U.S. patent application number 14/721637 was filed with the patent office on 2016-12-01 for radiology workflow coordination techniques.
The applicant listed for this patent is Virtual Radiologic Corporation. Invention is credited to Kimberlee Gerdeman, Andrew Grabiel, Kenneth Leer, Joe Schmugge, Wade J. Steigauf, Benjamin Strong, Shannon Werb, Angela Yates.
Application Number | 20160350480 14/721637 |
Document ID | / |
Family ID | 57399811 |
Filed Date | 2016-12-01 |
United States Patent
Application |
20160350480 |
Kind Code |
A1 |
Gerdeman; Kimberlee ; et
al. |
December 1, 2016 |
RADIOLOGY WORKFLOW COORDINATION TECHNIQUES
Abstract
Systems and methods for coordinating a medical imaging workflow
with the use of preparation and coordination actions, and similar
pre-processing protocols are disclosed herein. Imaging procedure
data from a medical imaging study, such as image data and order
data produced from imaging procedures (e.g., radiological imaging
procedures) at medical facilities is processed and presented for
review to a preparing user. The preparing user is offered the
ability to change the display characteristics of image
presentation, supplement erroneous or incomplete data and
information of the study, open a support request for the study, or
associate prior or comparison images with the study. The changes
provided by the preparing user within these or other portions of a
preparation protocol may be used to affect a subsequent display of
the medical imaging study, and in some examples, to affect the
assignment of the study in the workflow to particular imaging
users.
Inventors: |
Gerdeman; Kimberlee; (Eden
Prairie, MN) ; Grabiel; Andrew; (Eden Prairie,
MN) ; Leer; Kenneth; (Chanhassen, MN) ;
Schmugge; Joe; (Minneapolis, MN) ; Steigauf; Wade
J.; (Bloomington, MN) ; Strong; Benjamin;
(Tucson, AZ) ; Werb; Shannon; (Minneapolis,
MN) ; Yates; Angela; (Sioux City, IA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Virtual Radiologic Corporation |
Minneapolis |
MN |
US |
|
|
Family ID: |
57399811 |
Appl. No.: |
14/721637 |
Filed: |
May 26, 2015 |
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
G06F 19/321 20130101;
G16H 40/20 20180101; G16H 30/40 20180101; G16H 30/20 20180101 |
International
Class: |
G06F 19/00 20060101
G06F019/00; G06T 7/00 20060101 G06T007/00; A61B 6/00 20060101
A61B006/00 |
Claims
1. A method for management of a medical imaging workflow, the
method implemented by a computing device through an execution of
operations on at least one processor and memory of the computing
device, with the operations comprising: electronically processing
data associated with a medical imaging study, the data associated
with the medical imaging study including imaging data from a
medical imaging procedure; performing a preparation protocol upon
the data associated with the medical imaging study, the preparation
protocol establishing preparation data to affect an evaluation of
the medical imaging study; performing an electronic assignment of
the medical imaging study to a medical evaluator, the electronic
assignment being performed based on the data associated with the
medical imaging study and the preparation data; and making the
medical imaging study available to the medical evaluator for
evaluation, the medical imaging study being made available for
evaluation in response to a completion of the performing of the
preparation protocol; wherein the preparation data is used to
affect a display of the imaging data to the medical evaluator
within the evaluation of the medical imaging study.
2. The method of claim 1, wherein electronically processing the
data associated with the medical imaging study includes determining
whether a condition affects the evaluation of the medical imaging
study, wherein the performing of the preparation protocol is
initiated in response to determining that the condition affects the
evaluation of the medical imaging study, and wherein the condition
that affects the evaluation of the medical imaging study includes
at least one of: missing information in the data associated with
the medical imaging study, an error in the data associated with the
medical imaging study, an incorrect display orientation of images
in the imaging data, or an incorrect display arrangement of images
in the imaging data.
3. The method of claim 1, the operations of the method comprising:
transferring the imaging data associated with the medical imaging
study to a computing device associated with the medical evaluator
in response to the electronic assignment of the medical imaging
study to the medical evaluator; wherein making the medical imaging
study available to the medical evaluator for evaluation includes
listing the medical imaging study on a worklist in a graphical user
interface available to the medical evaluator; and wherein at least
a portion of the data associated with the medical imaging study is
pre-cached at the computing device associated with the medical
evaluator prior to listing the medical imaging study on the
worklist in the graphical user interface available to the medical
evaluator.
4. The method of claim 1, wherein performing the preparation
protocol upon the data associated with the medical imaging study
includes creating the preparation data that modifies one or more
data values of order data associated with the medical imaging
study.
5. The method of claim 1, wherein performing the preparation
protocol upon the data associated with the medical imaging study
includes creating the preparation data that modifies one or more
presentation characteristics of the imaging data associated with
the medical imaging study.
6. The method of claim 1, wherein performing the preparation
protocol upon the data associated with the medical imaging study
includes creating data for a support request associated with the
medical imaging study, the support request indicating additional
information required for performance of the evaluation of the
medical imaging study.
7. The method of claim 1, wherein performing the preparation
protocol upon the data associated with the medical imaging study
includes: identifying one or more comparison images for inclusion
in the evaluation of the medical imaging study, the one or more
comparison images used as a comparison with images in the imaging
data from the medical imaging procedure; obtaining the one or more
comparison images for inclusion in the evaluation of the medical
imaging study; and associating data for the one or more comparison
images with the medical imaging study.
8. The method of claim 1, the operations of the method comprising:
performing an initial electronic assignment of the medical imaging
study to the medical evaluator and one or more other medical
evaluators, the electronic assignment being performed based on the
data associated with the medical imaging study; and establishing an
initial listing of the medical imaging study on a worklist
available to the medical evaluator and respective worklists
available to one or more other medical evaluators, the initial
listing being established based on the data associated with the
medical imaging study; and removing the initial listing of the
medical imaging study on the worklist available to the one or more
other medical evaluators in response to a designation of the study
for evaluation to the medical evaluator.
9. The method of claim 8, wherein the designation of the study to
the medical evaluator occurs in response to a selection of the
medical imaging study in a graphical user interface via the
worklist available to the medical evaluator.
10. The method of claim 1, the operations of the method comprising:
making the medical imaging study available to the medical evaluator
for evaluation, prior to a completion of the performing of the
preparation protocol upon the data associated with the medical
imaging study, based on one or more of: a worklist available to the
medical evaluator being empty; a turn-around-time for evaluation of
the medical imaging study exceeding a predetermined amount of time;
or a priority indication for the medical imaging study.
11. The method of claim 1, wherein the medical imaging procedure is
a radiological imaging procedure, wherein the imaging data from the
medical imaging procedure includes radiology images produced for a
radiology study, and wherein the medical imaging study is provided
for a radiological read request for diagnostic evaluation of the
radiology images produced for the radiology study.
12. A non-transitory machine-readable medium, the machine-readable
medium including instructions, which when executed by a computing
machine having at least one hardware processor, cause the computing
machine to perform operations that: process data associated with a
medical imaging study, the data associated with the medical imaging
study including imaging data from a medical imaging procedure;
perform a preparation protocol upon the data associated with the
medical imaging study, the preparation protocol establishing
preparation data to affect an evaluation of the medical imaging
study; assign the medical imaging study to a medical evaluator,
based on the data associated with the medical imaging study and the
preparation data; and modifying an availability of the medical
imaging study for evaluation by the medical evaluator, the medical
imaging study being made available for the evaluation by the
medical evaluator in response to a completion of the preparation
protocol; wherein the preparation data is used to affect a display
of the imaging data to the medical evaluator within the evaluation
of the medical imaging study.
13. The machine-readable medium of claim 12, the instructions
further operable to cause the computing machine to perform
operations that: detect a data condition in the data associated
with the medical imaging study, the data condition including at
least one of: missing information in the data associated with the
medical imaging study, an error in the data associated with the
medical imaging study, an incorrect orientation of images in the
imaging data, or an incorrect arrangement of images in the imaging
data; and process data for the medical imaging study to correct the
data condition.
14. The machine-readable medium of claim 12, the instructions
further operable to cause the computing machine to perform
operations that: transfer the imaging data associated with the
medical imaging study to a computing machine associated with the
medical evaluator in response to assignment of the medical imaging
study to the medical evaluator, wherein at least a portion of the
data associated with the medical imaging study is cached at the
computing machine associated with the medical evaluator prior to
the medical imaging study being designated for performance by the
medical evaluator.
15. The machine-readable medium of claim 12, wherein performing the
preparation protocol upon the data associated with the medical
imaging study is implemented by one or more operations that: create
preparation data that modifies one or more data values of order
data associated with the medical imaging study; create preparation
data that modifies one or more presentation characteristics of the
imaging data associated with the medical imaging study; create data
for a support request associated with the medical imaging study; or
associate data for at least one comparison image with the medical
imaging study.
