WO2007050962A2 - Procede et systeme de capture d'actions utilisateur dans des gabarits de flux de travaux electroniques - Google Patents

Procede et systeme de capture d'actions utilisateur dans des gabarits de flux de travaux electroniques Download PDF

Info

Publication number
WO2007050962A2
WO2007050962A2 PCT/US2006/042131 US2006042131W WO2007050962A2 WO 2007050962 A2 WO2007050962 A2 WO 2007050962A2 US 2006042131 W US2006042131 W US 2006042131W WO 2007050962 A2 WO2007050962 A2 WO 2007050962A2
Authority
WO
WIPO (PCT)
Prior art keywords
workflow
program
user
data
electronic
Prior art date
Application number
PCT/US2006/042131
Other languages
English (en)
Other versions
WO2007050962A3 (fr
Inventor
Bruce Reiner
Original Assignee
Bruce Reiner
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Bruce Reiner filed Critical Bruce Reiner
Publication of WO2007050962A2 publication Critical patent/WO2007050962A2/fr
Publication of WO2007050962A3 publication Critical patent/WO2007050962A3/fr

Links

Classifications

    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00—Administration; Management
    • G06Q10/06—Resources, workflows, human or project management; Enterprise or organisation planning; Enterprise or organisation modelling
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H30/00—ICT specially adapted for the handling or processing of medical images
    • G16H30/40—ICT specially adapted for the handling or processing of medical images for processing medical images, e.g. editing
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/20—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/67—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation

