In telediagnostic services, is necesary asign a priority to a patient workflow when study analisis was made, which of fhir resources you think is correct for this notification?
Can you expand on your use-case a bit? Are you looking for the priority of the analysis that was done or the priority of the next steps coming afterward?
Sure, have this case:
1 Healthcare service make a imaging exam and sends a fhir imaginstudies message to teleradiology area
2 This area get study from central pacs server
3 Teleradiology area make a report that is loaded to pacs, for notification a imagingstudies message is sent to heathcare service
4 This is the issue, if i need to send a priority for worklist reorganzation in Healthcare service when images was reported from teleradiology area, which resource should be used?
Thank you very much
Let me expand on the description a bit, if I understand it correctly.
There are two phases to a Radiology exam: the technologist performs the imaging, then a radiologist reads the images and dictates a report. The radiologist typically does not work entirely in a first in-first out fashion: it is more urgent to read some studies than others, for a number of reasons. For example, suspected stroke should be read immediately; for teleradiology, where a radiologist reads remotely for a number of sites, one site may have a higher SLA than another; or an AI may have been run on the imaging and scored it as more or less urgent. The studies for the radiologist to read are typically presented to them in a (usually) prioritized worklist.
Options for indicating urgency are:
- Each read request could be represented as a Task, with the appropriate priority code.
- A Flag could be created with the procedure as the subject, coded to indicate priority.
- An extension on Procedure, ImagingStudy, or DiagnosticReport to indicate the priority.
- An Observation that the AI has found something about the study that Indicates it should be read soon.
I think either the Observation route or the Task route seem most appropriate (or both). In part, I’d question whether we want the ”server” or “client” making the decision. If I hook up my reading work list client to the institutional FHIR server, do I just display the list in the order of priority another system has determined, or do I use my own internal algorithms and information I gather from various sources (like Observations) to order the studies in my preferred way.
I don’t think this has been discussed in the Imaging WG, but I’m sure the general issue has been discussed elsewhere. I’d love to hear other’s thoughts.
Yes that is the situation: AI scored images as more or less urgent before been readed by radiologist, but worklist system is external, for that reason i can not do a direct procedure, only a notification. I like option o using Observation resource becouse i wont need create a extension, thank you