16. The machine-readable medium of claim 12, the instructions
further operable to cause the computing machine to perform
operations that: establish an initial assignment of the medical
imaging study to a plurality of other medical evaluators based on
the data in the medical imaging study; designate the medical
evaluator to perform evaluation of image data associated with the
medical imaging study, wherein operations that designate the
medical evaluator to perform evaluation of the image data are
performed subsequent to the completion of the preparation protocol
upon the data in the medical imaging study.
17. The machine-readable medium of claim 12, wherein the medical
imaging study is made available to the medical evaluator for
evaluation, prior to a completion of the preparation protocol upon
the data associated with the medical imaging study, based on one or
more of: a worklist operated by the medical evaluator reaching a
predetermined condition; a turn-around-time for evaluation of the
medical imaging study exceeding a predetermined amount of time; or
a priority indication for the medical imaging study.
18. A computer system, comprising: at least one hardware processor
and memory; a preparation module implemented with the at least one
hardware processor and memory, the preparation module configured
to: process data associated with a medical imaging study, the data
associated with the medical imaging study including imaging data
from a medical imaging procedure, and perform a preparation
protocol upon the data associated with the medical imaging study,
the preparation protocol establishing preparation data to affect an
evaluation of the medical imaging study; a study assignment module
implemented with the at least one hardware processor and memory,
the study assignment module configured to: assign the medical
imaging study to a medical evaluator, based on the data associated
with the medical imaging study and the preparation data; and a
study display state module implemented with the at least one
hardware processor and memory, the study display state module
configured to: affect a display of the imaging data at a computing
device of the medical evaluator for the evaluation of the medical
imaging study, based on an updated study display state indicated by
the preparation data.
19. The computer system of claim 18, the system further comprising:
a study data caching module implemented with the at least one
hardware processor and memory, the study data caching module
configured to: transfer the imaging data associated with the
medical imaging study to a computing machine associated with the
medical evaluator in response to assignment of the medical imaging
study to the medical evaluator, wherein at least a portion of the
data associated with the medical imaging study is cached at the
computing machine associated with the medical evaluator prior to a
designation of the study for evaluation to the medical
evaluator.
20. The computer system of claim 18, wherein the medical imaging
procedure produces data for a radiology study, the system further
comprising a radiology information system (RIS) module, the RIS
module configured to correlate the radiology study in a RIS
instance with the medical imaging procedure, and provide order data
produced for the medical imaging procedure.
21. The computer system of claim 18, wherein the medical imaging
procedure produces data for a radiology study, and the system
further comprising a Picture Archiving Communication System (PACS)
module, the PACS module configured to provide the imaging data
produced from the medical imaging procedure.
22. The computer system of claim 18, the system further comprising:
an image data processing module configured to obtain information
from image data associated with the medical imaging procedure; and
an order data processing module configured to obtain information
from order data associated with the medical imaging procedure;
wherein the preparation module is further configured to detect a
data condition in information from the image data or the order
data, the data condition including at least one of: missing
information in the image data or the order data, an error in the
image data or the order data, an incorrect orientation of images in
the image data, or an incorrect arrangement of images in the image
data.
23. The computer system of claim 22, the system further comprising:
a study viewing module implemented with the at least one hardware
processor and memory, the study viewing module configured to
display the study to the medical evaluator based on state changes
to the study, wherein the study display state module is configured
to process data for the medical imaging study to correct the data
condition in a display of the updated study display state to the
medical evaluator.
24. The computer system of claim 22, the system further comprising:
a study reporting module implemented with the at least one hardware
processor and memory, the study reporting module configured to
display a report for the study for editing by the medical
evaluator, based on state changes to the study.
Description
TECHNICAL FIELD
[0001] Embodiments pertain to techniques and systems for processing
electronic imaging data obtained from medical imaging procedures.
Some embodiments relate to data processing mechanisms in medical
imaging workflows involving the use of coordinators, assistants,
and other human or automated actors.
BRIEF DESCRIPTION OF THE DRAWINGS
[0002] FIG. 1 illustrates a system configuration enabled for
processing, coordinating, preparing, and assigning medical imaging
data and medical imaging requests according to an example described
herein.
[0003] FIG. 2 illustrates system operations in a workflow for
coordination and preparation of medical imaging data produced from
a medical imaging procedure according to an example described
herein.
[0004] FIG. 3 illustrates a flowchart of a process for preparation
and assignment of a medical imaging order according to an example
described herein.
[0005] FIG. 4 illustrates a flowchart of a process for coordination
and preparation of data for a medical imaging order according to an
example described herein.
[0006] FIG. 5A illustrates a worklist graphical user interface for
management of medical imaging studies by a preparing user according
to an example described herein.
[0007] FIG. 5B illustrates a study preparation graphical user
interface for management of a medical imaging study by an
evaluating user according to an example described herein.
[0008] FIG. 6A illustrates a worklist graphical user interface for
management of medical imaging studies by an evaluating user
according to an example described herein.
[0009] FIG. 6B illustrates a study reporting graphical user
interface for management of a medical imaging study by an
evaluating user according to an example described herein.
[0010] FIG. 7 illustrates a flowchart of example workflow
operations performed for processing data produced from a particular
medical imaging study according to an example described herein.
[0011] FIG. 8 illustrates a flowchart of additional workflow
operations performed for processing data produced from a particular
medical imaging study according to an example described herein.
[0012] FIG. 9 illustrates a system configuration of a medical
imaging data processing system arranged to process medical imaging
data according to an example described herein.
[0013] FIG. 10 illustrates an example of a machine configured to
perform computing operations according to an example described
herein.
DETAILED DESCRIPTION
[0014] The following description and the drawings sufficiently
illustrate specific embodiments to enable those skilled in the art
to practice them. Other embodiments may incorporate structural,
logical, electrical, process, and other changes. Portions and
features of some embodiments may be included in, or substituted
for, those of other embodiments.
[0015] The present disclosure illustrates various techniques and
configurations that enable pre-processing and coordination
activities in a medical imaging data environment. For example,
these pre-processing and coordination activities may be performed
upon medical imaging procedure data produced as part of a medical
imaging study. The medical imaging procedure data may include image
data captured by an imaging modality, and order data (such as data
indicating a request for a radiological image read), each produced
to facilitate a medical imaging evaluation (such as a radiology
read to be performed by a radiologist or a diagnostic evaluation by
another qualified medical professional). The pre-processing and
coordination activities may include active preparation steps that
are accompanied by actions performed on the medical imaging
procedure data prior to, or concurrent with, the medical imaging
evaluation.
[0016] The pre-processing and coordination activities enabled by
the present techniques may include activities such as: correcting
errors or supplying incomplete information for data fields in the
medical imaging procedure data; adjusting window/level, increasing
or reducing image sharpness, changing imaging hanging arrangements,
and affecting other visual characteristics of image displays for
images in the medical imaging procedure data; compiling prior
images and reports, identifying or labeling anatomical features,
implementing measurements, or identifying the most relevant images
in an imaging study; providing initial reports and diagnostic
information for the imaging study; and performing other relevant
analysis and modifications for the medical imaging procedure
data.
[0017] As further discussed herein, the results of these
pre-processing and coordination activities may be used to drive
assignments and evaluation activities for the medical imaging
procedure data. For example, information that is provided or
supplemented in the pre-processing activity may assist the
assignment of a request for evaluation of the image to an evaluator
such as a remote radiologist. The pre-processing and coordination
activities may also provide meta-data elements that are added for
downstream use by evaluators, reviewers, and medical professionals.
Further, the pre-processing and coordination activities may be used
to establish, modify, and bookmark different states of the medical
imaging evaluation process, including customized image viewing
states that can be resumed at remote workstations or locations. The
pre-processing and coordination activities thus may be used to
provide improved quality and accuracy of the data used in the
medical imaging evaluation process, in addition to improved
efficiency (and workflow routing) of the data and the associated
reading or diagnostic procedures occurring in the medical imaging
evaluation process.
[0018] In some of the following examples, reference is made to
radiology medical imaging procedures (e.g., computed tomography
(CT), magnetic resonance imaging (MRI), Ultrasound, and X-ray
procedures, etc.) and diagnostic evaluation of the images produced
from such imaging procedures that would be performed with an image
evaluation (e.g., radiology read) by a licensed and credentialed
radiologist. It will be understood that the applicability of the
presently described techniques and systems will extend to a variety
of medical procedures and specialties, including those not
involving traditional radiology imaging modalities. Such
specialties include, but are not limited, to pathology, medical
photography, medical data measurements such as
electroencephalography (EEG) and electrocardiography (EKG)
procedures, cardiology data, neuroscience data, preclinical
imaging, and other data collection procedures occurring in
connection with telemedicine, telepathology, remote diagnostics,
and other applications of medical procedures and medical science.
Accordingly, the performance of the data coordination,
pre-processing, and workflow preparation techniques described
herein may apply to a variety of medical data types and
settings.
