DE10114017A1 - Comprehensive radiological management system for use in hospitals etc. for planning and controlling radiological testing, and for managing and storing the resultant test images - Google Patents

Abstract

System comprises a generic workflow machine (107) for storing radiological process definitions and managing the implementation of the specific steps of the process definition, an information system (101) for storage of radiological test data, a number of arrangements (102) for implementing specific patient radiological tests and a workstation for executing radiological tests and for recording images. In addition an adapter (105) acts as an interface between information system, radiological test arrangements, workstations and work-flow machine. The workflow machine is able to give commands and receive news to simplify test scheduling, time- planning, test execution, and storing, indexing and retrieval of the test images. Independent claims are made for a method and a device for use with the proceeding system.

Description

This invention relates to clinical process management and, more specifically, it relates on an improved technique for defining, implementing and managing a medical device process. In a preferred embodiment, the invention is directed to a Workflow language in a generic workflow machine for managing or managing the process steps that are implemented in a radiology environment.

The process of managing (in the sense of a comprehensive definition, implementation and Managing or monitoring) radiology in a hospital or another clinical center is currently very complex and not always fully reliable. The Core process (often called the workflow or workflow) in a radiological environment Exercise is essentially done by merging different manual and computerized processes. For example, most include radiological um a radiology information system (RIS) to keep records and reports other information that thousands of CT scans (CT = computed tomography), MR Scans (MR = magnetic resonance) and other radiological procedures relate to hal A separate and often completely independent system for storing digital images can also be entertained. Such a storage system commonly becomes an image archer archiving and communication system (PACS = Picture Archiving and Communications System). A variety of systems exist to allow communication between the PACS and RIS systems, as different staff members wish. Nonetheless, the creation, maintenance, and maintenance and updating is all of these systems are largely operated manually or by humans, and exi little advanced technology for overall management of the entire radiologi process. Often, to implement a specific function, there are a variety of Systems, departments or staff members involved.

Existing workflow management systems rely heavily on all of these systems and the staff that determines which specific tasks need to be performed and do the same.  

Another problem affecting process management in the radiological environment is the fact that only very basic technical exchange of information and images between different workplaces and work functions. For example there it is not a system that reliably stores large sets of digital medical images on one Real time base between different users like a person taking radiological images makes, a receptionist, a radiologist and others, and different Mo dalities or types of execution (e.g. CT scanning machines, MRI machines, etc.) swaps.

In view of the above, there is a need in technology for a comprehensive workflow management system for managing the radiological processes from order placement to archiving images and all the steps in between. In addition, the process should a technique for storing and indexing images for later, renewed Call once the imaging is complete included.

This object is achieved by a system according to claim 1, a method according to claim 8, a system according to claim 9, a device according to claim 12 and a device according to claim 21.

Developments of the invention are specified in the subclaims.

The appropriate technology for process management of the radiological environment overcomes the above and other problems of the prior art. According to the technology a generic workflow machine is integrated into a combined PACS / RIS system. The workflow machine contains an adequate representation of the work flow process, which includes all relevant and suitable steps of the radiological process requests, organizes, manages and archives and saves the resulting images. The working The flow machine and the process definition together define the workflow manager. The Workflow manager preferably works on an interface with a DICOM Managers together.

The interfaces with the workflow manager are preferably standard realizes interfaces known in the radiology environment, such as DICOM and  HL7. In other embodiments, a general communication manager who not related to DICOM or HL7. In a preferred embodiment different steps in the radiological process are different Assigned training levels and only predefined sentences (groups) of personnel (Per members) is allowed to participate in the steps that certain (predetermined) Require training levels. In another embodiment, the tasks be assigned to several individuals. Once an individual is performing the task begins, the assignment to the others is deleted.

Further features and advantages result from the description of exemplary embodiments len based on the figures. From the figures show:

FIG. 1 is a block diagram showing the approximate shape the parts of the concept of the exemplary exporting shows the present invention;

Fig. 2 is a state diagram of an exemplary work flow;

Fig. 3 was the moment of exemplary workflow of Figure 2 in a second to.

