Implementing a Unified DICOM Broker for Cardiology An

Implementing a Unified DICOM Broker for Cardiology – An Experience Aravind Gundu. Rao Philips Healthcare April 09, 2008

Agenda v Dynamics in Echo and Cath Workflow v Xcelera Connect Unified Broker v Implementing DICOM MWL & MPPS v Using MWL and MPPS in a Multi-Modality Cath Lab v Realizing DICOM compliant Hemodynamic modality v Challenges faced during deployment v Summary Philips Healthcare, Apr 09, 2008 2

Dynamics in Echo Workflow Inbound HL 7 Automatically transfer demographics & MRN Check in Patient • Receive ADT from HIS • Order a Study Demographics & Schedule info to Modalities Perform Exam • Acquire, review, select & edit images • Perform measurements & calculations • Export to PACS (Xcelera) • Finalized Echo reports • Clinical data to Repository • Finding codes to HIS Transfer exams & measurements to PACS Outbound HL 7 Philips Healthcare, Apr 09, 2008 Finalize Report • Review serial studies & stress • Measurements & calculations • Score wall motion • Record clinical finding codes 3

Dynamics in Cath Workflow Cath Lab front desk Control room • Make worklist for Cath lab rooms • Enter pre-procedure details • View previous Cath lab reports • Procedure logging • Enter technical details Philips Healthcare, Apr 09, 2008 Control room Cardiologist’s office • Add images to report • Create clinical report 4

Xcelera Connect Unified Broker DICOM Modalities US Vascular US Echo CVIS MR CV Hemo Order Mgmt Result Mgmt HL 7 Prop HIS DICOM HL 7 Archive Xcelera Connect Patient Mgmt Financial Mgmt HL 7 EPR Xcelera Workstations Philips Healthcare, Apr 09, 2008 Clinical History 5

Modality Worklist HIS DICOM Modality US CV CVIS Demographics Patient Update SCU Prepare exam/patient Perform Exam(s) Schedule/Update Study SCP Non DICOM Modality (Cath/Echo Orders) HL 7 DICOM MWL HL 7 Appointment System PACS HL 7 Xcelera Connect Schedule/ Update Study (Echo Orders) Sonos Xcelera Philips Healthcare, Apr 09, 2008 6

Modality Performed Procedure Step DICOM Modality US CV CVIS SCU HL 7 Compliant Examination Results DICOM MPPS SCP Forward Examination Results HL 7 CVIS PACS DICOM Xcelera Connect Xcelera Forward MPPS DICOM Compliant Philips Healthcare, Apr 09, 2008 7

Multi Modality Cath Lab Procedure starts on a modality DICOM Modality IVUS MR CV CVIS Hemo Xcelera CLM Issue MWL Query / Send MPPS Prepare exam/patient Perform Exam(s) Schedule Study / Update Study DICO M PACS PPS Status HL 7 Xcelera Connect Philips Healthcare, Apr 09, 2008 8

DICOM Compliant Hemo Modality Hemo SCU DICOM MWL SCU Xcelera Connect CVIS SCP DICOM MPPS Philips Healthcare, Apr 09, 2008 9

Challenges in Deploying the Broker • Migration from the pre-existing broker at the hospital to the new interface engine without affecting the modality topology • Custom requirements at the hospital site – Custom query – Worklist filtering • Diagnosing the field issues • DICOM to HL 7 Mapping and Vice-Versa Philips Healthcare, Apr 09, 2008 10

Summary • It is possible to integrate the DICOM needs of Echocardiography workflow and Cardiac Catheterization workflow • This solution can be extended to other departments with in cardiology domain, say Electrophysiology department, to have a unified DICOM broker for Cardiology department • Interoperability, Enterprise brokering and Customization will be the challenge moving ahead Philips Healthcare, Apr 09, 2008 11