[0019] FIG. 1 provides an illustration of an example medical
imaging system configuration 100 (e.g., a radiology imaging
configuration), which enables the processing of data from medical
imaging procedures according to an example described herein. The
system configuration 100 may be used for capturing medical image
data in one location and for reviewing medical images associated
with the data in another location. The system configuration 100 may
include many geographically separated imaging devices and many
image review terminals. The system configuration 100, in a
radiology setting, may be embodied as a remote teleradiology system
connected to a plurality of healthcare locations, as a localized
radiology system used in a single hospital, healthcare provider
network, or private radiology practice. The system configuration
100 may also operate as an information processing network used to
process data from respective imaging procedures regardless of the
location of an eventual imaging evaluation.
[0020] For purposes of illustration, the system configuration 100
depicted in FIG. 1 includes an imaging system 104, an imaging order
processing system 102, an image review system 106, and a data
pre-processing and coordination system 108. The imaging system 104,
for example, may include an imaging device 120, such as a CT
scanner, a MRI scanner, or another imaging system (e.g., a
radiology imaging modality). Using an energy source such as x-rays
or magnetic fields, for example, the imaging device 120 may capture
image data associated with a subject 122 (e.g., a patient).
[0021] The imaging device 120 may be controlled by a technician 126
at the medical facility through the use of a workstation terminal
or other electronic input control 124. Prior to the technician 126
conducting the imaging procedure for a patient, information may be
entered into the electronic input control 124. Information from an
electronic medical record (EMR) or healthcare information system
(HIS) may also be accessed or updated for the imaging procedure.
Relevant information and metadata for the imaging procedure may be
placed within the image data itself, or within another data store
for further access and processing. For example, the imaging device
120 may produce radiological images generally consistent with the
Digital Imaging and Communications in Medicine (DICOM) format,
other industry-accepted standards, or proprietary standards.
[0022] Consistent with the appropriate image format, the images
produced by the image data source may include metadata. This
metadata may be generated by the imaging device 120, from input
collected by the electronic input control 124, or from input from a
HIS. Further, a series of images produced by the image data source
may be obtained directly by the imaging device 120 in the facility
shown in FIG. 1, or may be transferred in whole or in part from
another image capturing device or image data store connected to the
imaging device 120 or the medical facility's local network. The
imaging data source may also include data transmitted through use
of a local facility imaging server (not shown), such as a DICOM
server or other Picture Archiving and Communication System (PACS).
The metadata within each imaging data file may include
identification information such as a patient identifier and an
identifier of the series of images, in addition to information
about the type of imaging modality and the techniques used to
obtain the images. Further, for images formatted according to the
DICOM standard, data fields such as a unique image identifier, a
unique study identifier, the patient's name, and the facility from
which the image originates may be included.
[0023] The image data generated by the imaging device 120 may
include a series of two-dimensional images, with the collection of
some identifiable series of images typically referred to as a
"study". In some implementations, the image data may be used to
produce a three-dimensional model that can be further manipulated
and reformatted for generating two-dimensional (or
three-dimensional) images. In other implementations, the image data
may include three-dimensional models or graphical data generated by
the imaging device 120 or intermediate processing systems. Image
data captured by the imaging device 120 may be stored and processed
by the imaging order processing system 102 or another local or
remote imaging device server (e.g., one or more computers with a
processor and a memory), and may be provided to other systems and
computers in the system configuration 100 through network 130
(e.g., an intranet or the Internet).
[0024] In some implementations, medical imaging procedure data
provided to the imaging order processing system 102 results in data
being stored and processed by one or more computers. For example,
the imaging order processing system 102 may determine that the
medical imaging procedure data is to be forwarded to a viewing
system evaluating user 142 (e.g., a radiologist) at an image review
system 106. As shown, image data may be provided by the imaging
order processing system 102 through the network 130 to the image
review system 106. Additionally, the medical imaging procedure data
provided to the imaging order processing system 102 results in the
image data or the order data (or both) being processed by the data
pre-processing and coordination system 108. As further detailed
herein, this data may be handled by the data pre-processing and
coordination system 108 prior to, in parallel with, or at the same
time as the provision or assignment of the image data to the image
review system 106.
[0025] The image review system 106, for example, may include an
image display server 144 (e.g., one or more computers with a
processor and a memory), a display device 146 (e.g., a monitor),
and input devices 148A-148B (e.g., keyboards, computer mice,
joysticks, touch interfaces, voice recognition interfaces, and the
like). In some implementations, image data may be processed by the
image display server 144 and visually presented to the evaluating
user 142 as one or more images at the display device 146. Using the
input devices 148A-148B, the evaluating user 142 may interact with
the presented images, for example, by manipulating one or more user
controls included in a graphical user interface presented at the
display device 146 in association with the images. For example, the
evaluating user 142 may view an image (or a series of related
images), and may specify one or more image adjustments, such as
zooming, panning, rotating, changing contrast, changing color,
changing view angle, changing view depth, changing rendering or
reconstruction technique, and the like. By viewing and interacting
with presented image data and with the user interface, for example,
the evaluating user 142 may indicate a diagnostic finding or
produce a diagnostic finding output related to a radiological
imaging procedure performed on the subject 122.
[0026] The image pre-processing and coordination system 108, for
example, may also include a data processing server 154 (e.g., one
or more computers with a processor and a memory), a display device
156 (e.g., a monitor), and input devices 158A-158B (e.g.,
keyboards, computer mice, joysticks, touch interfaces, voice
recognition interfaces, and the like). In some implementations,
medical imaging procedure data may be processed by the data
processing server 154 and visually presented to a preparing user
152 within a graphical user interface at the display device 156. In
some implementations, the graphical user interface may be
interacted with by the preparing user 152 to effect processing and
changes to the medical imaging procedure data with the data
processing server 154. In some implementations, the data processing
server 154 may perform automated processing and changes to the
medical imaging procedure data; in other examples, the data
processing server 154 creates additional data used to record and
track changes from the medical imaging procedure data.
[0027] When the imaging order processing system 102 receives the
image, it may process the image with an image server. This
processing may include compressing or converting the image to a
different format using a compressor/converter module. This image
server may also operate to extract metadata from each image file in
a series of images. For example, the extracted metadata may include
header data for the image providing patient information and
hospital information for the hospital that sent the image. The
image server may then store all or part of the extracted
information in a study record that may be correlated with
appropriate orders and studies. The imaging order processing system
102 may operate to process related orders or correlate a particular
order (and order data) with a particular set of study images (and
image data). In some examples, the imaging order processing system
102 operates to perform a lateral and horizontal movement of
studies between an onsite facility and a remote/cloud location with
a closely orchestrated feed utilizing HL7 (Health Level 7) and
DICOM standards.
[0028] FIG. 2 illustrates a system operations diagram 200 of an
example workflow for generating and routing a set of data produced
from a particular medical imaging study (e.g., a radiology study)
with use of coordination and pre-processing activities according to
an example described herein. The system operations diagram 200 is
depicted as including image data 206 and order data 210 originating
from data of a medical imaging procedure (produced from an imaging
modality 202 or a data store 203 (or both) at one or more medical
imaging facilities 201), with the combination of image data and
order data collectively referred to as imaging procedure data 204.
It will be understood, however, that the imaging procedure data 204
may also be accompanied, integrated, or associated with information
from medical information systems (e.g., EMR data, HIS data, and the
like) that is not necessarily produced from the medical imaging
procedure.
[0029] The system operations diagram 200 illustrates a series of
operations executable with an image processing system, such as the
system configuration 100 or specific components of the imaging
order processing system 102 and data pre-processing and
coordination system 108. These operations include the receipt and
processing of the imaging procedure data 204 (e.g., radiology study
data, including one or both of a radiology order and a radiology
imaging data) originating from a particular medical imaging
facility or imaging source of the medical imaging facilities 201.
This imaging procedure data 204 is processed to obtain identifying
data associated with the medical imaging procedure, including an
identification of imaging characteristics, type of the imaging
procedure, and associated information related to the evaluation of
the imaging data. For example, the medical imaging procedure data
may include image data 206 and image metadata 208, where the image
metadata 208 may include identification information such as a
patient identifier and an identifier of the series of images, in
addition to information about the type of imaging modality and the
techniques used to obtain the images. The imaging procedure data
204 also may include order data 210 for an associated order to
perform the diagnostic evaluation of the image data. For example,
the order data 210 may be associated with data from an HL7 Order
Message (ORM) sent when a healthcare provider requests a service,
procedure, or treatment for a patient.
[0030] The imaging procedure data 204 may be provided to or
assigned within the medical imaging procedure management system 230
for further use and processing of the image data 206 and the order
data 210. For example, the medical image procedure management
system 230 may include a PACS module 232, where the PACS module 232
provides image storage and access features for the image data 206.
The medical imaging procedure management system 230 may further
include a Radiology Information System (RIS) module 234, where the
RIS module 234 provides information processing functions for the
order data 210. The PACS module 232 and RIS module 234 may
organize, correlate, and process the image data 206, image metadata
208, and order data 210.
