Cross - Enterprise Screening Mammography - Workflow Definition (XSM-WD) White Paper for 2011/2012 Arianna Cocchiglia, Francesca Vanzo, Luca Zalunardo January,

Cross - Enterprise Screening Cross - Enterprise Screening Mammography - Workflow DefinitionMammography - Workflow Definition

(XSM-WD)(XSM-WD)

White Paper for 2011/2012White Paper for 2011/2012

Arianna Cocchiglia, Francesca Vanzo, Luca ZalunardoArianna Cocchiglia, Francesca Vanzo, Luca ZalunardoJanuary, 17January, 17thth 2012 2012

IHE RadiologyIHE Radiology

Enhancing XSM-WD White Paper

The first Screening Mammography use case has been The first Screening Mammography use case has been defined also from the XDW Workflow Document point of viewdefined also from the XDW Workflow Document point of view

It was necessary to delineate one of the implementations It was necessary to delineate one of the implementations in order to create a template to figure out different in order to create a template to figure out different approaches on the screening service approaches on the screening service

It is important now to collect information about different It is important now to collect information about different screening programs from other countriesscreening programs from other countries

It shall be significant to provide a discussion on what is It shall be significant to provide a discussion on what is common between those different methods, guidelines,…common between those different methods, guidelines,…


The discussion

In the first place we will focus on the clinical point of In the first place we will focus on the clinical point of view and on fostering answers to gather different view and on fostering answers to gather different approaches. In the second part of the discussion we approaches. In the second part of the discussion we will analyze the technical aspects will analyze the technical aspects

In order to effectively facilitate country based approach In order to effectively facilitate country based approach sharing, the review of the Italian screening process has sharing, the review of the Italian screening process has been delineated from the clinical perspectivebeen delineated from the clinical perspective

Supposing different possible features for each potential Supposing different possible features for each potential step, some questions are listed near the following tasks step, some questions are listed near the following tasks


The Italian Mammography Screening workflow

IntroductionIntroduction

The Italian Screening program has several recomendations based on the The Italian Screening program has several recomendations based on the fourth edition of the fourth edition of the European guidelines for quality assurance in European guidelines for quality assurance in mammography screening (2006)mammography screening (2006). The current adherence to . The current adherence to mammography screening guidelines is based on each Region’s mammography screening guidelines is based on each Region’s resources resources The table displays some of the parameters of the italian regional The table displays some of the parameters of the italian regional

programs:programs:

*National Centre for Screening Monitoring (Osservatorio Nazionale Screening - ONS) and Italian Group for Mammography Screening (Gruppo Italiano Screening Mammografico - GISMa)



Organizational Organizational ModelModel

Double blind Reading

CS Evaluation

(After 2 years)

Invitation Letter

Mammography exam

Second Level

Third blind Evaluation

START CS: List of

eligible women

[+ +]

[+ -]

[- -]

Missing Appointment

[+]

[-]

CS: Central Information System

Biopsy,…



A complete and shared collection of the features concerning different Screening A complete and shared collection of the features concerning different Screening workflows is decisiveworkflows is decisive

For this purpose, we ask you please to communicate us your characteristics on For this purpose, we ask you please to communicate us your characteristics on different screening mammography programs, so as different screening mammography programs, so as to allow us to also create an to allow us to also create an accurate portrait of a common screening workflow (taking into account different accurate portrait of a common screening workflow (taking into account different aspects, differences and definitions)aspects, differences and definitions)

The Cross-Enterprise Screening Mammography Workflow Definition’s elements The Cross-Enterprise Screening Mammography Workflow Definition’s elements shall focus on these aspects to offer customizations and to match different shall focus on these aspects to offer customizations and to match different workflow requirementsworkflow requirements

In order to facilitate the sharing of significant details, for each Task of the process, In order to facilitate the sharing of significant details, for each Task of the process, several specific questions are placed in the corresponding slide during this several specific questions are placed in the corresponding slide during this presentation (any other in-deep examinations is well accepted)presentation (any other in-deep examinations is well accepted)

Any contribution can be sent to Any contribution can be sent to [email protected]@consorzioarsenal.it