FIG. 4 shows the same exemplary workflow from FIG. 3 in a further advanced state;

Fig. 5 the report status of the exemplary workflow of FIG. 4;

Fig. 6 shows the exemplary operation flow of Figures 2 to 5, which is fully completed, all the tasks have been executed.

Fig. 7 is an exemplary scenario, which is implemented using the workflow manager according to an embodiment of the present invention;

. Figure 8 shows the implementation of a slightly different scenario;

Fig. 9 is again a further scenario, as implemented according to an embodiment of the present invention;

FIG. 10 is a scenario in which a RIS order from the work list is removed;

FIG. 11 is a scenario in which an object of working to be implemented at the Mo dalität is selected; and

Fig. 12 shows a scenario according to an embodiment in which a scheduled procedure step (SPS = Scheduled Procedure Step) is implemented in a modality of the present invention.

Fig. 1 is a basic functional diagram showing an exemplary embodiment of the present invention. The arrangement in FIG. 1 includes a radiology information system / hospital information system (RIS / HIS) 101 , one or more modalities 102 , one or more workstations 103 , which can contain a multiplicity of computer terminals, a storage and archiving system 104 , and a DICOM system. Adapter 105 . Ultimately, the entire system is controlled and managed by workflow manager 107 .

The radiology information system (RIS) 101 is a computer system that maintains and manages administrative radiology information. The information contained in the RIS may include reports about examined patients, information regarding a patient's identity and medical history, and other information relevant to the radiological process. Optionally, the RIS may include an order placer 110 that includes an interface that allows a doctor or other clinical personnel to enter and order a specific test or exam. Ultimately, the order placer 110 sends messages to the order filler (OF) software 115 , which is responsible for generating the appropriate messages over line 117 to fill a specific order. Filling such an order can mean reserving the appropriate resources, staff, etc. to perform the particular test or investigation.

The workplaces 103 represent computer terminals at which various types of personnel such as doctors, clinical personnel or other medical and administrative personnel can enter and call up data, place orders, etc. Reports can be viewed, updated and generated. Medical images can be sent to other components in the system from memory 104 or to other locations in the system by instructing workflow manager 107 via workplaces 103 to accomplish the same. Thus, if a doctor desires to see an image, the workflow manager 107 can cause the instructions to be implemented that are appropriate to recall the image from the memory 104 at a workstation 103 .

DICOM adapter 105 implements the standard set of DICOM messages known in the art and available from a variety of published sources. This DICOM protocol allows various types or forms of modalities (e.g. CT scanning machines, MRI scanning machines etc.) to be communicated with other types of computers. The DICOM adapter provides a schedule for the appropriate steps as a reaction to orders that it fetches from the RIS system in order to perform a specific examination of tests (e.g. a CT scan). The DICOM adapter 105 also reports to the workflow manager 107 when a particular exam is completed.

The workflow manager 107 has software that is capable of interpreting the process definition, interacting with the workflow participants and, where necessary, invoking the use of information tools and applications.

The workflow manager 107 consists of software components for storing and interpreting process definitions, for creating and managing workflow stages when they are executed, and for controlling their interaction with workflow participants and applications.

Activities that are defined by the workflow definition are communicated to the users via a "Worklist API" made available. Process stages can be started or stopped and data can be exchanged in the process stage via a "process and data API" the.

The DICOM adapter and the HL7 adapter are both stages or implementations of one general concept of a protocol translator. HL7 is a purely event-driven (event driven) and such a synchronous protocol. DICOM is a synchronous protocol that is used in Is oriented in the direction of a polling mode. As a result, the Emp catch a DICOM object with the DICOM object provider on a regular basis Connect sis to get the latest updates.