Definitions

  • the present invention relates to an electronic image workflow method and system, which includes an electronic auditing function that captures actions that are performed during medical imaging interpretation.
  • a clinician who wants to review a 1 ,000+ MDCT exam, typically selects either reviewing an entire exam or relies on the radiologist's report. While direct review of the imaging study is preferred in order to directly visualize the abnormalities described and place in the correct clinical context, this is not practical due to time and technology constraints.
  • One solution includes generating a video file while the radiologist performs the entire process of image display, interpretation, and reporting. While this would provide the clinician with the viewing protocol and findings, it is not practical due to limitations in memory and storage. In particular, resulting video files would be too large for practical storage, transmission, and review.
  • the invention relates to a method and system that captures the "fundamental steps" of an interpretation process.
  • the invention provides a method and system for performing an electronic workflow sequence that enables users to selectively review clinically pertinent images, such as a small subset of the entire imaging dataset, in a manner that follows a workflow performed by the interpreting user.
  • the invention enables all users to employ the same image display formats, image processing techniques, and workstation tools for image manipulation.
  • the electronic workflow sequences may be performed on readily available, portable, wireless technologies to overcome any geographic separation between the radiologist and clinician and to enable the invention to be used at various locations.
  • the invention provides an electronic image workflow method and system, which includes a client computer or workstation with high-resolution image displaying devices, and an input device which is a programmable stylus or other input device, that captures actions that are performed on the image displaying device. According to one embodiment, the actions may be performed using the programmable stylus and/or other input device.
  • the performed actions which may include creating symbols, such as checkmarks, dots, or annotations etc., are pre-selected to signify certain information.
  • the performed actions may utilize an economy of actions that are diverse in nature and have broad based appeal to the population of end users.
  • the performed actions may be made applicable to a variety of different specific situations, modalities, pathologies, etc., in order to interpret the electronic imaging workflow system.
  • an electronic auditing tool may be provided that enables capturing of "fundamental" data that is contained within the electronic workflow sequence.
  • the electronic auditing tool may be configured to capture the individual steps that a user performs during a complex process of image interpretation.
  • the navigation process that is performed by the user employing various workstation tools may be captured and used to create a "movie.”
  • a "movie” represents actions that are performed by the user during the course of image review, analysis, and interpretation of a dataset.
  • an extensible markup language (XML) schema may be employed to capture and represent tasks and subtasks that are performed by the user.
  • the XML schema records the condensed audit trail of the user actions that are performed during the image review and interpretation process.
  • instructions of the electronic workflow sequence may be stored rather than the entire continuous "movie" of the electronic workflow sequence.
  • users may review the electronic workflow sequence and may skip, fast forward, rewind, and/or perform other actions on any portions of the electronic workflow sequence.
  • computerized intelligence agents may supplement individual user data input to the electronic medical record (EMR).
  • EMR electronic medical record
  • the computerized intelligence agents may query, retrieve, and add additional data to the snapshot of the user workflow system.
  • specialized workflow templates may be designed for individual components of image display, navigation, processing, interpretation, reporting/communication, and data extraction.
  • embedded links may be incorporated into the electronic workflow system to provide access to decision support tools, web sites (via specific
  • embedded links may supplement the informational content being shared.
  • the invention may embed decision support tools into the electronic workflow system.
  • electronic auditing of clinicians may be performed to identify the specific data that is most commonly accessed and used by clinicians.
  • frequently accessed decision support tools may be automatically inserted into the electronic workflow system.
  • infrequently accessed decision support tools may be automatically deleted from the electronic workflow system.
  • an intelligent electronic workflow system may be created that is customized to particular user viewing habits.
  • the invention provides a bidirectional electronic workflow system.
  • the invention provides improved communication between parties, with the potential to be used as an educational tool as well as a clinical tool to improve diagnostic accuracy and productivity.
  • the auditing tool and XML schema may be employed in medico-legal protection by demonstrating what imaging information was reviewed.
  • the auditing tool and XML schema may be employed in medico-legal protection to reconstruct the manner in which imaging information was reviewed.
  • the data recorded by the auditing tool may verify what portions of the comprehensive dataset were reviewed, what types of image processing was used, what decision support tools were used in the image review/interpretation process, among other auditing information.
  • the XML schema may serve as an adjunct to the formal report and may provide the electronic workflow sequence by recording the image review process.
  • the invention provides an effective electronic communication tool.
  • FIG. 1 is a schematic showing the electronic image workflow system according to one embodiment of the invention.
  • FIGS. 2A and 2B illustrate flowcharts showing the electronic image workflow sequence method according to one embodiment of the invention.
  • FIGS. 3A and 3B illustrates a flowchart showing the auditing method according to one embodiment of the invention.
  • the present invention relates to methods and systems for generating electronic workflow templates that represent user workflow sequences.
  • Applications of this electronic workflow system may be utilized for any type of electronic workflow system that would benefit from presenting captured "fundamental" data that is organized in a workflow sequence to recreate and review the sequence of actions as a multi-media display, that are performed by a user in the fields of medicine (i.e., radiology, endoscopy, surgery, etc.)
  • the medical (i.e., radiology) application will be the exemplary embodiment as discussed below.
  • the present invention includes a computer-implemented method and computer system that function to create a database that includes workflow templates that define electronic workflow systems.
  • the workflow templates may be created using various parameters that define the multi-media display and sequence of actions that are presented to users.
  • workflow templates provide end-users with the ability to follow a pre-designed workflow sequence.
  • workflow templates may include XML schema having specific directions for performing clinical and imaging data extraction, such as image display, navigation, image processing, application of supporting decision support tools, report creation and communication protocols, among other functions.
  • end-users may use the workflow templates to effectively review the imaging data in a "hands off manner.
  • end-users may use the workflow XML schema to automatically drive workflow.
  • end-users may switch between navigating through workflow systems in an "automatic” and “manual” manner, wherein performing manual navigation includes performing end-user driven tasks.
  • the end-users may return to "automatic" workflow navigation mode to re-engage the automatic workflow template navigation and to continue from a selected point within the workflow template navigation sequence, such as the launching point of switching between "automatic” and "manual” navigation.
  • end-users may define workflow sequences and store them as workflow templates.
  • the workflow templates may be defined according to various parameters, data sets, target user group, and/or other features.
  • the creation of workflow templates includes defining navigation through a workflow sequence as being "automatic" and/or “manual.”
  • the workflow sequences may be electronically recorded and stored as workflow templates.
  • an electronic workflow system is defined by a cumulative sequence of frames that create the workflow templates.
  • the electronic workflow systems may enable recreation of the exact protocols and data that are captured by the end-users that created the electronic workflow sequence.
  • the target end-users may review the electronic workflow system and may modify the electronic workflow system by incorporating additional information, such as unique queries or findings into the exam-specific workflow templates.
  • the electronic workflow systems may be modified using XML schema that records the newly introduced user-specific data.
  • the target end-user may electronically share the modified workflow templates with the original end-user or end-user that created the electronic workflow sequence.
  • the invention enables the target end user to share any new observations, questions, or additional clinical data that may not have been available to the original end-user at the time that the original exam review/interpretation was created.
  • the above-described bidirectional functionality of the workflow template provides for continuous clinical dialogue and updating.
  • the bidirectional functionality may transform the imaging exam and the corresponding report into a dynamic, as opposed to static, data source.
  • computerized intelligence agents may also query, retrieve, and/or add additional data to the workflow templates in order to supplement data that is entered to the electronic medical record (EMR) by end-users.
  • EMR electronic medical record
  • specialized workflow templates may be provided having individual components, such as image display, navigation, processing, interpretation, reporting/communication, data extraction and/or other components.
  • data extraction may be performed both before and after exam interpretation.
  • the specialized workflow templates may be accessed by end- users, such as radiologists, radiation oncologists, surgical specialists, medical sub-specialists, and/or other end users.
  • specialists may include oncologists, pulmonologists, neurosurgeons, orthopedic surgeons, among other specialists.
  • the individual specialists may create individual specialized workflow templates, which may be context-specific information, such as based on clinical indication, anatomic region, disease state, imaging modality, among other context-specific information.
  • the dynamic nature of the workflow template provides unique educational and research applications. For example, from an education perspective, the entire workflow process may be reviewed and refined retrospectively to identify "best practice" standards and to teach different user groups. According to one embodiment, these user groups may include technologists, residents in training, clinicians, attending radiologists, among other user groups. According to one embodiment, the user groups may provide customized versions of the workflow templates for educational purposes. [00037] According to one embodiment, the workflow sequences may be stored in extensible markup language (XML) schema to allow for easy accessibility and transportability of complex and data-intensive information. As a result, the workflow templates may be easily modified according to end-user preferences and may be electronically downloaded. [00038] Although the method and system of the present invention are described as being directed to the analysis of digital images, the invention can also be adapted for use with analog images, such as conventional x-ray films, photographs, paper-based images, among other analog images.
