 Table of Contents 1. Introduction 2. Integration HIS/RIS/PACS via HL7 messages 3. aycan PACS with HIS (without RIS) 4. aycan workflow RIS/PACS with tomedo in a practice 5. aycan workflow RIS/PACS with tomedo in a practice at a hospital (with HIS) 6. Desktop integration of viewer 7. References 8. Appendix aycan workflow HIS/RIS/PACS integration with HL7 and DICOM Page 2 of 12

3 1. Introduction Modern HIS/RIS/PACS architectures are characterized by their modular structures. Using standard interfaces custom and tailored solutions can be easily implented in imaging centers and hospital radiology departments. You can use the best vendor/product for each component of the workflow. Each component workflow (RIS, EHR), archive (VNA) and viewer are connected through standardized interfaces (DICOM, HL7, etc) providing a workflow optimally adapted to the users need. Image 1: Deconstructed PACS In this document we describe different scenarios and provide an overview of the existing interfaces for the integration. 2. Integration HIS/RIS/PACS via HL7 messages 2.1 HIS/RIS requests an examination ORM from HIS/RIS to PACS With an HL7 ORM message (Order Entry) the HIS/RIS to requests an examination at the PACS. The following actions are possible: a) The patient is created in the tomedo RIS when the connection between center and hospital is made. b) Generates the DICOM modality worklist c) Optional prefetching of prior images on the diagnostic workstations aycan workflow HIS/RIS/PACS integration with HL7 and DICOM Page 3 of 12

4 2.2 Status update The communication of the statuses is performed as follows: a) between aycan workstation and aycan store: DICOM MPPS b) between aycan store and RIS/HIS: HL7 ORM Message 2.3 Transmission of findings a) MDM to HIS A rich text document with the results are sent to the HIS using an HL7 MDM message and include a link or an embedded document. b) ORU to KIS The results and diagnosis are sent to the HIS in text format using an ORU message. Image 2: IHE Scheduled Workflow 2.4 Making studies/images available a) DICOM UID The DICOM study UID is transmitted from the PACS to the HIS. The hospital PACS will then transfer the DICOM study via DICOM service Query/Retrieve. The study then appears in the clinic's diagnostic viewer. b) aycan web Webviewer The aycan PACS transmits a structured URL with access to the HTML5 Webviewer to the HIS. c) DICOM transfer Auto-routing used to do a direct DICOM transfer to the hospital s PACS. The study then appears in the clinic's diagnostic viewer. 2.5 Updates of demographic data With the IHE profile "PIR" (Patient Information Reconciliation), changes to patient demographic data can be transmitted via HL7 ADT message from the HIS/RIS to the PACS. aycan workflow HIS/RIS/PACS integration with HL7 and DICOM Page 4 of 12

5 3. aycan PACS with HIS (without RIS) Legend: Grey Blue Green HIS PACS Workflow in the clinic PACS Activity HIS Activity Hospital Information System Picture Archiving and Communication System DICOM Digital Imaging and Communications in Medicine HL7 Health Level 7 WL MPPS PIR Worklist Modality Performed Procedure Step Patient Information Reconciliation Image 3: aycan PACS with HIS (without RIS) 1 The patient is admitted, the exam/scan is requested 1a aycan workstation receives the previous images from the PACS (prefetching) 1b The modality obtains the patient information via Worklist (WL) 2 The exam/scan is carried out, the modality archives the study in aycan store, study information is reported to the HIS Study Status: done 3 The study appears in the worklist for findings Study status: reviewed 4 The dictation is made by the physician; Study Status: dictated 5 The dictation is opened by the transcriptionist; Study Status: write 6 The finding is completed, it is carried out an export to PACS and HIS Study Status: finalized aycan workflow HIS/RIS/PACS integration with HL7 and DICOM Page 5 of 12