The DICOM adapter manages scheduled procedure steps (SPS = Scheduled Procedu for Steps) for a DICOM modality, which he receives from the RIS system, generates PLC for Ar jobs that are different from the modalities and synchronizes his behavior with the Process states in the workflow manager.

The HL7 adapter can receive HL7 messages and use them to start process states or to update existing process states in accordance with the internal process model. In general, an event adapter will process all types of messages or events, such as events in medical standards that are relevant to the medical field (HL7, EDIFACT, etc.), or events of applications or databases. HL7 adapter 106 is just one example of an event adapter.

In this embodiment, the event handler is able to schedule scheduled process steps (SPS) in the Modality Worklist (MWL) of the DICOM adapter based on an HL7 Order Request Message (ORM) sent by the RIS system 110 (or more specifically, by its order filler / scheduler module 115 ).

In one embodiment, if a particular exam requires multiple steps, the system may be implemented so that the DICOM adapter 105 is responsible for initiating, monitoring, and completing all of the steps, and then notifies the workflow manager 107 of the completion of the exam . In other embodiments, workflow manager 107 may be updated as a result of tasks that have been initiated and completed outside of control of the workflow manager itself. In any case, the system is designed such that the workflow manager 107 maintains an adequate representation of the workflow process so that the workflow manager knows the status of the entire radiological system, the pending orders, the reports, etc.

The HL7 adapter can receive messages (e.g. HL7 protocols) and start them of process states or for updating existing process states Use according to the internal process model. For example, the event handler received a request to do a specific exam, the DICOM adapter direct to the same, and then report the results to the RIS.

Ultimately, memory 104 , also known as an archive system, contains electronic memory for CT images, MRI scans, and all other relevant image information. The memory is preferably implemented in a separate, specialized server (or a corresponding device) which is optimized for the huge amount of memory which is required with regard to the image information.

Having described each of the functions separately, the description now turns to an exemplary process shown in FIGS. 2-6 . Referring to FIG. 2, the generic template (order entry), schedule entry (SCHEDULING), the appropriate examinations (a CT examination (CT examination) and MRI (MR examination) are shown as examples) and a report request (REPORTING). Screens 205 to 208 represent the interface of a computer terminal for a variation of personnel.

Figure 2 represents a specific workflow stage in which the radiology test is a part. The arrangement of FIG. 2 contains blocks that are directed to standard steps 211 through 215 for entering the job, scheduling the exams, completing the various exams, and entering the report at 215 . Screens 205 through 208 represent tasks associated with various members of the staff as they appear, for example, on computer screens. These numerous computer screens are shown as workplaces 103 in FIG. 1. When the workflow manager 107 executes the workflow from FIG. 2, an order entry is generated. Depending on the availability, the level of training and other parameters set by the system, the receiver B (RECEPTIONIST B) assigns the job on the screen 205 , as shown in FIG. 2.

Once the job is accepted and processed, the scheduling software is called up by the workflow manager 107 , as shown in FIG. 3. The scheduling is associated with a medical technician at work place 207 for scheduling. The medical technician can be responsible for clarifying schedules with the patient and with other personnel within the radiological organization. When the scheduling has taken place, the state of the workflow manager, as shown in FIG. 4, is obtained by giving the assignment for carrying out the CT examination and the MR examination to the staff members who are at 206 and 207 accordingly has been.

It should be noted that the workflow manager would have authorization to assign the execution of the particular task to more than one person. This is made possible by the fact that once the task has been performed, it is immediately removed from the list for all other staff members to whom the task was assigned. Thus, when the MR scan has been performed by the person at work 207 , as shown in FIG. 4, the work flow manager immediately removes it from the work list of the person sitting at work 206 . In the example shown by FIG. 4, it turns out that the CT scan was carried out by the person from the work station 206 and the MR scan was carried out by a different person at the work station 207 .

Once all of the tasks are completed, the state shown in Fig. 5 results, in which the radiologist report is associated with a particular radiologist reading the images and the data making up his / her report into the computer system of Enter workplace 208 from.

