Download - PACS Presentation HIMSS 2015-Roadmap and IHE
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Monief Eid BSc, Lean Six Sigma Black Belt, PROSCI, C A P, ITIL V3 Foundation and Prince2 Certified
National PACS Program Director
The National BIG Picture: Tele-medical Imaging, The Vision for Patient Services (modified based on non-disclosing
information about MOH)
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Design Strategy
MOH PACS Roadmap & Organization Structure
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2020
Stage 4 Will focus on Continuous
Integration & Maintain the
standard
2018
Stage 3 Will focus on
Increasing PACS Deployment
2016
Stage 2 Will focus on Maintaining
Interoperability
2014
Stage 1 Will focus on
Building The Core &
Interoperability
National PACS Program Road Map
MOH PACS Roadmap Main Milestones
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(Medical Imaging Services “Radiology, Cardiology Pathology, Dental , Ophthalmology & Breast Cancer)
- Stand Alone image System with Specialty info
System at sites. - Build RFP , standard and
Business process With system
Owner. - Execute projects
and maintain it.
1- Create National Specialty Application Solution on national level i.e. National Cardiac Registry/Repository, National Dental Registry/ Repository, etc 2- This will take MOH to Wider services i.e. Tele-Cardiology, Tele- Pathology Tele- Dental etc
Nati
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MOH Tele-Medical Imaging Project Overview
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MOH Tele-Medical Imaging Project Overview
Radiology – CT, MRI, PET,
Diagnostic Radiology, Fluoroscopy, Ultrasound, Nuclear Medicine, Breast Imaging, Interventional
Radiology, DEXA
Dermatology - Visible Light Imaging
Cardiology – Cardiac Cath, Echocardiology,
Nuclear
GI Lab Ophthalmology
Pathology Wound Care Otorhinolaryngology Neurosurgery Oncology
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MOH Tele-Medical Imaging Project Overview
Before After
A True Vendor Neutral Archive solution is a single set of software tools to centralize all medical imaging systems into one perpetual repository.
Simpler management
Seamless migrations
Independent of PACS deployment
Scales to meet all MOH capacity needs
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E-health Portfolio Management E-health Portfolio Management
PACS Program Assistance
PACS Program Assistance
PACS Program Manager PACS Program Manager
PM coordinator
Based on Western Region
PM coordinator
Based on Western Region
Senior PM (Zone
Manager) Covers
Western Region
Senior PM (Zone
Manager) Covers
Western Region
Technical Director
Covers whole Kingdome
Technical Director
Covers whole Kingdome
Change
Management & Training Director
Covers whole Kingdome
Change
Management & Training Director
Covers whole Kingdome
Senior PM (Zone
Manager) Covers Central
Region
Senior PM (Zone
Manager) Covers Central
Region
ICT PACS Program
Organization Chart
PACS PMs Based in
Central Region
PACS PMs Based in
Central Region
PACS PMs Based in Western Region
PACS PMs Based in Western Region
Admin Support
Admin Support
PACS Technical
Managers/ specialists
Covers Integration, Interface,
DICOM, HL7, IHE, etc. Based in
Western and Central Regions
PACS Technical
Managers/ specialists
Covers Integration, Interface,
DICOM, HL7, IHE, etc. Based in
Western and Central Regions
Change Management
& Training Managers/ specialists
Based in Western
and Central Regions
Change Management
& Training Managers/ specialists
Based in Western
and Central Regions
PM coordinator
Based on Central Region
PM coordinator
Based on Central Region
Senior PM (Zone Manager)
Covers Eastern Region
Senior PM (Zone Manager)
Covers Eastern Region
PACS PMs Based in
Eastern Region
PACS PMs Based in
Eastern Region
PM coordinator Based on Eastern
Region
PM coordinator Based on Eastern
Region
Service Director Covers the whole
Kingdom
Service Director Covers the whole
Kingdom
Service Managers/ specialists
Based in Western
and Central Regions (Divided
by Zones)
Service Managers/ specialists
Based in Western
and Central Regions (Divided
by Zones)
PMO Director, Covers whole Kingdome (This could be Zone Role Manager too)
PMO Director, Covers whole Kingdome (This could be Zone Role Manager too)
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Thank You ………. Q & A
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PACS Project Integration and IHE
MOH Approach is Cross Enterprise Document Sharing XDS/XDS-I Solutions (Profiles)
IHE
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IHE Value Construct (Enterprise Cross Sharing)
