Stream: implementers
Topic: DICOM & Worklists
Grahame Grieve (Nov 18 2016 at 14:10):
@Brad Genereaux - can you write a few sentences here about FHIR and Modality Worklists - thanks
Brad Genereaux (Nov 19 2016 at 10:35):
Sure, @Grahame Grieve - DICOM Modality Worklist (MWL) is the communication to the modality of patient/order demographic information. For example, "patients for CT Room 1", "patients for Ultrasound", "today's patients to be scanned". The X-Ray Technician, standing at the actual modality (i.e., a touchscreen monitor hardwired to the X-Ray machine), selects the patient from this list to be immediately scanned. Then - the machine scans the patient, and creates DICOM combining the acquired images and the selected demographic information, which is transmitted to the PACS. This way, we prevent the "manual typing errors" that occur when MWL is unavailable (and someone has to type the patient ID, patient Name, etc at the modality).
The compelling discussion that we had at FHIR DevDays - while it will be a long long time before we see updated modalities in hospitals that do DICOMweb/FHIR (modalities stay in the hospital for quite some time, and are infrequently replaced / firmware updated) - it doesn't seem to be that far of a stretch to create a FHIR MWL Proxy - that could receive MWL queries (classic DICOM) from modalities, make FHIR DiagnosticRequest or ProcedureRequest queries, and then transform that back into a MWL response to return back to the modality. As part of STU3, we submitted a couple of important changes to the search criteria in ProcedureRequest to support and enable this workflow possibility.
Grahame Grieve (Nov 19 2016 at 16:10):
thanks for the explanation. I'll know what to say the next time someone asks me about MWL. I presume, then, that ProcedureRequest is the preference?
Peter Scholz (Nov 22 2016 at 14:57):
@Brad Genereaux At the end of the day both ways of proxy might be a good idea. For sure the "big" modalities which stay in the hospital will stick to DICOM for quite a while ( as they integrate with RIS on a DICOM base), but some smaller ones like ultrasound or cardiographic may be interested to query using FHIR in future times.
We just built a small worklist provider for modalities not beeing connected to a RIS , and I'm thinking of scheduling extensions towards proxy capabilities here.
Alex Goel (May 02 2017 at 20:22):
Is there a way for careplan to inform a worklist? Who is responsible for making a careplan?
Lloyd McKenzie (May 03 2017 at 00:16):
Anyone can create a CarePlan - including the patient themselves.
Alex Goel (May 03 2017 at 13:14):
@Lloyd McKenzie Is there a way to generate a worklist from the CarePlan?
Lloyd McKenzie (May 03 2017 at 14:40):
Not within the spec right now, but you could propose us adding an operation if you can describe how it would work in a standard way - and you're certainly free to define your own operation
Lloyd McKenzie (May 03 2017 at 14:40):
You'd invoke it on a CarePlan and get back a List
Alex Goel (May 03 2017 at 15:05):
@Lloyd McKenzie thanks! Will try to figure this out
Last updated: Apr 12 2022 at 19:14 UTC