Recruitment Recruitment

The regional screening programs utilize The regional screening programs utilize anagraphical systems in order to create anagraphical systems in order to create lists of women according to several lists of women according to several parameters (age, time of previous exams or parameters (age, time of previous exams or other clinical events, address, local health other clinical events, address, local health authorities, mobile units,…)authorities, mobile units,…)

Each list is forwarded to the afferent Each list is forwarded to the afferent screening mammography unit (See the screening mammography unit (See the following slide)following slide)

QuestionsWhat guidelines are considered or are mandatory? (international, national, regional)

Who manages the screening? (centrally by the state, region,…)

What are the eligibility requirements and how are the list generated (range of age)?

QuestionsWhat guidelines are considered or are mandatory? (international, national, regional)

Who manages the screening? (centrally by the state, region,…)

What are the eligibility requirements and how are the list generated (range of age)?



RecruitmentRecruitment

TheThe person in charge whom receives the list: person in charge whom receives the list: inserts the mammography screening inserts the mammography screening

appointments data into the RIS worklist in the appointments data into the RIS worklist in the screening mammography agenda screening mammography agenda

*acknowledges the Region when it is needed*acknowledges the Region when it is needed In In some screening programs the RIS some screening programs the RIS

contains a mammography dedicated module contains a mammography dedicated module integrated with the main screening program: integrated with the main screening program: in this case there would not be human in this case there would not be human interventionintervention the *Region or the Screening Unit sends out the *Region or the Screening Unit sends out

the Invitation Letter (depends on the specific the Invitation Letter (depends on the specific program)program)

QuestionsWho actually sends out the recruitment letters?

How is implemented the import of the worklist’s items?

Is the RIS worklist agenda automatically synchronized with a CS? (kind of integration and format of messages,…)

Are different enterprises RIS (LHA, Sites ) involved for the single exam?

QuestionsWho actually sends out the recruitment letters?

How is implemented the import of the worklist’s items?

Is the RIS worklist agenda automatically synchronized with a CS? (kind of integration and format of messages,…)

Are different enterprises RIS (LHA, Sites ) involved for the single exam?



Transfer of the exam – Transfer to the RIS



AdmissionAdmission

This step gathers the actual patient admission and This step gathers the actual patient admission and the mammography exam executionthe mammography exam execution

the RIS is aware of the admission worklist from the the RIS is aware of the admission worklist from the previous stepprevious step

the RIS manages the exam as usual in the radiology the RIS manages the exam as usual in the radiology workflow (state of the appointment: state of workflow (state of the appointment: state of admission, execution,…)admission, execution,…)

If a woman refuses/misses her scheduled If a woman refuses/misses her scheduled appointment, the RIS state of the exam remains the appointment, the RIS state of the exam remains the same (at the end of the day this information shall be same (at the end of the day this information shall be comunicated to the Regional Screening or Central comunicated to the Regional Screening or Central Information System)Information System)

QuestionsHow are the worklist ruled/ composed/scheduled? (who and how)

When changes occur on an exam (day of the visit, acquisition modality), is possible to update the exam data without create a new “access number”?

QuestionsHow are the worklist ruled/ composed/scheduled? (who and how)

When changes occur on an exam (day of the visit, acquisition modality), is possible to update the exam data without create a new “access number”?



AdmissionAdmission

AsAs usual, the technician: usual, the technician: performs and completes the mammography performs and completes the mammography

for the screening patient by selecting her for the screening patient by selecting her from the modality worklist (if it is integrated from the modality worklist (if it is integrated with the RIS or entering the data directly on with the RIS or entering the data directly on it) and updates the order status by closing the it) and updates the order status by closing the procedureprocedure

transmits the study to PACS transmits the study to PACS basically the examination consists of two basically the examination consists of two

standard projections for each breaststandard projections for each breast images are available for the two specialists images are available for the two specialists

interpretationinterpretation

in some programs, the RIS informs the in some programs, the RIS informs the regional Central System about the availability regional Central System about the availability of the mammograms of the mammograms

QuestionsAre there any specifics about the image acquisition? (legal/regulatory requirements)