Medical Imaging
Exchange
Sharing the Reports
Sharing Images
Referrals
Cross Reporting
Other Government (Non-MOH)
Private Services
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Medical Imaging
Exchange
Sharing the Reports
Sharing Images
Referrals
Cross Reporting
Other Government (Non-MOH)
Private Services
Electronic business services
Automated Government Process
Avoided redundant imaging, Electronic imaging ordering
and results delivery
Electronic access, second opinion and
patient travel
Electronic submission of
reportable conditions and
specialty
Electronic referrals, consultation letter
delivery, chart requests
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Management & Administration
Referring Community
Radiologists
Radiographers & Technologists
Receptionists &
Secretaries
- RIS streamlines workflow within a Radiology Department by managing every step of a patient's journey through... Order Receipt, Scheduling, Registration, Examination and Documentation.
- DIRS/TRS Enables the sites without an existing RIS/PACS solution to have order, scheduling , modality worklist and exam documentation capabilities. DITS/TRS will enable facilities to do cross reporting and scheduling.
- DIRS/TRS will improve medical image reporting time especially for CT/MRI.
- DIRS/TRS will create national medical imaging platform
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Document Source
Document Repository
Document Registry
Document Consumer
Provide & Register Document Set
Register Document Set
Patient Identity Feed
Query Documents
Retrieve Documents
Patient Identity Source
PACS Project Integration and IHE
IHE XDS/XDS-I Principle
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Document Source
Document Repository
Document Registry
Document Consumer
Provide & Register Document Set
Register Document Set
Patient Identity Feed
Query Documents
Retrieve Documents
Patient Identity Source
PACS Project Integration and IHE
IHE XDS/XDS-I Principle
RIS/PACS
Generates and Stores
Images, Image Manifest,
Reports
Stores
Index
RIS/PACS,
HIS or EMR
Interprets/
Retrieves
Images Manifest,
Images,
Reports
Adds/stores
Report
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XDS Actors 1. Document Source – Produces and publishes documents – Responsible for sending documents and metadata to a repository 2. Document Consumer – Queries a registry for documents – Retrieves selected documents from one or more repositories 3. Document Registry – Maintains metadata about each registered document in a document entry – Includes a link to the document in the repository 4. Document Repository – Responsible for the persistent storage of documents – Assigns a URI to documents for subsequent retrieval by a consumer 5. Patient Identity Source – Provides a unique identifier for each patient and maintains a collection of identity traits
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XDS Concepts * The XDS registry is the cornerstone of the document sharing process – The source registers information to be exchanged in the registry – The registry only maintains metadata for the document (and not the document itself) – Clinical information is not exposed * The XDS repository maintains the actual clinical document – Clinical documents can be kept within the enterprise’s repository or they can be transferred to another enterprise’s repository. – Allows for data encryption. * Source initiates the sharing process and provides the clinical document and the associated metadata * Consumer queries the registry and retrieve the data from the relevant repository
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- A Document Source actor initiates the Provide and Register Document Set Transaction. - For each document in the submitted set, the Document Source Actor provides both the documents and the corresponding metadata to the Document Repository. -The Document Repository is responsible to persistently store these documents, and to register them in the Document Registry using the Register Documents transaction.
PACS Project Integration and IHE
Document Source
Document Repository
Provide & Register Document Set
Provide & Register Document Set [ITI-15]
Provide and Register Document Set
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PACS Project Integration and IHE
- A Document Repository actor initiates the Register Document Set transaction. - This transaction allows a Document Repository Actor to register documents with a Document Registry, by supplying metadata about each document to be registered. This document metadata will be used to create an XDS Document Entry in the registry.