  • analog images such as conventional x-ray films, photographs, paper-based images, among other analog images.
  • an electronic workflow system 100 of the invention is designed to interface with existing information systems such as a Hospital Information System (HIS) 10, a Radiology Information System (RIS) 20, and a Picture Archiving and Communication System (PACS) 30, among other systems.
  • the system 100 may be configured to conform with the relevant standards, such as the Digital Imaging and Communications in Medicine (DICOM) standard, DICOM Structured Reporting (SR) standard, the Radiological Society of North America's Integrating the Healthcare Enterprise (IHE) initiative, and/or other standards.
  • DICOM Digital Imaging and Communications in Medicine
  • SR DICOM Structured Reporting
  • IHE Integrating the Healthcare Enterprise
  • bi-directional communications between the electronic workflow system 100 and the information systems allows the electronic workflow system 100 to retrieve information from these systems, update information therein and provide the desired workflow templates that are generated by the electronic workflow system 100.
  • the electronic workflow system [00041] According to one embodiment of the invention, the electronic workflow system
  • the 100 may include a client computer 101, such as a PC, which may or may not be interfaced or integrated with the PACS 30.
  • the invention includes an imaging display device 102 that is capable of providing high resolution of digital images in 2-D or 3-D, for example.
  • the client computer 101 may include a mobile terminal, such as a mobile computing device, or a mobile data organizer (PDA), that is operated by the user accessing the program remotely from the client computer 101.
  • PDA mobile data organizer
  • commands may be input through a programmable stylus, keyboard, mouse, speech processing system, laser pointer, touch screen, or other input mechanism 104.
  • the input or selection mechanism may be input through a programmable stylus, keyboard, mouse, speech processing system, laser pointer, touch screen, or other input mechanism 104.
  • the input or selection mechanism 104 may be constituted by a dedicated piece of hardware. Alternatively, the functions of the input or selection mechanism 104 may be executed by code instructions that may be executed on the client processor 106. According to one embodiment, the display unit 102 may display the selection window and a stylus or keyboard for entering a selection, for example. [00044] As described in co-pending U. S . Patent Application No . 11 /512, 199, filed August
  • a multi-functional programmable navigational stylus 104 may be provided to enable input of gestures, symbols, and/or icons through the imaging display device 102.
  • other actions may be performed by the multi-functional programmable navigational stylus 104 that are intrinsic to the image display device 102, such as navigation, interpretation, and electronic workflow processes.
  • the actions performed by the multi-functional programmable navigational stylus 104 on the image display device 102 may be superior to actions that are performed using traditional computer keyboard or mouse methods, both within the PACS and Electronic Medical Report (EMR).
  • the client computer 101 typically includes a processor 106 that operates as a client data processing device.
  • the processor 106 may include a central processing unit (CPU) 107 or parallel processor and an input/output (I/O) interface 108, a memory 109 with a program 110 having a data structure 111, wherein all of the components are connected by a bus 112.
  • the client computer 101 may include an input device or means 104, a display 102, and may also include one or more secondary storage devices 113.
  • the bus 112 may be internal to the client computer 101 and may include an adapter for receiving a keyboard or input device 104 or may include external connections.
  • the imaging display device 102 may comprise a high resolution touch screen computer monitor.
  • the imaging display device 102 may be configured to allow images, such as x- rays, to be readable and for the gestures or symbols to be applied easily and accurately.
  • the imaging display device 102 can be other touch sensitive devices including tablet, pocket PC, and plasma screens.
  • the touch screen would be pressure sensitive and responsive to the input of the stylus 104, which may be used to draw the gestures or symbols of the present invention, directly onto the image displaying device 102.
  • high resolution goggles may be used to provide end users with the ability to review images without the physical constraints of an external computer.
  • a surgeon may wear specialized high resolution goggles to display the cross-sectional radiological image of a brain tumor in 3-D format and may note markings on the image, to highlight the pathology in question and to report pertinent characteristics (i.e., anatomic localization, size, etc.), to serve as a guide during surgery.
  • These goggles may be used for image-guided surgery and gesture-based reporting, for example, such as disclosed in co-pending U.S. Patent Application No.
  • the graphical user interface associated with the client computer 101 may be a client application that is written to run on existing computer operating systems.
  • the client application may be ported to other personal computer (PC) software, personal digital assistants (PDAs), and cell phones, and any other digital device that has a screen or visual component and appropriate storage capability.
  • PC personal computer
  • PDAs personal digital assistants
  • the processor 106 at the client computer 101 may be located internal or external thereto, and may execute a program 110 that is configured to include predetermined operations.
  • the processor 106 may access the memory 109 in which may be stored at least one sequence of code instructions comprising the program 110 and the data structure 111 for performing predetermined operations.
  • the memory 109 and program 110 may be located within the client computer 101 or may be located external thereto.
  • the program 110 may be performing the function rather than the entity of the system itself.
  • the program 110 that runs the electronic workflow method and system may include a separate program code for performing a desired operation or may be a plurality of modules that perform sub-operations of an operation, or may be part of a single module of a larger program 110 providing the operation.
  • the modular construction facilitates adding, deleting, updating and/or amending modules therein and/or features within the modules.
  • the processor 106 may be adapted to access and/or execute a plurality of programs 110 that correspond to a plurality of operations.
  • An operation rendered by the program 110 may include, for example, supporting the user interface, performing data mining functions, performing e-mail applications, etc.
  • the data structure 111 may include a plurality of entries, each entry including at least a first storage area that stores the databases or libraries of gesture symbols, or image files, for example.
  • the storage device 113 may store at least one data file, such as image files, text files, data files, audio, video files, etc., in providing a particular operation.
  • the data storage device may include, for example, a database, such as a distributed database that is connected via a network, for example.
  • the database may be a computer searchable database.
  • the database may be a relational database.
  • the storage device 113 may be connected to the server 120 and/or the client computer 101, either directly or through a communication network, such as a LAN or WAN.
  • an internal storage device 113, or an external storage device 114 is optional, and data may also be received via a network and directly processed.
  • the client computer 101 may be connected to other client computers 101 and/or servers 120, including administration, billing or other systems.
  • the connections may be provided via a communication link 116 as a client communication means, using a communication end port specified by an address or a port.
  • the communication link 116 may include a mobile communication link, a switched circuit communication link, or may involve a network of data processing devices such as a LAN, WAN, the Internet, or combinations thereof.
  • the communication link may be to e- mail systems, fax, telephone, wireless communications systems such as pagers and cell phones, wireless PDA's and other communication systems.
  • the communication link 116 may be an adapter unit capable of executing various communication protocols in order to establish and maintain communication with the server 120, for example.
  • the communication link 116 may be constituted by a specialized piece of hardware or may be realized by a general CPU that executes corresponding program instructions.
  • the communication link 116 may be at least partially included in the processor 106 to execute corresponding program instructions.
  • the server 120 may include a processor 121 having a CPU 122 or parallel processor, which is a server data processing means, and an I/O interface 123.
  • the server 120 may be constituted by a distributed CPU 122, including a plurality of individual processors 121 that are located on one or a plurality of machines.
  • the processor 121 of the server 120 may be a general data processing unit.
  • the processor 121 may include a data processing unit having large resources (i.e., high processing capabilities and a large memory for storing large amounts of data).
  • the server 120 may include a memory 124 with program 125 having a data structure 126, wherein all of the components may be connected by a bus 127.
  • the bus 127 or similar connection line may include external connections, if the server 120 is constituted by a distributed system.
  • the server processor 121 may have access to a storage device 128 for storing preferably large numbers of programs for providing various operations to the users.
  • the data structure 126 may include a plurality of entries, each entry including at least a first storage area which stores image files, for example.
  • the data structure 126 may include other stored information as one of ordinary skill in the art would appreciate.
  • the server 120 may be a single unit. According to an alternative embodiment, the server 120 may be a distributed system of a plurality of servers 120 or data processing units, and may be shared by multiple users in direct or indirect connection to each other. According to one embodiment, the server 120 may execute at least one server program for a desired operation, which may be needed in serving a request from the client computer 101. According to one embodiment, the communication link 129 from the server 120 may be adapted to communicate with a plurality of clients.
  • the invention may be implemented in software that may be provided in a client and server environments. According to one embodiment, the invention may be implemented in software that can be provided in a distributed system over a computerized network across a number of client systems. Thus, in the present invention, a particular operation may be performed either at the client or the server, at the edge of a network or at the center, or both. Therefore, at either the client or the server, or both, corresponding programs for a desired operation/service are available.
  • At least one client computer 101 and at least one server 120 are each connected to a network 220 such as a Local Area Network (LAN), Wide Area Network (WAN), and/or the Internet, over communication links 116, 129.
  • a network 220 such as a Local Area Network (LAN), Wide Area Network (WAN), and/or the Internet
