Health informatics - Medical Data Interchange: HIS/RIS-PACS and HIS/RIS - Modality Interface

1.1   This European Prestandard specifies information objects and services to be used when transferring information between medical imaging modalities and information systems in a healthcare environment.
1.2   This European Prestandard does not specify the information or usage domains of particular modalities or information systems as these vary according to local and national practices.
1.3   This European Prestandard only applies to information sent between a modality and an information system in the form of a worklist, in response to a request from that modality.  It provides:
   - a description of the content of the messages that transfer the worklist information and
   - a communication mechanism to transfer these messages.
1.4   This European Prestandard is applicable only to character-based (i.e. alphanumeric) information.  It does not apply to information presented as images or graphics.
1.5   This European Prestandard does not cover information objects and services to be used when transferring administrative, request, report and diagnostic service plan information between  DISs (of imaging departments) to or from HIS.  This is covered by  CEN/TC 251/PT3-022.

Zdravstvena informatika - Izmenjevanje medicinskih podatkov: HIS/RIS-PACS in HIS/RIS - Zvrstni vmesnik

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Status
Withdrawn
Publication Date
11-Dec-2001
Withdrawal Date
17-Aug-2004
Current Stage
9960 - Withdrawal effective - Withdrawal
Start Date
18-Aug-2004
Completion Date
18-Aug-2004

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SLOVENSKI STANDARD
SIST ENV 13939:2003
01-oktober-2003
Zdravstvena informatika - Izmenjevanje medicinskih podatkov: HIS/RIS-PACS in
HIS/RIS - Zvrstni vmesnik
Health informatics - Medical Data Interchange: HIS/RIS-PACS and HIS/RIS - Modality
Interface
Ta slovenski standard je istoveten z: ENV 13939:2001
ICS:
35.240.80 Uporabniške rešitve IT v IT applications in health care
zdravstveni tehniki technology
SIST ENV 13939:2003 en
2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.

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SIST ENV 13939:2003

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SIST ENV 13939:2003
EUROPEAN PRESTANDARD
ENV 13939
PRÉNORME EUROPÉENNE
EUROPÄISCHE VORNORM
December 2001
ICS 35.240.80
English version
Health informatics - Medical Data Interchange: HIS/RIS-PACS
and HIS/RIS - Modality Interface
This European Prestandard (ENV) was approved by CEN on 19 October 2000 as a prospective standard for provisional application.
The period of validity of this ENV is limited initially to three years. After two years the members of CEN will be requested to submit their
comments, particularly on the question whether the ENV can be converted into a European Standard.
CEN members are required to announce the existence of this ENV in the same way as for an EN and to make the ENV available promptly
at national level in an appropriate form. It is permissible to keep conflicting national standards in force (in parallel to the ENV) until the final
decision about the possible conversion of the ENV into an EN is reached.
CEN members are the national standards bodies of Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Greece,
Iceland, Ireland, Italy, Luxembourg, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland and United Kingdom.
EUROPEAN COMMITTEE FOR STANDARDIZATION
COMITÉ EUROPÉEN DE NORMALISATION
EUROPÄISCHES KOMITEE FÜR NORMUNG
Management Centre: rue de Stassart, 36  B-1050 Brussels
© 2001 CEN All rights of exploitation in any form and by any means reserved Ref. No. ENV 13939:2001 E
worldwide for CEN national Members.

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SIST ENV 13939:2003
ENV 13939:2001 (E)
Contents
FOREWORD.3
INTRODUCTION .4
1. SCOPE.5
2. NORMATIVE REFERENCES.5
3. DEFINITIONS AND ABBREVIATIONS .6
3.1 Definitions .6
3.2 Abbreviations.6
4. NORMATIVE TECHNICAL REQUIREMENTS.7
ANNEX A: Overview of the DICOM Basic Worklist Management (Modality Worklist
Management SOP Class) (informative) .8
ANNEX B: Mapping between the models specified in CEN/TC 251/PT3-022 and NEMA PS
3 Supplement 10 (informative).10
ANNEX C. (normative) DICOM Supplement 10 “Basic Worklist Management (Modality
Worklist Management formative)………………………….………………………….…… .…12
2