6 4. aycan workflow RIS/PACS with tomedo in a practice Legend: Grey Blue RIS PACS Workflow in the practice PACS/RIS activity Radiology Information System Picture Archiving and Communication System DICOM Digital Imaging and Communications in Medicine WL Worklist Image 4: aycan workflow RIS/PACS with tomedo in a practice 1 The patient is admitted, the exam/scan is requested (GDT) 1a aycan workstation receives the previous images from the PACS (prefetching) 1b The modality obtains the patient information via Worklist (WL) 2 The exam/scan is carried out, the modality archives the study in aycan store, study information to be reported to the RIS 3 The tomedo RIS opens the images in aycan workstation 4 The findings are created using voice recognition (for example, Nuance SpeechMagic, Nuance Medical 360 Direct, Nuance Dragon Dictate) 5 This diagnosis is completed aycan workflow HIS/RIS/PACS integration with HL7 and DICOM Page 6 of 12

7 5. aycan workflow RIS/PACS with tomedo in a practice at a hospital (with HIS) Legend: Grey Blue Workflow in the practice PACS/RIS/ HIS activity HIS/RIS Hospital/ Radiology Information System PACS Picture Archiving and Communication System DICOM Digital Imaging and Communications in Medicine WL Worklist Image 5: aycan workflow RIS/PACS with tomedo in a practice at a hospital (with HIS) 1 The hospital sends the exam/scan order to the practice 2 The patient is admitted, the exam/scan is requested 2a aycan workstation receives the previous images from the PACS (prefetching) 2b The modality obtains the patient information via Worklist (WL) 3 The exam/scan is carried out, the modality archives the study in aycan store, study information is reported to the RIS. 4 The tomedo RIS opens the images in aycan workstation 5 The results are created using voice recognition (for example, Nuance SpeechMagic, Nuance Medical 360 Direct, Nuance Dragon Dictate) 6 The diagnosis is completed 7 The hospital receives the images and the final results. aycan workflow HIS/RIS/PACS integration with HL7 and DICOM Page 7 of 12

8 6. Destop integration with viewer 6.1 aycan workstation Diagnostic aycan workstation (as diagnostic and post-processing workstation) can be integrated via the following interfaces for a request of studies: > File Interface (as GDT) > XML-RPC > Structured URL Systems already integrated are: tomedo, MediStar, Turbomed, Albis, David, M1, MCS ISYNET, MacDoc, Q-Med, medavis, MedQ, isoft RadCentre ish.med, Axium, Centricity RIS, Nexus, Softland EL, Myris. Image 6: Communication between aycan workstation and a RIS/HIS aycan workflow HIS/RIS/PACS integration with HL7 and DICOM Page 8 of 12

9 6.2 aycan web image distribution > Structured URL > HTML5 image distribution can be controlled via REST interface. Image 7: aycan web image distribution aycan workflow HIS/RIS/PACS integration with HL7 and DICOM Page 9 of 12

10 7. References IHE Scheduled Workflow HL7 version 2 message types aycan reporting workflow chart aycan ID81434 aycan workstation communication with RIS/HIS aycan ID53126 SOP - Integration of aycan workstation in clinical environments SOP - Integration of aycan web in clinical environments aycan workflow HIS/RIS/PACS integration with HL7 and DICOM Page 10 of 12

