The present invention generally relates to workflow management in clinical
applications, e.g. management of the different tasks to be performed by an individual
or a team of individuals in a medical imaging environment. Workflow management is
for instance important in medical applications such as radiology, where a technician
makes medical images of a patient (e.g. an x-ray scan, a CT scan, an MR scan, an
ultrasound scan, etc.), a radiologist interprets the medical images, a transcriptionist
produces a report reflecting the radiologists interpretation, and a clinician receives
the report and advises the patient. The individuals involved in the entire workflow
may be working at a single facility (e.g. a hospital or imaging centre) or may be
working at different locations (e.g. a hospital or enterprise with multiple facilities). In
order to govern the different tasks to be performed, a workflow management tool will
be deployed and made accessible to the involved individuals at different locations.
The current invention in particular concerns a method and tool for workflow
management in clinical applications where additional information, e.g. belated
medical images, laboratory results, diagnostic information, post-operative
information, etc. may arrive in the system at a point in time a report has been
generated already for the medical procedure where the additional, belated
information belongs to.
Background of the Invention
[02] The article "From Shared Data to Sharing Workflow: Merging PACS and
Teleradiology" from the authors Menashe Benjamin, Yinon Aradi and Reuven
Schreiber, published in the European Journal of Radiology 73 (2010) 3-9, describes
a system combining storage of medical images and workflow management for
radiology. The radiologists or other users of the system may be working on-site or
remotely. In order to increase the radiologist's efficiency, the known system produces
individual worklists per site, and also a global worklist wherein the tasks of the
individual worklists per site are combined for the radiologist
[03] Since medical images are typically sent between different systems, it may
happen that the arrival of a medical image in the known workflow management tool is
late interpretation and/or diagnosis of the medical images that were available before
arrival of the additional image, may have taken place already and the result thereof
may be captured in a report that is already available in the system. Traditional
workflow management systems either do not notify the author(s) of existing report(s)
of the addition of belated information as a result of which the additional information,
e.g. a medical image, s not considered and the report may be inaccurate.
Alternatively, manually entered notifications may be sent, often through alternative
communication channels such as e-mail or s s to notify the involved individuals of
the late arrived image or other information. Such manual notifications alerting the
people involved are error prone, and often, they are unnecessary because they are
addressed to individuals that do not immediately have to perform a task as a result of
the late arrival of additional information.
[04] It is an objective of the present invention to disclose a computer-implemented
method and tool that overcome the above identified shortcomings of existing tools.
More particularly, it is an objective to disclose such a method and tool for use in
clinical applications that ensures that additional, belated clinical information is
considered in existing reports related to the medical procedure without flooding
unnecessary, superfluous and disturbing notifications through various communication
channels.
Summary of the Invention
[05] According to the present invention, the above defined objectives are realized
by the computer-implemented method for operating a data processing system for
task management on clinical information defined by claim 1, the method comprising:
- receiving by the system Digital Imaging and Communications in Medicine
(DICOM) or HL7 or EDIFACT-EDI standardized messages comprising additional
clinical information in relation to a medical procedure, additional to already stored
information on the medical procedure;
- verifying via metadata in the standardized messages if a report already exists
in the system for the medical procedure; and
- triggering a workflow engine to automatically create in the system a task for
verification of the report in view of the additional clinical information received to
thereby avoid sending manually entered notifications by e-mail or sms.
[06 Thus, the invention consists in checking whether a report was already created
for a medical procedure when belated information such as an additional scan arrives
in the system. If a report already exists, the system shall automatically create a task
for the author of that report to verify if the report is still valid or needs to be updated in
view of the additional information. This way, unnecessary notifications are avoided,
while it is ensured that the existing report will be reviewed by its author for
correctness in view of of the newly available information.
[07] Optionally, as defined by claim 2 , the computer-implemented method according
to the present invention further comprises:
- applying assignment rules to the task for assigning the task to a person or
team using the system.
[08] This way, it can be avoided for instance that a task is assigned to someone no
longer working with the system.
[09] Also optionally, as defined by claim 3, the computer-implemented method
according to the present invention further comprises:
- sending a notification to inform one or more users of the system on the task;
and
- updating for the one or more users each task list whose query matches with
the task.
[ ] Hence, the users may be notified of creation of the task, e.g. through a pop-up
window on their screens, and/or their task lists may be updated automatically to
include the new task.
[11] According to another optional aspect, defined by claim 4, the computerimplemented
method according to the present invention may further comprise:
- adding comments to the task.
[1 ] This way, it becomes possible to inform the author of the report for instance of
the reason why the task was generated.
[13] Still optionally, as defined by claim 5, the computer-implemented method
according to the present invention may further comprise:
- adding escalation rules to the task to be applied when the task is not executed
within a set time interval.
