Success of DICOM standard

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Success of DICOM standard

• Cor Loef
• Industry Co-Chair
• DICOM Strategic Advisory Committee

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Success of DICOM standard

• Mission and goal of the DICOM standard
• Some recent new developments
• View on the future of DICOM
• Summary

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Mission and goal of DICOM

• Mission of DICOM
• Create and maintain international standards for
  communication of bio-medical diagnostic and
  therapeutic information
• Goals of DICOM
• Achieve interoperability and improve workflow
  efficiency between imaging systems and other
  information systems

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Some recent new developments

• 16 parts of official DICOM 2003 edition available
  at http//medical.nema.org
• Security
• De-identification, Clinical Trials
• Applications of structured reporting (DICOM SR)
  Evidence documents
• Chest CAD
• Cath Lab Reporting
• OB-GYN, Vascular US, Echocardiography

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Some recent new developments

• New Media
• DVD-R, E-mail attachments, large capacity MODs
• New Objects
• Multi-frame MR
• New CT, XA, VL
• JPEG 2000
• Configuration Management

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Multi-frame MR

• New object definition supporting latest
  advancements in MR technology
• Support for very large data sets, split of an
  acquisition between several multi-frame objects
• New concepts functional groups

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Ultrasound Procedure Reporting

• A number of supplements covering different areas
  of US procedure reporting
• OB-GYN
• Vascular
• Echocardiography
• Further advances the concept of Evidence
  Documents objects generated by machine, that
  are not images but are carrying the supplemental
  coded information for the procedure to aid in
  diagnosis

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DICOM Object Access via Net

• In addition to the e-mail distribution of DICOM
  objects, DICOM recently spearheaded a joint Work
  Item with ISO TC215 WADOWeb Access to DICOM
  Persistent Objects
• In currently prototype phase
• Will allow for web-access to images in different
  formats utilizing standardized URL (HTTP-GET)
• In conjunction with standardized MIME type allows
  for access using a Web Browser

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Charter of Strategic Advisory Committee

• To develop and maintain the long-term strategic
  plan of the DICOM Standards Committee
• To review standards and technology trends in
  healthcare, biomedical imaging, commerce,
  telecommunications, and informatics
• To consider issues and opportunities related to
  the strategic evolution of DICOM
• To provide liaison to other standards developing
  organizations ISO, HL7, JIRA, CEN.

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Quality of care improved by information and IT

• All relevant information the care giver and
  patient need, anywhere and anytime, for the
  best clinical decisions,through one common and
  simple user interface, adapted for the task.

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All relevant info accessible
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Trends in Imaging-IT

• Horizontal Integration
• Vertical Integration
• Active workflow
• Data explosion
• Web based PACS

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Vertical Integration
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Active Workflow
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Workflow in Radiology
Digital Radiology
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Users default display protocol
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Paradigm shift in PACSClinical Applications to
PACS
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Multi-slice CT 1000 images
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Post-processing everywhere

• Viewing and Advanced Image Processing
• clinical SW packages
• move towards modalities, PACS and web

3D
Spine
Cardiac MR
Endo3D
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Post-processing everywhere

• Analysis tools to enhance clinical decisions
• Echo measurements calculations
• Left Ventricular Analysis
• Quantitative Coronary Analysis
• Vascular X-Ray Analysis
• Vascular X-Ray Post-Processing

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Horizontal Integration
Hospital Information System, Master Person Index
Radiology workflow
Cardiology workflow
Ultrasound workflow
Pathology workflow
Radiology PACS
Cardiology PACS
Ultrasound PACS
Visible Light PACS
One Image Management Infrastructure
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Horizontal Integration

• Image (information) management system supports
  archiving/retrieving of all types of clinical
  objects (incl. visible light) and Structured
  Reports

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DICOM SR Creation - Example -Radiology
Header
Report Type
Findings
Image data from PACS
Conclusions
Image Refs.
(Pointer)
select
Coding Schemesbehind pop-up menus
Report Templates
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Web based PACS
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Web and Security
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Electronic Health Record

• Image Management system and Departmental
  Information Systems must be EHR-prepared
  (Query/Retrieve)
• EHR emphasis today on visual integration on the
  desktop, will become the integrated, secure,
  patient centric, source of health information
• Need for coded vocabularies to represent medical
  knowledge and the patients health condition

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Electronic Health Record

• Web front-end
• viewing not only of images but also waveforms,
  measurements, reports, lab results, etc
• need the capability to access the original
  medical images
• Support for (DICOM) Structured Reporting
• XML and XML Schema for the exchange of clinical
  documents

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EHR Visual Integation
Efficiency
Back-Office
Clinical Information System
Clinical Information System
messages
Integrated Clinical Viewing at the desktop
Improve Clinical Decisions
Front Office
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Summary

• DICOM is well positioned to continue to serve
  integration needs of medical imaging, including
  workflow, evidence information recording,
  effective access to imaging results in the
  enterprise
• Active cooperation with other standards assures
  DICOM objects integration into future EHR
  whether by reference, or through well-defined
  trans-coding mechanisms.