System and method for creating and rendering DICOM structured clinical reporting via the internet

Abstract

The assembly and communications of a generic reporting engine for offering clinical structured reports using the Internet in an encrypted manner is provided. This method of rendering structured reports employs a DICOM Structured Reporting (SR) software database engine that maps clinical report data into a clinical structured reporting data format using a Report Editor Plug-in which is responsible for constructing the report editor GUI, for parsing the DICOM SR report to show it in the Report Editor window and to store the report content created in the GUI to the DICOM SR format. The report engine can be configured with any number of software plug-ins, so totally different ways of acquiring user input may be implemented. The current invention implements the software plug-ins using a tree-like GUI. The current implementation of this plug-in is based on DICOM SR pull model which is considered more feasible to control its presentation form, but the reporting engine allows for implementation of push model report editor plug-ins. Nothing in this novel approach to clinical reporting prevents the application from implementing a report editor from editing any DICOM SR report in a generic way, like recognizing a report from voice dictation. The Reporting Engine of the present invention provides a way for the plug-ins to recognize if they are able to open the report or not. It can be done either by software plug-ins' report introspection or the process is configurable in the using the invention's reporting engine. The novel reporting engine provides a way of configuring a Report Editor Plug-in, so with one generic plug-in one may have many report templates just by configuring the plug-in. The currently implemented plug-in uses this possibility to define the report definition and GUI tree in a configuration file.

1 . (canceled) 
   
   
       2 . A method for implementing a structured clinical reporting system over the Internet, the structured clinical report having a DICOM Structured Reporting format, and the Internet adapted to work in conjunction with hypertext transfer protocol (HTTP) for connecting a server and multiple workstations via the Internet, the method comprising the steps of:
 (a) providing communication between a workstation and the server via the Internet, 3     (b) adapting a reporting system to have a reporting engine, the reporting engine is in operative communication with the workstation, an image viewer-editor and the server,   (c) providing the workstation for creating the clinical report, signing the clinical report, rendering the clinical report, transmitting the clinical report to and from the server via the Internet,   (d) providing the workstation for manipulating a study list stored on the server,   (e) providing a picture archiving and communications system (PACS) server,   (f) providing communication between the PACS server and a database server,   (g) providing communication between the PACS server and a viewer and the workstation over the HTTP protocol,   (h) providing communication between the PACS server and an imaging modalities using a DICOM interface, such as the PACS server is in operative communication with imaging modalities via DICOM protocol and is in operative communication with the database, whereby the workstation comprising the viewer further comprises the reporting engine, the image viewer-editor and the study list viewer is in operative communication with the PACS server via the Internet using the HTTP protocol.   
   
   
       3 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 2  wherein the image viewer-editor is a DICOM viewer having rich client characteristics. 
   
   
       4 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 2  wherein the workstation provides the automatic downloading, installing and running of the rich-client viewer. 
   
   
       5 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 2  wherein the image viewer-editor is a rich client capable of being installed remotely. 
   
   
       6 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 2  wherein the image viewer-editor is a DICOM viewer implemented in JAVA language having rich client characteristics. 
   
   
       7 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 2  wherein the image viewer-editor is a DICOM viewer automatically downloaded and installed using Java Web Start technology. 
   
   
       8 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 2  wherein the study list viewer is implemented in WWW-based, thin-client technology. 
   
   
       9 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 2  wherein the study list-viewer comprises a graphical user interface for displaying patient exams, studies and information listed by specific category including chronological order and status. 
   
   
       10 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 2  wherein access to the database is from a remote workstation to the PACS server such that database traffic between the remote workstation and the database server is tunneled over secure HTTP protocol. 
   
   
       11 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 2  wherein a DICOM object is downloaded from the PACS server to the interface viewer using WADO protocol. 
   
   
       12 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 2  further comprising Web Services for providing communication between the PACS server and a client-side, rich-client viewer. 
   
   
       13 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 2  wherein the workstation is a computer. 
   
   
       14 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 2  wherein the workstation consists of a central processor unit and a random access memory. 
   
   
       15 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 2  wherein the picture archive communication systems (PACS) comprises a central data storage device. 
   
   
       16 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 2  wherein the clinical reports are stored and transmitted using a DICOM Structured Report format. 
   
   
       17 . The method for implementing a structured clinical reporting system over the Internet, the structured clinical report having a DICOM Structured Reporting format, and transmitted over the Internet over HTTP protocol between multiple workstations and the server via the Internet as defined in  claim 2 , wherein the step of adapting a reporting system to have a reporting engine comprises the steps of:
 (a) sending images, optional reporting pages and structured reports from DICOM modality to the PACS server, where the images, optional reporting pages and structured reports are defined as a study,   (b) storing the study in the PACS server,   (c) forwarding the study from the PACS server to an image-DSR conversion engine,   (d) determining whether the image-DSR conversion engine can make the appropriate conversion of the study,   (e) extracting measurement information from the DICOM modality images,   (f) determining if the study contains measurement data for further analysis; if conversion is appropriate, populating the study data into the report in DSR format; if conversion is not appropriate, then the report opens in DSR format without data,   (g) storing the values acquired in the DICOM structured report format, and   (h) storing the produced structured clinical report in the PACS server.   
   
   
       18 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 16  wherein optical character recognition is used to obtain measurements from the study list images of the DICOM modality. 
   
   
       19 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 16  wherein optical character recognition is used to obtain measurements from the study list clips of the DICOM modality. 
   
   
       20 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 16  wherein the DICOM modalities comprise one or more of ultrasound, x-ray, computer tomography, positron emission technology, nuclear imaging and fluoroscopy. 
   
   
       21 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 16  wherein the OCR data is converted to a DICOM Structured Report (DSR) coding schema. 
   
