HIMSS and RSNA

Integrating the Healthcare Enterprise

Scheduled Workflow (SWF) Connectathon Test Cases

Revision 2006.12.17 December 17, 2006 IHE Technical Framework: Year 3 ______

Contents

1 Introduction...... 2 2 Tests...... 2 2.1 ADT_Placer: ADT actors send several ADT message sequences to Order Placers...... 2 2.2 ADT_Filler: ADT actors send several ADT message sequences to DSS/Order Fillers. 3 2.3 SWF_ORDERS: Order Handling...... 5 2.4 SWF_OF_OP_AN: Appointment Notification Option...... 7 2.5 SWF_OF_Modality_Interface...... 7 2.6 SWF_Modality_IM_Interface...... 10 2.7 MOD_GROUP_CASE: Modality Group Case Option...... 12 2.8 MOD_ASSIST_ACQ: Assisted Aquisition Protocol Setting Option...... 13 2.9 MOD_BILLING_MATERIAL: Modality Billing Material Management Option...... 14 2.10 SWF_OF_IM: OF and Image Manager Interaction...... 15 2.11 SWF_EC_IM: Workflow - Evidence Creator & IM...... 17 2.12 SWF_MOD_Store: Acquisition Modality & Evidence Creator Stores Images to Central_Archive...... 19 2.13 SWF_IM_Store: Image Manager Accepts/Stores Image and Evidence Objects...... 19 2.14 SWF_ID_IM: Image Display & Image Manager Interoperability...... 21 2.15 SWF_DISPLAY: Image Display of all Vendors’ Waveforms, Images & Evidence Documents...... 23 2.16 SWFPIR: Group test for PIR and Scheduled Workflow...... 24

1 Introduction This document describes the IHE Connectathon tests for the Scheduled Workflow (SWF) Integration Profile. At a given Connectathon, only a subset of these tests may be required.

2 Tests

2.1 ADT_Placer: ADT actors send several ADT message sequences to Order Placers

1.1.1 Special Instructions None.

1.1.2 Description ADT system broadcasts ADT messages to Order Placers (only). Observer will ask Order Placers to show results of ADT messages.

1.1.3 Evaluation On the Order Placer user interface or database, verify:  Patient COMPANY^George is an inpatient (his name was changed from COMPANY^Monday).  Patient COMPANY^Tuesday was merged with patient Doe^COMPANY. To be verified in ADT messages :  A01, A04, A05, A11, A38 : At least one of the fields PID-18 Patient Account Number or PV1-19 Visit Number shall be valued.  A01 : PV1-3 PV1-7 PV1-10 PV1-17 shall be valued  A04, A05, A11, A38 : PV1-3 PV1-7 PV1-10 PV1-17 shall not be valued  ADT^A40 shows both '^Tuesday' and '^Doe' patient names Project manager may ask you to give names with titles, prefix, suffix and or aliases. For example:  Jean-Baptiste Poquelin, alias Molière

 Clark Kent alias Superman  Johann Wolfgang von Goethe alias Goethe  Martin Luther King, Jr  Michelangelo Buonarroti alias Michelangelo  Silvio Berlusconi alias il Cavaliere  Dr Jack Rabbit

1.1.4 Actors ADT Order Placer

1.1.5 Steps RAD-1 Pre-register patient COMPANY^Monday, where 'COMPANY' is the name of the ADT system under test. (ADTÂ05) RAD-1 Register COMPANY^Monday as inpatient. (ADTÂ01) RAD-12 Change COMPANY^Monday to COMPANY^George. (ADTÂ08) RAD-12 Change COMPANY^George to an outpatient. (ADTÂ07) RAD-1 Register Doe^COMPANY as inpatient. (ADTÂ01) RAD-1 Register COMPANY^Tuesday as inpatient. (ADTÂ01) RAD-12 Discharge Doe^COMPANY. (ADTÂ03) RAD-12 Merge COMPANY^Tuesday and Doe^COMPANY. (ADTÂ40) RAD-12 Change COMPANY^George to an inpatient. (ADTÂ06) RAD-12 Transfer COMPANY^George to an new location. (ADTÂ02) RAD-12 Cancel transfer. (ADTÂ12)

2.2 ADT_Filler: ADT actors send several ADT message sequences to DSS/Order Fillers

1.1.7 Description

ADT system broadcasts ADT messages to DSS/Order Fillers (only). Observer will ask DSS/Order Fillers to show results of ADT messages.

