Part 2: Answers to XDS/XDS-I webinar audience questions
Posted by Jackie Walsh on Thu, Feb 25, 2010 @ 01:31 PM
Dr. Bak's responses, continued.
6.) Q: Do you view the point to point nature of DICOM (e.g. AET and ip address requirement) as a detriment to XDS-I? i.e., consumers of images need to have a DICOM connection to PACS and have a configured AET...
A: Absolutely! We are now moving to a WAN world with any number of users who can be anywhere…the vision of “anytime, anywhere, anyplace”! If we rely on DICOM to retrieve, you have to configure systems to talk to every possible other system, setup static IP addressing at the server and client end, etc.…totally impractical!
It is better to relegate DICOM to the LAN and shift to Internet protocols for all WAN traffic.
7.) Q: Are any conventional PACS archives currently XDSI compliant or does XDSI require the creation of a vendor neutral archive that is XDSI compliant.
A: XDS does not require the use of a vendor neutral archive. The PACS vendors offer XDS-I compliance (not all but they are all moving to this), specifically: 1. Source actor compliance – this allows the PACS to publish its data to the XDS domain 2. Repository actor compliance – this allows the PACS to host the images as well as the documents that are published. This is a good thing as it allows the hospital to maintain custodianship of the images as well as the published “documents.”
8.) Q: Interested in finding out name of Proxy server vendor used - capable of JIT order messages.
A: Please look at Mawell, DeJarnette, Softmedical – there are a few more but I am not overly familiar with all of them!
9.) Q: What patient & exam identifiers are used to query the Registry?
A: The primary query key is the global patient ID. Additional information includes patient demographics, etc. but not much of this is very reliable. Having said this, for imaging information, the Registry holds Modality, Body Part, procedure Description, Institution Name, Exam Date. All of these are queriable fields.
10.) Q: How do second opinions, consultations, over reads, preliminary reports associated with a given study get handled (i.e., created, transmitted, stored)
A: XDS-I provides a mechanism for changing documents. One can add addendums, delete documents and deprecate a document. The IHE XDS-I Content Supplement document describes a varity of use case that XDS-I shod and can support. One of these is called the “Treatment Consult” use case. This is an example of:
-Publishing a study
-Asking a specialist or radiologist to provide a consult
-Adding a final report or consult report to the study “record”