  • LAN Local Area Network
  • WAN Wide Area Network
  • PACS 30 if separate
  • interaction with users may be through secure and non-secure internet connectivity.
  • the steps in the methods consistent with the present invention are carried out at the client computer 101 or at the server 120, or at both.
  • the server 120 may be accessible by the client computer 101 over for example, the Internet using a browser application or the like.
  • the client computer 101 may communicate via a wireless service connection.
  • the server system 120 may communicate with network/security features, via a wireless server, which connects to, for example, voice recognition.
  • voice recognition a system for example, voice recognition.
  • the client computer In another embodiment consistent with the present invention, the client computer
  • the server 120 may include all of the components necessary to support the software platform of the invention. Further, the present client-server system may be arranged such that the client computer 101 may operate independently of the server system 120, but that the server system can be optionally connected. In the former situation, additional modules may be connected to the client computer 101. In another embodiment consistent with the present invention, the client computer 101 and server system 120 may be disposed in one system, rather being separated into two systems.
  • the underlying technology allows for replication to various other sites. Each new site may maintain "state" with its neighbors so that in the event of a catastrophic failure, other server systems can continue to keep the application running, and allow the system to load- balance the application geographically as required.
  • the electronic workflow system 100 and method as used in an exemplary radiology method and system includes a client computer 101 with image displaying device.102, and an input device 104, such as a programmable stylus 104 as an input mechanism.
  • the programmable stylus 104 may be used to perform other tasks that are intrinsic to the image display, navigation, interpretation, and reporting processes of the invention.
  • the present invention would be applicable for other medical disciplines, such as navigating through complex datasets, including, for example, endoscopy, cardiology, neurology, and surgery.
  • the radiologist may turn on the client computer 101, which may be a stand-alone PC, or connected to a client workstation known in the radiological field as the PACS workstation 30.
  • the client computer 101 may be the PACS 30, and some or all of the present invention, with respect to the imaging display device 102, computer memory 109 and program 110 etc., may be contained within the PACS 30 instead of being provided separately.
  • the user may log onto the PACS system 30 once the client computer 101 is operational.
  • the 125 may include an electronic auditing function that enables capturing of "fundamental" data that is part of and contained within the radiologist electronic workflow system 100.
  • the electronic auditing function may be configured to capture the individual steps that a radiologist performs during a complex process of medical image interpretation.
  • the program 110 will display a log-on menu that prompts the user to enter unique identifier information, such as a password, biometrics, and/or other unique identifier information.
  • the program 110 may prompt the user to enter additional information, such as patient information, clinical indication, and/or other additional information.
  • additional information such as patient information, clinical indication, and/or other additional information.
  • the program 110 may receive the unique identifier information and/or the additional information and may access the storage device 113 having data associated with the unique identifier information and/or the additional information.
  • step or operation 202 a plurality of icons or menus may be presented to the user based on information retrieved from the storage device 113.
  • the user may be prompted to "access existing workflow templates" or "request assistance from the program 110 to select a workflow template.” If the user selects to "access existing workflow templates,” then the program 110 will enable the user to select an appropriate workflow template in operation 206.
  • the program 110 will direct the program 110 to utilize a best guess to select a workflow template in operation 208.
  • the program 110 may query the EMR based on the unique identifier information and/or the additional information to select the appropriate workflow template.
  • the workflow templates may be customized for each user.
  • the program 110 may offer automated default workflow templates without prompting the user.
  • the program 110 may select workflow templates based on user profiles.
  • the program 110 may adapt workflow template selection to incorporate various parameters. [00079] After a workflow template is selected in operation 208 or accessed in operation
  • the end-user may be prompted by the program 110 to perform a series of actions.
  • the program 110 will initiate the steps involved in the data collection process.
  • auditing software and XML code may be used to record the individual actions that a user performs to generate an electronic workflow template.
  • the program 110 will receive the input by the user with respect to selection of a patient and an exam that has been conducted.
  • the program 110 will open pertinent imaging folders for user review of the medical images.
  • the program 110 will access pertinent patient demographics and clinical data from, for example, the hospital/radiology information system (HIS/RJS) and/or electronic medical record (EMR), upon selection of the patient.
  • HIS/RJS hospital/radiology information system
  • EMR electronic medical record
  • data may be accessed from the PACS 30, and additional information, including but not limited to laboratory data, pathology reports from the Electronic Medical Record (EMR), patient demographics, and billing, may be accessed from data storage 113 by the program 110.
  • the PACS 30 may store information in these databases according to existing standards such as DICOM.
  • the data from the PACS 30 may be stored in an examination image storage device 114, 128 for example, where it can be accessed via the client computer 101 for display on the image displaying device 102.
  • the electronic workflow system 100 may directly access the PACS images in storage 113 without the need for an intermediate storage device 114 or 128, for example.
  • a specific hanging protocol may be selected for displaying individual sequences within the multi-sequence exam.
  • a hanging protocol may be a manner in which a user prefers to arrange a plurality of images for comparison purposes.
  • a hanging protocol may define a display format for performing a historical comparison study of x-ray information, wherein the comparison is performed for images that are taken over a period of several months.
  • the relevant imaging plane(s) may be selected for navigation through the data set, by the user, and displayed and/or recorded by the program 110. According to one embodiment, more than one imaging plane may be selected, based on, for example, the modality, anatomy, and pathology being investigated.
  • the program 110 will display the image in a format selected by the user for use during image review.
  • the program 110 will display the images at a navigational speed selected by the user for sequentially reviewing the images.
  • the program 110 will apply the specific imaging processing parameters selected by the user to highlight certain types of anatomy and/or pathology, on the display.
  • displaying specific imaging processing parameters may include the user selecting, and the program 110 displaying, additional applications for the user to access.
  • the program 110 will receive notations from the user (i.e., using the stylus 104, for example), and provide highlighting of individual images, and will receive instructions from the user's application of specific workstation tools to enhance (i.e., brightness, size), measure, and diagnose the pathologic findings in question.
  • the tools provide applications such as textual analysis, morphology, density, etc., and are based on user preferences. These preferences can be automated.
  • the program 110 will synchronize specific sequences from current and/or historical exams to identify how identified pathology changes with different techniques or how identified pathology changes over time. Synchronization is performed by the program 110 linking the same anatomic views, using the same techniques, for example, such that the views are displayed by showing current and previous image studies.
  • Computerized decision support tools include functions such as textual analysis, neural networks for differential diagnosis, etc., which can be manually provided, or can be automated.
  • the program 110 may generate an electronic report upon request by the user, based on the cumulative findings that are made during the comprehensive image review/interpretation process by the program 110 and the user.
  • the program 110 may prompt the user regarding whether or not any data within the electronic workflow system should be edited. If any data needs to be edited, then the program 110 may present a menu in operation 246 to enable the user to access any of the data entry user interfaces. If editing is not needed, then the program 110 the user may be prompted by the program 110 requesting whether or not the data collection is finalized in operation 242. In operation 242, the program 110 may perform an audit of the operations conducted above, to determine whether or not any gaps are present, and whether or not data collection is finalized. For example, if the CAD tool used by the user found morphology that was overlooked by the radiologist, the program 110 may notify the user by a warning message box, etc., and may automatically return the display to the image in question.
  • the program 110 will return to operation 212. If the data collection is finalized, then the workflow template is completed and saved by the program 110 in operation 244.
  • a radiologist may generate in excess of 1000 individual tasks or subtasks with an input device, such as key strokes, mouse clicks, manipulation, programmable stylus, or other input.
  • this condensed data may be captured using an electronic auditing function of program 110, which automatically recognizes and records all pertinent tasks or subtasks that are performed by the radiologist or user.
  • the vast data that is produced by the electronic auditing function of program 110 is parsed, organized, and analyzed in a logical and reproducible fashion to provide direct clinical utility by program 110.
  • Direct clinical utility is defined as efficiently capturing a portion of the review process for electronic reporting and consultation for every day clinical use.
  • the navigation process that is performed by the radiologist or user using various workstation tools may be captured and used by the program 110 to create a workflow "movie.”
  • a workflow "movie" represents actions that are performed by the radiologist or user during the course of image review, analysis, and interpretation of a dataset.
  • the program 110 of the present invention captures each of the separate actions that are performed on the images by the radiologist or user.
  • the actions by the user in data collection for example, may be employed to create each "frame" of the movie.
  • the separate actions that are performed by a user and recorded by the program 110 on a given dataset may be represented in a very tiny fraction (less than 1/1000* ) of the size of a file that would be required to capture a continuous video itself, even with the use of compression such as MPEG.
  • an XML schema may be employed to capture and represent tasks or subtasks that are performed by the radiologist or user in the data collection.
  • the XML schema records the condensed audit trail of the radiologist or user actions that are performed during the image review and interpretation process.
