Integrating the Health-care Enterprise Pathology and Laboratory Medicine Guideline for Digital Pathology Interoperability.

Integrating the health-care enterprise (IHE) is an international initiative to promote the use of standards to achieve interoperability among health information technology systems. The Pathology and Laboratory Medicine domain within IHE has brought together subject matter experts, electronic health record vendors, and digital imaging vendors, to initiate development of a series of digital pathology interoperability guidelines, called "integration profiles" within IHE. This effort begins with documentation of common use cases, followed by identification of available data and technology standards best utilized to achieve those use cases. An integration profile that describes the information flow and technology interactions is then published for trial use. Real world testing occurs in "connectathon" events, in which multiple vendors attempt to connect their products following the interoperability guidance parameters set forth in the profile. This paper describes the overarching set of integration profiles, one of which has been published, to support key digital pathology use cases.

Digital Imaging and Communications in Medicine Whole Slide Imaging Connectathon at Digital Pathology Association Pathology Visions 2017.

As digital pathology systems for clinical diagnostic work applications become mainstream, interoperability between these systems from different vendors becomes critical. For the first time, multiple digital pathology vendors have publicly revealed the use of the digital imaging and communications in medicine (DICOM) standard file format and network protocol to communicate between separate whole slide acquisition, storage, and viewing components. Note the use of DICOM for clinical diagnostic applications is still to be validated in the United States. The successful demonstration shows that the DICOM standard is fundamentally sound, though many lessons were learned. These lessons will be incorporated as incremental improvements in the standard, provide more detailed profiles to constrain variation for specific use cases, and offer educational material for implementers. Future Connectathon events will expand the scope to include more devices and vendors, as well as more ambitious use cases including laboratory information system integration and annotation for image analysis, as well as more geographic diversity. Users should request DICOM features in all purchases and contracts. It is anticipated that the growth of DICOM-compliant manufacturers will likely also ease DICOM for pathology becoming a recognized standard and as such the regulatory pathway for digital pathology products.

Cross-organizational workflow in radiology: an empirical study of the quality of shared metadata elements in Region Västra Götaland, Sweden.

BACKGROUND: Challenges related to the cross-organizational access of accurate and timely information about a patient's condition has become a critical issue in healthcare. Interoperability of different local sources is necessary. PURPOSE: To identify and present missing and semantically incorrect data elements of metadata in the radiology enterprise service that supports cross-organizational sharing of dynamic information about patients' visits, in the Region Västra Götaland, Sweden. MATERIAL AND METHODS: Quantitative data elements of metadata were collected yearly from the first Wednesday in March from 2006 to 2011 from the 24 in-house radiology departments in Region Västra Götaland. These radiology departments were organized into four hospital groups and three stand-alone hospitals. Included data elements of metadata were the patient name, patient ID, institutional department name, referring physician's name, and examination description. RESULTS: The majority of missing data elements of metadata was related to the institutional department name for Hospital 2, from 87% in 2007 to 25% in 2011. All data elements of metadata except the patient ID contained semantic errors. For example, for the data element "patient name", only three names out of 3537 were semantically correct. CONCLUSION: This study shows that the semantics of metadata elements are poorly structured and inconsistently used. Although a cross-organizational solution may technically be fully functional, semantic errors may prevent it from serving as an information infrastructure for collaboration between all departments and hospitals in the region. For interoperability, it is important that the agreed semantic models are implemented in vendor systems using the information infrastructure.

Simulation of radiology workflow and throughput.

Emerging electronic health technologies create an unending transformation process. This calls for new ways to plan and prepare the radiology department for these changes. There is a lack of literature addressing ways to predict the effects of implementing and using new technologies in healthcare. Innovative services by means of simulation is a technique that could predict effects of changes beforehand. The aim of this study was to validate the use of discrete event simulation to plan future examination throughput changes in the radiology department of Alingsås Hospital in Sweden after both the investment in a new MRI suite and the closing down of two old rooms. The simulation scenario presented here was based on real life local examination throughput in combination with the total examination throughput from other radiology departments in the region already having MRI suites in use.

Better quality in healthcare through gamified simulation based skill training application.

Although the screening of abdominal aortic diameter helps to identify men with abdominal aortic aneurysm and saves lives, there is need to coordinate and synchronize screening personnel's way to work. This article describes the design of a game based skill training application that could give the screening personnel an additional opportunity to refine measuring of abdominal aortic diameter in ultrasound images. The design work follows the steps of the Goal Directed design process. Consequently, the design activities are divided into six phases: the Research, Modelling, Requirements Definition, Framework Definition, Refinement and Development support. The design process described in this paper finishes with usability testing of an interactive prototype. The evaluation of the design was conducted with end users by studying their subjective ratings and performance on given tasks. The overall results of the usability testing show that the interactive prototype of the skill training application is not yet fully usable. Consequently, further improvement of the interface design is needed. The identified usability issues and collected qualitative and quantitative material about the interaction between test participants and the interface can guide the next design iteration and lead to more usable design.