   
       22 . The method for implementing a structured clinical reporting system over the Internet as defined in  claim 16  wherein the extracted measurement data from the DICOM modality comprises one or more of names, values, units of measurements, and patient information. 
   
   
       23 . The method for implementing a structured clinical report system over the Internet, the structured clinical report having a DICOM Structured Reporting format, and transmitted over the Internet using HTTP protocol between multiple workstations and a server via the Internet comprising the steps of:
 (a) adapting a reporting system to have a reporting engine comprising a generic report transformer,   (b) determining a report type to be created having given a set of source reports to populate data from,   (b) searching transformations that could produce the desired report type to determine a set of one or more transformations that can produce the desired report from a given set of source reports,   (c) narrowing the set of transformations by applying the specific source report criteria,   (d) providing a user selection of a source report selected from the group of populate from, convert and transform,   (e) if no report type can be identified, creating a report to accommodate the specific source report criteria, and   (f) creating the requested report type from the set of transformations.   
   
   
       24 . A method for implementing a structured clinical report system over the Internet, the structured clinical report in operative association with a Graphical User Interface (GUI) to create or amend a report having a plurality of parts, the method comprising the following steps:
 (a) providing a set of structured main tabs corresponding to a part of the report being created,   (b) providing that each structured main tab is divided into one or more sub-tabs,   (c) providing that each sub-tab further comprises an arbitrary number of at least one of headers, measurement tables and fast search code lists,   (d) providing that each header further comprises an arbitrary number of concepts to be selected mutually or non-exclusively within the header such that mutual selection is implemented with GUI elements while non-exclusive selection is done with GUI elements,   (e) providing that each concept comprises an arbitrary number of GUI elements, and   (f) providing that each concept corresponds to at least one concept in the DICOM SR template.   
   
   
       25 . The method for implementing a structured clinical report system over the Internet for implementing the GUI as defined in  claim 24  wherein the GUI elements comprise labels, edit boxes, spinners and combo boxes. 
   
   
       26 . The method for implementing a structured clinical report system over the Internet for implementing the GUI as defined in  claim 24  further comprising a GUI definition stored in an external configuration file as a report template. 
   
   
       27 . The method for implementing a structured clinical report system over the Internet for implementing the GUI as defined in  claim 24  further comprising:
 (a) a context help user interface element such that the content depends on the current sub-tab being displayed and the content changes dynamically after switching, and   (b) the content of the context help user interface element is stored together with a report template.   
   
   
       28 . The method for implementing a structured clinical report system over the Internet for implementing the GUI as defined in  claim 24  further comprising the steps of:
 (a) loading and validating the GUI definition into the computer memory where a tree-like structure of a template merges into a GUI form supplied by a report editor plug-in,   (b) adjusting the GUI definition dynamically by a report editor plug-in based on the report being edited,   (c) creating the GUI components,   (d) populating the GUI components from the source report,   (e) allowing the report editor plug-in to modify the loaded report template such that the GUI is altered on the fly based on a user's input, and   (f) populating the report by taking information from the GUI elements and storing them in specific places in the DICOM SR report as defined by the report template.   
   
   
       29 . A method for implementing a system for automatic population of values of parameters acquired by an imaging modality into a DICOM structured report using optical character recognition, comprising the steps of:
 (a) providing a pluggable software extraction engine that accepts DICOM objects from another DICOM application entity,   (b) providing a pluggable software extraction engine having a plug-in chooser that determines which software plug-in should be used to extract data values from a given study,   (c) providing a set of software plug-ins in active communication with an engine, the engine being able to recognize the values from at least one of the bitmap image and the reporting page produced by a DICOM imaging modality of a given vendor, and   (d) providing a pluggable software extraction engine in operative communication with a PACS server to store produced DICOM structured reports for further distribution.   
   
   
       30 . The method for implementing a system for automatic population of values of parameters acquired by an imaging modality into a DICOM structured report using optical character recognition as defined in  claim 29  further comprising the steps of:
 (a) providing a pluggable software extraction engine having an image filter to sort the appropriate images with measurement for further analysis,   (b) providing a segmentation block for separating the logical parts of at least one of an image and a report page, wherein the logical parts comprise visual segments, headers, measurement names, measurement values and units of measurement,   (c) providing a value object extraction block for recognizing the semantics of a found segment, the segment comprising alpha-numeric data and numeric data such that the data is stored in structures defined as value objects,   (d) providing a value object to DICOM SR format conversion block for serializing the value objects, and   (e) mapping from extracted value objects to DICOM SR concepts by an external configuration file.   
   
   
       31 . A structured clinical reporting system for use over the Internet, with a structured clinical report having a DICOM Structured Reporting format, and the Internet adapted to work in conjunction with hypertext transfer protocol (HTTP) for connecting a server and multiple workstations via the Internet, the system comprising:
 (a) a workstation in communication with the server via the Internet,   (b) a reporting system comprising a reporting engine, the reporting engine is in operative communication with the workstation, an image viewer-editor and the server,   (c) the workstation for creating the clinical report, signing the clinical report, rendering the clinical report, and transmitting the clinical report to and from the server via the Internet,   (d) the workstation for manipulating a study list stored on the server,   (e) a picture archiving and communications system (PACS) server in communication with a database server,   (f) the PACS server in communication with a viewer and the workstation over the HTTP protocol,   (g) the PACS server in communication with an imaging modalities using a DICOM interface, such as the PACS server is in operative communication with imaging modalities via DICOM protocol and is in operative communication with the database, whereby the workstation comprising the viewer further comprises the reporting engine, the image viewer-editor and the study list viewer is in operative communication with the PACS server via the Internet using the HTTP protocol.