Aravind GunduRaoPhilips Healthcare

April 09, 2008

Implementing a Unified DICOM Broker for Cardiology – An Experience

2Philips Healthcare, Apr 09, 2008

Agenda

Dynamics in Echo and Cath Workflow

Xcelera Connect Unified Broker

Implementing DICOM MWL & MPPS

Using MWL and MPPS in a Multi-Modality Cath Lab

Realizing DICOM compliant Hemodynamic modality

Challenges faced during deployment

Summary

3Philips Healthcare, Apr 09, 2008

Dynamics in Echo Workflow

Finalize Report• Review serial studies & stress• Measurements & calculations• Score wall motion• Record clinical finding codes

Transfer exams & measurements

to PACS

Automatically transfer demographics & MRN

Perform Exam• Acquire, review, select & edit images

• Perform measurements

& calculations• Export to PACS (Xcelera)

Demographics& Schedule info to

Modalities

Check in Patient

• Receive ADT from HIS

• Order a Study

Inbound HL7

• Finalized Echo reports• Clinical data to Repository• Finding codes to HIS

Outbound HL7

4Philips Healthcare, Apr 09, 2008

Dynamics in Cath Workflow

Control room Cardiologist’s office

• Add images to report

• Create clinical report

Control room

• View previous Cath lab reports

• Procedure logging• Enter technical

details

Cath Lab front desk

• Make worklist for Cath lab rooms

• Enter pre-procedure details

5Philips Healthcare, Apr 09, 2008

Xcelera Connect Unified Broker

EPRLaptop com puter

Laptop com puter

Laptop com puter

CV HemoUS EchoUS Vascular

Archive

DICOM

DICOM Modalities

Xcelera Workstations

Xcelera

HIS

HL7

CVIS

HL7

HL7

Prop

Order MgmtResult Mgmt

Patient MgmtFinancial Mgmt

Clinical History

Xcelera Connect

MR

6Philips Healthcare, Apr 09, 2008

Modality Worklist

Xcelera Connect

DICOM MWL

(Cath/Echo Orders)

HL7

Schedule/Update Study

CVIS

(Echo Orders)

Appointment System

Patient Update

Schedule/Update Study

Xcelera

PACSHL7

Sonos

Non DICOM Modality

SCP

US CV

DICOM Modality

Prepare exam/patient Perform Exam(s)

Demographics

HIS

SCU

HL7

7Philips Healthcare, Apr 09, 2008

Modality Performed Procedure Step

Xcelera Connect

DICOM MPPS

CVIS

HL7

USCV

DICOM Modality

Examination ResultsForward Examination Results

HL7 Compliant

CVIS

DICOM Compliant

Forward MPPS

Xcelera

PACS

DICOM

SCP

SCU

8Philips Healthcare, Apr 09, 2008

Multi Modality Cath Lab

IVUS CV

Xcelera Connect

DICOM

DICOM Modality

Prepare exam/patient Perform Exam(s)

Xcelera CLM

CVIS

PACS

Schedule Study / Update Study

HL7

Hemo

Procedure starts on a modality

PPS Status

Issue MWL Query / Send

MPPS

MR

9Philips Healthcare, Apr 09, 2008

DICOM Compliant Hemo Modality

Xcelera Connect

CVIS

Hemo

DICOM MWLSCU SCP

DICOM MPPS

SCU SCP

10Philips Healthcare, Apr 09, 2008

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 HL7 Mapping and Vice-Versa

11Philips Healthcare, Apr 09, 2008

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