1.1.8 Evaluation On the DSS/Order Filler user interface or database, verify:  Patient COMPANY^George is an inpatient (his name was changed from COMPANY^Monday).  Patient COMPANY^Tuesday was merged with patient Doe^COMPANY. To be verified in ADT messages :  A01, A04, A05, A11, A38 : At least one of the fields PID-18 Patient Account Number or PV1-19 Visit Number shall be valued.  A01 : PV1-3 PV1-7 PV1-10 PV1-17 shall be valued  A04, A05, A11, A38 : PV1-3 PV1-7 PV1-10 PV1-17 shall not be valued  ADT^A40 shows both '^Tuesday' and '^Doe' patient names Project manager may ask you to give names with titles, prefix, suffix and or aliases. For example:  Jean-Baptiste Poquelin, alias Molière  Clark Kent alias Superman  Johann Wolfgang von Goethe alias Goethe  Martin Luther King, Jr  Michelangelo Buonarroti alias Michelangelo  Silvio Berlusconi alias il Cavaliere  Dr Jack Rabbit

1.1.9 Actors ADT DSS/Order Filler

1.1.10 Steps RAD-1 Pre-register patient COMPANY^Monday, where 'COMPANY' is the name of the ADT system under test. (ADTÂ05) RAD-1 Register COMPANY^Monday as inpatient. (ADTÂ01) RAD-12 Change COMPANY^Monday to COMPANY^George. (ADTÂ08) ______6 2006.01.31 Copyright © 2006: HIMSS/RSNA SWF Connectathon Test Cases ______

RAD-12 Change COMPANY^George to an outpatient. (ADTÂ07) RAD-1 Register Doe^COMPANY as inpatient. (ADTÂ01) RAD-1 Register COMPANY^Tuesday as inpatient. (ADTÂ01) RAD-12 Discharge Doe^COMPANY. (ADTÂ03) RAD-12 Merge COMPANY^Tuesday and Doe^COMPANY. (ADTÂ40) RAD-12 Change COMPANY^George to an inpatient. (ADTÂ06) RAD-12 Transfer COMPANY^George to an new location. (ADTÂ02) RAD-12 Cancel transfer. (ADTÂ12)

2.3 SWF_ORDERS: Order Handling

1.1.11 Special Instructions This test is identical to the Radiology CATH_ORDERS, ECHO_RODERS and STRESS_ORDERS Connectathon Test Cases, but uses radiology orders. For systems participating in multiple profiles, only 3 instances of this test need to be run across profiles. Use the RIS MALL as an ADT simulator to register patients for this test. If there is an idle ADT actor that wants to collaborate, you are free to use that system; that ADT system will not be recognized in the test results.

1.1.12 Description This test verifies the ability of the Order Placer, DSS/Order Filler and Image Manager to exchange order and status information (RAD-TF-1: 3.3.3 and RAD-TF-2: 4.3.4) – patients are registered; orders are created and cancelled at both the OP and DSS/OF. NOTE: The following transactions are tested in other test cases and are not verified in detail here, but you could check for the proper exchange of these messages  [RAD-1] ADT notifies OP and DSS/OF of new patient registration.

1.1.13 Evaluation On the OP user interface or database, verify that:  Orders 11050 or 12110 are cancelled.  There is an order 12150 (Radiological Examination: Right Wrist) for patient SYS_NAME^ORDERS2.

On the DSS/OF user interface or database, verify that:  There is no order 111050 waiting to be scheduled for patient SYS_NAMEÔRDERS1.  There is a scheduled item 912150 for patient SYS_NAMEÔRDERS2.  A copy of the ORR message from the OP (transaction RAD-3) has been captured, eg in [test-case-no]-orr-msg.txt. ORC-2 should contain the Placer Order number recorded at the OP for Order 12150 for patient SYS_NAMEÔRDERS2.

1.1.14 Actors Order Placer DSS/Order Filler

1.1.15 Steps NULL On the RIS Mall, register two patients with names: SYS_NAMEÔRDERS1 and SYS_NAMEÔRDERS2. (SYS_NAME is the name of the Order Placer & Order Filler systems under test, eg. OP_ABC-OF_DEFÔRDERS2). RAD-2 On the OP, place order 11050 (Magnetic Resonance Imaging: Neck) for patient SYS_NAMEÔRDERS1. RAD-2 On the OP, place order 12110 (Radiological Examination: Right Hand) for patient SYS_NAMEÔRDERS2. RAD-2 On the OP, cancel order 11050 for SYS_NAMEÔRDERS1. RAD-1 On the OF, schedule order 12110 for SYS_NAMEÔRDERS2. NULL The next 5 transactions test Order Replacement (Cancel/New) from the DSS/OF. RAD-3 On the DSS/OF, cancel order 12110 (Radiological Examination: Right Hand) for SYS_NAMEÔRDERS2. (You will be scheduling a wrist exam instead.) NULL Before you execute the next step, on the Order Filler, prepare to capture in the Kudu chat window a copy of the ORR message sent from the OP to the OF, for example in a log file named [test-case-no]-orr-msg.txt, for later evaluation. RAD-3 On the OF, create and schedule a new procedure 912150 (DX: Wrist R) for SYS_NAMEÔRDERS2. RAD-3 Order Placer should provide the Placer Order number in an ORR message. (This is the message to capture on the OF.) NULL Record the Placer Order number from the OP______in the Kudu chat window.

2.4 SWF_OF_OP_AN: Appointment Notification Option

1.1.17 Description Appointment Notification [RAD-48] is an optional transaction used by DSS/OF actors to notify an OP of new appointments, rescheduled SPSs and cancellations (RAD-TF-2:4.48).

