Title: DICOM SR
1DICOM SR
- Requirements
- Applications
- Benefits
W. Dean Bidgood, Jr., M.D., M.S.
SR Data Solutions, Inc. www.srdata.com (919)
806-2220
2No report is unstructured.
But not all reports are effective ..
A picture is worth a thousand words Knowledge
is valuable Dont waste it.
Its time for DICOM SR
3With SR, Useful Structure is Available
- User decides how much structure to use
and precisely controls (with templates) not only
the type of content
- But also the degree of OPTIONALITY
- And the MODE OF EXPRESSION
where required
4SR Distinctives
- Supports high-end applications
- Practical approach to codes and terminology
- Availability (trading partners)
5Simple Entry Point
Title and text Links to images . But also
supports advanced applications
6DICOM Environment
- Unique object identifiers
- Consistent soft-copy display
7SR Highlights
- Integrate fully into the DICOM environment
- Support measurements by imaging devices
- Enable collaborative reporting by any number of
persons or devices
8SR Highlights
- Enable links to key images of any case
- Enable links to regions of interest within images
and waveforms
- Template-driven content and structure
9Customization Permitted For
SR PROMOTES INNOVATION AND DEFERS TO INDUSTRY
STANDARDS IN THESE AREAS
10Structured Documentation
- Forty years of progress .
, Lindberg, Hall, Pendergrass, Barnett,
Greenes, Wheeler, Simborg, Gitlin, Clayton,
McDonald, Weed, Shortliffe, Hammond, Stead, Cote,
Sowa, Bernauer, McCray, Johnson, Rector, Kuhn,
Cimino, Huff, Campbell, Bell, Kahn, Poon,
Friedman, ..
- 1960s Lab, Radiology (1969), Early SQL
- 1970s Hopkins (76), ACR-NEMA, Early SNOMED
- 1980s OBUS (82), SGML (86), HL7, UMLS,
- 1990s UltraSTAR, DICOM (93), WWW, CMT, DRML
- 2000 NEMA SR Workshop rollout of DICOM SR
11SR Applications
12Ultrasound Measurements
Immediate Need
Generate with image
LOINC codes
Spatial Coordinates
13CAD Device
Emerging application
Generate from image
BIRADS codes
Spatial coordinates
14Device Output
- Predictable content and meaning
- Measurements, codes, text
15Numeric Measurement
- LOINC code -- measurement name
Concept Name ( LOINC )
Units ( SNOMED )
Numeric Value
NUM Content Item
16Inference Tree
17Author Thomas Kennedy
18Content Integration
Author Harry Solomon
19Miscellaneous Documents
- Intradepartmental messages
- Quality control (e.g. densitometry, floods, .)
20Interpretation
21Link Features to Description
New nodule superimposed with right fourth rib
10 PTX
Cavitation
Free air
22Whos talking?
Who said what
Persons and/or devices
DIRECT or QUOTED
OBSERVER CONTEXT
23How good is the evidence?
Source (Study Instance UID)
CURRENT or OTHER
Audit trail
PROCEDURE CONTEXT
24What are they talking about?
Patient? Data? Procedure?
Mother? Twin A? Twin B?
Slide block
, cut
, stain
, re-stain
OBSERVATION SUBJECT
25What is being said?
Document title
Heading for type of content
Concept name (coded label)
OBSERVATION CATEGORY
26Anywhere in the document
WE KNOW
Whos talking
Source of evidence
Subject and scope talked about
Category of information
OBSERVATION CONTEXT
27Accountability
Referring physician and request
Status (COMPLETE, VERIFIED)
Verifying Observer, organization
Evidence checklist CURRENT, OTHER
ADMINISTRATIVE CONTEXT
28Delivery to Point of Care
- DICOM SR Documents in database
- DICOM to PACS workstations
- Web to enterprise
29Analysis
Scientific research
Education and training
Clinical trials
Performance evaluation
30Databaseable Reporting
Chuck Thomas coined this term
Enhance understanding in consultation
Increase effectiveness
Say it once!
Re-use clinical findings for training
Increase efficiency
Improve outcomes