[0031] Data from the medical image procedure management system 230
may be provided to a data assignment system 240 for purposes of
assignment to one or more selected evaluators for diagnostic
interpretation, analysis, or other evaluation of the image data
206. For example, the data assignment system 240 may maintain a
series of evaluator worklists 242 which are used to propagate the
assignment of studies to respective evaluators. The data assignment
system 240 may use a set of assignment logic and rules 244 to
determine the appropriate assignment of studies to the respective
evaluators. Accordingly, the data assignment system 240 can operate
to provide imaging data to an evaluation system 260 operated by a
respective evaluator. The evaluation system 260 may include a
worklist 262 of assigned studies to review by a particular
evaluating user; an image viewer 264 to output and control the
display of various images from the image data; and reporting
functions 266 to collect and compile a diagnostic report for
medical findings from the image data.
[0032] Data from the medical image procedure management system 230
also may be provided to a data coordination and preparation system
250 that is used to review, prepare, correct, modify, augment, or
change the imaging procedure data 204 in connection with the
assignment and evaluation functions described above. For example,
the data coordination and preparation system 250 may apply a
preparation protocol 252 to perform automated or computer-assisted
operations to modify the imaging procedure data 204 (or to modify a
working copy of the imaging procedure data 204).
[0033] The data coordination and preparation system 250 may also
include a data modification interface 254, which may be embodied by
a graphical user interface, to allow a preparing user to make
changes to the imaging procedure data 204. For example, if a
preparing user determines that prior comparison study data (e.g.,
historical imaging procedure data 275) is not properly included in
(or linked or associated) to the imaging procedure data 204, the
preparing user may access a particular set of imaging procedure
data 275 from a data archive 270 (or, from the data store 203 at a
site of the medical imaging facility 201), and associate the
particular set of imaging procedure data 275 to the imaging
procedure data 204. In a similar example, the preparing user may
perform operations to correct known errors, update visual
characteristics, for either order data 210 or image data 206. As a
result of these changes or additions to the imaging procedure data
204, the data assignment system 240 may provide a more accurate
assignment. For example, if a particular specialty is identified as
a result of the correction, or information that affects the
assignment of the study to a particular evaluator is corrected or
augmented, the assignment will be more accurate and less
susceptible to encounter technical delays, re-transmission, or
re-assignment.
[0034] The updates that are provided or added to the imaging
procedure data 204 may be changes to representations of display
states for the imaging procedure data 204. For example, changes to
the data may be provided within a set of image display states
indicated by preparation data such as bookmark data 280. The
bookmark data 280 may be established or updated by the data
coordination and preparation system 250 to track a state for a
display of the image data 206 that can be subsequently accessed by
the evaluation system 260. The bookmark data 280 may be used to
establish relevant views and image display states that assist the
display of the study, series, or individual images to the
evaluating user.
[0035] In some examples, the bookmark data 280 is communicated as
part of an "image manifest" that is used to specify the image
display characteristics (e.g., image presentation and organization
characteristics) of a particular image study state for a plurality
of images. The state for the display of the image data 206 may be
updated to include various changes to presentation features, image
orientations, image positions, and other changes from a default or
unmodified display state of the image data. Accordingly, the
preparing user may utilize the data modification interface 254 to
create and update display changes perfected in the bookmark data
280. Changes may be received from a preparing user with the use of
an image viewer in the data modification interface 254, as the
preparing user previews or demonstrates the image display that will
occur at the evaluation system 260. Other types of preparation data
may be established or otherwise updated by the preparing user.
[0036] Although not expressly depicted within FIG. 2, other fields
of information may be established or updated by the data
coordination and preparation system 250 for provision to and use by
the evaluation system 260. These fields of information may include
measurements, image annotations, preliminary image findings and
report data, order data modifications, and the like, and data
values for these fields of information may be received within the
data modification interface 254. These fields of information may be
communicated via the bookmark data 280, such as bookmark data
included with the image manifest that is read by the data
coordination and preparation system 250. The fields of information
may also be used to provide updates to the PACS 232 or RIS 234
modules, or other components of the medical image procedure
management system 230. In other examples, the fields of information
may be communicated as state data to the data assignment system
240, or propagated throughout the system in diagram 200 to
evaluating users as part of display preferences, assignment data,
or other relevant data values.
[0037] In some examples, the image display state that is
established by the data coordination and preparation system 250
(e.g., specified in the bookmark data 280) differs from that
established by hanging protocols. Whereas a hanging protocol may be
used at the evaluation system 260 to arrange multiple series of
images in a display relative to each other, a hanging protocol is
typically not knowledgeable about orientation of the images within
the series. Further, a hanging protocol typically only evaluates
metadata, whereas the data coordination and preparation system 250
may be used to evaluate the actual display that will occur for
rendering and evaluation of the image data. The use of human
preparing users and advanced processing algorithms at the data
coordination and preparation system 250 thus provides for more
flexibility and accuracy for visual presentation changes than is
available with traditional techniques and rules for organizing
medical image displays.
[0038] The image display state that is established by the data
coordination and preparation system 250 thus allows the full
reorientation, position, and modification of a display state, to
customize a display state of one or more images by actions of a
preparing user. The image display state that is established by the
data coordination and preparation system 250 accomplishes these
modifications through the use of the image manifest that is
communicated to respective systems. The image manifest may be used
to provide a uniform way to evaluate and organize images, despite
the original format of the study and discrepancies in format or
organization from the original modality or medical imaging
facility. Accordingly, the involvement of a preparing user and the
use of a preparation protocol at the data coordination and
preparation system 250 will result in time, processing, and
technical efficiencies, to enable an evaluating user (e.g., a
radiologist) to more quickly access data of improved quality, in a
standardized and uniform format.
[0039] FIG. 3 illustrates a flowchart 300 of a preparation and
assignment process that may be performed in an image data
processing system, such as the systems depicted in FIGS. 1 and 2,
according to an example described herein. This preparation and
assignment process may be initiated through the receipt of a
request for a medical imaging evaluation from a medical facility,
for example, at a radiology practice or at a teleradiology
provider. In other examples, portions of this preparation and
assignment process may be initiated as a standalone data
verification process, such as may be performed by a third party
vendor to validate or evaluate imaging procedure data.
[0040] In the flowchart 300, various operations are performed to
validate the medical imaging evaluation request, which as depicted,
may take the form of an order (e.g., image read request) to
evaluate an imaging study. The workflow operations are commenced
with the creation of the imaging evaluation order (operation 310),
or a similar access or retrieval of the imaging evaluation order.
The operations continue with the validation of the imaging
evaluation order (operation 320). This validation may involve
computer-assisted or computer-exclusive analysis of data, to ensure
that data fields necessary to perform the imaging evaluation are
provided or accessible. If necessary fields are not present in the
order data or in image data associated with the order, then the
study may be immediately escalated to a service center (such as an
operations center), rejected, or flagged.
[0041] The operations of the flowchart 300 continue with the
evaluation of the medical imaging procedure data using a prep rule
engine (evaluation 330). The prep rule engine may evaluate various
rules and conditions to determine whether further preparation and
coordination of the study is allowed or preferable. For example,
certain types of medical imaging orders (and data associated with
the orders) may be subject to a rule that indicates further prep is
required, whereas time-sensitive medical imaging orders may be
subject to a rule that precludes further prep. Other analyses by
the prep rule engine (in evaluation 330) may involve an analysis of
the type of order or study to determine whether information is
missing or incorrect, whether images are not in a correct display
state, or like evaluations on substantive study information.
[0042] If the evaluation by the prep rule engine (evaluation 330)
indicates the usefulness of further coordination and preparation of
the medical imaging procedure data, then the coordination and
preparation of the medical imaging procedure data (operation 350)
may be commenced after (or concurrent with) the initial assignment
of the study to one or multiple evaluators (operation 340). The
initial assignment of the study to multiple evaluators may be
performed even though the study is not visible or accessible for
evaluation (e.g., the study is hidden, locked, or restricted) via
the worklist of the respective initial evaluators.
[0043] For example, the multiple evaluators that receive the
initial assignment may not be aware that their respective computer
systems have received an initial assignment for a study evaluation,
although the respective computer systems begin to receive and
process image data for the study. Pre-loading and pre-caching
activities may download or retrieve the relevant medical imaging
procedure data (including order and image data) in the background
to multiple available or pre-selected evaluators while the study
awaits additional coordination and preparation actions, or while
initial coordination and preparation actions are being conducted
for the study. The study may be made visible (or accessible, or
unlocked) on the worklist of multiple evaluators (or a particular
designated evaluator) immediately after the completion of the
coordination and preparation activities (operation 360), or after
the completion of determined conditions that release the study for
evaluation to the evaluator(s). In some examples, at the completion
of the coordination and preparation activities, data such as
bookmark data, an image manifest, or other image display state
information is communicated to and loaded on the computer system of
the evaluator(s), such as a particular evaluator who accepts the
assignment and begins the diagnostic evaluation.