How are handled additional information to the order? (anamnestic data,…)

How is handled the recall for the repetition of mammograms? (wrong projections,…)

QuestionsAre there any specifics about the image acquisition? (legal/regulatory requirements)

How are handled additional information to the order? (anamnestic data,…)

How is handled the recall for the repetition of mammograms? (wrong projections,…)



Double Reading EvaluationsDouble Reading Evaluations In most of the italian programs each In most of the italian programs each

healthcare enterprise’s RIS is combined with healthcare enterprise’s RIS is combined with a mammographic module (integrated with the a mammographic module (integrated with the Regional observatory on screening)Regional observatory on screening)

two expert radiologists interpret the two expert radiologists interpret the mammograms and sumit the reports and the mammograms and sumit the reports and the pre-formatted screening report pre-formatted screening report

the parallel double reading can also be the parallel double reading can also be sequential in some italian programs (task pool sequential in some italian programs (task pool scheduling of the evaluation)scheduling of the evaluation)

QuestionsWhat is the level of expertise of the mammography radiologist who will interpret the images? (n. of mammograms readings per year, supervisor presence,…)

How is organized the reading chain in other MS Program? (single, double reading)

How is handled the double blind reading?

Is there any diagnosis tool (CAD, …)?

QuestionsWhat is the level of expertise of the mammography radiologist who will interpret the images? (n. of mammograms readings per year, supervisor presence,…)

How is organized the reading chain in other MS Program? (single, double reading)

How is handled the double blind reading?

Is there any diagnosis tool (CAD, …)?

Double blind reading



Double Reading EvaluationsDouble Reading Evaluations Screening reports (inserted with the RIS) are mainly pdf Screening reports (inserted with the RIS) are mainly pdf

and CDAand CDA The reports are digitally signed before the sumbission The reports are digitally signed before the sumbission

(p7m, pdf, xml detached or enveloping or enveloped)(p7m, pdf, xml detached or enveloping or enveloped) For each exam there should be two distinct reports, For each exam there should be two distinct reports,

otherwise in many implementations, actually only one otherwise in many implementations, actually only one unique report is provided:unique report is provided: the first radiologist produces the first version and the the first radiologist produces the first version and the

last radiologist adds her/his interpretation to it (the last radiologist adds her/his interpretation to it (the inclusion of the previous contribute is performed by inclusion of the previous contribute is performed by the RIS: the second radiologist shall not see the first the RIS: the second radiologist shall not see the first report) and signes all report) and signes all

The regional observatory collects two boolean The regional observatory collects two boolean responses and timing statsresponses and timing stats

QuestionsWhat is/are the format/s of the report? (DICOM SR Template 4200 “Breast Imaging Report” modifications, legacy solutions)

What kind of digital signature is/are used specifically in screening reports?

QuestionsWhat is/are the format/s of the report? (DICOM SR Template 4200 “Breast Imaging Report” modifications, legacy solutions)

What kind of digital signature is/are used specifically in screening reports?



Example of legacy applicationsExample of legacy applications

QuestionsHow are handled the screening applications? (integration with the RIS, manual entering of results, pre-compiled schemas,…)

Are there any other steps in your program? (ask for further mammogram,…)

QuestionsHow are handled the screening applications? (integration with the RIS, manual entering of results, pre-compiled schemas,…)

Are there any other steps in your program? (ask for further mammogram,…)



Example of legacy applicationsExample of legacy applications



CS EvaluationCS Evaluation

The Central Information System or the local screening The Central Information System or the local screening mammography unit, collects and evaluates the two mammography unit, collects and evaluates the two boolean results:boolean results:

If boIf both reports are negative the CS sends a letter including th reports are negative the CS sends a letter including the negative result to the patient and the process ends the negative result to the patient and the process ends

If both reports are positive the CS will compose an “Alert” If both reports are positive the CS will compose an “Alert” letter including instructions and the second level of the letter including instructions and the second level of the screening process starts screening process starts

If the two results are discordant (one positive, one negative) If the two results are discordant (one positive, one negative) in most of the programs, the CS re-schedules one blind in most of the programs, the CS re-schedules one blind reading in another worklist for a third evaluation. In this reading in another worklist for a third evaluation. In this case we have another “Evaluation task” case we have another “Evaluation task”

QuestionsAre there implementations with “consensus conference” instead of a system evaluation?