  • a thick client model such as a workstation or client computer 101
  • a thin client model such as one or more servers 120
  • the audited steps may be recorded by the program 110 at the client computer 101, and in another embodiment, the audited steps may be recorded by the program 110 at the server 120.
  • a graphical user interface is displayed by the program 110 to target end-users, which can allow the user to review the interpretation process of the electronic workflow system of the present invention utilizing a review interface.
  • the user is requested by the program 110 to select one of a plurality of icons that represent existing workflow templates.
  • the user is prompted by the program 110, in operation 304, regarding whether to recreate all or less than all of the interpretation process.
  • the user may be directed by the program 110 in operation 306, to a reviewing interface that includes options for the user to return to a particular action, or can skip, fast forward, rewind and/or perform other actions on the selected electronic workflow system, similar to that of a DVD remote control.
  • the program 110 may direct the electronic workflow template to the beginning (i.e., operation 206) and may allow the workflow template to be run in real-time to re-create the entire interpretation process.
  • Reviewing the entire electronic workflow template may include the program 110 displaying the data collection process from operation 206 through operation 244.
  • other users may review, edit, or otherwise modify, and/or save the electronic workflow template in a similar manner as reviewed and/or saved by the original creator/user of the electronic workflow template.
  • individual clinicians may review and/or save an electronic workflow template in a similar manner to how radiologists review and/or save an electronic workflow template.
  • the modified session may be saved as a new file, which may be used in conjunction with the original dataset to create a new "movie".
  • users may review the electronic workflow system and in response to their selections, the program 110 may skip, fast forward, rewind, and/or perform other actions on any portions of the electronic workflow system, in an editing process in operation 334.
  • the revised workflow template may be saved by the program 110.
  • the workflow template may be closed by the program 110 [000104]
  • a brain MRI exam is performed on a patient with documented lung carcinoma and new onset of headaches.
  • the brain MRI may be performed with or without contrast using six (6) different imaging sequences performed in axial, coronal, and sagittal planes.
  • the results of the brain MRI may be correlated with a previous non-contrast brain MRI performed two years earlier.
  • the radiologist that is interpreting the study may perform the laborious process of linking various sequences from the current study (e.g., axial Tl with and without contrast), in addition to linking current and historical comparable sequences.
  • the radiologist navigates through the volumetric data set in different planes, a number of enhancing mass lesions are depicted in the cerebellum, right thalamus, and left cerebral cortex.
  • the radiologist may perform two dimensional (2-D) and three-dimensional (3-D) reconstructions to show the anatomic relationships of these masses to critical structures within the brain, as well as identify the arteries and veins providing blood supply.
  • each individual subtask that is performed by the radiologist to obtain those various images and views may be recorded by the program 110 for subsequent playback and editing.
  • an electronic workflow template file is created and may be edited by the user in operations 242 and/or 334, wherein the edits of the image files may be performed using clinician preferences and settings.
  • preferences and settings may include slice thickness; image display format; decision support tools, such as segmentation, textual analysis, CAD, temporal subtraction, differential diagnosis; workstation tools, such as magnification, measurements, zoom and scroll; 2-D and 3-D image processing, such as MIP reconstructions, volume rendering, multi-planar reformatting; navigation; synchronization of multiple sequences; compression algorithm; color overlays; annotation of key images; and/or other preferences and settings.
  • decision support tools such as segmentation, textual analysis, CAD, temporal subtraction, differential diagnosis
  • workstation tools such as magnification, measurements, zoom and scroll
  • 2-D and 3-D image processing such as MIP reconstructions, volume rendering, multi-planar reformatting
  • navigation synchronization of multiple sequences
  • compression algorithm color overlays
  • annotation of key images and/or other preferences and settings.
  • each clinician may be provided with or assigned a particular workflow template, which is preset by the radiologist, for example, and stored by the program 110, and which allows each of the clinicians the ability to perform, review, and edit certain functions of the electronic workflow template of the present invention.
  • a family practitioner may be primarily interested in a summary of pertinent findings.
  • a "key image” or "key movie” folder may be displayed by the program 110 and when selected by the user, the XML codes recording the radiologist activity for this subset of images may be played back by the program 110.
  • an oncologist may prefer a more detailed review of the imaging dataset.
  • all comparison sequences that link current and historical exams may be included by the program 110 so that the user can determine temporal changes.
  • all linear and volumetric measurements may be included by the program 110 in the oncologist review, along with multi-planar reconstructions of the tumors in question.
  • These templates may be customized by or for each user according to their various levels of sophistication and their varying levels of predetermined access to editing.
  • a neurosurgeon may prefer an extremely detailed review of anatomy in 3-D to simulate the operative field and may request complex 3-D reconstructions with volume rendering from the program 110.
  • This reconstructive data may be included by the program 110 in the neurosurgical electronic workflow template, complete with volumetric measurements and image processing to highlight arterial and venous anatomy.
  • the reconstructive data for neurosurgeon review may be launched by the program 110 by the user accessing the radiologist report or by accessing the images directly.
  • the electronic data may be effectively parsed out by program 110 of the comprehensive auditing data that is collected by the program 110 during the radiologist interpretation process.
  • the different data sets for the different practitioners may be created by the program 110 using pre-selected XML codes that are contained within the electronic workflow systems 100.
  • the individual XML codes are distinct and separate and may be selected based on user preferences.
  • the user preferences may be modified by the user at any time and saved by the program 110.
  • the program 110 of the present invention enables users to focus reviews on specific subsets of imaging data that is of clinical interest to the end-users.
  • the program of the client computer 101 and/or server 120 may store the "instructions" (i.e., actions) of the electronic workflow system rather than the entire "movie” of the electronic workflow system.
  • the present invention dramatically reduces storage, transmission, and time requirements for video play back, as well as providing other benefits to the user.
  • the computerized intelligence agents of the program 110 may supplement individual user data input to the electronic medical record (EMR).
  • EMR electronic medical record
  • the computerized intelligence agents of the program 110 may query, retrieve, and add additional data to the snapshot of user workflow sequences.
  • the computerized intelligence agents monitor actions that are performed by users, wherein the actions may be performed using an auditing tool or function.
  • the computerized intelligence agents monitor the user actions that direct the client computer 101 to performs steps.
  • the computerized intelligent agents learn to perform the user actions, including repetitive actions or other types of actions based on anatomy, clinical indications, patient profile, and/or other criteria.
  • the computerized intelligent agents may query EMR to identify actions or other criteria that are associated with the exam and/or patient.
  • the computerized intelligent agents may incorporate actions and/or commands into an existing workflow template to created a modified existing workflow template.
  • the computerized intelligent agents may incorporate actions and/or commands into a workflow template to create a new workflow template.
  • a radiologist may be tasked with interpretation of a chest CT exam, which may include at least 500 individual images.
  • the clinical indication for the exam may be "lung cancer screening.”
  • the radiologist may activate a generic workflow template for screening the chest CT.
  • the generic workflow template may be an automated workflow template that defines the protocol for data extraction, image display, navigation, interpretation, and reporting.
  • the user can effectively review the imaging data in a "hands off manner, with the electronic workflow system XML schema automatically driving the workflow.
  • the radiologist may elect to convert to a "manual snapshot" status during the image review/interpretation process.
  • the "automatic to manual” conversion may be performed electronically through one of many inputs, such as a mouse click on a "manual" icon, a computer keyboard preset button, an electronic stylus, a speech command, or other input.
  • the radiologist may convert back to "automatic mode” after performing the desired "manual" tasks.
  • the manual tasks performed by the user may be recorded in XML schema by the program 110, and may be stored as a new exam/user-specific workflow template by the program 110.
  • converting back to "automatic mode” may have the program 110 engage the generic workflow template, which returns to the point in the sequence in which the automatic mode was stopped. In operation by the user, the "automatic to manual” and “manual to automatic” conversion may occur several times, based on the preferences of each individual user.
  • the radiologist may highlight a number of significant findings, such as key findings, that are entered into the radiology report and saved by the program 110, such as "pulmonary nodule", before completing the interpretation/reporting process.
  • the key findings may be recorded by the program 110 into the workflow of user workflow sequences by recording all relevant data, including (but not limited to) the individual image number, anatomic location (in 3-dimensions), image processing parameters used, quantitative data (linear/volumetric/density measurements, textual analysis, interval growth), differential diagnosis, and computer-generated malignancy probability, among other information.
  • the radiologist may electronically link ancillary data, which may be extracted from the EMR (e.g., patient past medical history, lab data, bronchoscopy findings) or the Internet (i.e., teaching file images, journal article references, anatomic atlases), in addition to the computer-generated finding-specific data, to the electronic workflow template file.
  • EMR electronic medical record
  • the Internet i.e., teaching file images, journal article references, anatomic atlases
  • any subsequent data that is contained within the EMR and is relevant to a specific finding may be linked by the program 110 back to the original report by the intelligent computer agents.
  • notification may be sent by the program 110 to both the authoring radiologist and clinicians that are involved in the care of the selected patient.
  • information may be electronically tagged by the program 110 to denote the author, date and source of "new" information.
  • the radiologist may receive notification of a revised workflow template by the program 110.