[0044] If the evaluation of the prep rule engine (in evaluation
330) indicates no need for preparation and coordination of the
medical imaging data, or no further coordination and preparation
actions (in operation 350) remain to be conducted, then the
evaluation of the imaging data may be commenced with the assignment
of the study to the evaluator(s) (operation 360). This study
assignment may be accompanied by operations that make the order and
the study data visible on the worklist of the evaluator(s). As
suggested above, the study may become visible on the worklist of
the evaluator(s) during (but prior to) the conclusion of
coordination and preparation actions (in operation 350). For
example, if the data for the study is verified as complete, but
only image orientation or presentation verification issues remain,
then the study data may appear on the worklist of the evaluator(s),
and a particular evaluator user may begin the diagnostic
evaluation. The particular evaluator user may then receive updates
to the bookmark data, image manifest, and image display states
during the diagnostic evaluation as the coordination and
preparation actions are completed by a preparing user.
[0045] Finally, the workflow concludes by the performance of the
study evaluation by the particular evaluator user (operation 370),
which results in the creation of a report or other data results.
The report or data results then may be communicated to the original
ordering medical facility (operation 380) or stored in a results
medical information database. The changes to the study data, and
the creation of metadata associated with the study data changes,
that occur with the coordination and preparation actions may be
leveraged by the evaluating user. For example, corrected or
supplemented metadata information (including image measurements and
diagnostic information) supplied by the coordination and
preparation actions may be pre-populated in evaluator reports or
report data. All or portions of the performance of the study
evaluation (operation 370) may occur in real-time during or
concurrent with the performance of the coordination and preparation
actions (operation 350).
[0046] FIG. 4 illustrates a flowchart 351 of the various operations
that may be performed by the coordination and preparation actions
(operation 350) suggested in FIG. 3, such as operations conducted
as part of an image review preparation protocol. Although the
flowchart 351 depicts various operations in a sequence, it will be
understood that the coordination and preparation actions (of
operations 350A-350G) may be performed in an alternate sequence, or
performed in response to the detection of certain conditions or
events.
[0047] As shown in the flowchart 351, the coordination and
processing operations may include: adjusting image presentation
(operation 350A), which may involve changes to the orientation,
window/level, contrast, visibility, hanging, or arrangement of
visual images (and associated series and studies of the visual
images); establishing bookmarking and image presentation markers
(operation 350B), which may involve annotating visual image
displays and tracking specific viewing or presentation states of
visual image displays; and associating primary or comparison images
with a study (operation 350C), which may involve retrieval,
processing, and review of image data from a remote database,
archive, or other image data store. If necessary data is missing
from the study that prevents completion of one or more of these
operations (or subsequent evaluation of the study), a support
request may be opened (operation 350D) such as with a request to an
operations center, medical facility, or monitoring location. The
preparation status of the study may remain "open" or in a "pending"
state until the resolution of the support request (operation 350E).
In other scenarios, if the support request has been opened, the
study will continue for evaluation by the evaluator, but relevant
missing data fields of the study may be flagged or identified.
[0048] Based on the operations above and the results of any support
request, additional manual corrections or changes may be applied to
order data or image data (operation 350F). For example, manual
changes from the original order data may be established to
supplement incomplete data fields, supply missing medical
information, or correct incorrectly identified scenarios (such as
radiology images taken with contrast but labeled as without
contrast). Based on the preceding updates and changes in the
coordination and preparation actions, and any study data received
from the preparing user, the data associated for the image study is
updated or supplemented (operation 350G).
[0049] In connection with operations at the medical imaging data
coordination and preparation system, a plurality of automated rules
may be applied to implement the preceding actions as automated
changes to the medical imaging procedure data. For example, items
of information (such as misspelled data fields) can be
automatically detected and corrected by a computer system. In some
examples, automated rules may be processed prior to any preparation
or coordination activities by human actors such as by the preparing
user. In other examples, the changes from the medical imaging
procedure data are human-assisted, such as would be provided in a
graphical user interface allowing a preparing user to review and
reject or accept changes to the items of information. Accordingly,
the coordination and preparation actions may involve any number of
manual adjustments for the presentation of the image study,
consistent with the computer-aided, computer-assisted, or
data-driven techniques described herein.
[0050] In connection with the evaluation of prior or comparison
studies, the preparing user may be presented with a detailed
patient timeline to review prior medical comparisons. For example,
a timeline view may be compiled in a graphical user interface to
display and hang prior imaging studies, imaging reports, and
relevant medical evaluation information that would assist the image
evaluation. This timeline view may be presented to the preparing
user to receive markings and annotations by the preparing user. For
example, the preparing user may be provided with the ability to
select which study of a set of previous radiology studies to use as
the prior study, or to select which particular study, series, or
image of a study is the most relevant recent comparison for
purposes of the specific medical evaluation being performed. This
timeline functionality may be integrated with retrieve/query
features of a PACS system, such as a PACS system of the originating
medical facility or of a radiology medical practice. In further
examples, automated techniques may be used to pre-select a most
relevant comparison image based on scoring metrics and image
analysis. However, such automated techniques may be used in
combination with actions of the preparing user to present an
interface to verify or confirm an automatic selection of this
comparison image.
[0051] In further examples, graphical user interfaces (GUIs) may be
designed to receive interactions and updates to the medical imaging
procedure data, as part of the preparation and coordination
process. For example, a graphical user interface displayed to the
preparing user may include a worklist to display a status of
numerous medical imaging orders. This worklist may include an
indication of high-priority orders or orders requiring immediate
attention by the preparing user. Further examples of worklists for
preparing and evaluating multiple medical imaging studies are
described below.
[0052] In some examples, some or all functions of the preparing
user may be conducted by a radiology practitioner assistant (e.g.,
an individual who is a certified and registered radiographer), or
other medically trained personnel. Further, a radiology
practitioner assistant may perform initial medical evaluation
actions (including establishing medical diagnoses, reports, and
findings) during the coordination and processing actions, with such
evaluation actions being later reviewed and confirmed by an
evaluating radiologist. In other examples, the functions of the
preparing user may be limited to basic data entry and image
modification, such as may be performed by a radiology technician or
similarly trained person.
[0053] FIG. 5A illustrates a worklist graphical user interface 500,
provided to a preparing user (e.g., preparer), such as would be
provided at the data modification interface 254 operated in the
coordination and preparation system 250 of FIG. 2. The worklist
graphical user interface 500 may include various highlights, flags,
or other indications of data fields that are determined to be
incomplete. The preparing user may utilize the worklist graphical
user interface 500 to access data for one or a plurality of
studies, with the worklist capable of being filtered based on data
fields such as status, facility, patient information, time, imaging
source, and other predetermined or calculated characteristics.
[0054] FIG. 5B illustrates a study preparation graphical user
interface 550, provided to a preparing user (e.g., preparer), such
as would be provided at the data modification interface 254
operated in the coordination and preparation system 250 of FIG. 2.
This study preparation interface may be provided as a result of the
selection of a particular study on a worklist for the preparing
user, and may include information relative to a particular study.
The study preparation interface or an equivalent user interface may
offer the preparing user with a subset (or an extension of) the
control to access and manipulate study and study data that are
typically managed by administrative users, such as operations
center users. For example, the study preparation graphical user
interface 550 includes controls 552 to view images, access order
support, view order information, view patient information, or
refresh case details. Accordingly, the preparing user may be able
to review or manage data individually or collectively for a variety
of studies, including studies yet to be assigned for a plurality of
evaluators.
[0055] Within the study graphical user interface 550, various
options can be provided to the preparing user to change and modify
study data and study data characteristics for a particular study.
The study graphical user interface 550 may be arranged to provide
access to other data sources (such as image archives) where the
preparing user can obtain additional relevant information. A
further option can be provided to indicate when the particular
study is ready for review, to escalate the study to a support
center, and the like.
[0056] FIG. 6A illustrates a worklist graphical user interface 600,
provided to an evaluating user (e.g., radiologist) such as would be
provided at the worklist 262 operated in the medical imaging
evaluation system 260. In some examples, the study will not be
displayed on the worklist graphical user interface 600 until
preparation actions are complete and released by the preparing user
with the graphical user interface 500. In other examples, the study
may appear on the evaluator worklist graphical user interface 600
(even if preparation actions have started but are not complete) if
a turnaround time elapses (such as a maximum amount of time). In
still other examples, the study may appear on the worklist
graphical user interface 600 if some but not all preparation
actions are complete (such as after the preparing user has verified
that the study meets some minimum requirements). For example, if
the study has not been completely prepared yet, the data for the
study may be updated and refreshed at the evaluation system
260.
[0057] FIG. 6B illustrates a study reporting graphical user
interface 650, provided to an evaluating user (e.g., radiologist)
such as would be provided with reporting or study management
functionality in the medical imaging evaluation system 260.