What happens in normal, abnormal, suspicious cases?

QuestionsAre there implementations with “consensus conference” instead of a system evaluation?

What happens in normal, abnormal, suspicious cases?



ENDEND

The CS/screening unit receives the [- -] results The CS/screening unit receives the [- -] results and sends the letter with the negative result to the and sends the letter with the negative result to the patient, also informing her, that the next screening patient, also informing her, that the next screening appointment will be scheduled after two years appointment will be scheduled after two years from this onefrom this one

QuestionsWho does send out the “negative result” letter?

What is the screening frequency in negative cases?

QuestionsWho does send out the “negative result” letter?

What is the screening frequency in negative cases?



Second LevelSecond Level

The CS/screening unit receives the [+ +] results The CS/screening unit receives the [+ +] results and then:and then:

notifies the result to the radiology department in notifies the result to the radiology department in order to schedule another appointment (for biopsy, order to schedule another appointment (for biopsy, ultrasound,…)ultrasound,…)

sends the “Alert” letter to the patient which includes sends the “Alert” letter to the patient which includes the data of the next appointment and the kind of the data of the next appointment and the kind of examinations or contact information examinations or contact information

The XSM-WD is not intended to handleThe XSM-WD is not intended to handle the Second Level (which is managed by the Second Level (which is managed by the department workflow) the department workflow)

QuestionsHow is recorded the result of the screening?

Is the second level manually triggered or not?

QuestionsHow is recorded the result of the screening?

Is the second level manually triggered or not?



Further orders requests



Evaluation 3Evaluation 3

A third expert radiologist interprets the A third expert radiologist interprets the mammograms and sumits the last reportmammograms and sumits the last report

In some of the programs, the third radiologist is In some of the programs, the third radiologist is aware of the previous results: in that case she/he aware of the previous results: in that case she/he is asked to arbitrate on them is asked to arbitrate on them (even (even in this case the number in this case the number of unnecessary of unnecessary recalls is reduced)recalls is reduced)

QuestionsAre there any implementations where the third evaluation is always recommended? (Supervision report for evaluation purpose when the first two radiologists are not enough expert,…)

QuestionsAre there any implementations where the third evaluation is always recommended? (Supervision report for evaluation purpose when the first two radiologists are not enough expert,…)



ResponseResponse

TheThe CS/screening unit analyzes the new result CS/screening unit analyzes the new result and produces the response and produces the response If the third report is negative the CS/screening If the third report is negative the CS/screening

unit sends a letter with the negative result to unit sends a letter with the negative result to the patient and the use case ends (the patient and the use case ends (also also informing her, that the next screening informing her, that the next screening appointment will be scheduled after two years appointment will be scheduled after two years from this onefrom this one) )

If the third report is positive the CS/ screening If the third report is positive the CS/ screening unit composes an “Alert” letter including unit composes an “Alert” letter including instructions and the second level of the instructions and the second level of the screening process takes placescreening process takes place

QuestionsHow is the third reading response managed?

QuestionsHow is the third reading response managed?




WD of the Italian Mammography Screening program

As As shown during the latest t-con, the White Paper relies on shown during the latest t-con, the White Paper relies on of theof the ITI XDW profile ITI XDW profile by using the by using the Workflow Document Workflow Document which manages and gathers the process details in the which manages and gathers the process details in the screening path screening path

Workflow and Tasks Informations Workflow and Tasks Informations

Each Task includes:Each Task includes:

Input Document ReferencesInput Document References

Output Document ReferencesOutput Document References


The Mammography Screening Task Diagram

INPUT……..INPUT……..