[14] This way, non-execution of the verification task within a certain time limit could
be brought to a supervisor's attention enabling the latter to re-assign the task.
[15] According to yet another optional aspect defined by claim 6, the computerimplemented
method according to the current invention comprises:
- triggering a distribution flow for an updated version of the report.
[16] Hence, based on the outcome of the report verification task, a distribution flow
for the updated report could be triggered.
[17] As is further specified by claim 7, the additional clinical information may be a
belated medical image.
[18] Optionally, as defined by claim 8 , the type of the belated image may be
verified and the task for verification of the report may be generated only when the
belated image is of a predefined type.
[19] If for instance the DICOM standard is used for communicating medical images
between different systems, the present invention may filter on the type of image such
that only the arrival of real images leads to the creation of a verification task for
existing reports. This way, verification tasks are avoided to be triggered by late arrival
of derived images in the system. As a result, the number of unnecessary tasks
created automatically is reduced, further increasing the efficiency of the system.
[20] In addition to the method defined by claim 1, the present invention relates to a
corresponding data processing system as defined by claim 9, comprising means for
carrying out the computer-implemented method.
[21] The current invention in addition also relates to a computer program as defined
by claim 10 comprising software code adapted to perform the computer-implemented
method.
[22] The invention further relates to a computer readable storage medium as defined
by claim 11, comprising the computer program.
Brief Description of the Drawings
[23] Fig. 1 is a flow chart of a first embodiment of the method according to the
present invention; and
[24] Fig. 2 is a flow chart of a second embodiment of the method according to the
present invention.
Detailed Description of Embodiment(s)
[01] Fig. 1-2 illustrate embodiments of the current invention implemented as part
of a software application for workflow management in radiology. Such workflow
management application typically has a client-server architecture.
[02] The server part of the application receives queries from the client part, runs
these queries on a centralized or distributed database system wherein at least the
medical images, medical reports, and tasks are stored and maintained. The server
part also notifies the client part in case of changes in the database system that match
with one of the queries received from that client, in order to enable the client part to
update and refresh the information displayed to the user.
[03] The client part of the application enables the user to configure queries, and it
generates the desktops for different types of users and the various screens according
to the user's preferences and configuration settings. In the application for radiology,
the desktops generated by the client part may for instance comprise a diagnostic
desktop for radiologist users, a configuration desktop for administrator users, a
transcriptionist desktop for the transcriptionist-user that uses the system to transfer
speech recordings into text, a clinician desktop for the clinician-user that reads the
medical reports from the radiologist(s) and advises the patient, a technologist
desktop for the technician-user that makes the medical images. Each of these users
makes use of one or more task lists accessible through his/her desktop for workflow
management. Each such task list can be configured, i.e. the data fields to be
displayed in a screen as part of the task list can be selected by the user, filtering
criteria enabling selection of the relevant tasks for that task list are configurable by
the user, and the criteria to be applied for sorting the tasks within the task list can be
configured by the user. In the embodiments described in the following paragraphs, a
radiologist user is assumed to have authored a report. At a later point in time,
additional images are uploaded in the database system by a technician.
[04] Fig. 1 illustrates a basic implementation of the method according to the
invention. In step 101 , one or several additional medical images are received by the
system that is used for workflow management in a medical imaging environment. The
additional image(s) may for instance be images resulting from an additional scan,
e.g. an x-ray scan, a CT scan, an MRI scan, an ultrasound scan, etc., or they may be
processed images, e.g. a 3D reconstruction, an image supplemented with data, etc.
In step 102, the system automatically verifies if the additional images belong to a
medical procedure for which a report has been produced already. If no report is
existing in the system for that medical procedure, the method shall end, as is
indicated by 104 in Fig. 1. The received additional images shall be stored together
with earlier stored images in order to be processed and/or studied later. In case a
report is already existing for that medical procedure, the existing report may be
inaccurate or incomplete because it was produced without considering the additional
images. In such case, a workflow engine in the system shall automatically create a
task for the author of the existing report to verify the existing report in view of the
additional images. This is indicated by step 103 in Fig. 1. The automatically
generated task shall be added to the overall task list in the system and be treated,
i.e. notified to the author, escalated, etc. in a manner similar to other tasks. The
method again ends at step 104.