Features of the study reporting graphical user interface 650 may
include a timeline 652 (including data that may be supplemented or
edited by the preparing user); study information 654 (including
data that may be supplemented or edited by the preparing user); a
study reporting result interface 656 (including data that may be
supplemented or edited by the preparing user); and like interfaces
which may be affected by the results of the preparing user. It will
be understood that the data provided by the preparation actions
described throughout this disclosure may be implemented in the
study reporting graphical user interface 650 through various
controls, inputs, and displays.
[0058] In accordance with the assignment process above, data for
the medical imaging procedure may be sent to multiple evaluators.
In this scenario, although multiple users have been preliminarily
assigned the medical imaging study, the data of the study will not
be accessible for evaluation until the study is released and the
study appears on the worklist. Thus, data for the study (such as
metadata, order data, or even the image data) may be cached to a
plurality of possible evaluators (although the assignment may
change), and the study will not be visible to the possible
evaluators until certain conditions have completed. These
conditions may include: when the study is completely prepped (or
certain prepping actions have occurred); the turn-around-time
expires; or if the worklist for the particular evaluator is empty.
In these and other scenarios, the default action may involving
perform the assignment to at least one best matched evaluator,
regardless of the status of the coordination and preparation
actions.
[0059] Based on the actions performed upon the data and the display
by the particular evaluating user and the preparing user, the
system may learn preferences and necessary changes to implement for
subsequent imaging studies. Accordingly, changes that are repeated
or errors that are repeatedly detected may be corrected or
supplemented with automated rules. Other techniques may be used for
logging and recording changes in presentation and style for
particular preparing users and evaluating users. Logging also may
be performed to determine which types of changes are commonly
implemented by preparing users, versus evaluating users, including
the creation of prompts or suggestions for preparing users if the
change is commonly performed by evaluating users (or a particular
evaluating user). In further examples, changes from respective
evaluating users (e.g., radiologists) including visual display
preferences can be logged, monitored, and adapted into rules and
automated changes.
[0060] FIG. 7 illustrates a flowchart 700 of an example workflow
for processing data produced from a particular medical imaging
study according to an example described herein. The particular
sequence depicted in the flowchart 700 is illustrated to emphasize
the end-to-end actions which may occur in image processing and
evaluation activities, such as for processing of radiology images
and orders. However, it will be understood that the sequence of
operations may vary depending on the precise data operations to be
performed upon the study data produced by the imaging procedure and
the originating medical facility, the conditions present when
evaluating the study data, the state of the study data (including
the number of errors in the study data), and human actions used to
effect the preparation or coordination actions.
[0061] The flowchart 700 illustrates a series of operations
executable with an image processing system, such as the system
configuration 100 or specific components of the imaging order
processing system 102. These operations include the processing of
data associated with a request for a medical imaging evaluation
data (e.g., processing of order data or image data originating from
a medical imaging procedure) (operation 710). This data is
processed to determine the particular characteristics and type of
the imaging procedure, and whether preparation and coordination is
required (or available).
[0062] Based on identified information from the procedure data, the
characteristics of the procedure can be analyzed, and a preparation
protocol may be executed upon the data (operation 720). For
example, the preparation protocol may involve an evaluation of
order data and image data metadata, to apply automated rules and
corrections to study data. The preparation protocol may also
involve the use of human-assisted review and corrections,
consistent with the actions described in FIGS. 2, 3, and 4
above.
[0063] Based on the preparation protocol, the medical imaging
request may be initially assigned to one or more medical
evaluators. In some scenarios, order data, metadata, or image data
for the medical imaging study may be transferred to (e.g., copied,
downloaded, or pre-cached) a plurality of medical evaluators
(operation 740), but not visible or accessible on the worklist of
the evaluators, after the preparation protocol has begun. The
preparation protocol continues and is ultimately completed upon the
data (operation 750).
[0064] Upon completion of the preparation protocol, at least one
particular medical evaluator from the plurality of medical
evaluators may be designated to perform the evaluation of the
medical imaging data (operation 760). For example, this designation
may occur in response to making the study visible on the worklist
of the medical evaluator(s) in response to the preparation protocol
being completed, in response to receiving an indication of certain
actions in the preparation protocol being completed, or like
conditions. In other examples, the designation of a study to a
particular medical evaluator(s) (operation 760) may be conducted
upon the occurrence of other conditions, such as a turnaround time
elapsing, a worklist of the medical evaluator being empty, or like
scenarios. Once the particular medical evaluator selects or
otherwise confirms the receipt and acceptance of the study, the
evaluation of the medical imaging data commences.
[0065] FIG. 8 provides an illustration of a flowchart 800 of
additional workflow operations that may be performed upon a
particular imaging study (and associated imaging data) based on the
preparation protocol described herein. The operations depicted in
flowchart 800 are provided as example operations, but it will be
understood that many of the depicted operations need not occur in
sequence, but may occur in parallel, conditionally, or in other
variations. Further, some or all of the operations depicted in
flowchart 800 may occur in addition to the preparation protocol
actions suggested in flowchart 700.
[0066] As illustrated, the various operations of flowchart 800 may
include processing operations that are performed to accomplish
preparation of the medical imaging procedure data for further
evaluation. For example, the operations may include: verifying
completeness of data (imaging data and request data) associated
with a medical imaging evaluation request (e.g., a radiology order)
(operation 810); verifying and obtaining comparison and prior
imaging data (e.g., images from previous radiology studies for
comparison) (operation 820); verifying and obtaining relevant
clinical information in the evaluation request (e.g., medical
information fields in a radiology order) (operation 830); and
verifying a visual arrangement of images (operation 840).
[0067] Based on the result of the verifications, data associated
with the medical imaging evaluation request may be updated
(operation 850). Additionally, new data and metadata fields such as
bookmarking, image manifests, or other arrangements of data for
image presentation may be established (operation 860). Based on the
new data and metadata fields, an updated assignment may be
initiated to a particular evaluator (or set of evaluators)
(operation 870). Further based on the new data and metadata fields,
an updated visual arrangement of the study may be initiated at a
graphical display of the particular evaluator (operation 880) who
accepts or is otherwise designated to perform the evaluation.
[0068] FIG. 9 illustrates an example configuration of a system
architecture 900 configured to implement the presently described
processing system according to an example described herein. System
architecture 900 may implement components such as the imaging order
processing system 102 and features of the image review system 106
and the data pre-processing and coordination system 108. The system
architecture 900 may include a radiology information system module
920, a picture archiving communication system module 930, an order
data processing module 940, an image data processing module 950, an
image data preparation module 960, a study display state module
970, a study assignment module 980, a study data caching module
992, a study data routing module 994, a study viewing module 996,
and a study reporting module 998. In operation with these modules,
the system architecture 900 may further include a plurality of
databases or data stores, including a medical imaging database 902,
an imaging procedure database 904, an imaging evaluation state
database 906, and an evaluator database 908.
[0069] The medical imaging database 902 may provide a location for
storage of imaging data (and metadata) for medical imaging
procedures and associated studies. The imaging procedure database
904 may provide a location for storage of information to identify
and process information for respective medical imaging procedures.
The imaging evaluation state database 906 may provide a location
for storage of metadata for imaging evaluation states including
image manifests, bookmarks, annotations, and data fields used to
perform respective image evaluations. The evaluator database 908
may provide a location for storage of information specific to
evaluator preferences, capabilities, and characteristics related to
the display of study images at an evaluator.
[0070] The various modules may perform functional operations to
effect the processing, coordination, and assignment techniques
described herein. For example, the radiology information system
module 920 may be used to provide respective information processing
functions of a RIS. The picture archiving communication system
module 930 may be used to provide image storage and access features
of a Picture Archiving Communication System (PACS). The order data
processing module 940 may be used to process orders, and determine
relevant information for pre-processing data of studies for
evaluation. The image data processing module 950 may be used to
request, receive, validate, and store images of studies for
evaluation. The image data preparation module 960 may be used to
perform imaging processing operations on imaging data obtained from
a set of data associated with a medical imaging procedure, or from
a customer imaging device, an image archive, medical facility data
store, or other imaging data source.
[0071] The study display state module 970 may be used to provide
consistent review of a study state between a preparing user and an
evaluating user, or to establish and provide custom study viewing
outputs (such as hanging protocols, display characteristics, and
the like) based on the characteristics of the imaging study. The
study assignment module 980 may be used to determine a preliminary
assignment or listing of the study on a worklist for one or more
medical evaluators, or to implement a finalized assignment of the
study for evaluation by a particular evaluator who accepts or is
otherwise confirmed to conduct the study. The study data caching
module 992 may be used to coordinate pre-caching and pre-loading
operations to computer workstations and network locations
associated with one or more medical evaluators, in connection with
study initial and finalized assignments and the associated imaging
and study state data for the evaluation. The study data routing
module 994 may be used to route, obtain, or direct imaging data and
study state data for study evaluations among different medical
platforms and locations based on the preparation actions, such as
directing a radiology study to be read onsite versus remotely, or
facilitating a request for imaging data to be obtained from a
medical facility or image archive. The study viewing module 996 may
be used to view studies (and specific types of rendering data) on
screen by an evaluating user. The study reporting module 998 may be
used to establish reporting functions for the evaluating user,
either from a report that is primarily created by the evaluating
user, or pre-populated by a previous reviewer such as a radiology
practitioner assistant (RPA).