OUTPUT- Invitation Letter

OUTPUT- Invitation Letter

TASK 1: RECRUITMENT

TASK 2a: ADMISSION

INPUT- Previous Exams- Invitation Letter

INPUT- Previous Exams- Invitation Letter

OUTPUT- Images (KOS Document)- Anamnestic Document

OUTPUT- Images (KOS Document)- Anamnestic Document

TASK 2b: ADMISSION

INPUT- Invitation Letter

……………

INPUT- Invitation Letter

……………

OUTPUT- “No admission” Document

END

OUTPUT- “No admission” Document

END

TASK 3: EVALUATION 1

INPUT- Images (KOS Document)- Anamnestic Document


OUTPUT- Report 1OUTPUT- Report 1





If a woman misses her scheduled appointmentOR

OR

Task 1 Task 1 4 4


The Mammography Screening Task Diagram

Task 5 Task 5 9 9TASK 5: CS EVALUATION

INPUT- Report 1- Report 2

INPUT- Report 1- Report 2

OUTPUT- Response Report (--,++,+-)

OUTPUT- Response Report (--,++,+-)

INPUT- Response Report


TASK 6a: END (--)

OUTPUT- Letter to Patient

END

OUTPUT- Letter to Patient

END

TASK 6b: SECOND LEVEL (++)



OUTPUT- Letter to Patient (“Alert”)

- Planning DocumentEND

OUTPUT- Letter to Patient (“Alert”)

- Planning DocumentEND

TASK 6c: EVALUATION 3




TASK 7: RESPONSE

INPUT- Report 3

INPUT- Report 3

OUTPUT- Response Report (+,-)

OUTPUT- Response Report (+,-)TASK 9: SECOND LEVEL (+-+)TASK 8: END (+--)

OR OR OR

OR

OR


Actors and Transaction XSM–WD Diagram

Complete Complete DiagramDiagram

XDS Lifecycle XDS Lifecycle Management Management

Tools coordinate Tools coordinate Workflow Workflow Document Document updatesupdates

XDS Lifecycle XDS Lifecycle Management Management

Tools coordinate Tools coordinate Workflow Workflow Document Document updatesupdates


Actors and Transaction XSM–WD

XDW XDW Specific Specific ActorsActors

XDS XDS Specific Specific ActorsActors


XSM–WD in the XDS environment

The The complete Actor and Transactions Digram shows several complete Actor and Transactions Digram shows several transactions and groupable actors transactions and groupable actors

Since the Workflow Document is meant to be constantly Since the Workflow Document is meant to be constantly updated with the information conveyed by the updated with the information conveyed by the XDS XDS transactionstransactions, we will consider the XSM-WD Workflow Document , we will consider the XSM-WD Workflow Document from this point of viewfrom this point of view


Workflow Document: Creation and update

The The Content Creator Content Creator constitutes the first version of the Workflow constitutes the first version of the Workflow DocumentDocument

The The Content Updater Content Updater modifies and adds new data based on the modifies and adds new data based on the tracking of the screening processtracking of the screening process

The The Content Consumer Content Consumer retrieves the Workflow Document retrieves the Workflow Document


Workflow Document: Creation

The The Content Creator Content Creator constitutes the first version of a constitutes the first version of a Workflow Document and places it into a new Workflow Document and places it into a new Workflow Context Folder (stored in the Document Workflow Context Folder (stored in the Document Repository) which will be a fixed reference for the Repository) which will be a fixed reference for the Workflow Document. This actor shall:Workflow Document. This actor shall:

Create a New Workflow Context FolderCreate a New Workflow Context Folder

Generate the First Version of the XSM-WD Workflow Document with Generate the First Version of the XSM-WD Workflow Document with the Description information, the Recruitment Task setting as the Description information, the Recruitment Task setting as “Completed” the Task’s status including the Input/Output Document “Completed” the Task’s status including the Input/Output Document ReferencesReferences

Submit the Workflow Document to the Folder stored in the Document Submit the Workflow Document to the Folder stored in the Document RepositoryRepository


Workflow Document: Update

The The ContentContent UpdaterUpdater modifies and adds new data modifies and adds new data based on the tracking of the screening process and based on the tracking of the screening process and provides it to the Document Repository and Registry provides it to the Document Repository and Registry by a Replace. The Content Updater shall: by a Replace. The Content Updater shall:

