Imaging intentionally performed during a patient encounter without an associated imaging order.

What is Encounter-Based Imaging?

Clinical Areas

Lightweight Devices

Lightweight Devices

What is Encounter-Based Imaging?�

What is Encounter-Based Imaging?�

Order-based Imaging

• Scheduled
• Radiology / Cardiology
• CT, MR, PET, XA, MG, Echo, …
• Worklists
• Integrated systems

Encounter-based Imaging

• Ad-hoc
• Dermatology, Wound Care,Burn Unit, ER, ...
• Tablets, Cameras, PoCUS, ...

Common Requirements

• Medial Record
• Image Retention Policies
• Cross-department Availability
• Follow-up
• Billing

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From Photo to Medical Document

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Patient

Name, Date of Birth, Age, MRN, Other IDs, …

Encounter

Department, Specialty, Physician, Referring Physician, �Admission ID, Admission Date/Time, Reason for Admission, …

Procedure

Modality, Imaging Procedure, Body Part, Reason for Imaging, �Accession #, Acquisition Date/Time, Device, Operator, …

Pixel

Rows, Columns, Bit Depth, Pixel Size, Encoding, ...

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Metadata

Encounter Based Imaging Workflow

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Standardizes

• Demographics
• Admission details
• Procedure details

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... building on the IHE Scheduled Workflow Profile

• Borrows: accession, query for metadata, standardized storage
• Adds: new devices, DICOMweb, result notification
• Skips: order, MPPS, Storage Commitment

EBIW Actors

Encounter Manager

• Coordinates encounters between a care provider and a patient and associated data (e.g. practice management system).

Acquisition Modality

• Acquires and creates medical images (e.g., point of care ultrasound).

Lightweight Modality

• Acquires medical images and communicates using lightweight (RESTful) protocols.

Image Manager/Archive

• PACS or VNA

Result Aggregator

• Facilitates the collection, discovery and access of clinical results. Often an EMR.

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Encounter-Based Imaging Workflow

Use Case:

• Point-of-Care Ultrasound (ER)
• Scan wristband

[Get metadata]

• Scan Patient

[Add metadata]

[Store Images]

[Notify EMR]

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EMR, MPI, PAM, PDQ,�etc.

Get �Imaging

Context

Store Images

(Patient ID,

Notify Visit ID,

Imaging Acq. Time,

Result Procedure Code,

Accession #,

Body Part,

etc.)

EMR

https://wiki.ihe.net/index.php/Process

Profile Realization

Identify Profiles, Actors, Options and Transactions

Identify Transaction Requirements

Use Case

• User needs
• Jurisdictional

• SOP class
• FHIR Resources
• HL7 segments
• DICOM tags
• Mapping
• Display

Trial Implementation

Final text

Process

Sources / Artifacts

Planning

• Committee
• Consensus

IHE Profile Development Cycles

• Radiology = Annual (August – May)
• ITI, PCC, Devices = Continuous

Maintenance

EBIW

Work Items

• Trial Implementation here
• FHIR Query for Imaging Context (Draft)
• CP480 Add HL7 mapping to EBIW (WIP)

Connectathon Testing

• https://connectathon-results.ihe.net

Connectathon Benefits

• Customer visibility: results matrix and integration statement
• Access to all profile actors
• Simulation of real-world connectivity @ customer facility
• Identify potential issues before product is released to the marketplace
• Ensures a common application of standards in the marketplace
• Exposure to global vendors