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 Link to this message Mayur Arte  posted on Saturday, March 19, 2005 - 08:55 am Edit Post Delete Post Print Post
can any one tell me the role of IHE, MPPS and MWL
in Integration between any HIS or LIS and RIS.
 Link to this message Dave Harvey  posted on Monday, March 21, 2005 - 10:23 am Edit Post Delete Post Print Post
MWL & MPPS allow communications between an imaging modality and the RIS (or in some cases a RIS/PACS/broker). MWL allows the RIS to send pateint and examination details to the modality, and MPPS allows the modality to send back details of what it has done. Although they are closely related, they are defined as independent services, so it is possible to support MWL without MPPS (though the reverse is not really viable). Neither of these services directly involves the HIS.

IHE defines how various DICOM and HL7 services (including MWL & MPPS) work together, and the "Big picture" does include the HIS, the PACS, workstations and several other "actors".

The aims of all these standards is to try to ensure that all the parts of the overall radiology "system" can tell what is happening, and what has happened elsewhere, and they are therefore important in any integration project.

Does this help?

Dave Harvey
 Link to this message Keith Morrissey  posted on Monday, March 21, 2005 - 07:16 pm Edit Post Delete Post Print Post
Commencing PACS/RIS/EPR implementation here in st james's dublin

Most of our Modalities will support MWL However few will support MPPS.

Just wondering what information exactly will MPPS feed back from Modality to RIS.

I presume it is mainly the information currently inputted by the radiographer into RIS to "complete/status" a study in exam management

I would be interested in hearing peoples practical experiences of Utilising MPPS with their imaging Modalities.

Have there been any problems with workflow etc ??

How widely utilised is MPPS ??

Keith Morrissey
 Link to this message Mayur Arte  posted on Tuesday, March 22, 2005 - 04:40 am Edit Post Delete Post Print Post
We are LIS Providers. We have a client who is also using an RIS System. Our aim is to integrate both these systems. where in LIS, user will register the patient and test requests, and we have to intimate RIS for the tests registered belonging to Radiology Department. We feel it must be done using HL7. But People from RIS are asking to use MPPS and MWL. This is the scenario, and we are through with HL7 (Already having HL7 solution for integrating between HIS. For integrating RIS it would not be much difficult) Thanks

Mayur Arte
 Link to this message Lester Cram  posted on Wednesday, March 23, 2005 - 12:43 pm Edit Post Delete Post Print Post
The european IHE site is very good with a lot of tutorials explaining the various actors and interactions between them.

MWL and MPPS are internal to the RISPACS under their model and HL7 messaging is only used for
ADT(admission discharge transfer) and OP(orderplacer) or OF(order filler messages) between a HIS order entry interface and a RIS
The RIS should accept these messages using an HL7 reciever daemon and the format of the HL7 messages should conform to the IHE templates.
(These are available from the IHE site in the MESA test suite of programs)
Any completed MPPS is available on the RIS and it plus any postprocessing entered by the technician could be made available back to the HIS as a push or pull model using HL7

The problem with MPPS is what to include as this is modality and geographically variable.
 Link to this message William Teh  posted on Thursday, March 24, 2005 - 12:19 am Edit Post Delete Post Print Post
> [Does anybody have any knowledge on when the NHS Breast Screening > Programme is planned to interface with NPfIT and PACS?]
 Link to this message Anne Hubbard  posted on Thursday, March 24, 2005 - 05:38 pm Edit Post Delete Post Print Post
There are no plans to interface with PACS at the present time -there is a digital sub-comittee of the big 18 working on this.
 Link to this message Mayur Arte  posted on Thursday, March 31, 2005 - 06:12 am Edit Post Delete Post Print Post
Can we integrate an LIS and a Modality with HL7. what are the requirements for integrating in either using HL7 ,DICOM or any other methodology. We register the patients in our LIS software and tests are carried out on Radiology Equipments. Where user has to feed demography data of patients again into equipments. and then they take out print outs of reports Thanks
 Link to this message Ivan Brown  posted on Thursday, March 31, 2005 - 08:26 am Edit Post Delete Post Print Post
I presume that the LIS is HL7 compliant either V2+ or 3.0. If so then the system needs to compile a DICOM Worklist (DMWL) for the modality via either a bespoke interface using HL7 to DICOM translation or via a commercially available Broker. Most "pure" Interface/Integration engines such as SeeBeyond use HL7 messaging alone and will not do this.

The modality should then utilise DPPS to send the completion info back to the Interface to the LIS to indicate that the episode is complete and can be cleared from the DICOM worklist and the LIS order/request list again using the interface. Alternatively the Episode could be completed on the LIS if this has the standard RIS capability for Post Procedure entry and this can then clear its (HL7) worklist and send a message across the Interface to clear the DICOM Worklist. There are pros and cons to each approach dependent on the capabilities of the systems and the workflow.