Get the only “Approved” version of the Workflow Document in the FolderGet the only “Approved” version of the Workflow Document in the FolderUpdate XSM-WD Workflow Document Description elementsUpdate XSM-WD Workflow Document Description elementsInclude the new Task, added to the content of the latest Workflow Document Include the new Task, added to the content of the latest Workflow Document version, with its own Input/Output Document Referencesversion, with its own Input/Output Document ReferencesSave all changes in a new Workflow Document, setting as “Deprecated” the last Save all changes in a new Workflow Document, setting as “Deprecated” the last one and as “Approved” the current version)one and as “Approved” the current version)Submit the updated Workflow Document to the Folder (stored in the Document Submit the updated Workflow Document to the Folder (stored in the Document Repository)Repository)


Workflow Document: Update

The case with The case with moremore ContentContent UpdatersUpdaters which modify and add new data which modify and add new data using a using a common latest version of the Workflow Document common latest version of the Workflow Document would succeed would succeed only for the first Content Updater who submits it. Infact the other(s) would only for the first Content Updater who submits it. Infact the other(s) would submit the Workflow Document with the documentUniqueID of a submit the Workflow Document with the documentUniqueID of a “Deprecated” Workflow Document and this can not be accepted“Deprecated” Workflow Document and this can not be accepted

Example Task 3-4Example Task 3-4: : The second radiologist Content Consumer should The second radiologist Content Consumer should always refer to the Evaluation 1 Worflow Document to avoid errors: always refer to the Evaluation 1 Worflow Document to avoid errors:

Into the Folder there will be Into the Folder there will be only one Workflow Document only one Workflow Document with the with the “Approved” status“Approved” status. All the previous ones are . All the previous ones are located into the same Folder will have a “Deprecated” located into the same Folder will have a “Deprecated” statusstatus

The second radiologist will not see the screening Images on his/her The second radiologist will not see the screening Images on his/her worklist until the first one will have finished his/her evaluationworklist until the first one will have finished his/her evaluation

Another etrieve of the “actual” Workflow Document and update of it Another etrieve of the “actual” Workflow Document and update of it only at the end of each Evaluation (for these two Tasks) only at the end of each Evaluation (for these two Tasks)


Workflow Document: Retrieve

The The Content Consumer Content Consumer retrieves the Workflow retrieves the Workflow Document, obtains informations from it,…Document, obtains informations from it,…

This actor should retrieve the latest version which This actor should retrieve the latest version which coincides with the unique “Approved” versioncoincides with the unique “Approved” version

Input/Output Document references for each Task includeInput/Output Document references for each Task include : :

XDSDocumentEntry.uniqueIdXDSDocumentEntry.uniqueIdhomeCommunityIdhomeCommunityId

Possible Possible queriesqueries::

Find the Workflow Folder for a PatientFind the Workflow Folder for a PatientGet the Workflow Folder in which a particular Workflow Document is storedGet the Workflow Folder in which a particular Workflow Document is storedGet one or more document referenced in a Workflow DocumentGet one or more document referenced in a Workflow Document……


XSM–WD Workflow Document

The XDM-WD Workflow Document cutomization complies The XDM-WD Workflow Document cutomization complies the XDW XML Schema which includes elements from the the XDW XML Schema which includes elements from the following standards: following standards: HL7 CDAHL7 CDA OASIS WS-Human TaskOASIS WS-Human Task

The four part The four part Document Document composition: composition:

See XDW Profile for the See XDW Profile for the detailed description of all detailed description of all WD elements WD elements



The XSM-WD Workflow Document The XSM-WD Workflow Document at Task 3 “Evaluation 1”:at Task 3 “Evaluation 1”:


INPUT- images (KOS Document)

- anamnestic doc


- anamnestic doc


Workflow Document Information:id : documentIdtitle : « Screening Mammography Workflow Document » effectiveTime : …confidentialityCode : …•languageCode : …patient : Jane Doe author : Dr.Kris workflowIstanceID : workflowDocumentSequenceNumber : « 3 »workflowStatus : « OPEN »workflowDefinitionReference : to workflow definition template (urn: OID:…)•XDWdocumentHistory : …