Document Repository
Document Registry
Register Document Set [ITI-14]
Register Document Set
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PACS Project Integration and IHE
- The Query Registry transaction is issued by the Document Consumer Actor on behalf of a care provider to a Document Registry - The Document Registry Actor searches the registry and returns a list of matching document entries including the locations and identifier of each document in the Document Repository
Document Registry
Document Consumer
Query Documents
Query Registry [ITI-16]
Query Registry
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PACS Project Integration and IHE
Document Repository
Document Consumer
Retrieve Documents
- A Document Consumer Actor initiates the Retrieve Document transaction. - The Document Repository will return the document that was specified by the Document Consumer
Retrieve Document
Retrieve Document [ITI-17]
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PACS Project Integration and IHE
Document Registry
Patient Identity Feed
Patient Identity Source
- This is IHE ITI Transaction 8, defined as part of the Patient Identifier Cross- Referencing Integration Profile - It conveys the patient identifier and corroborating demographic data. - Its purpose in the XDS Integration Profile is to populate the registry with patient identifiers that have been registered for the affinity domain
Patient Identity Feed
Patient Identity Feed [ITI-8]
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Patient Identity Source
Patient Identity Source
Feeds identity of known patients to Document Registry
Patient Identity Cross-referencing (PIX) Manager
Index of everything
Index of everything
Can be any type of system, but often a HIS or
EMR
Can be any type of system, but often a HIS or
EMR
Can be any type of system, but often a HIS or
EMR
Can be any type of system, but often a HIS or
EMR
Similar to a Master Patient
Index (MPI)
Similar to a Master Patient
Index (MPI)
Document Consumer
Source
Document Source
Document Registry
Document Repository
Source of documents and meta-data
Initiates search and retrieval for consumer of documents Indexes
documents and supports search (query)
PIX Manager PIX Manager
Document Consumer Document Consumer
Document Source
Document Source
Document Registry
Document Registry
Document Repository Document Repository
Patient Identify Feed
Query Documents
Retrieve Document
Register Document Set Provide &
Register Document Set
Stores documents, requests indexing in Document Registry, and supports retrieval
Documents stored here Documents stored here
Overview: XDS Actors
and Transactions
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Patient Identity Source
Patient Identity Source
Feeds identity of known patients to Document Registry
Patient Identity Cross-referencing (PIX) Manager
Document Consumer
Patient Identity Source
Document Source
Document Registry
Document Repository
Source of documents and meta-data
Initiates search and retrieval for consumer of documents Indexes
documents and supports search (query)
PIX Manager PIX Manager
Document Consumer Document Consumer
Document Source
Document Source
Document Registry
Document Registry
Document Repository Document Repository
Patient
Identify
Feed Query Documents
Retrieve Document
Register Document Set
Provide & Register
Document Set
Stores documents, requests indexing in Document Regi
Stuff Going In
Stuff Coming
Out
Stuff Stored & indexed
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Patient Identity Source
Patient Identity Source
A DICOM image viewer, such as
PACS
A DICOM image viewer, such as
PACS
This is where the images are stored This is where the images are stored
Document Consumer
Source
Document Source
Document Registry
Document Repository
Overview: XDS-I Actors
and Transactions
Source of documents and meta-data
Initiates search and retrieval for consumer of documents Indexes
documents and supports search (query)
PIX Manager PIX Manager
Imaging Document Consumer*
Imaging Document Consumer*
Imaging Document Source
Imaging Document Source
Document Registry
Document Registry
Document Repository Document Repository
Patient Identify Feed
Query Documents
Retrieve Document
Register Document Set
Provide & Register
Document Set
Image Manager/Archive
Image Manager/Archive
Retrieve Images & Related DICOM Objects
(C-MOVE, Web Service (SOAP) or WADO-URI)
Stores documents, requests indexing in Document Registry, and supports retrieval
