posted on Tuesday, December 20, 2011 - 07:08 pm
XDR is the IHE standard for point to point transfer of clinical documents. Here is my first attempt at defining metadata for XDR using radiology reports & requests in NHS terms. Most of metadata is very similar to XDS with very minimum additions for XDR.
Adoption of XDR will allow for vendor neutral transfer of radiology reports from 1 RIS to another, RIS to GP system, GP Ordercomms to RIS. XDR largely replaces snail mail, fax etc with a vendor neutral electronic transfer of documents.
posted on Wednesday, January 18, 2012 - 09:10 am
----CDA & XDR adaptors for existing RIS ----CDA & XDR for RIS to RIS & RIS to GP System report transfer
At the next meeting, we will explore whether by using "adapters" we could make any existing RISes compliant for standards based exchange of radiology reports using XDR of IHE (point to point transfer of documents). There are similar initiatives for CDA adoption for radiology reports ongoing in Canada, I understand. It would be useful to learn from this.
We will also explore using of the existing hub & spoke of IEP for radiology reports from RIS to RIS using XDR--from one hospital to another. Similar kind of transfers using global standards would be possible for RIS to GP systems for report transfer electronically (using adaptors to make GP systems complaint with XDR).
We all know that PACS to PACS image transfer is relatively simple due to DICOM push which can be established between any 2 PACS systems (or through IEP acting as a hub). However, RIS to RIS reports transfer has been difficult due to lack of standards. However, I do think there is hope for us. There will be some good talks on this issue on 27th April. Do put XDR & CDA into you RIS procurement requirements.
13.40 Point to Point transfer of documents/Images using IHE Profiles (XDR etc)—Dr. Dave Harvey (IHE-UK) 13.55 CDA & XDR adaptors for legacy RISes—Mr. Michel Pawlitz (KarosHealth) 14.15 RIS to RIS report transfer using XDR via IEP –Mr. Peter Young (Burnbank)
Most Trusts replacing PACS are including an enterprise wide XDS based VNA within their procurement. Hence, it is important that we as a community try to get some consistency in the XDS-I/XDR metadata. Here is an updated document which I think will be useful to many Trusts going ahead. At UKRC, the GE team was talking to me & Dave Harvey about XDS-I/XDR metadata for implementation at GOSH (London). They were using this document as a starting point. The Sintero Team is also using a similar metadata model for NHS which has been discussed & debated at lenght with IHE-UK. There missing items within the metadata 1. Intended recipient should be an XDS-I metadata item too (not just XDR) 2. There just be a "linking number" which allows for linking of documents--Accession no. Canada Infoway is also looking at streamlining their metadata. Hopefully we can learn from one another.
At Doncaster we are looking to use the following metadata set for XDS/XDR. Our initial project is to store Radiology images, reports & scanned requests into the XDS VNA from Acuo. Reports & requests will be metadata wrapped PDF--source will be Rogan-Canon RIS. Images will come from Fujifilm PACS. If this is successful from a clinical point of view, we will consider other enterprise content.