Workflow Document Information:id : documentIdtitle : « Screening Mammography Workflow Document » effectiveTime : …confidentialityCode : …•languageCode : …patient : Jane Doe author : Dr.Kris workflowIstanceID : workflowDocumentSequenceNumber : « 3 »workflowStatus : « OPEN »workflowDefinitionReference : to workflow definition template (urn: OID:…)•XDWdocumentHistory : …

XSM-WD Workflow Document

TaskList

The main Workflow Document The main Workflow Document Informations are located in the first part Informations are located in the first part of the structureof the structure

Some elements are updated upon on the Some elements are updated upon on the specific Task: author, specific Task: author, workflowDocumentSequenceNumber workflowDocumentSequenceNumber workflowStatus,…workflowStatus,…

The following part is composed by the list The following part is composed by the list of the actual and the previous Tasksof the actual and the previous Tasks



The XSM-WD Workflow Document The XSM-WD Workflow Document at Task 3 “Evaluation 1”:at Task 3 “Evaluation 1”:



- anamnestic doc


- anamnestic doc


The taskList element includes all The taskList element includes all generated Tasks itemsgenerated Tasks items


XDWTaskXDWTask

taskEventHistory taskEventHistory

taskDataName : Recruitmentid :Status : COMPLETEDDate/time : Input : Lists of eligible womenOutput : Recruitment LetteractualOwner : CS – MS Service…

taskDataName : Recruitmentid :Status : COMPLETEDDate/time : Input : Lists of eligible womenOutput : Recruitment LetteractualOwner : CS – MS Service…

XDWTaskXDWTask


taskDataName : Admissionid :Status : COMPLETEDDate/time : Input : Invitation Letter, Previous examsOutput : KOS Document, Anamnestic DocumentactualOwner : Dr. White…

taskDataName : Admissionid :Status : COMPLETEDDate/time : Input : Invitation Letter, Previous examsOutput : KOS Document, Anamnestic DocumentactualOwner : Dr. White…

XDWTaskXDWTask


taskDataName : Evaluation 1id :Status : COMPLETEDDate/time : Input : KOS Document, Anamnestic DocumentOutput : Report 1actualOwner : Dr. Kris…


The last Task’s The last Task’s actualOwneractualOwner represents the represents the authorauthor for the general for the general information of the information of the Workflow Document Workflow Document


Example: taskData Element in XSM-DW<ns3:taskData>

<ns2:taskDetails>

<ns2:id>3</ns2:id>

<ns2:taskType>Requested</ns2:taskType>

<ns2:name>Evaluation 1</ns2:name>

<ns2:status>COMPLETED</ns2:status>

<ns2:createdTime>YYYY-MM-DDTHH:MM:SS.0Z</ns2:createdTime>

<ns2:lastModifiedTime>YYYY-MM-DDTHH:MM:SS.0Z</ns2:lastModifiedTime>

<ns2:renderingMethodExists>false</ns2:renderingMethodExists>

</ns2:taskDetails>

<ns2:description></ns2:description>

<ns2:input>

<ns2:part name="xdw">

<reference uid="urn:oid:1.2.3.4.4.3.2.2.X"/> <!– KOS Document -->

</ns2:part>


<reference uid="urn:oid:1.2.3.4.4.3.2.2.Y"/> <!– Anamnestic Document-->

</ns2:part>

</ns2:input>

<ns2:output>


<reference uid="urn:oid:1.2.3.4.4.4"/> <!– Report 1 -->

</ns2:part>

</ns2:output>

</ns3:taskData>

XDWTaskXDWTask




Work in progress: Work in progress: The entire The entire customization on the customization on the Screening Screening Mammography Mammography Workflow DocumentWorkflow Document


Process Flow


Process Flow


Process Flow


Process Flow


Process Flow


Process Flow


Process Flow

Documents

Cross - Enterprise Screening Mammography - Workflow Definition (XSM-WD) White Paper for 2011/2012 Arianna Cocchiglia, Francesca Vanzo, Luca Zalunardo January,