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SIST ENV 13939:2003
ENV 13939:2001 (E)
FOREWORD
This European Prestandard has been prepared by CEN/TC 251 Health Informatics under mandate M/021
from the European Union and EFTA order voucher BC/CEN/93/17.7.
This European Prestandard was prepared by CEN/TC251/PT4-020 together with ACR/NEMA Working
Group VI.
ANNEX A of this standard is informative. It describes the mapping between this European Prestandard and
CEN/TC 251/PT3-022: Request and Report Messages for Diagnostic Service Departments.
Annex B is also informative. It gives an overview of NEMA PS 3 Supplement 10.
Annex C is normative and consists of the DICOM Supplement 10 “Basic Worklist Management (Modality
Worklist Management SOP Class)” (NEMA PS 3 Supplement 10).with the amendments developed jointly
between CEN and ACR/NEMA.
According to the CEN/CENELEC Internal Regulations, the national standards organizations of the following
countries are bound to announce this European Prestandard: Austria, Belgium, Czech Republic, Denmark,
Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, Netherlands, Norway, Portugal,
Spain, Sweden, Switzerland and the United Kingdom.
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SIST ENV 13939:2003
ENV 13939:2001 (E)
INTRODUCTION
The use of digital medical image acquisition systems (modalities) is growing rapidly. New developments in
information technologies support the inclusion of images in information systems (IS). The introduction of
systems to handle digital medical images (PACS) throughout the hospitals requires integration of the
modalities with the PACS and with the existing information systems. These developments urgently require a
standard for the interoperability between the imaging systems and the existing information systems in the
hospital.
Firstly, digital medical images need to be coupled with the related information entities (such as patient and
imaging procedure) as maintained in various information systems in the hospital. This coupling needs to be
established at the moment of image acquisition.
Second, the logistic aspects of performing imaging examinations, such as scheduling and tracking, is
currently supported by information systems without any interaction with the modality. In future the logistic
process needs to be supported by the Modality and the IS together.
The scenario can be globally described as follows:
- Before a medical image can be acquired by a modality, the administrative system needs to make the
relevant administrative and technical information available to the modality operator, e.g.:
- Patient information (name, ID number, date of birth, etc.)
- Scheduling information (procedure to be performed, special requirements, etc.)
This information will normally be held by other ISs within or outside the imaging department. It is
normally made available by sending a worklist to the modality
- When the image has been acquired by the modality, it needs to be coupled with the related patient
information such as patient and type of imaging procedure performed. The image and related data
will then be stored locally or sent to the PACS or other information system.
- When the work is complete, administrative information (e.g. procedure performed, comments on the
acquisition process) and technical information (e.g. equipment settings) will be sent from the
modality to one or more of the information systems.
These and other related requirements can be fulfilled by the realisation of an interface between the modality
and the Information System (IS) environment. The IS comprises all information systems that support any
activities in the hospital, such as care, diagnosis, logistics, and administration.
This European Prestandard defines such a standard interface by reference to DICOM Supplement 10 “Basic
Worklist Management (Modality Worklist Management SOP Class)” (NEMA PS 3 Supplement 10) which
results from joint work of CEN/TC251/PT020 and ACR-NEMA Working Group VI.
This European Prestandard explicitly does not cover the integration of DISs (of imaging departments) with
HIS. This is covered by CEN/TC 251/PT3-022 Mandate MO21/BC/CEN/93/17.9 FWD (CEN/TC 251/PT3-
022).
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SIST ENV 13939:2003
ENV 13939:2001 (E)
1. SCOPE
1.1 This European Prestandard specifies information objects and services to be used when transferring
information between medical imaging modalities and information systems in a healthcare environment.
1.2 This European Prestandard does not specify the information or usage domains of particular modalities
or information systems as these vary according to local and national practices.
1.3 This European Prestandard only applies to information sent between a modality and an information
system in the form of a worklist, in response to a request from that modality. It provides:
- a description of the content of the messages that transfer the worklist information and
- a communication mechanism to transfer these messages.
1.4 This European Prestandard is applicable only to character-based (i.e. alphanumeric) information. It
does not apply to information presented as images or graphics.
1.5 This European Prestandard does not cover information objects and services to be used when
transferring administrative, request, report and diagnostic service plan information between DISs (of
imaging departments) to or from HIS. This is covered by CEN/TC 251/PT3-022.
2. NORMATIVE REFERENCES
This European Prestandard incorporates by dated or undated reference, provisions from other publications.
These normative references are cited at the appropriate places in the text and the publications are listed
hereafter. For dated references, subsequent amendments to or revisions of any of these publications apply to
this European Prestandard only when incorporated in it by amendment or revision. For undated references
the latest edition of the publication referred to applies.
NEMA PS 3 Supplement 10 “Basic Worklist Management (Modality Worklist Management
SOP Class)”
CR 1350: 1993 Investigation of syntaxes for existing interchange formats to be used in healthcare
ENV 12052: 1995 Medical Informatics - Medical image and related data interchange format -
MEDICOM
ENV 12539 Medical Informatics - Request and report messages for diagnostic service
departments
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SIST ENV 13939:2003
ENV 13939:2001 (E)
3. DEFINITIONS AND ABBREVIATIONS
3.1 Definitions
For the purposes of this standard the following definitions apply:
departmental information system: information system used within a healthcare department to serve the
needs of that department.
information system environment: one or more information systems that support healthcare activities.
EXAMPLES: PACS systems, DIS, clinical systems, HIS, RIS.
: medical image acquisition device.
modality
worklist: structured presentation of tasks to be performed by a modality
NOTE: usually includes task information, patient demographic information and scheduling information
3.2 Abbreviations
ACR-NEMA The joint committee of the American College of Radiology and the National Electrical
Manufacturers Association
DICOM Digital Imaging and Communications in Medicine
DIS Departmental Information System
HIS Hospital Information System
IS Information System
MEDICOM Medical Image Communication
PACS Picture Archiving and Communication System
RIS Radiology Information System
SOP Class Service Object Pair Class
6