  • the radiologist may be provided with the specific added and/or revised content of the revision, by the program 110.
  • the radiologist may amend the report and the program 110 may save the amendments in memory.
  • any subsequent reviewers of the exam and/or report may access the longitudinal data with the program 110 providing time and author stamps, illustrating the timing and source of data entry.
  • the informational content may be automatically retrieved by intelligent agents of the program 110.
  • the informational content may be sent by the program 110 to the radiologist based on an automated rule set that may be user-specific and/or context-specific.
  • specialized workflow templates may be designed by the program 110 based on user preferences, for individual components of image display, navigation, processing, interpretation, reporting/communication, and data extraction.
  • specialized workflow templates may be created for use by the program 110 based on user preferences, before and after exam interpretation.
  • generic workflow templates may be designed by the user for the comprehensive process of image review, interpretation, and reporting.
  • specialized workflow templates may be applicable to higher end users of imaging data including radiologists, radiation oncologists, surgical and medical sub-specialists (e.g., oncologists, pulmonologists, neurosurgeons, orthopedic surgeons).
  • an individual specialist may create individualized specialized workflow templates using the program 110, which may be context- specific and may be based on clinical indication, anatomic region, disease state, and imaging modality.
  • specialized workflow templates may be implemented by the program 110 and utilized by the user for image display workflows, navigation workflow s, image processing workflow s, interpretation snapshots, reporting/communication snapshots, data extraction snapshots, among other specialized workflow templates.
  • the data extraction workflow template may serve as an informational template that contains data that is unique to the specific patient, clinical indicator, and imaging exam performed.
  • data may be extracted by the program 110 from various informational sources within the medical enterprise including the EMR, PACS, HIS/RIS, among other data sources.
  • each individual end user may establish unique preferences and profiles that are integrated into specialized workflow templates by the program 110.
  • the specialized workflow templates may include context-specific data.
  • specialized data extraction workflow templates may be provided for a radiologist, a pulmonologist, a family practitioner, and a thoracic surgeon by the program 110.
  • the imaging exam being evaluated may be a chest CT that is performed to evaluate a patient with chronic cough and poorly defined right upper lobe density on chest radiography.
  • the patent may recently have undergone both bronchoscopy and thoracsocopy for diagnosis.
  • a workflow template for a general radiologist may include both report and imaging data from recent chest imaging exams, such as a recent chest radiograph and a prior chest CT performed one year earlier.
  • pertinent data from the patient's medical history which is contained in the most recent hospital discharge summary, may be queried by the user so that the program 110 may identify any underlying risk factors that might predispose the patient to chest malignancy.
  • any previous pathology reports or pertinent laboratory data also may be recorded by the program 110 in the general radiologist workflow template.
  • a workflow template for a pulmonologist may incorporate additional clinical data that may not be contained within the radiologist workflow template based on user-specific preferences.
  • a more detailed clinical data profile may be integrated into the pulmonologist workflow template, by the program 110.
  • the more detailed clinical data profile may include pulmonary function studies, genetic profiles, bronchoscopy images and report data.
  • genetic testing on this patient may reveal an abnormality which may lead to an automated query of the Internet or other research tool by the program 110. For example, two national human genome websites, may be queried by the program 110.
  • the automated query by the program 110 may result in the program 110 notifying the user of links to related articles on molecular pharmacology and tumor biomarkers.
  • a workflow template for a family practitioner may contain extracted data from recent progress notes, consultants' reports, as well as links to articles.
  • the patient's laboratory data may reveal an abnormally low sodium level.
  • the differential diagnosis by the program 110 may include SIADH (Syndrome of inappropriate ADH secretion).
  • the computer intelligent agents of the program 110 may search pre-selected Internet sites for pertinent review articles on SIADH, including the national medical websites, for example.
  • the computer intelligent agents of the program 110 may create links in the family practice workflow template to pertinent articles for user review.
  • a workflow template for a thoracic surgeon may contain key imaging, clinical, and pathologic data from previous operative notes in addition to the patient's previous thoracoscopy.
  • a note by a user may have been made of early signs of chest wall invasion, with the pathologic report citing bronchogenic carcinoma.
  • a review of the surgical options and the relevant case reports may reveal journals that were retrieved from pre-selected medical websites.
  • the computer intelligent agents of the program 110 may create links to articles that are integrated into the thoracic surgeon workflow template.
  • the thoracic surgeon image display workflow template may be modified.
  • the user may modify the workflow template.
  • the program 110 may modify the workflow template.
  • the user can manually perform additional actions and then may prompt the workflow template to incorporate changes into an existing workflow template.
  • the modified workflow template may be saved as a new workflow template or as a modified workflow template.
  • the program 110 may recognize the manual changes using, for example, electronic auditing tools and then may create a new workflow template that is associated with the user.
  • the new workflow template may be generated based on a defined set of descriptors, including a patient clinical profile, ancillary data, clinical indication, imaging modality/anatomic region, image acquisition and/or processing parameters, among other descriptors. In either case, whether performed by the user or the program 110, the end result is a set of user and context- specific workflow templates that may be automatically transported and engaged whenever a user signs into a computer to access medical imaging datasets.
  • thoracoscopy data that reports chest wall invasion may trigger modifications to the image display workflow template, calling for additional 3-D multi-planar reconstructions to be performed.
  • data within one specialized workflow template may have an interaction effect on data within another workflow template.
  • program 110 may alternate between displaying generic workflow templates and specialized workflow templates.
  • a user makes assumptions regarding an anticipated target end-user. For example, the user may anticipate that the target end-user is a family practice physician that desires to access an imaging study (e.g. Brain MRI) on a patient with the clinical indication of "seizures.”
  • the generic workflow template is created for a family practice physician user group.
  • the generic workflow template may be created based on a combined intuition of the user establishing the original templates (e.g. neuroradiologist), a family practice physician user group profile, and the statistical analysis of the auditing tool taken from a subset of family practitioners.
  • the anticipated target end user may review the brain MRI using the generic workflow template.
  • the anticipated target end user may manually perform additional actions while viewing the images.
  • the additional actions may not be defined within this generic workflow template.
  • the program 110 may recognize the additional actions and may query the targeted end-user on whether or not the additional actions should be stored to a modified workflow template or a specialized workflow template for Brain MRI/Seizures. If the targeted end-user responds affirmatively, then the program 110 creates a new specialized workflow template that is unique to the end-user, the modality (MRI), the anatomic region (Brain), and the clinical indication (Seizure).
  • the target end-user may find an abnormality in the imaging study (i.e. area of pathology) during the image review that warrants further investigation.
  • an imaging sequence e.g. axial T2 spin echo sequence
  • an area of increased signal intensity may be identified relative to the surrounding brain.
  • the target end user may be unsure of the underlying pathology and exact anatomic location.
  • the target end user may manipulate program 110 to initiate a decision support tool that will attempt to define the anatomic region (e.g., hippocampus) and the specific type of imaging characteristics using data from the additional imaging sequences performed.
  • the target end user may utilize a computerized differential diagnosis program to identify the potential types of pathology causing this signal abnormality.
  • the program 110 may identify and list, for example, mesial temporal sclerosis as the principle differential diagnostic entity of concern.
  • the program 110 may perfonn a search to identify a specialized workflow template for that pathologic entity (i.e. mesial temporal sclerosis), which is utilized by another end-user (e.g., neurologist).
  • the program 110 may query the target end- user regarding whether or not a workflow template should be changed from the "generic" workflow template to this 'specialized" workflow template for further review.
  • the target user may prompt the program 110 to return to the "generic" template, or vice versa, at any time during an interaction with the dataset.
  • workflow templates may offer the individual end user the ability to "turn on” and turn off' the workflow template functionality.
  • the end user may switch from a generic workflow template protocol to a specialized workflow template protocol within the same image review electronic workflow system, and the program 110 will comply accordingly.
  • a radiologist may review a chest CT using the generic workflow template protocol and may identify a pulmonary nodule, which the radiologist may highlight using the programmable stylus 104, for example.
  • the radiologist may instruct the client computer 101 or server 120 to convert the generic chest CT workflow template into a specialized "nodule" workflow template, as described below.
  • the conversion may activate a sequence of events, specific to the radiologic finding (i.e., nodule) in question.
  • the radiologist may review the CT dataset using a generic workflow template protocol, which may specify a number of parameters including the imaging plane, slice thickness, processing parameters, navigation speed, window/level presets, and/or other parameters.
  • the radiologist may identify a nodule on a specific image and highlight that nodule. The nodule may be highlighted using an input device, such as a mouse, a track ball, an electronic stylus, a speech command, or other input device.
  • the radiologist may issue a command to activate the specialized lung nodule workflow template after highlighting the image and specific finding in question.
  • the nodule workflow template protocol may be launched by the program 110, which includes a pre-defined sequence of events, including linear and volumetric measurements of the suspected nodule; calculation of interval change with historical comparison images, such as identifying the same anatomic region in 3 -dimensional space; automated density measurement calculation; implementation of decision support tools for nodule characterization, such as textual analysis, computer-aided detection, imaging databases for pattern recognition; query of clinical data to identify risk factors and pertinent medical history; determination of malignant probability based on calculation of doubling time, morphologic characteristics, density, and clinical historical data; among other factors.