[05] Fig. 2 illustrates a more advanced implementation of the method according to
the invention. In step 201 , the system again receives one or several additional,
belated medical images in relation to a medical procedure for which the system
performs task management. In order to reduce the amount of unnecessary tasks
generated by the system, the system in step 202 first verifies the type of the
additional image(s). If the DICOM (Digital Imaging and Communications in Medicine)
standard is used to transfer the additional images to the system, the DICOM
metadata may be consulted by the system in order to determine if an additional
image is a "real" image, i.e. a first capture, or a processed image, i.e. a second
capture that contains for instance data, parameter values, a 3D reconstruction, etc. If
the additional image is a second capture, i.e. a derived image obtained through
processing of existing images that are already available in the system, the system
shall assume that it is not necessary to generate additional tasks and immediately
terminate at step 207. If the additional image is a first capture, the system shall
automatically verify in step 203 if a report is already existing for the medical
procedure where the additional image relates to. In case no report exists in the
system for that medical procedure, the method shall again terminate at step 207. The
additional image(s) shall then be stored in the system for later evaluation. If however
one or several reports exist already for the medical procedure where the additional
image belongs to, a workflow engine in the system will automatically create a task for
the author(s) of each of these reports to verify the existing reports in view of the
additional image. This is done in step 204 in Fig. 2. The system thereupon
automatically assigns the created task to the person or group of persons that
authored the existing report(s). This is done in step 205. In case the author is no
longer working or no longer using the system, the verification task shall be assigned
to another responsible for the medical procedure according to assignment rules that
are predefined in the system. This way, it is avoided that a newly created task will be
assigned to a person or team that is no longer using the system. In step 206, the
system automatically notifies the user(s) whereto the verification task is assigned. In
addition, the system automatically updates all task lists of these user(s) whose query
matches with the newly created task. Indeed, in an application for radiology
departments for instance, a radiologist shall typically maintain different task lists, like
for instance high priority tasks that need to be completed by a close deadline,
reading tasks like the interpretation of certain medical images as soon as these
images have become available in the system, and sign-off tasks. When the high
priority task list is empty, the radiologist shall start to work on the reading tasks.
When both the high priority task list and the reading task list are empty, the
radiologist will switch to sign-off tasks. St is noticed that tasks may appear in multiple
individual lists, or dynamically move from one list to another. A reading task or signoff
task may for instance become a high priority task when its deadline is nearing.
Each task list is defined by a query. Tasks that match with the query appear in the
task list. Thanks to the current invention, the task for verification of an existing report
that is automatically created by the system upon arrival of an additional "real" image,
shall appear in the task lists of the assigned persons whose queries match with the
created task.
[06] Optionally, more sophisticated embodiments of the method according to the
invention could be contemplated. Comments could for instance be attached to the
created verification task to explain why the task was created. Such comments could
contain a reference or link to the additional image(s) received by the system. The
system may also implement escalation rules that define which responsible or
supervisor needs to be informed when the task for verification of the existing report is
not completed by the assigned person(s) within a given time frame. The system may
also automatically trigger a distribution flow as soon as the existing report has been
reviewed and eventually has been updated by the person(s) to whom this task was
assigned. This way, it is ensured that all persons making use of the report become
aware of the existence of a new version of the report that also considers the
additional images arrived late in the system.
[07] It is further noticed that although the DICOM standard was mentioned in
relation to the embodiments described here above for formatting / reporting medical
images, it will be apparent to the person skilled in the art of medical imaging and
related task management that the present invention is not limited to the use of this
standard. Alternative protocols for formatting and reporting medical images, like HL7
or EDIFACT-EDI standards may be used. The present invention may take benefit of
the protocol for filtering if the metadata contain an indication of the type of image, as
is the case for DICOM.
[08] It is also remarked that the invention illustrated here above with two
embodiments in the field of medical imaging, may be applied more widely to late
arrival of any type of clinical information in a task management system. Such clinical
information may include laboratory results, diagnostic information, post-operative
information, etc. Upon late arrival of such information in the system, i.e. arrival at a
point in time where a report already exists for the medical procedure where the newly
arrived information belongs to, a task for verification of the existing report(s) can be
generated automatically with same advantages as described here above in relation
to medical images.
[09] The method according to the invention shall typically be computerimplemented
on a system or platform with client-server architecture. The images and
tasks are maintained centrally or distributed on one or more servers. Users access
their task lists and consult images stored in the system via a client device. A data
processing system or computing device that is operated according to the present
invention can include a workstation, a server, a laptop, a desktop, a hand-held
device, a mobile device, a tablet computer, or other computing devices, as would be
understood by those of skill in the art.
[ ] The data processing system or computing device can include a bus or network
for connectivity between several components, directly or indirectly: a memory or
database, one or more processors, input/output ports, a power supply, etc. One of
skill in the art will appreciate that the bus or network can include one or more busses,
such as an address bus, a data bus, or any combination thereof, or can include one
or more network links. One of skill in the art additionally will appreciate that,
depending on the intended applications and uses of a particular embodiment,
multiple of these components can be implemented by a single device. Similarly, in
some instances, a single component can be implemented by multiple devices.