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SIST ENV 13939:2003
ENV 13939:2001 (E)
4. NORMATIVE TECHNICAL REQUIREMENTS
Message exchange between a modality and an information system environment, covered by the scope of this
European Prestandard, shall meet the requirements specified in the following documents:
ANNEX C of this European Prestandard    NEMA PS3 Supplement 10 Basic Worklist
Management (Modality Worklist Management SOP
Class)
ENV 12052 Medical Informatics - Medical image and related data
interchange format - MEDICOM
NOTE: Message exchanges within the scope of this European Prestandard must conform to the Modality
Worklist Management SOP Class, as specified in NEMA PS3 Supplement 10. This in turn references other
parts of NEMA PS3 which have been standardised in Europe as ENV 12052. This is why both standards are
included in this Clause.
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SIST ENV 13939:2003
ENV 13939:2001 (E)
ANNEX A: Overview of the DICOM Basic Worklist Management (Modality Worklist
Management SOP Class) (informative)
A.1 Introduction
This annex provides a brief overview of the DICOM supplement which is referenced in the Normative
Technical Requirements of this European Prestandard.
Figure 1 presents an overview of the existing Parts of DICOM. The DICOM supplement referenced by this
European Prestandard contains the following parts:
 A supplement to DICOM Part 3 containing the Real World Model and Module Definitions for the
Modality Worklist SOP Class
 A supplement to DICOM Part 4 specifying the Basic Worklist Management Service Class and the
Modality Worklist SOP Class
 A supplement to DICOM Part 6 listing the new data elements introduced by the Module Definitions for
the Modality Worklist SOP Class
Part 4 Service Classes Specification
Part 3 Information Objects
Part 11
Media
Storage
Appli
Part 2
-cation
Part 5 Data Structures and Encoding / Part 6 Data
Confor-
Profiles
mance
Part 10 Storage Media
Part 7 Message Exchange
and File Format
Part 8
Part 12 Media Format
Part 13
Network Support
and Physical Media
Print
Pt-to-Pt
Network Communication Media Interchange
Figure 1: Overview of DICOM Parts
A.2 Scope and Field of Application for the Basic Worklist Management Service Class
The Basic Worklist Management Supplement to the DICOM Standard specifies the Basic Worklist
Management Service Class, which supports the exchange of any type of worklist from one Application Entity
(AE) to another AE. The Basic Worklist Management Service Class contains the Modality Worklist SOP
Class, which supports the transfer of the Modality Worklist from the Information System (IS) to the
Modality.
A.3 Basic Worklist Management Service Class
The Basic Worklist Management Supplement to the DICOM Standard specifies a DICOM Basic Worklist
Management Service Class, which defines an application-level class-of-service which facilitates the transfer
of worklists.
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SIST ENV 13939:2003
ENV 13939:2001 (E)
A worklist is the structure to present information related to a particular set of tasks. It specifies particular
details for each task. The information may support the selection of the task to be performed first and may
support the performance of that task. One example is the worklist used to present information about
scheduled imaging procedures at an imaging modality to the operator of that modality.
The Basic Worklist Management supplement defines a service for communicating such worklists. The
following are characteristics for this service class:
- The worklist has to be queried by the AE associated to the equipment on which, or by which, the
tasks included in the worklist have to be performed. In this query, a number of search keys can be
used, defined for each particular worklist SOP class.
- The worklist consists of worklist items, each item is related to one task. A worklist item contains
attributes from different objects related to the task.
Note: The Basic Worklist Management Service Class is used as a mechanism to pass the worklist
from the IS to the AE associated to the application where the task is to be performed. If
that application wants to send information to the IS about a task that has or has not been
performed, it uses another mechanism implemented in a different Service Class.
The Basic Worklist Management Service Class is generic to support exchange of different kind of worklists.
Currently there is only one SOP class defined in the Basic Worklist Management Service Class: The
Modality Worklist SOP Class.
A.4 Modality Worklist SOP Class
The Modality Worklist SOP Class facilitates the transfer of worklists from the IS to the Modality comprising
attributes from the real-world objects: Scheduled Procedure Step, Requested Procedure, Imaging Service
Request, Facility Episode, Visit, and Patient. The Modality Worklist SOP Class covers the most important
