Part 3: Answers to XDS/XDS-I webinar audience questions
Posted by Jackie Walsh on Fri, Feb 26, 2010 @ 12:35 PM
Here are the last of the questions from the webinar. Let us know if you have more.
11.) Q: How would one publish a list of studies that are stored on a lagacy PACS to an XDS registry
A: This is a batch job. More sophisticated methods could be developed in the source actor to query the PACS for all priors as new studies are published. This would balance the performance hit over time.
12.) Q: Is it possible to make this an automated process. So radiologists are not required to log on and request data?
A: Definitely. But that is a function of the PACS. In the Canadian projects we have stipulated to the Consuming PACS vendors that they need to expand their pre-fetch algorithms to include discovery and retrieval from the XDS domain
13.) Q: Have you run into trouble credentialing multiple facilities (who are competitors) to see and control each other's information?
A: Not in Canada as we are a publicly funded health system.
14.) Q: How do you get multiple RIS systems to utilize a EMPI? What do you do with duplicates/typos?
A: Integration with the EMPI is from the “registration” service. This is typically in the HIS (ADT function) but could also be as part of a standalone RIS – assuming it support broadcasting HL7 ADT messages. There are two stages to EMPI integration:
1. Passive integration – in this case you send ADT information to the EMPI and do not get anything back in the ADT. When you query the EMPI from your source/consumer actor, you get the global ID. In this scenario the registration staff are unable to reconcile information at the time of registration so you are dependent on the medical records team managing the quality of data in the EMPI.
2. Active Integration – in this case the registration person can check the patients credentials in the EMPI and make corrections as needed. As such, reconciliation happens at the time of patient registration and off-loads the burden on the medical records team that manages the EMPI.
15.) Q: Peter, is XDS repository contributing to an EPR in Canada?
A: I am not quite sure of the question. Let me say that we have not integrated an XDS-I consumer into an EHR or EMR application yet. This is something that will be implemented in Ontario shortly.
16.) Q: What’s your thought on NHIH CONNECT for connecting different entities?
A: Need to review CONNECT architecture and services…not overly familiar with this yet!
17.) Q: Which PACS vendors are XDS compliant to date?
A: Check IHE Connectathon results for XDS-I actor compliance.
18.) Q: Cardiology applications?
A: Cardiology information is (for the most part) DICOM so it can be added to the XDS-I repository. However, I am not familiar with any Cardiology PACS systems that are XDS compliant yet.
19.) Q: Would like to hear more about the on-demand viewing. Would like to hear more about when new versions of images may be created by someone viewing an image on-demand or otherwise from somewhere other than the originating enterprise.
A: XDS On-demand viewers tend not to offer “source” actor capabilities i.e. they cannot publish a document to the XDS domain. As such, these viewers do not let you make changes to the documents. This may change over time!