  • specialized workflow templates may be engaged by the end-user for any pertinent findings. Once the analysis has been completed, the end-user may return to the generic workflow template.
  • the dynamic nature of workflow templates provides unique educational and research applications. From an education standpoint, the entire workflow process may be reviewed and refined retrospectively to identify "best practice" standards and teach different user groups. These user groups may include technologists, residents in training, clinicians, and attending radiologists. Each different user group may have their own customized versions of workflow templates for educational purposes. For example, the technologist educational workflow template may have detailed protocols for image processing and manipulation. [000144] According to one embodiment, the technologist workflow template may audit interactions between technologists and the computer workstations (e.g., CT). According to one embodiment, the simulations may be used for additional technologist training.
  • the computer workstations e.g., CT
  • the program 110 may have an electronic wizard pop up on the display, to offer instruction and additional options to the technologist in training.
  • the resident workflow templates may contain detailed protocols for image display, navigation, and interpretation.
  • attending radiologists may have educational workflow templates that focus on more esoteric applications of decision support and different reporting strategies.
  • clinician workflow templates may focus on clinical data extraction, image review, and supporting data.
  • the research applications of workflow templates may go beyond existing imaging data repositories.
  • imaging teaching files used for both educational and research purposes, may be static in nature and may include collections of images with specific findings and diagnoses.
  • the researcher may access the full complement of imaging and clinical data using the workflow templates.
  • the researcher may review the entire image review, display, interpretation, and reporting process, along with supplemental data. This provides far more robust data to the researcher and provides the ability to perform outcomes analysis, which is currently constrained by excessive time constraints inherent to chart review, in order to obtain correlating clinical data.
  • a researcher may go through the following sequence of events when searching imaging databases, with and without using an electronic workflow template. For example, a researcher may perform an analysis of patients with metastatic small cell carcinoma. The researcher may desire to evaluate a number of different factors including patient demographic profiles; the extent of disease at time of diagnosis; response to treatment; imaging characteristics of disease (before, during, and after treatment); anatomic locations of disease; and diagnostic accuracy of different imaging modalities, among other factors.
  • the researcher would access available imaging databases and search under the diagnosis of metastatic small cell carcinoma. The researcher would find large numbers of annotated images of different anatomic locations and different imaging modalities, with a minimum of supporting clinical data.
  • the researcher may access the workflow template capabilities to access to the full complement of clinical (i.e., EMR) and imaging data (i.e., PACS) that is contained within the comprehensive workflow template.
  • EMR electronic medical record
  • PACS imaging data
  • the electronic consultative capabilities of the electronic workflow template also provides a time stamped record of additional data inputs, queries, and clinical outcomes, that may be automatically queried and retrieved using computerized intelligent agents of the program 110.
  • data contained within the workflow template may be represented in a non-proprietary, standardized format, which is independent of individual vendors PACS and EMR technologies, using DICOM-SR standards. This allows for workflow templates that are archived from different facilities to contain easily accessible and anonymized data, in a standardized format.
  • short cuts may be incorporated into the electronic workflow system process.
  • the short cuts may be independent of the end user and the client computer 101 or server 120 that are accessed for review.
  • the short cuts may be incorporated into the computer keyboard (e.g., Control S equals "Start, Control P equals "Stop”, etc.), a programmable mouse, delivered via speech commands, and/or provided via other devices.
  • the clinician may select the "Skip" command manually, via speech and/or through another method.
  • the present invention may provide enhanced functionality as compared to a DVD remote control.
  • the present invention may enable users to perform functions on the electronic workflow system, such as rewinding, skipping, fast forwarding, and/or other performed functions.
  • end-users may elect to store the XML code for "edited" electronic workflow systems as a standard default for future review.
  • the "recently edited" electronic workflow system may be presented as the default electronic workflow system.
  • the amended XML schema may direct play back of the imaging data, based on the revisions made during a previous electronic workflow system.
  • a report or other document may be associated with an electronic workflow system having an XML format.
  • the report or other document may include a conventional text based document.
  • the report or other document may include a DICOM structured report, which may be accessed automatically or may be accessed by activating a specific icon, such as a movie camera.
  • end users may access the structured reporting icon at any time to reconfigure a customized workflow template.
  • the workflow template may be context-specific.
  • the workflow template may be based on a specific imaging modality, anatomy being reviewed, a specific type of pathology, and/or other factors.
  • embedded links may be incorporated into the electronic workflow system by the program 110 to provide access to decision support tools, web sites (via specific URL's), and/or other resources.
  • embedded links may supplement the informational content being shared.
  • CAD computer-aided detection software
  • segmentation Another example of a decision support tool is segmentation, which allows for individual components within an image to be segmented, such that different organ systems may be isolated.
  • the program 110 of the present invention may embed decision support tools into the electronic workflow system.
  • a patient may undergo a chest CT after presenting with a cough and suspected lung cancer.
  • a pulmonologist reviewing the electronic workflow system may access and incorporate a CAD program to automate lung nodule detection.
  • the CAD program 110 may include a pre-determined CAD overlay, which is based on the specific pulmonologist's preferences.
  • the pulmonologist concurrently may desire to have segmentation incorporated into the chest CT for detailed assessment of the pulmonary arteries.
  • web links may be incorporated into the electronic workflow process by the program 110.
  • specific URL's may be included in the XML code by the program 110.
  • the pulmonologist may desire to review recent articles outlining new treatment options for small cell lung carcinoma.
  • the pulmonologist may embed the URL for an Internet resource, such as the National Library of Medicine, into the electronic workflow system by providing search terms using data entry techniques such as manual entry, speech entry and/or other types of data entry.
  • the program 110 of the present invention may provide access to articles that are specific to the search.
  • the retrieved articles may be stored for review by the program 110 during the electronic workflow process.
  • the electronic workflow system may incorporate the equivalent of video clips into the EMR, which may become a part of or be independent from the report.
  • the electronic workflow system may include other pertinent patient data, such as laboratory data, text notes, pathology, EKG and/or other pertinent patent data so as to create a condensed composite of all data.
  • the program 110 of the workflow template system creates a comprehensive shorthand version of key imaging findings by capturing the navigational steps, image presentation states, measurements, and annotations.
  • the present invention provides an easy to use vehicle for education and research, by the program 110 storing electronic workflow systems that may be indexed according to various parameters including pathology, organ system, and imaging modality.
  • electronic auditing of clinicians may be performed by the program 110 to identify the specific data that is most commonly accessed and used by clinicians.
  • frequently accessed decision support tools may be automatically inserted into the electronic workflow system by the program.
  • infrequently accessed decision support tools may be automatically deleted from the electronic workflow system by the program 110.
  • an intelligent electronic workflow system may be created that is customized to particular user viewing habits.
  • the XML schema enables the underlying software program 110 employed in the present invention to be open and non-proprietary.
  • the program 110 of the present invention facilitates transfer of the electronic workflow system across all picture archival and communication (PAC) systems, irrespective of the vendor.
  • PAC picture archival and communication
  • the XML schema may be used across multiple devices for image review, including tablet PCs, PDAs, and other wireless devices.
  • the auditing tools of the present program 110 may record specific events that occur during a "live" electronic workflow system.
  • the auditing tools of the program 110 may record specific events that occur during asynchronous image review and manipulation of data.
  • the present invention provides a bidirectional electronic workflow system. According to one embodiment, the present invention provides improved communication between parties, with the potential to be used as an educational tool as well as a clinical tool to improve diagnostic accuracy and productivity. According to one embodiment, the auditing tool and XML schema may be employed in medico-legal protection by demonstrating what imaging information was reviewed. According to one embodiment, the auditing tool and XML schema may be employed in medico-legal protection to reconstruct the manner in which imaging information was reviewed.
  • the data recorded by the auditing function of the program 110 may verify what portions of the comprehensive dataset were reviewed, what types of image processing was used, what decision support tools were used in the image review/interpretation process, among other auditing information.
  • the XML schema may serve as an adjunct to the formal report and may provide the electronic workflow system by recording the image review process.
  • the present invention provides an effective electronic communication tool.
  • a radiologist may simply copy the workflow templates and integrate them into his/her customized profile. This action may be performed in a manner that is similar to saving and modifying word processing documents or other known applications.
  • files may be created and stored by the program 110 according to anatomic region, imaging modality, clinical indication, pertinent findings, among other factors.
  • users may direct the program 110 of the workflow template archive to incorporate these modifications into the new workflow templates.
  • the end-user may be prompted by the program 110 to inquire whether the user wants this change to be incorporated into the workflow template (i.e. Save Changes).