11 8. Appendix 8.1. Example HL7 messages for 2.1 ORM MSH ^~\& KIS KIS aycan aycan ORM^O01 MSGID P 2.3 PID Mustermann^Max M Innere Aumühlstraße^^Würzburg^^97076^D PV1 1 O ACA&Ambulanz Allgemeine Chirurgie& & ^^^CA&Allgemeine Chirurgie& & ^ ^^^^ 2159&^Pille^Paula^^^^^^^^T^^^^^Südstr. 5^12345^Beispieldorf^D^H^^^Frau&Sehr geehrte Frau Kollegin,^^ ^N Unb 0 ORC SC SC ^^^^^dringend Testmann^Test Testmann^Test Testmann^Test ACA^CA Testmann^Test 34^terminiert OBR ^^ CRHANDG2E Test klin. Angaben ^^^^ Handgelenk in 2 Ebenen^rechts RAD RÖN CA ^^5^ ^^Routine/elektiv zu Fuß Test Fragestellung ^geplant for 2.2 Template for HL7 return from aycan store to RIS/HIS Includes the study status MSH ^~\& ay ay HIS HIS ${SENDTIME} ORM^O01 ${PROCESSINGID} P 2.5 PID 1 ${cdcmpatid} ${cdcmpatname} ${cdcmpatbirdat} ${cdcmpatsex} $ {cdcmstuaccnum} OBR ${cdcmstuaccnum} ${cdcmstudes} ${cdcmstudat} ZDS ${cdcmstuinsuid} ${STUDYSTATUS} ${nsturelimg} for 2.3 a) MDM MSH ^~\& KIS KIS aycan aycan MDM^T01^MDM_T01 MSGID T 2.5^DEU&&HL70399 AL NE DEU 8859/ ^^ ^ISO EVN B1 PID Mustermann^Max M Innere Aumühlstraße^^Würzburg^^97076^D PV1 1 O ACA&Ambulanz Allgemeine Chirurgie& & ^^^CA&Allgemeine Chirurgie& & ^ ^^^^ 2159&^Pille^Paula^^^^^^^^T^^^^^Südstr. 5^12345^Beispieldorf^D^H^^^Frau&Sehr geehrte Frau Kollegin,^^ ^N Unb 0 TXA transferreport application/pdf ^Testmann^Test^^^Dr.^^^^^^^L^HZL ^^ ^SHA pdf^CARDDAS AU U AV ^Testmann^Test^^^Prof.^^^^^^^L^HZL^ for 2.3 b) ORU MSH ^~\& aycan aycan KIS KIS Muster ORU^R P 2.3 AL PID Mustermann^Max M Innere Aumühlstraße^^Würzburg^^97076^D PV1 O ^STAT_ZA ORC RE SSS ROE-KW OBR SSST _1^SSS Röntgen des Thorax f KW f ^Hans^Thomas^^^Dr. med. ^Hans^Hansen ^Hans^Hans OBX ST Untersuchung: \.in+0\röntgen des Thorax p. a. im Stehen vom :\.br\\.br\Indikation: Infiltrat?\.br\\.br\Befund: \.br\soweit in einer Ebene beurteilbar, normale Konfiguration und Größe des Herzschattens. Regelrechte Abbildung der Hili. Normales Lungengefäßbild. Kein Nachweis rundherdartiger, flächenhafter oder streifiger Verschattungen über beiden Lungen. Frei einsehbare Zwerchfellrippenwinkel. Spondylosis deformans der BWS. Initiale AC- Gelenksarthrose beidseits.\.br\\.br\beurteilung: \.br\soweit in einer Ebene beurteilbar, altersentsprechender Herz-Lungen-Befund.\.br\ \.br\\.in-0\ F aycan workflow HIS/RIS/PACS integration with HL7 and DICOM Page 11 of 12

12 for 2.5 ADT MSH ^~\& aycan_hl7 aycan aycan_pir aycan ADT^A P EVN PID 1234 Mustermann^Max M WH 42^GALAXY^RD^^ORION^ PV1 E V133-2^^^ADT V 8.2. aycan workstation desktop integration Example: study call close=yes&action=hpopen&idtype=accnum&idvalue=123456&qr=aycan_qr This URL causes the following: * Use aycan workstation with IP and port " :8080" * All viewers are closed (close = yes) * Open the specified study and apply Hanging Protocols (&action=hpopen) * Use the AccessionNumber "123456" (&idtype=accnum&idvalue=123456) * If the study is not local, get it from the node with AETitle "AYCAN_QR" (&qr=aycan_qr) Example: Open Query window With XML-RPC, aycan workstation offers even more possibilities for remote control. curl -d "<?xml version='1.0' encoding='utf- 8'?><methodCall><methodName>OpenDICOMQR</methodName><params><param><value><struct><member ><name> searchfieldid</name><value><string>123456</string></value></member></struct> </value></param></params></methodcall>" This requires an HTTP client, e.g. curl. This command opens the Query/Retrieve window and searches for Patient ID "123456" aycan web desktop integration Example: Search for Patient ID "123456" with modality CT and MR Example: Open the study with AccessionNumber "123456" including login with user and password accessionnumber=123456&username=aycan&password=test&action=open aycan provides a detailed, technical guide upon request. aycan workflow HIS/RIS/PACS integration with HL7 and DICOM Page 12 of 12