The ability to succeed with this scenario depends on the range and sophistication or otherwise of the LIS's modules. Desktop integration using CCOW protocols to any PACS is another "ball game".

The essential approach is to make sure that all parties agree a Functional and Technical Specification ahead of any implementation. Relying solely on IHE, IHE-E, DICOM and CCOW written standards of each potential vendor alone is unlikely to lead to a successful implementation. Hl7 messaging can be open to some "interesting" interpretations.Good luck!
 Link to this message Mayur Arte  posted on Thursday, March 31, 2005 - 08:37 am Edit Post Delete Post Print Post
Yes, we are HL7 Compliant. in order to get through which HL7 messages are required to pass them to a DICOM Convertor. cant it be possible without using DICOM at all and using just HL7.

How feasible is it to bring PACS into the picture where in PACS will take care of DICOM and LIS will communicate with PACS using HL7.

What can be other possibilities?

Thanks for the reply Ivan.
 Link to this message Dave Harvey  posted on Thursday, March 31, 2005 - 08:48 am Edit Post Delete Post Print Post
> can't it be possible without using DICOM at all and using just HL7.

NO, you will NOT be able to integrate imaging modalities using HL7, as the universally agreed convention is that ALL their imaging needs are met via DICOM, and there is no expectation that they will be able to converse in any flavour of HL7.

Dave Harvey
 Link to this message Ivan Brown  posted on Thursday, March 31, 2005 - 08:57 am Edit Post Delete Post Print Post
To answer each point:

Some modality vendors cannot support HL7 messaging and will only accept DICOM messages both for DMWL and DPPS. They may provide interfaces but these are usually doing DICOM/HL7 translation at individual modality level which may be very costly and can introduce surprising errors depending on how the translation is interpreted.

The PACS interface Broker or so called brokerless will do the HL7/DICOM transaltion centrally but depends on all modalities being DMWL and DPPS enabled. There are many "flavours" of this (see Dave Harvey's earlier post)

Short of writing an Integated RIS/LIS/HIS/PACS software programme with full brokering and desktop integration facilities interfacing is the only game in town!
 Link to this message John Parker  posted on Monday, February 09, 2009 - 02:56 pm Edit Post Delete Post Print Post
We're looking at MPPS to improve our work-flow but are struggling to get a couple of free text entries, which we would use for radiographers comments and contrast media.

Whilst i generally don't like fiddling with standards (oh, OK then) has anyone got a work-around for populating these RIS fields via MPPS?
(we're talking Agfa NX2 CR and Meditech RIS (v5.4)

 Link to this message Margaret Cosens  posted on Monday, February 09, 2009 - 10:44 pm Edit Post Delete Post Print Post
John, why not use the free text field for Radiographer comment that's already in Meditech RIS? Or you can write a CDS screen to add to the Radiographer e/e routine. Fields can be created as free text, group response, number, whatever. I can point you to someone at CoCH to talk to, if this would do the trick.
 Link to this message Neelam Dugar  posted on Tuesday, February 10, 2009 - 12:13 pm Edit Post Delete Post Print Post
Hi John,

You raise an interesting issue. If modality would allow all radiographer input straight into modality itself, it would improve the efficiency of radiographers, as they would not have to deal with RIS at all (RIS will largely be a scheduling and reporting system).

However, I personally think this would be difficult. Exam details put in by radiographers include things like ID check, name of radiographers, Contrast, allocation to a radiologist for reporting, notes etc. It also has the scanned request card for radiographers to see. In theory, this could all be possible but I do not think MPPS as a standard is robust enough for this (personal view).

Examination completed and ready for reporting is currently in our Trust done by radiographers completing exam details on RIS.
 Link to this message John Parker  posted on Thursday, February 12, 2009 - 05:51 pm Edit Post Delete Post Print Post
Hi Margaret/ Neelam,

thanks for the replies...

Meditech RIS does have all the fields we want, but it appears our main (by a country mile) image acquisition (ie plain film), using Agfa NX2 CR cannot support all fields....(operator, different taken status messages, free text fields)

NX3 'may' improve on this, but isn't yet on the LSP radar....

I'm not sure if the MPPS spec is not well defined, to meet all the need, or supplier implementation of it is not as good as it could be...

 Link to this message Nagaraj  posted on Wednesday, February 25, 2009 - 03:13 pm Edit Post Delete Post Print Post
Where can we find the tool to compare the MWL and MPPS and IOD objects for testing the correct mapping of the attributes like Requested Procedure ID to Performed Procedure Step ID, etc.?

Thanks in advance
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