[0072] FIG. 10 is a block diagram illustrating an example computing
system machine 1000 upon which any one or more of the methodologies
herein discussed may be run according to an example described
herein. Computer system 1000 may be embodied as a computing device,
providing operations of the components featured in the various
figures, including components of the imaging order processing
system 102, the imaging system 104, the image review system 106,
the data pre-processing and coordination system 108, modules and
data storage elements in system architecture 900, or any other
processing or computing platform or component described or referred
to herein. In alternative embodiments, the machine operates as a
standalone device or may be connected (e.g., networked) to other
machines. In a networked deployment, the machine may operate in the
capacity of either a server or a client machine in server-client
network environments, or it may act as a peer machine in
peer-to-peer (or distributed) network environments. The computer
system machine may be a personal computer (PC) that may or may not
be portable (e.g., a notebook or a netbook), a tablet, a Personal
Digital Assistant (PDA), a mobile telephone or smartphone, a web
appliance, or any machine capable of executing instructions
(sequential or otherwise) that specify actions to be taken by that
machine. Further, while only a single machine is illustrated, the
term "machine" shall also be taken to include any collection of
machines that individually or jointly execute a set (or multiple
sets) of instructions to perform any one or more of the
methodologies discussed herein.
[0073] Example computer system 1000 includes a processor 1002
(e.g., a central processing unit (CPU), a graphics processing unit
(GPU) or both), a main memory 1004 and a static memory 1006, which
communicate with each other via an interconnect 1008 (e.g., a link,
a bus, etc.). The computer system 1000 may further include a video
display unit 1010, an alphanumeric input device 1012 (e.g., a
keyboard), and a user interface (UI) navigation device 1014 (e.g.,
a mouse). In one embodiment, the video display unit 1010, input
device 1012 and UI navigation device 1014 are a touch screen
display. The computer system 1000 may additionally include a
storage device 1016 (e.g., a drive unit), a signal generation
device 1018 (e.g., a speaker), an output controller 1032, and a
network interface device 1020 (which may include or operably
communicate with one or more antennas 1030, transceivers, or other
wireless communications hardware), and one or more sensors
1028.
[0074] The storage device 1016 includes a machine-readable medium
1022 on which is stored one or more sets of data structures and
instructions 1024 (e.g., software) embodying or utilized by any one
or more of the methodologies or functions described herein. The
instructions 1024 may also reside, completely or at least
partially, within the main memory 1004, static memory 1006, and/or
within the processor 1002 during execution thereof by the computer
system 1000, with the main memory 1004, static memory 1006, and the
processor 1002 constituting machine-readable media.
[0075] While the machine-readable medium 1022 is illustrated in an
example embodiment to be a single medium, the term
"machine-readable medium" may include a single medium or multiple
media (e.g., a centralized or distributed database, and/or
associated caches and servers) that store the one or more
instructions 1024. The term "machine-readable medium" shall also be
taken to include any tangible medium that is capable of storing,
encoding or carrying instructions for execution by the machine and
that cause the machine to perform any one or more of the
methodologies of the present disclosure or that is capable of
storing, encoding or carrying data structures utilized by or
associated with such instructions. The term "machine-readable
medium" shall accordingly be taken to include, but not be limited
to, solid-state memories, optical media, and magnetic media.
Specific examples of machine-readable media include non-volatile
memory, including, by way of example, semiconductor memory devices
(e.g., Electrically Programmable Read-Only Memory (EPROM),
Electrically Erasable Programmable Read-Only Memory (EEPROM)) and
flash memory devices; magnetic disks such as internal hard disks
and removable disks; magneto-optical disks; and CD-ROM and DVD-ROM
disks.
[0076] The instructions 1024 may further be transmitted or received
over a communications network 1026 using a transmission medium via
the network interface device 1020 utilizing any one of a number of
well-known transfer protocols (e.g., HTTP). Examples of
communication networks include a local area network (LAN), wide
area network (WAN), the Internet, mobile telephone networks, Plain
Old Telephone (POTS) networks, and wireless data networks (e.g.,
Wi-Fi, 3G, and 4G LTE/LTE-A or WiMAX networks). The term
"transmission medium" shall be taken to include any intangible
medium that is capable of storing, encoding, or carrying
instructions for execution by the machine, and includes digital or
analog communications signals or other intangible medium to
facilitate communication of such software.
[0077] Other applicable network configurations may be included
within the scope of the presently described communication networks.
Although examples were provided with reference to a local area
wireless network configuration and a wide area Internet network
connection, it will be understood that communications may also be
facilitated using any number of personal area networks, LANs, and
WANs, using any combination of wired or wireless transmission
mediums.
[0078] The embodiments described above may be implemented in one or
a combination of hardware, firmware, and software. For example, the
modules in the system architecture 900 of the processing system may
be client-operated software or be embodied on a server running an
operating system with software running thereon. While some
embodiments described herein illustrate only a single machine or
device, the terms "system", "machine", or "device" shall also be
taken to include any collection of machines or devices that
individually or jointly execute a set (or multiple sets) of
instructions to perform any one or more of the methodologies
discussed herein.
[0079] Examples, as described herein, may include, or may operate
on, logic or a number of components, modules, or mechanisms.
Modules are tangible entities (e.g., hardware) capable of
performing specified operations and may be configured or arranged
in a certain manner. In an example, circuits may be arranged (e.g.,
internally or with respect to external entities such as other
circuits) in a specified manner as a module. In an example, the
whole or part of one or more computer systems (e.g., a standalone,
client or server computer system) or one or more hardware
processors may be configured by firmware or software (e.g.,
instructions, an application portion, or an application) as a
module that operates to perform specified operations. In an
example, the software may reside on a machine readable medium. In
an example, the software, when executed by the underlying hardware
of the module, causes the hardware to perform the specified
operations.
[0080] Accordingly, the term "module" is understood to encompass a
tangible entity, be that an entity that is physically constructed,
specifically configured (e.g., hardwired), or temporarily (e.g.,
transitorily) configured (e.g., programmed) to operate in a
specified manner or to perform part or all of any operation
described herein. Considering examples in which modules are
temporarily configured, each of the modules need not be
instantiated at any one moment in time. For example, where the
modules comprise a general-purpose hardware processor configured
using software, the general-purpose hardware processor may be
configured as respective different modules at different times.
Software may accordingly configure a hardware processor, for
example, to constitute a particular module at one instance of time
and to constitute a different module at a different instance of
time.
[0081] Additional examples of the presently described method,
system, and device embodiments are suggested according to the
structures and techniques described herein. Other non-limiting
examples may be configured to operate separately, or can be
combined in any permutation or combination with any one or more of
the other examples provided above or throughout the present
disclosure.
[0082] Example 1 includes subject matter (such as a method, means
for performing acts, machine readable medium including instructions
that when performed by a machine cause the machine to performs
acts, or an apparatus to perform) comprising: electronically
processing data associated with a medical imaging study, the data
associated with the medical imaging study including imaging data
from a medical imaging procedure; performing a preparation protocol
upon the data associated with the medical imaging study, the
preparation protocol establishing preparation data to affect an
evaluation of the medical imaging study; performing an electronic
assignment of the medical imaging study to a medical evaluator, the
electronic assignment being performed based on the data associated
with the medical imaging study and the preparation data; and making
the medical imaging study available to the medical evaluator for
evaluation, the medical imaging study being made available for
evaluation in response to a completion of the performing of the
preparation protocol; wherein the preparation data is used to
affect a display of the imaging data to the medical evaluator
within the evaluation of the medical imaging study.
[0083] In Example 2, the subject matter of Example 1 may include,
wherein electronically processing the data associated with the
medical imaging study includes determining whether a condition
affects the evaluation of the medical imaging study, wherein the
performing of the preparation protocol is initiated in response to
determining that the condition affects the evaluation of the
medical imaging study, and wherein the condition that affects the
evaluation of the medical imaging study includes at least one of:
missing information in the data associated with the medical imaging
study, an error in the data associated with the medical imaging
study, an incorrect display orientation of images in the imaging
data, or an incorrect display arrangement of images in the imaging
data.
[0084] In Example 3, the subject matter of any one of Examples 1 to
2 may include, the operations of the method transferring the
imaging data associated with the medical imaging study to a
computing device associated with the medical evaluator in response
to the electronic assignment of the medical imaging study to the
medical evaluator; wherein making the medical imaging study
available to the medical evaluator for evaluation includes listing
the medical imaging study on a worklist in a graphical user
interface available to the medical evaluator; and wherein at least
a portion of the data associated with the medical imaging study is
pre-cached at the computing device associated with the medical
evaluator prior to listing the medical imaging study on the
worklist in the graphical user interface available to the medical
evaluator.