It should be noted that workflow manager 107 can maintain an adequate representation of a workflow process so that at all times it fully knows the specific workflow level (the specific workflow state) and the states of each task within that level. By providing such a centralized point of monitoring and control, delays are eliminated and efficiency is increased. In addition, the training and authorization levels can be maintained by the workflow manager for each person, i.e. monitored, updated, assigned, etc. This allows the workflow manager 107 to assign the tasks to only one or more people who meet specific criteria.

The system is not dependent on the fact that different members of the staff determine which tasks have to be carried out in which order in order for an order to be filled or executed. Instead, the specific tasks are automatically assigned to the appropriate personnel by the workflow manager 107 .

It is important that the workflow manager be able to communicate with a variety of different computer systems such as a RIS 101 , modalities 102 , work stations 103 and memory 104 using standard protocols and established languages such as HL7 and DI COM. By centralizing control and implementation of process management in a single generic workflow manager, many prior art problems, such as errors and incorrect timing and delays, can be avoided.

FIGS. 7 to 12 illustrate a plurality of typical scenario is that te by the beispielhaf embodiment shown in Fig. 1, can be performed. A brief summary of each of the scenarios is given below:

Start workflow (WF) with MWL order ( Fig. 7)

The DICOM adapter asks for the work list of the radiology information system (RIS) planned procedural steps (PLC). For each new PLC identified in the work list is decorated, it starts a process state in the workflow, arranges all PLC-related Data to this process state and makes the PLC via the modalities worklist Modalities available.

Start WF-HL7 job ( Fig. 8)

The event handler receives HL7 events such as HL7 ORM events from the hospi tal information system (HIS) or the radiology information system (RIS). For every ORM Message that indicates the creation of a new order, he starts a process step in the Workflow manager according to the type of event and the content of the message. The workflow manager makes the new information available to the DICOM adapter created a new PLC for new work content. At this point the modality can be changed to the access newly created PLC.

Order update ( Fig. 9)

The DICOM adapter queries the work list of the radiology information system (RIS) and determines planned procedure steps (PLC) that have been updated. Update for everyone The PLC in the work list updates the changed information in the process machine and in the DICOM PLCs, which are presented to the modalities.

Order removal ( Fig. 10)

The DICOM adapter queries the work list of the radiology information system (RIS) and determines planned procedural steps (PLC) that have been removed since the last query. For each remote PLC in the work list, he then determines the process level in the area Flow manager connected to the PLC that has been removed. This process step fe is ending (or interrupted).  

Query work list ( Fig. 11)

A workplace (e.g. a modality or a report application) asks the DICOM Adapters according to all PLCs that are suitable or intended to be used in the workplace to be available. The PLC is displayed in the worklist GUI at the workplace.

Execute PLC ( Fig. 12)

An SFS is started and completed. The progress is in the workflow manager based on incoming, executed procedural steps (PPS) determined by the DICOM can be received. This scenario is used to track progress on the ar workplaces used.

While the above describes the preferred embodiments of the invention, ver various other modifications or additions will be apparent to those skilled in the art. Such Modifications and additions are intended to be covered by the following claims.

Claims (21)

