North American 2010 Connectathon & Interoperability Showcase Series

1. North American 2010 Connectathon & Interoperability Showcase Series Radiology UpdateProfiles for Media Exchange Chris Lindop Interoperability & Standards Mgr GE Healthcare Radiology Planning Committee Co-chair Radiology Technical Committee Co-chair

2. Profiles for Imaging Media Exchange IHE two core profiles for Imaging media exchange • Portable Data for Imaging (PDI) • Standardize CD media • Import Reconciliation Workflow • Fix demographics, IDs and codes Now include: • Portable Data for Imaging (PDI) – Extensions • New media(DVD & USB), Compression & Security • IHE Basic Image Review (BIR) Profile • Baseline behavior for viewer software

3. Portable Data for Imaging (PDI)– Value Statement You may be part of the problem. Easier, perhaps.

4. Portable Data for Imaging (PDI)– Value Statement or… and…

5. Portable Data for Imaging (PDI)

6. Portable Data for Imaging (PDI) Compatibility requirements • Standard CD format and file system • Consistent disc organization • Use most genericDICOM media profile • Images MUST be present in DICOM • May have copies as “web content” (i.e. JPEGs) • Avoid most common mistakes (highlighted)

7. PDI –Extensions DVD Additional Media: Compression • Optionally allowed • Both Lossless and lossy specified; but lossless is recommended • On-board “Sender Software” recommended. Encryption • Optionally allowed; password-based or key-based • Please consider support needs before creating

8. PDI –Extensions Sending Software 1) Insert CD; Run Sending Software 2) “Enter Password:” 3) Sending Software Decrypts CD Images 4) “Enter Destination:” 6) Sending Software decompresses & convertsImages (as needed) 5) DICOM Association Negotiation 7) Send Images (C-STORE)

9. PDI - Extensions Actors/Transactions New Actor for PDI Portable Media Sender

10. New Media type Options • Baseline Media: CD • DICOM STD-GEN-CD Media Application Profile • New Media Options: • DVD Option • Creator Uses DICOM STD-GEN-DVD-JPEG or • DICOM STD-GEN-DVD-J2K Media Application Profile* • USB Option • Creator UsesDICON STD-GEN-USB-JPEG or • DICON STD-GEN-USB-J2K Media Application Profile* • Both options require support for compression • JPEG lossy and lossless • JPEG 2000 reversible and irreversible NOTE: DVD option will allow for CD Compression * Importer must support both Media Application Profiles

11. Privacy Protection Options • Privacy Protection Options • Standard Password-Based Encryption (PBE) • RSA Public Key Infrastructure (PKI) • Use the secure DICOM Media Application Profiles • STD-GEN-SEC-CD for CD • STD-GEN-SEC-DVD-JPEG or STD-GEN-SEC-DVD-J2K for DVD • STD-GEN-SEC-USB-JPEG or STD-GEN-SEC-USB-J2K for USB • Options require encryption of all DICOM files • including the DICOMDIR, and any files with Patient identifiable information • Note: Options NOT compatible with the Web Option • Media supplied viewers or sending SW must be capable of requesting • password (PBE option) or • use the RSA private key (PKI Option)

12. Portable Media Sender Option • Required when disk is encrypted (Privacy Protection Option) • Only required to be capable of decryption if encrypted • decrease risk of unreadable data by recipient • Transfers objects on the media • to an Image Manager and/or Report Manager • Reconciles key patient and study attributes • Decompresses instances if necessary • Decrypts instances if necessary • Required to convert multi-frame to single frame if necessary

13. Import Reconciliation Workflow (IRWF)

14. “The Images are in the PACS but are messed up” The patient ID is wrong, it doesn’t come up in a query I can’t hang the new images with the old The unknown procedure codes mess up my hanging protocols The images aren’t linking to the EMR. Patient’s chart won’t come up Impact: Lost time Incomplete data Drags on effectiveness Import Reconciliation Workflow – Value Statement

15. Import Reconciliation Workflow (IRWF) During image import, details are fixed to match (or not conflict with) local values • Patient IDs, Name • Procedure Codes, Accession Numbers, etc. Two ways of getting demographics • DICOM Worklist Query • HL7 Patient Demographics Query

16. Basic Image Review (BIR) BASIC Image Review Defines a Baseline • Feature set • Look and feel • Performance* • Minimum Platform* “Advanced” Button = Show me what else you can do * PDI-Basic viewer Option only

17. Basic Image Review ( BIR) - Value Statement

18. Basic Image Review (BIR) – Value Statement Facilities distribute images; Physicians review them • Often a physician has own viewer but may need to rely on the media-supplied veiwer Rising frustration; too often the viewer: • requires installation on a locked down machine • does not successfully run • starts up too slowly • does not successfully load the images • warns the images are of “non-diagnostic quality” • is missing some basic critical function • has Yet Another GUI where basic operations are non-obvious Impact: • delayed care, inaccessible information, repeat examination and irradiation, and poor use of valuable clinician time.

19. Basic Image Review (BIR) Trial Implementation Spec released Potential applications of BIR Spec. • Media Viewer (PDI Option) • Requires a BIR Compliant viewer be placed on media • Clinician’s Desktop Viewer • Basic Radiology Review Station • Web Portal

20. SOP Class Support Notes: • PDI Basic Viewer Option - requires only SOP Class support on media • non-PDI requires a partial display requirement for SOP classes not listed

21. Simple Restricted Feature Set • Display of grayscale and color images from any modality • basic grayscale or color rendering of the images as encoded • without additional image processing • visual navigation of series through the use of thumbnails • side-by-side comparison of at least two sets of image • with synchronized scrolling, panning and zooming • annotation of laterality, of body part and sagittal side, orientation • Simple nuclear medicine windowing mode • spatial localization of cross-sectional images • annotation of demographics, management and basic technique • simple measurements of linear distance and angle • cine capability • Example: cardiac US, XA, CT or MR • Reference ICONS are provided to enhance common look & feel • NO FUSION or MPR

22. Performance Requirements NOTE: PDI- BIR Option Only Reference platform and image set specified for testing Large data-set and small data set available in the IHE website