posted on Tuesday, June 27, 2006 - 04:42 pm
>>How do you specify for a 3rd party workstation that can 1. query a GPWL based on rules (e.g. a performing physician/all CT for today) <<
The main specification is included in the IHE-TF (Vol II section 126.96.36.199.2.1 !!) with 2 sub-options - user and patient orientated - you would specify that at least the user orientatated option must be supported. Modality seems to be missing from this list - I think that it is subsumed in the "workitem code sequence", but it would be wise to specify independently just in case of problems.
>> 2. that is able to display current CXR with a prior CXR. <<
Just write this as a requirement, as you would currently.
On a related note, whilst reviewing the IHE documentation to answer this I found all 3 possible solutions to a previous question - guides are given for the report manager (GPWL SCP) being grouped with the DSS (RIS), IM (PACS) or stand-alone - see radiology tech framework - ver 6 Vol II, section 13.1.1
Dave, Did Agfa PACS at the European Connectathon provide GPWL SCP as Image manager actor?
posted on Tuesday, June 27, 2006 - 10:02 pm
Quite apart from the IHE connectathon "Ground rules" (only the published results can be quoted), I genuinely don't know how the AGFA actor was "Grouped" as we only tested overall functionality (which I did in this case from the SCU end!).
One point to remember, the IHE pass applies to AGFA as a company, and not to any particular product, though the rules are that systems tested should either be existing systems, or within 6 months of expected release. So whilst AGFA can't plead ignorance of the profile, or insurmountable technical obstacles, there is no guarantee (other than OBS provisions!) that they will build it into any particular product in the near future.
posted on Thursday, June 29, 2006 - 12:13 am
This is exactly the point I made in my prior posting - the fact that AGFA has demonstrated compliance does NOT mean that any or all of their products (in this case IMPAX) comply - it merely means that they have a PROTOTYPE of SOMETHING which does.
Put another way, your statement "Hence it should have GPWL within the Impax PACS (box)" is not necessarily valid.
Where do you go from here....you refer to the OBS, and use the IHE connectathon results to refute any "it's not possible" arguments.
Dave, for the not so technically aware about to finish a business case, what do we need to specify in our contract? Could you produce a paragraph or 2 that specifies these details for us and others to include in our business cases/discussions.
Phillip, For desk-top integration you cannot rely entirely on IHE for specification as per discussions previously. You are lucky if you are able to specify for your contract. Make the most of it. For us we have to take everything thrown at us and be told that it is in the contract (but cannot see the contract for ourselves)
As Neelam pointed out, there are things you need to specify in addition to the basic IHE requirements, but the radiology user's handbook is an excellent starting point. Given the wide variety of systems discussed on this thread, I'm not entirely sure which system you're looking to specify -can you elaborate?
After all this, it seems there are 2 important standards for Desk-top Integration 1. Dicom GPWL standards for worklist 2. CCOW standards for syncronistation between RIS and PACS (using accession as context for syncronistation)
Phillip, So, if you were writing out the contract for your PACS, and wanted a provision of a standardised method of desk-top integration, you would say 1. PACS must provide a Dicom GPWL as SCP(service class provider) 2. PACS Viewer must use CCOW for desk-top integration with RIS (using Accession no. as a context for synchronisation) 3. PACS viewer must provide Dicom GPWL as SCU
Similarly, for contract for RIS you must state: 1. RIS must use CCOW for desk-top integration with RIS (using Accession no. as a context for synchronisation)
I have written some functional workflow specification for desk-top integration, which is attached here. Please could you let me know if provision of GPWL and CCOW standards are adequate to meet this functional workflow requirements. Suppliers are reluctant to provide standards, and say that a proprietary interface is required to meet these workflow requiremnts. I would be grateful for your input.
I would also be grateful for any comments on workflow, by those who have DTI or have specified for DTI.
Users need to realise the importance of standards adherance. Since the advent of PACS and desk-top integration, Modality workstations have become less and less used. Reasons are they lack the workflow advantage of PACS workstations, and even if you view images on madality workstation, you have to then go to the PACS workstation to report your exam. If your RIS supplier provided you with GPWL and used HL7 CCOW for synchronisation with RIS , you could get desk-top integration between your RIS and any modality workstation (provided they conformed to GPWL as SCU and used CCOW for synchronisation). This will provide you with almost plug and play desk-top integration, irrespective of the vendor of workstation. This will remove the monopoly of PACS vendors to workstations.
Legacy vendors like McKesson complained about the monopoly market of LSPs. Many users still retained their products, showing the power of the customer. However, for RIS vendors to continue to stay in the market they need to develop their products in line with the needs of the consumer. IF they do then, it will be the users who will fight to keep them on, in preference to a vendor who does not want to develop their product.
The other issue that users need to start thinking about is, in 2013 LSP reign will end. Unless you have standardised interfaces, you will find yourself locked into both RIS and PACS supplier's expensive and outdated systems. Whereas if you use standardised intefaces you can change PACS without worrying about changing RIS and vice-versa. Today when it is time to change your CT scanner do you have to buy it from the same supplier as your PACS/ or your leagy CT supplier. Answer is 'no'. This is due to Dicom standards. It is about time we extend this to RIS and PACS integration.