Abstract

La présente invention concerne un procédé et système de flux de travaux électroniques intégrant un poste de travail client comportant un afficheur haute résolution et un organe d'entrée, le système capturant les actions menées sur l'afficheur. Les actions menées sont de celles qui s'intègrent à un traitement d'interprétation d'images médicales à l'écran. Pour la capture et la représentation des tâches et sous-tâches, on utilise une logique à langage de balisage extensible de type XML. La logique XML enregistre l'historique condensé des actions utilisateurs menées pendant l'examen et l'interprétation des images. L'invention permet un stockage des instructions ou des actions du système de flux de travaux électroniques, mais les actions peuvent également se stocker sous forme d'un film complet du système de travaux électroniques. Pour la restitution, l'invention permet ainsi, entre autres avantages, de réduire les besoins en mémoire, transmission et ressource temps.
PCT/US2006/042131 2005-10-26 2006-10-26 Procede et systeme de capture d'actions utilisateur dans des gabarits de flux de travaux electroniques WO2007050962A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US73003705P 2005-10-26 2005-10-26
US60/730,037 2005-10-26

Publications (2)

Publication Number Publication Date
WO2007050962A2 true WO2007050962A2 (fr) 2007-05-03
WO2007050962A3 WO2007050962A3 (fr) 2009-04-23

Family

ID=37968597

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2006/042131 WO2007050962A2 (fr) 2005-10-26 2006-10-26 Procede et systeme de capture d'actions utilisateur dans des gabarits de flux de travaux electroniques

Country Status (1)

Country Link
WO (1) WO2007050962A2 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2327042A1 (fr) * 2008-08-21 2011-06-01 TeraRecon, Inc. Gestion de modèle de flux de travail pour un traitement de données d'image médicale
WO2014167536A2 (fr) 2013-04-11 2014-10-16 Koninklijke Philips N.V. Autorisation d'un utilisateur à étudier des données d'image
WO2015173210A1 (fr) * 2014-05-13 2015-11-19 Agfa Healthcare Inc. Système et procédé apparenté de sélection automatique d'un protocole d'accrochage pour une étude médicale
US10586017B2 (en) 2017-08-31 2020-03-10 International Business Machines Corporation Automatic generation of UI from annotation templates
US20210125709A1 (en) * 2019-10-23 2021-04-29 Koninklijke Philips N.V. System and method to visualize and coordinate image acquisition workflows

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030204481A1 (en) * 2001-07-31 2003-10-30 International Business Machines Corporation Method and system for visually constructing XML schemas using an object-oriented model
US20050197864A1 (en) * 1998-11-25 2005-09-08 Koritzinsky Ianne M.H. Imaging system protocol handling method and apparatus

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050197864A1 (en) * 1998-11-25 2005-09-08 Koritzinsky Ianne M.H. Imaging system protocol handling method and apparatus
US20030204481A1 (en) * 2001-07-31 2003-10-30 International Business Machines Corporation Method and system for visually constructing XML schemas using an object-oriented model

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2327042A1 (fr) * 2008-08-21 2011-06-01 TeraRecon, Inc. Gestion de modèle de flux de travail pour un traitement de données d'image médicale
EP2327042A4 (fr) * 2008-08-21 2014-10-08 Terarecon Inc Gestion de modèle de flux de travail pour un traitement de données d'image médicale
US10114926B2 (en) 2008-08-21 2018-10-30 Terarecon, Inc. Workflow template management for medical image data processing
WO2014167536A2 (fr) 2013-04-11 2014-10-16 Koninklijke Philips N.V. Autorisation d'un utilisateur à étudier des données d'image
WO2014167536A3 (fr) * 2013-04-11 2015-01-29 Koninklijke Philips N.V. Autorisation d'un utilisateur à étudier des données d'image
US10088992B2 (en) 2013-04-11 2018-10-02 Koninklijke Philips N.V. Enabling a user to study image data
WO2015173210A1 (fr) * 2014-05-13 2015-11-19 Agfa Healthcare Inc. Système et procédé apparenté de sélection automatique d'un protocole d'accrochage pour une étude médicale
US10586017B2 (en) 2017-08-31 2020-03-10 International Business Machines Corporation Automatic generation of UI from annotation templates
US20210125709A1 (en) * 2019-10-23 2021-04-29 Koninklijke Philips N.V. System and method to visualize and coordinate image acquisition workflows

Also Published As

Publication number Publication date
WO2007050962A3 (fr) 2009-04-23

Similar Documents

Publication Publication Date Title
US8117549B2 (en) System and method for capturing user actions within electronic workflow templates
US20210210179A1 (en) Evolving contextual clinical data engine for medical information
US10134126B2 (en) Intelligent dynamic preloading and processing
US7421647B2 (en) Gesture-based reporting method and system
CN108475538B (zh) 用于将第三方应用集成在图像解读工作流中的结构化发现对象
US8335694B2 (en) Gesture-based communication and reporting system
CA2381653C (fr) Procede et procedure informatiques de creation de rapports electroniques multimedia
US20070237378A1 (en) Multi-input reporting and editing tool
US20140013199A1 (en) Generating a report based on image data
US20060271403A1 (en) Medical report producing apparatus, medical report referencing apparatus, and method for producing medical report
US20120221347A1 (en) Medical reconciliation, communication, and educational reporting tools
US20080117230A1 (en) Hanging Protocol Display System and Method
US8311847B2 (en) Displaying radiological images
CN1615489A (zh) 图像报告方法和系统
US20080175460A1 (en) Pacs portal with automated data mining and software selection
Gambino et al. A framework for data-driven adaptive GUI generation based on DICOM
JP2013520750A (ja) マルチ・タッチ式臨床システムにおいてジェスチャの構造化ライブラリを用いるシステム及び方法
WO2007050962A2 (fr) Procede et systeme de capture d'actions utilisateur dans des gabarits de flux de travaux electroniques
Roy et al. Visual interpretation with three-dimensional annotations (VITA): three-dimensional image interpretation tool for radiological reporting
Bui et al. Medical data visualization: Toward integrated clinical workstations
WO2006058738A1 (fr) Système d’évaluation d’image, procédés et base de données
Kades et al. Efficient DICOM Image Tagging and Cohort Curation Within Kaapana
Reiner Automating radiologist workflow part 1: the digital consultation
WO2007143084A2 (fr) Outil de rapport et d'édition à entrées multiples
HIDKI et al. The MedGIFT project: Global perspectives of a medical doctor

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application
NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 06826954

Country of ref document: EP

Kind code of ref document: A2