[0085] In Example 4, the subject matter of any one of Examples 1 to
3 may include, wherein performing the preparation protocol upon the
data associated with the medical imaging study includes creating
the preparation data that modifies one or more data values of order
data associated with the medical imaging study.
[0086] In Example 5, the subject matter of any one of Examples 1 to
4 may include, wherein performing the preparation protocol upon the
data associated with the medical imaging study includes creating
the preparation data that modifies one or more presentation
characteristics of the imaging data associated with the medical
imaging study.
[0087] In Example 6, the subject matter of any one of Examples 1 to
5 may include, wherein performing the preparation protocol upon the
data associated with the medical imaging study includes creating
data for a support request associated with the medical imaging
study, the support request indicating additional information
required for performance of the evaluation of the medical imaging
study.
[0088] In Example 7, the subject matter of any one of Examples 1 to
6 may include, wherein performing the preparation protocol upon the
data associated with the medical imaging study includes:
identifying one or more comparison images for inclusion in the
evaluation of the medical imaging study, the one or more comparison
images used as a comparison with images in the imaging data from
the medical imaging procedure; obtaining the one or more comparison
images for inclusion in the evaluation of the medical imaging
study; and associating data for the one or more comparison images
with the medical imaging study.
[0089] In Example 8, the subject matter of any one of Examples 1 to
7 may include, the operations of the method performing an initial
electronic assignment of the medical imaging study to the medical
evaluator and one or more other medical evaluators, the electronic
assignment being performed based on the data associated with the
medical imaging study; and establishing an initial listing of the
medical imaging study on a worklist available to the medical
evaluator and respective worklists available to one or more other
medical evaluators, the initial listing being established based on
the data associated with the medical imaging study; and removing
the initial listing of the medical imaging study on the worklist
available to the one or more other medical evaluators in response
to a designation of the study for evaluation to the medical
evaluator.
[0090] In Example 9, the subject matter of any one of Examples 1 to
8 may include, wherein the designation of the study to the medical
evaluator occurs in response to a selection of the medical imaging
study in a graphical user interface via the worklist available to
the medical evaluator.
[0091] In Example 10, the subject matter of any one of Examples 1
to 9 may include, the operations of the method making the medical
imaging study available to the medical evaluator for evaluation,
prior to a completion of the performing of the preparation protocol
upon the data associated with the medical imaging study, based on
one or more of: a worklist available to the medical evaluator being
empty; a turn-around-time for evaluation of the medical imaging
study exceeding a predetermined amount of time; or a priority
indication for the medical imaging study.
[0092] In Example 11, the subject matter of any one of Examples 1
to 10 may include, wherein the medical imaging procedure is a
radiological imaging procedure, wherein the imaging data from the
medical imaging procedure includes radiology images produced for a
radiology study, and wherein the medical imaging study is provided
for a radiological read request for diagnostic evaluation of the
radiology images produced for the radiology study.
[0093] Example 12 includes subject matter (such as embodied on a
computer readable medium) comprising instructions for a computing
machine configured to: process data associated with a medical
imaging study, the data associated with the medical imaging study
including imaging data from a medical imaging procedure; perform a
preparation protocol upon the data associated with the medical
imaging study, the preparation protocol establishing preparation
data to affect an evaluation of the medical imaging study; assign
the medical imaging study to a medical evaluator, based on the data
associated with the medical imaging study and the preparation data;
and modifying an availability of the medical imaging study for
evaluation by the medical evaluator, the medical imaging study
being made available for the evaluation by the medical evaluator in
response to a completion of the preparation protocol; wherein the
preparation data is used to affect a display of the imaging data to
the medical evaluator within the evaluation of the medical imaging
study.
[0094] In Example 13, the subject matter of Example 12 may include,
the instructions further operable to cause the computing machine to
perform operations that: detect a data condition in the data
associated with the medical imaging study, the data condition
including at least one of: missing information in the data
associated with the medical imaging study, an error in the data
associated with the medical imaging study, an incorrect orientation
of images in the imaging data, or an incorrect arrangement of
images in the imaging data; and process data for the medical
imaging study to correct the data condition.
[0095] In Example 14, the subject matter of any one of Examples 12
to 13 may include, the instructions further operable to cause the
computing machine to perform operations that: transfer the imaging
data associated with the medical imaging study to a computing
machine associated with the medical evaluator in response to
assignment of the medical imaging study to the medical evaluator,
wherein at least a portion of the data associated with the medical
imaging study is cached at the computing machine associated with
the medical evaluator prior to the medical imaging study being
designated for performance by the medical evaluator.
[0096] In Example 15, the subject matter of any one of Examples 12
to 14 may include, wherein performing the preparation protocol upon
the data associated with the medical imaging study is implemented
by one or more operations that: create preparation data that
modifies one or more data values of order data associated with the
medical imaging study; create preparation data that modifies one or
more presentation characteristics of the imaging data associated
with the medical imaging study; create data for a support request
associated with the medical imaging study; or associate data for at
least one comparison image with the medical imaging study.
[0097] In Example 16, the subject matter of any one of Examples 12
to 15 may include, the instructions further operable to cause the
computing machine to perform operations that: establish an initial
assignment of the medical imaging study to a plurality of other
medical evaluators based on the data in the medical imaging study;
designate the medical evaluator to perform evaluation of image data
associated with the medical imaging study, wherein operations that
designate the medical evaluator to perform evaluation of the image
data are performed subsequent to the completion of the preparation
protocol upon the data in the medical imaging study.
[0098] In Example 17, the subject matter of any one of Examples 12
to 16 may include, wherein the medical imaging study is made
available to the medical evaluator for evaluation, prior to a
completion of the preparation protocol upon the data associated
with the medical imaging study, based on one or more of: a worklist
operated by the medical evaluator reaching a predetermined
condition; a turn-around-time for evaluation of the medical imaging
study exceeding a predetermined amount of time; or a priority
indication for the medical imaging study.
[0099] Example 18 includes subject matter (such as a device,
apparatus, or machine) comprising: at least one hardware processor
and memory; a preparation module implemented with the at least one
hardware processor and memory, the preparation module configured
to: process data associated with a medical imaging study, the data
associated with the medical imaging study including imaging data
from a medical imaging procedure, and perform a preparation
protocol upon the data associated with the medical imaging study,
the preparation protocol establishing preparation data to affect an
evaluation of the medical imaging study; a study assignment module
implemented with the at least one hardware processor and memory,
the study assignment module configured to: assign the medical
imaging study to a medical evaluator, based on the data associated
with the medical imaging study and the preparation data; and a
study display state module implemented with the at least one
hardware processor and memory, the study display state module
configured to: affect a display of the imaging data at a computing
device of the medical evaluator for the evaluation of the medical
imaging study, based on an updated study display state indicated by
the preparation data.
[0100] In Example 19, the subject matter of Example 18 may include,
a study data caching module implemented with the at least one
hardware processor and memory, the study data caching module
configured to: transfer the imaging data associated with the
medical imaging study to a computing machine associated with the
medical evaluator in response to assignment of the medical imaging
study to the medical evaluator, wherein at least a portion of the
data associated with the medical imaging study is cached at the
computing machine associated with the medical evaluator prior to a
designation of the study for evaluation to the medical
evaluator.
[0101] In Example 20, the subject matter of any one of Examples 18
to 19 may include, wherein the medical imaging procedure produces
data for a radiology study, the system a radiology information
system (RIS) module, the RIS module configured to correlate the
radiology study in a RIS instance with the medical imaging
procedure, and provide order data produced for the medical imaging
procedure.
[0102] In Example 21, the subject matter of any one of Examples 18
to 20 may include, wherein the medical imaging procedure produces
data for a radiology study, and the system a Picture Archiving
Communication System (PACS) module, the PACS module configured to
provide the imaging data produced from the medical imaging
procedure.
[0103] In Example 22, the subject matter of any one of Examples 18
to 21 may include, the system an image data processing module
configured to obtain information from image data associated with
the medical imaging procedure; and an order data processing module
configured to obtain information from order data associated with
the medical imaging procedure; wherein the preparation module is
further configured to detect a data condition in information from
the image data or the order data, the data condition including at
least one of: missing information in the image data or the order
data, an error in the image data or the order data, an incorrect
orientation of images in the image data, or an incorrect
arrangement of images in the image data.
[0104] In Example 23, the subject matter of any one of Examples 18
to 22 may include, a study viewing module implemented with the at
least one hardware processor and memory, the study viewing module
configured to display the study to the medical evaluator based on
state changes to the study, wherein the study display state module
is configured to process data for the medical imaging study to
correct the data condition in a display of the updated study
display state to the medical evaluator.
[0105] In Example 24, the subject matter of any one of Examples 18
to 23 may include, a study reporting module implemented with the at
least one hardware processor and memory, the study reporting module
configured to display a report for the study for editing by the
medical evaluator, based on state changes to the study.
* * * * *