the dicom 2014 chengdu workshop august 25 chengdu, china dicom and the future of medicine charles e....

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THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee, Wisconsin, USA Professor of Radiology – representing the American College of Radiology (ACR)

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Page 1: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,

THE DICOM 2014 Chengdu Workshop

August 25 Chengdu, China

DICOM and the Future of Medicine

Charles E. Kahn, Jr., MD, MS

Medical College of WisconsinMilwaukee, Wisconsin, USA

Professor of Radiology – representing the American College of Radiology (ACR)

Page 2: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,

Introduction

This presentation explores DICOM’s impact on clinical medical practice – today and tomorrow

- Why do physicians work on DICOM?

- How can DICOM improve medical practice?

August 2014 DICOM Chengdu Workshop Charles Kahn DICOM and the Future of Medicine2

Page 3: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,

An Example

Radiology Reporting

An international effort• Led by the Radiological Society of North America (RSNA)• Soon to include the European Society of Radiology (ESR)

Goals• Improve the communication of radiology procedures• Allow “data mining” of radiology results

August 2014 DICOM Chengdu Workshop Charles Kahn DICOM and the Future of Medicine3

Page 4: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,

Radiology Reporting

• Library of “best practice” templates• RadReport.org

• Standard for report templates• Integrating the Healthcare Enterprise (IHE)• “Management of Radiology Report

Templates” (MRRT) profile

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Page 5: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,

radreport.org

Page 6: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,
Page 7: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,

FindingsHeart

NormalLungs

No acute disease[Mild biapical scarring

is unchanged.]Bones

Degenerative changes[Unchanged.]

[The pacemaker is unchanged.]

Heart (RID1385)

Observations section (RID28486)

Normal (RID13173)

Lungs (RID13437)

Set of bones (RID28569)

Page 8: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,

Why Templates?

• Reduce variability of reports• Improve completeness• Encourage best practices

• Improve interoperability • Support automation of report production• Support validation of report content• Promote data extraction

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Page 9: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,

Turkish Chinese

骨龄Kemik Yaşı

Impression (RID13170)

Normal (RID13173)

“Bone Age” template

Page 10: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,

Multiple layers of constraint

Courtesy of H. Solomon

HL7 v3 RIMAbstract Data Classes

CDA r2Refined Data Classes and

structures for clinical documents

DICOM (Sup 155)Additional requirements, templates,

and business names for radiology reports

Professional ContentSpecific content for

specialized procedures

v3 XML ITSData Encoding

Page 11: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,

Clinical Knowledge

Report Authoring Template

Report Authoring Process

Imaging Study Data

Clinician Interpretation

CDA Report Instance

Templates

Business Names

Element CDA

Structure

Report Formatting

Process

Business Name

Production Logic

CDA Imaging Report

Document

Authoring Template Element Structure

IHE MRRT

RSNA RadReport

Courtesy of H. Solomon

Page 12: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,

DICOM’s Role

New “Work Item”• Proposed to DICOM Standards Committee

• Assigned to Work Group 8 (Structured Reporting)

– Harry Solomon (GE Healthcare), co-chair– Charles Kahn (ACR), co-chair

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Page 13: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,

Working Group 8

DICOM Supplement 155• Defines how radiology reports are exported

into HL7 Clinical Document Architecture (CDA)

• CDA provides a universal format for clinical results

– Integrates radiology results with entire health record– Allows “data mining” for research and quality

improvement

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Page 14: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,

Why do physicians work on DICOM?• Technical expertise• Advocacy and communication with physician

communities • Contribution to international effort

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Page 15: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,

How can DICOM improve medical practice?

• Standards foster competition to create better products

• DICOM helps advance the worldwide adoption of new medical imaging technology

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Page 16: THE DICOM 2014 Chengdu Workshop August 25 Chengdu, China DICOM and the Future of Medicine Charles E. Kahn, Jr., MD, MS Medical College of Wisconsin Milwaukee,

Author Information

Prof. Charles Kahn• [email protected]• Dept. of Radiology

Medical College of Wisconsin9200 W. Wisconsin Ave.Milwaukee, WI 53226USA

谢谢

August 2014 DICOM Chengdu Workshop Charles Kahn DICOM and the Future of Medicine16