DICOM General Purpose Worklist The next major political

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DICOM General Purpose Worklist The next major political battle in PACS Dr David Harvey

DICOM General Purpose Worklist The next major political battle in PACS Dr David Harvey

Why a DICOM Talk today ? n n n DICOM General Purpose worklist is

Why a DICOM Talk today ? n n n DICOM General Purpose worklist is to reporting workstations what basic DICOM is to a CT Scanner You wouldn’t (I hope!) since 1995 buy a CT without checking the DICOM conformance You shouldn’t buy a reporting station (or PACS) in 2004 without doing the same

“Traditional” DICOM Queries n Concerned with “static” data, which once generated is never altered.

“Traditional” DICOM Queries n Concerned with “static” data, which once generated is never altered. n n n Images RT plans etc. Provides excellent methods for creating, storing, querying and retrieving such data, if your starting point is a particular patient or study

Why original DICOM Queries are not suitable for workstations n n n No information

Why original DICOM Queries are not suitable for workstations n n n No information or reporting status (unreported / in progress) No way of querying for “things to do” If patient IDs etc. are entered by hand, then there is a delay while images are actually retrieved. Radiologists need a “NEXT” button

Key Features of GP Worklist Provides: n A vendor independent method of interfacing efficient

Key Features of GP Worklist Provides: n A vendor independent method of interfacing efficient reporting stations to a PACS n A mechanism to simulate the “reporting pile” (but in multiple places simultaneously) n A Locking mechanism to prevent accidental double reporting n Wide range of query and priority fields to support chosen working practices. n Sufficient information to allow images to be pre-fetched.

Why Have a DICOM Interface? n n n Is the best RIS/PACS supplier also

Why Have a DICOM Interface? n n n Is the best RIS/PACS supplier also the best workstation supplier? Is the best workstation supplier also the best RIS/PACS supplier Or do you compromise?

Hot it works (the technical bit) n n Modelled on the existing modality worklist

Hot it works (the technical bit) n n Modelled on the existing modality worklist (MWL) and modality performed procedure step (MPPS) services Workstation first queries for items of a requested type Then it selects and locks an item Then marks it compeleted

MWL/MPPS GP Worklist Overall Data Flow Queryfor for. Examinations Work Items Query List of

MWL/MPPS GP Worklist Overall Data Flow Queryfor for. Examinations Work Items Query List of those available GPWL MWL/MPPS SCU (Client) Lock (In Progress) Lock OK Mark Complete OK GPWL MWL/MPPS SCP (Server)

Worklist Data Source n Exactly the same options as used by proprietary systems: n

Worklist Data Source n Exactly the same options as used by proprietary systems: n n n RIS PACS Broker

Vendors have no technical excuses n n n Data sources already exist (used for

Vendors have no technical excuses n n n Data sources already exist (used for their proprietary systems) DICOM mechanisms already exist (used for MWL/MPPS) So where is it ?

Can I use it Now? At present, NO – because: n n n It

Can I use it Now? At present, NO – because: n n n It has only been in DICOM for 3 years (short time by development scales) Like all such protocols, it requires support from both SCP (server/PACS) and SCU (client/workstation) PACS suppliers don’t like it’s potential to eat into the very lucrative proprietary workstation market Only a few independent workstations support it yet Users haven’t yet learnt about it and demanded it!

Will it become available? Perhaps ? n Negative Features n n Not all DICOM

Will it become available? Perhaps ? n Negative Features n n Not all DICOM features become adopted widely Arguments from major PACS vendors: n n Responsibility, Reliability etc. User ignorance May become an expensive retrofit option Positive Features n n n Adoption into IHE will push implementation by vendors Some smaller vendors are already using it Like original DICOM, a few knowledgeable users may be sufficient to push the market

But won’t the national Program make this obsolete? n n Life of your RIS

But won’t the national Program make this obsolete? n n Life of your RIS ~7 -10 yrs Life of Government Initiatives ~2 -4 yrs n n Trusts 4 ys (then merged) Information for Health – 3 yrs NPf. IT – 3 yrs ? You will still be using your system long after the LSP has lost interest or gone bankrupt!

Conclusions n n In 1994, you could buy a CT scanner which worked well

Conclusions n n In 1994, you could buy a CT scanner which worked well with it’s own expensive secondary console, but if you wanted flexibility and choice for the future, you needed to insist on DICOM C-STORE In 2004, you can buy a PACS which works well with it’s own expensive tied reporting stations, but if you want flexibility and choice in the future, you need to insist on DICOM General Purpose Worklist n If not there yet (insist on a firm, dated commitment, with guaranteed interconnection)

References n DICOM Standard Home Page n n DICOM Newsgroup n n http: //www.

References n DICOM Standard Home Page n n DICOM Newsgroup n n http: //www. dclunie. com/dicom-status/status. html news: comp. protocols. dicom My E-mail (Dave Harvey) n mailto: dave@medicalconnections. co. uk