Can someone please enlighten me whether a Dicom service exists or in the process being defined that would allow PACS to query RIS or be informed of imaging requests in RIS? I know of PPS and Availability Notification services but cannot think of any other Dicom services between RIS and PACS. I understand that for the majority of the existing PACS installations, a PACS broker is used to query/transfer RIS requests to PACS, either using HL7 or direct database query. Is there a Dicom service to perform similar function independent of HL7 protocol?
posted on Thursday, October 01, 2009 - 10:11 pm
Scheduled Workflow profile of IHE deals with a standardised HL7 message flow between RIS and PACS (also PAS, ordercomms, and modalities).
Many PACS, and modality vendors already declare themselves to be SWF compliant. IHE connectathons prove these inter-operability concepts. The challenge is to get our local UK suppliers of Ordercomms, RIS and PAS suppliers to support this profile.
CFH/lSP era has been an era of single monolithic systems. When we move to multivendor based best of breed IT systems-robust international interoperability standards will be key.
In my view there are 3 IHE profiles that are the backbone of healthcare inter-operability 1. SWF 2. PIR 3. XDS/XDS-i
Dave Harvey gave an excellent presentation on SWF at our Spring 2009 meeting.
Another concept to bear in mind when talking about an integrated health record with standards is context synchronization -CCOW
We are going to explore both XDS and CCOW concept on 23rd oct at BIR.
Thanks Neelam. I now realize how wrong I was in my assumption that Dicom alone could address some of the shortcomings in RIS/PACS/Modality workflow integration. My limited practical experience on Dicom and HL7 system integration on departmental level, made me highly appreciative of Dicom compared to HL7. I just cannot see how the benefits of IHE profiles such as SWF and PIR can be realized in the existing NHS setting, where due to contractual arrangement, only piece-meal refreshment of the existing PACS and other IT systems are possible.
Bahman, The ease of DICOM inter-operability such as we see today is a result of many champions around the world. Not many years ago every vendor of CT or MRI tried to see you a miniPACS and a modality workstation. From a commercial perspective it makes very good business sense. However, it is pressure from standards groups on an international level which have resulted in the level of inter-operability of DICOM. Trusts did not replace all modalities in one go. It has been a gradual process. However, insisting on standards is key.
Adoption of SWF, PIR and XDS and CCOW will not happen overnight. 1. User community understanding the requirement for standards adoption 2. User community putting this in their requirements 3. Vendors adopting standards 4. National strategy demanding inter-operability standards are the few drivers that will help. We can all do our little bit in our own little Trusts trying to influence the direction of travel towards inter-operability standards.
posted on Wednesday, October 07, 2009 - 05:05 pm
I meant to say "all CT and MRI vendors tried to sell you a MiniPACS"