• Post Acquisition Workflow (PAWF)

Kevin O’Donnell

Toshiba Medical Research Institute

Problem Statement• Post-processing volumes continue to grow; needs management

• IHE Post-Processing Workflow (PPWF) is based on DICOM GP-WorklistGPWL is complex to implementDICOM recently retired GPWL in favor of UPSUnified Procedure Step is both simpler and more flexibleIHE Radiation Oncology adopted UPS for managing treatment workflow

• Need a profile refresh based on UPS

• Also need a framework for deploying Plug-in DICOM apps for processing

Example “Workitem” Tasks:

• 3D View Generation• Computer Aided

Detection• Clinical Applications• Pre-fetching• Image Routing• CD Burning• Image Importing• …

Value Proposition

• Clinical Use Cases:– Manage CAD, 3D or Clinical Image Lab– Integrate 3rd Party applications

• Systems it would impact:– RIS, PACS, CAD, 3D, Clinical Apps

• Value proposition:– Efficient queue-based work management– Exact task description & accurate data list– Monitor workitem completion to drive

reading worklist & billing– Collect performance metrics– Add PACS functions with plug-in apps

some text: #Numerical Details 12.2 14.5 11.8 7.6

Outlier: #Performing Phys.Over Target: 12.2%

Worklist

Images

Status

Re-designs PPWF Profile to use new features of DICOM

IHE Post-Acquisition WorkflowIHE PAWF Profile builds on DICOM UPS

Essential Profile Features:

• Worklist managed processing– Automated & manual

• Progress notifications– Any interested system

(RIS, Billing, Reading Worklist, Dashboards, Analytics)

– Subscription-based

• Cancelation requests– With reason & contact

• Hosted applications (“DICOM plugins”)

WorkitemManager

Workitem Performer

Watcher

ImageManager

WorkitemCreator

HostingSystem

HostedApp

DSS / Order Filler

UPS Object

Sched. Task Details

Progress

Performed Task Details

Relationship

A Workitem has its attributes grouped into 4 Modules:

(this does not affect processing; just for logical organization)

UPS Workitem Structure

UPS Object

Sched. Task Details

Progress

Performed Task Details

Relationship Relationship Module- Patient demographics- Admission details

- Order details- Requested Procedure- Accession #

- Reason for Requested Procedure- Requesting physician/department- etc…

UPS Workitem Structure

UPS Object

Sched. Task Details

Progress

Performed Task Details

Relationship

Scheduled Proc. Info. Module- Priority- Requested perform/completion time- Requested resources/location- Requested Procedure descrip./codes- Requested Processing parameters

- List of Input data IDs & Location- Input Data Availability Flag- etc…

UPS Workitem Structure

UPS Object

Sched. Task Details

Progress

Performed Task Details

Relationship

Progress Module- UPS State (Scheduled, In-Progress, Completed, Canceled)

- Progress Status – Numerical (e.g. % complete)

- Progress Status – Description (e.g. Annealing phase complete)- Contact information for performer (e.g. phone #)

- etc…

UPS Workitem Structure

UPS Object

Sched. Task Details

Progress

Performed Task Details

Relationship

Performed Proc. Info. Module- Time Performed/completed- Performing resources/location

- Performed Procedure descrip./codes- Performed Processing parameters

- List of Output data IDs & Location- etc…

UPS Workitem Structure

Perform UPS Workitems

• Typical Pull Workflow- Query, Claim, Update,

Complete

• Input / Output References- Local to Performer; Local Image Manager; Other Image Manager

• Hosted applications (plugins)- Performer may choose to

be a Hosting System

- Apps may be 3rd party

WorkitemManager

Workitem Performer

ImageManager

HostingSystem

HostedApp

QueryGetClaim

Retrieve

Store

UpdateComplete

Start AppStart Task

Finalize Task

Create UPS Workitems

• By Workitem Manager- Internal logic

- Triggered by DSS/Order Filler scheduling

- Triggered by Image Manager Data

• By Workitem Creator- Explicit create request

- Can be grouped with any relevant system

• By Workitem Performer- Explicit create request

- “Unscheduled”/Self-scheduled/Ad Hoc

WorkitemManager

Workitem Performer

ImageManager

WorkitemCreator

DSS / Order Filler

Create

Procedure Scheduled

Availability Query

Procedure Updated

Availability Notification

Create

Monitor UPS Workitems

• Subscribe / Unsubscribe- Globally or for Individual

Workitems

• Applications/Usage- Schedule subsequent tasks

- Report progress

- Bill for performed tasks

- Populate reading worklist

- Drive dashboard

- Analyze dept. performance

- Claim assigned workitems

WorkitemManager

Workitem Performer

Watcher

WorkitemCreator

QueryManage Subscriptions

Send Notification…

CreatedClaimedProgressUpdatedCompleted

Createdfor WP1

Cancel UPS Workitems

• Workitem Manager- Can directly cancel unclaimed workitems

- Otherwise notifies Performer

• Workitem Performer- Cancels at its own discretion

• Watcher- Waits for Notification task was either Completed or Canceled

WorkitemManager

Workitem Performer

Watcher

WorkitemCreator

Request Cancel

Send Notification…Canceled

Cancel Requested Canceled

Unix, Mac, PC Internet ServerCommercial Vendor #2

…Commercial Vendor #1

Standard API

Application Hosting

Portable applications that ‘plug into’ any host that implements the

standardized ‘socket’= DICOM Part 19

Application Hosting

• Separate provision of infrastructure from applications.

- Hosting Systems (Infrastructure) provide data retrieval, storage, and workflow management.

- Applications provide data processing/analysis and return results to the infrastructure.

• Minimize the ‘reinvention of the wheel’.• Support/Combine multiple applications on a single workstation.• Deploy applications across multiple platforms

Application Hosting

Based on DICOM Part 19• DICOM Plugin Interface & Architecture• Web service between “Host” & “Application”

- WS end-points on same machine

- WSDL definitions in PS 3.19

- language neutral (C++, C#, Java, etc.)• Application launch, progress/status,

suspend/cancel, complete• Access to components of DICOM objects, or entire objects• XML Model of DICOM Header

- choose to access file, native XML model, abstract XML model

See also: openxip.org for open source tools, reference implementation

Next Steps

• Review Trial Implementation of PAWF:

http://www.ihe.net/Technical_Framework/index.cfm#radiology

• Sign-up to participate in 2014 IHE Connectathons