Feeds identity of known patients to Document Registry
Patient Identity Cross-referencing (PIX) Manager
*XDS Document Consumer not shown, but would be present
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Patient Identity Source
Patient Identity Source
A DICOM image viewer, such as
PACS
A DICOM image viewer, such as
PACS
This is where the images are
stored
This is where the images are
stored
Document Consumer
Patient Identity Source
Document Source
Document Registry
Document Repository
Source of documents and meta-data
Initiates search and retrieval for consumer of documents Indexes
documents and supports search (query)
PIX Manager PIX Manager
Imaging Document Consumer*
Imaging Document Consumer*
Imaging Document
Source
Imaging Document
Source
Document Registry
Document Registry
Document Repository Document Repository
Patient
Identify
Feed Query Documents
Retrieve Document
Register Document Set
Provide & Register
Document Set
Image Manager/Arc
hive
Image Manager/Arc
hive
Retrieve Images & Related DICOM Objects
(C-MOVE, Web Service (SOAP) or WADO-URI)
Feeds identity of known patients to Document Registry
Patient Identity Cross-referencing (PIX) Manager
These Parts are
Different for Imaging
These Parts are Different
for Imaging
These Parts are the
same for XDS & XDS-I
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PACS Project Integration and IHE
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PACS Project Integration and IHE
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PACS Project Integration and IHE
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Integration Profile Implemented Actors Implemented
Scheduled Workflow (SWF) Image Manager/Image Archive
Patient Information Reconciliation (PIR) Image Manager/Image Archive
Consistent Presentation of Images (CPI) Image Manager/Image Archive
Access to Radiology Information (ARI) Image Manager/Image Archive
Key Image Note (KIN) Image Manager/Image Archive
Post-Processing Workflow (PWF) Image Manager/Image Archive
Evidence Documents (ED) Image Manager/Image Archive
Mammography Image (MAMMO) Image Manager/Image Archive
Consistent Time (CT) Time Client
Imaging Object Change Management (IOCM) Image Manager/Image Archive Change Requestor
Audit Trail and Node Authentication (ATNA) Secure Node
Patient Identity Cross-Reference (PIX) Patient Identity Cross Reference Consumer Patient Identity Cross Reference Manager
Patient Demographics Query (PDQ) Patient Demographics Query Patient Demographics Query Manager
Cross-Enterprise Document Sharing (XDS) Document Source Document Repository Document Registry Document Consumer Cross-Community Access
Cross-Enterprise Document Sharing for Imaging (XDS-I)
Imaging Document Source Document Repository Document Registry Imaging Document Consumer Cross-Community Access
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Consumer Registry
Repository
1. Sources post document packages to the Repository
2. Repository registers the documents metadata and pointer with the Registry
3. Consumers search for documents with specific information
4. Consumers retrieve selected documents from Repository (-ies)
XDS Document (Metadata):
Class
Patient Id
Author
Facility
Date of Service
…
XDS Document (Metadata):
Class
Patient Id
Author
Facility
Date of Service
…
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• Achievements: 1. Having MOH Sharing Image/Report Use Cases.
2. Having MOH IHE Imaging/Reports profiles.
3. Having MOH Radiology procedures exam codes.
4. Having MOH HL7 Specification for all HL7 integration with all information require to have the best connectivity quality.
5. Having MOH HL7 test environment and simulation to be use by deferent companies and minimize the time of integration.
6. Setup Business Intelligence center where we can improve the quality of work within PACS / RIS in all MOH hospitals.
7. Having business Intelligence central data warehouse for all PACS / RIS systems, neutral vendor based on MOH with maximum security ,low internet connectivity and high quality.
8. Run MOH Business Intelligence application to analyze all systems and workflows across MOH PACS / RIS systems.
9. Monitoring systems performance through dashboards and interactive tools
10. Monitor all suspicious or mess usage of the system by Business Intelligence indicators.
11. Generate Daily, Weekly, Monthly And Yearly Report
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Thank You ………. Q & A