[ ] The data processing system or computing device can include or interact with a
variety of computer-readable media. For example, computer-readable media can
include Random Access Memory (RAM), Read Only Memory (ROM), Electronically
Erasable Programmable Read Only Memory (EEPROM), flash memory or other
memory technologies, CDROM, digital versatile disks (DVD) or other optical or
holographic media, magnetic cassettes, magnetic tape, magnetic disk storage or
other magnetic storage devices that can be used to encode information and can be
accessed by the data processing system or computing device.
[ ] The memory can include computer-storage media in the form of volatile and/or
nonvolatile memory. The memory may be removable, non-removable, or any
combination thereof. Exemplary hardware devices are devices such as hard drives,
solid-state memory, optical-disc drives, or the like. The data processing system or
computing device can include one or more processors that read data from
components such as the memory, the various I/O components, etc.
[13] The /O ports can allow the data processing system or computing device to be
logically coupled to other devices, such as /O components. Some of the S/O
components can be built into the computing device. Examples of such /O
components include a microphone, joystick, recording device, game pad, satellite
dish, scanner, printer, wireless device, networking device, or the like.
[14] Although the present invention has been illustrated by reference to specific
embodiments, it will be apparent to those skilled in the art that the invention is not
limited to the details of the foregoing illustrative embodiments, and that the present
invention may be embodied with various changes and modifications without
departing from the scope thereof. The present embodiments are therefore to be
considered in all respects as illustrative and not restrictive, the scope of the invention
being indicated by the appended claims rather than by the foregoing description, and
all changes which come within the meaning and range of equivalency of the claims
are therefore intended to be embraced therein. n other words, it is contemplated to
cover any and al! modifications, variations or equivalents that fall within the scope of
the basic underlying principles and whose essential attributes are claimed in this
patent application. t will furthermore be understood by the reader of this patent
application that the words "comprising" or "comprise" do not exclude other elements
or steps, that the words "a" or "an" do not exclude a plurality, and that a single
element, such as a computer system, a processor, or another integrated unit may
fulfil the functions of several means recited in the claims. Any reference signs in the
claims shall not be construed as limiting the respective claims concerned. The terms
"first", "second", third", "a", "b", "c", and the like, when used in the description or in
the claims are introduced to distinguish between similar elements or steps and are
not necessarily describing a sequential or chronological order. Similarly, the terms
"top", "bottom", "over", "under", and the like are introduced for descriptive purposes
and not necessarily to denote relative positions. It is to be understood that the terms
so used are interchangeable under appropriate circumstances and embodiments of
the invention are capable of operating according to the present invention in other
sequences, or in orientations different from the one(s) described or illustrated above.

CLAIMS
1. A computer-implemented method (100; 200) for operating a data processing
system for task management on clinical information, said method comprising:
- receiving (101 ; 201) by said system Digital Imaging and Communications in
Medicine (DICOM) or HL7 or EDIFACT-EDI standardized messages comprising
additional clinical information in relation to a medical procedure, additional to already
stored information on said medical procedure;
- verifying (102; 203) via metadata in said standardized messages if a report
already exists in said system for said medical procedure; and
- triggering a workflow engine to automatically create (103; 204) in said system
a task for verification of said report in view of said additional clinical information
received to thereby avoid sending manually entered notifications by e-mail or sms.
2. A computer-implemented method (200) according to claim 1, further
comprising:
- applying (205) assignment rules to said task for assigning said task to a
person or team using said system.
3. A computer-implemented method (200) according to any of the preceding
claims, further comprising:
- sending (206) a notification to inform one or more users of said system on said
task; and
- updating (206) for said one or more users each task list whose query matches
with said task.
4 . A computer-implemented method according to any of the preceding claims,
further comprising:
- adding comments to said task.
5. A computer-implemented method according to any of the preceding claims,
further comprising:
- adding escalation rules to said task to be applied when said task is not
executed within a set time interval.
6. A computer-implemented method according to any of the preceding claims,
further comprising:
- triggering a distribution flow for an updated version of said report.
7. A computer-implemented method according to any of the preceding claims,
wherein said additional clinical information is a belated medical image.
8. A computer-implemented method (200) according to claim 7, wherein a type
of said belated image is verified (202) and said task for verification of said report is
only generated when said belated image is of a predefined type.
9. A data processing system comprising means for carrying out the computerimplemented
method of any of claims 1 to 8.
10. A computer program comprising software code adapted to perform the
computer-implemented method of any of claims 1 to 8.
11. A computer readable storage medium comprising the computer program of
any of claims 1 to 8.