1. System for managing a radiological process, with
a generic workflow machine ( 107 ) for storing a definition of the radio logical process and for managing the implementation of the specific stages of the process definition,
an information system ( 101 ) for storing data relating to radiological tests,
a plurality of modalities ( 102 ) for implementing specific radiological tests in patients,
at least one work station ( 103 ) for commissioning radiological tests and for reporting images,
an adapter ( 105 ) which is connected to the information system, the modalities and the at least one work station and serves as an interface with the workflow machine, and
means within the workflow engine for issuing commands and receiving messages and facilitating the commissioning, scheduling and effecting of various radiological tests and the storage, indexing and retrieval of the resulting images, thereby implementing a specific level of process definition becomes. 2. System according to claim 1, wherein the adapter is implemented using the DICOM standard. 3. System according to claim 1 or 2, wherein the workflow machine is programmed to assign at least one task to the to implement the specific level is needed to multiple people. 4. The system of claim 3, the further a means for automatically eliminating the assignment of a task to or Multiple people if one of the multiple people to whom the task has been assigned de that has completed the task.   5. System according to one of claims 1 to 4, wherein the adapter ( 105 ) communicates with a storage server ( 104 ) that stores images, and with the workstations ( 103 ), the modalities ( 102 ) and the information system ( 101 ). 6. System according to any one of claims 2 to 5, in which several steps required by a modality through the adapter below The DICOM standard can be monitored and controlled, and the adapter to the workflow machine only the beginning and completion of one radiological tests implemented by the modality are reported. 7. System according to any one of claims 1 to 6, in which
several steps required by a modality that are monitored and controlled by the workflow machine, and
the adapter reports to the workflow machine the status of each step as performed by the modality. 8. A method of performing a radiological examination comprising the steps of:
Creating a workflow level in a workflow machine, the workflow level defining various tasks, each of which is required to complete the workflow level,
Assign the generated tasks to different staff members and different equipment,
Maintain a representation of a workflow process in the workflow machine that is adequate to keep track of the state of all of the tasks, and
Use a DICOM adapter to interface the workflow machine with one or more modalities, workstations, and storage media to thereby implement a radiological environment. 9. System for managing a radiological process, with
a DICOM adapter ( 105 ) which is placed between a generic workflow machine ( 107 ) and a plurality of workplaces ( 103 ) and modalities ( 102 ),
wherein the generic workflow machine communicates with the DICOM manager to schedule and implement radiological processes, and communicates with the modalities and workstations to capture, store and retrieve images and associated report data, and the workflow machine is a representation of the workflow process, which is adequate to reflect the state of the radiological processes. 10. The system of claim 9, wherein
an adequate representation of a workflow process includes an indicator of whether a specific modality has completed an associated investigation, and
an adequate representation of a workflow process does not contain information that is indicative of each step in the completion of the investigation by the modality or other workplaces. 11. The system of claim 9, wherein
an adequate representation of a workflow process includes an indicator of whether a specific modality has completed an associated investigation, and
an adequate representation of a workflow process also contains information that is indicative of each step in the completion of the investigation by the modality or other workplaces. 12. Device for controlling and managing a radiology information system (RIS 101 ), with
a workflow manager ( 107 ),
an HL7 adapter ( 106 ), the HL7 adapter providing communication between the workflow manager and the RIS ( 101 ), and
a DICOM adapter ( 105 ), which also effects communication between the RIS ( 101 ) and the workflow manager ( 107 ). 13. The apparatus of claim 12, further comprising a plurality of modalities ( 102 ) communicating with the workflow manager ( 107 ) via the DICOM adapter ( 105 ). 14. The apparatus of claim 12 or 13, further comprising means for assigning a task from the workflow manager ( 107 ) to a plurality of units. 15. The apparatus of claim 14, further a means for deleting the association after one of the units has completed the association has given. 16. The device according to one of claims 12 to 15, further comprising a storage medium ( 104 ) for storing a plurality of medical images. 17. The device according to one of claims 12 to 16, further comprising at least one workstation terminal ( 103 ) which communicates with the DICOM adapter ( 105 ). 18. The apparatus of claim 17, wherein the workstation terminal ( 103 ) and the storage medium ( 104 ) communicate via the DICOM adapter ( 105 ). 19. Device according to one of claims 12 to 18, the further a means of storing medical images and retrieving stored stored images in response to requests to do so from a workstation. 20. Device according to one of claims 12 to 19, the further a means of assigning tasks to work lists with multiple units connected, and to monitor the completion of these tasks. 21. Device for managing a radiology information system (RIS), which has a workflow manager ( 107 ) and at least two different protocol translators ( 105 , 106 ), the translators each communicating with the RIS.