requirements for interoperability between an Imaging Acquisition Device, i.e. Modality (MOD), and the
Information System (IS). These Requirements are:
- Verify patient (e.g. send patient demographic information from an IS to a Modality, to verify that
the person to be examined is the intended patient).
- Select a procedure step from the IS (e.g. send Procedure Step information from an IS to a
Modality).
- Select Imaging Procedure.
- Prepare the Imaging Procedure (Step).
- Couple DICOM images with related information from the IS (e.g. patient demographics, procedure
description, ID data structure from the IS, contextual IS information).
- Capture all the attributes from the IS, that are mandatory to be inserted into the DICOM Image
Object.
The Modality Worklist SOP Class is not intended to provide access to all IS information and services which
may be of interest to a Modality operator or attending physician. Its primary focus is the efficient operation
of the image acquisition equipment. DICOM SOP Classes and non-DICOM Services which fall beyond the
scope of the Modality Worklist SOP Class may be needed.
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SIST ENV 13939:2003
ENV 13939:2001 (E)
ANNEX B: Mapping between the models specified in CEN/TC 251/PT3-022 and NEMA PS
3 Supplement 10 (informative)
B.1 Introduction
The scope of this European Prestandard is communication between medical imaging modalities and
information systems. An information system in this context can be any information system that supports
healthcare activities such as care, diagnosis, logistics, and administration. This also incorporates PACS
systems and departmental information systems (DISs), such as radiology information systems (RISs).
The scope of ENV 12539 is messages for exchanging requests for, and reports of, diagnostic services. This
includes messages for exchanging requests for, and reports of, investigations performed in medical imaging
departments.
Therefore, in some cases, an information system may have to conform to both standards. For example, a RIS
may conform to this European Prestandard for interchange of information with one or more modalities, and
may also conform to ENV 12539 for exchanging requests and reports with a HIS
Service Provider Organisation
(eg Radiology department)
Modality
    PT4-020
       PT3-022 Requests
Clinical
Hospital or
Department
Radiology
MEDICOM
or
Department
General
Information System
Practice
Imaging
    PT4-020
       PT3-022 Plan reports and Reports
Workstation
MEDICOM
Hospital or
Radiology
Department
Modality
        PT4-020
Information
System
Other Service Providers
(eg Another radiology department)
Figure 2: Domains of this European Prestandard and ENV 12539
B.2 Use of Different models in this European Prestandard and ENV 12539
This European Prestandard models the medical imaging domain according to the principles established in
DICOM. The models in ENV 12539 are based on the principles established in CEN/TC 251/WG3, as
described in CR 1350: 1993.
Also, each set of models has been derived for a specific purpose. In the case of ENV 12539, the model was
used to derive the message models and thereby define the messages. In the case of this European
Prestandard, the model has been used only to get agreement as to the concepts and relationships under
discussion.
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SIST ENV 13939:2003
ENV 13939:2001 (E)
In addition, the two sets of models have been derived for different business purposes.  ENV 12539 supports
the “business” of requesting examinations and receiving reports. This European Prestandard supports the
“business” of organising work within a medical imaging department. Although each shares many of the same
concepts, each has a different view of those concepts. This is illustrated in Figure 3 below.
Requester/report recipient’s view Medical imaging department view
Patient
Patient
Request
Request Report
Received for this patient
Which led to this report Sent for this patient
Procedures
Images
On which this Carried out in response to
report is based this request
Procedures
Images
From which these images
Resulting from these
were derived
procedures
Report
Based on these images
Figure 3:Different views of shared concepts related to a report
Note: Figure 3 is an illustration of how models may differ according to the interests of the viewer. A
requester/recipient of the report has different interests to those of the medical imaging department.
Therefore the same concepts would be modelled differently to meet the needs of each.
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SIST ENV 13939:2003
ENV 13939:2001 (E)
Annex C. Digital Imaging and Communications in Medicine
(MEDICOM/DICOM) - Supplement 10: Basic Worklist
Management
CEN/TC251/WG4 ACR-NEMA
Status: Text for Letter Ballot - November 16, 1995
12

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SIST ENV 13939:2003
ENV 13939:2001 (E)
Table of Contents
Table of Contents .13
Foreword.15
Scope and Field of Application.15
Basic Worklist Management Service Class .15
Modality Worklist SOP Class.16
Part 3 Addendum.17
7.3 Extension of the DICOM model of the real-world .18
7.3.1. Definition of the Extensions of the DICOM Real-World Model.19
7.3.1.1 PATIENT .19
7.3.1.2 FACILITY EPISODE .19
7.3.1.3 IMAGING SERVICE REQUEST.20
7.3.1.4 PROCEDURE TYPE .20
7.3.1.5 REQUESTED PROCEDURE .20
7.3.1.6 SCHEDULED PROCEDURE STEP .20
7.3.1.7 PROCEDURE PLAN.21
7.3.1.8 ACTION ITEM .22
C.4.10 Scheduled Procedure Step Module .23
C.4.11 Requested Procedure Module .24
C.4.12 Imaging Service Request Module .25
ANNEX X (Informative) Integration of Modality Worklist in the Original DICOM Standard .28
Part 4 Addendum.31
Annex Z (Normative) Basic Worklist Management Service Class.32
Z.1 Overview.32
Z.1.1 Scope.32
Z.1.2 Conventions .33
Z.1.3 Worklist Information Model .33
Z.1.4 Service Definition .33
Z.2 Worklist Information Model Definition .34
Z.2.1 Entity/Relationship Model Definition .34
Z.2.2 Attributes Definition .34
Z.2.2.1 Attribute Types .35
Z.2.2.1.1 Matching Key Attributes.35
Z.2.2.1.1.1 Required Matching Key Attributes .35
Z.2.2.1.1.2 Optional Matching Key Attributes .35
Z.2.2.1.2 Return Key Attributes.36
Z.2.2.2 Attribute Matching.36
Z.2.2.3 Matching Multiple Values .36
Z.3 Worklist Information Model .37
Z.4 DIMSE-C Service Group .37
Z.4.1 C-FIND Operation .37
Z.4.1.1 C-FIND Service Parameters.37
Z.4.1.1.1 SOP Class UID.37
Z.4.1.1.2 Priority.37
Z.4.1.1.3 Identifier .37
Z.4.1.1.3.1 Request Identifier Structure .37
Z.4.1.1.3.2 Response Identifier Structure .37
Z.4.1.1.4 Status .37
Z.4.1.2 C-FIND SCU Behavior.38
Z.4.1.3 C-FIND SCP Behavior .38
Z.4.1.3.1. "Worklist" Search Method.39
Z.5 Association Negotiation .39
Z.6 SOP Class Definitions.39
Z.6.1 Modality Wo
...

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