1.1.18 Evaluation On the Order Placer user interface or database, verify:  In the captured SIU message, AIS-3 contains an identifier for the first SPS scheduled on the DSS/OF.  AIS-4 contains the scheduled start date/time.  The second order placed has a status of 'cancelled'.

1.1.19 Actors Order Placer – Departmental Appointment Notification option DSS/Order Filler – Departmental Appointment Notification option

1.1.20 Steps RAD-2 On the OP, place two new orders.1 NULL On the OP, prepare to capture a copy of the reschedule message in the Kudu chat window, for example in a log file named OF_SYSTEM_appt_not.txt, for later evaluation. RAD-48 On the OF, schedule an exam for the both orders. RAD-48 On the OF, reschedule the first scheduled exam. RAD-48 On the OF, cancel the second scheduled exam.

2.5 SWF_OF_Modality_Interface

1.1.21 Special Instructions  Use the RIS Mall to register a patient and create an order (Requested Procedure) for this test.

 The Modality should be configured to send MPPS to the DSS/OF.  The Modality will C-STORE images in this test, but storage to an Image Manager is not part of the evaluation. If there is not an available Image Manager to C-STORE to, the Modality should be configured to send its objects to the Connectathon CENTRAL_ARCHIVE.

1.1.22 Description In this test, the Modality and DSS/OF test their interfaces for these actions:  Modality Worklist  The Unscheduled Case Note that the ability of the DSS/OF to forward MPPS messages as a PPS Manager is not exercised in this test.

1.1.23 Evaluation Connectathon Monitor will ask the Acquistion Modality to show evidence that:  it supports either Broad or Patient-Based MWL queries. (It may support both.) Broad Worklist: The Modality operator should demonstrate on its user interface the ability to query by combination of SPS Start Date, Modality type, Scheduled AE title. Patient-Based Worklist: The Modality operator should demonstrate on its user interface the ability to query by combination of Patient Name, Patient ID, Accession Number, Requested Procedure ID.  In the Unscheduled Case, the MPPS message sent by the Modality (captured on the DSS/OF) contains:  (0010,0010) Temporary Patient ID created by the Modality (Patient ID reconciliation is not evaluated in this test)  (0020,000D) Study Instance UID created by the Modality  (0008, 1032) Procedure Code Sequence is empty  In (0040,0270) – Scheduled Step Attributes Sequence, the following attributes are empty (zero-length): - (0008,1110) Referenced Study Sequence - (0008,0050) Accession Number - (0032,1060) RP Description - (0040,1001) Requested Procedure ID - (0040, 0007) SPS Description - (0040,0008) Scheduled Procedure Code Sequence - (0040,0009) SPS ID

Connectathon Monitor will ask the DSS/OF to show evidence that:  It creates valid DICOM Study Instance UIDs (0020,000D): - containing a registered root of the form: 1.2.yyy.xxxxxx where yyy is a 3 digit country code (eg 840 for US), and xxxxxx is a six-digit organization code provided by ANSI. - each component (separated by “.”) consists of one or more digits. The first digit of each component shall not be zero unless the component is a single digit. - maximum length of 64 characters  a RP/SPS has been created for this procedure using the modality-provided Study Instance UID received in the MPPS.

1.1.24 Actors DSS/OF Acquisition Modality

1.1.25 Steps NULL The DSS/OF should prepare to capture MPPS N-Create messages received from the Modality. NULL Modality Actor: Use the RIS Mall to register one outpatient for this test. The patient name should be a combination of the DSS/OF and Modality under test. Use this format: OF^MOD. NULL Modality Actor: Use the RIS Mall as an OP to send an order for one radiology procedure recognized by your system to the DSS/OF. NULL DSS/OF schedules the procedure for the Modality under test. RAD-5 Modality queries the DSS/OF for worklist. RAD-6 Modality selects the correct item off the worklist, starts the procedure, and sends MPPS N-CREATE to the DSS/OF. RAD-8 Modality collects images and stores them to the CENTRAL_ARCHIVE or an Image Manager. This step is not evaluated in this test. RAD-7 Modality completes the procedure and sends MPPS N-SET COMPLETED to the DSS/OF. NULL This begins the Unscheduled case. In the scenario, the patient is registered but the emergency procedure is unscheduled. No Modality Worklist is done. NULL Both Patient and Procedure are manually entered on the Modality. Use patient name of the form: OF-MOD^Unsched.

RAD-6 Modality sends MPPS In Progress to DSS/OF. NULL Verify on the DSS/OF that a RP/SPS has been created for this procedure using the modality-provided Study Instance UID. RAD-8 Modality stores images to the CENTRAL_ARCHIVE or an Image Manager. This step is not evaluated in this test. RAD-7 Modality completes the procedure and sends MPPS N-SET COMPLETED to the DSS/OF. NULL The post-procedure reconciliation done by the DSS/OF is not exercised in this test.

2.6 SWF_Modality_IM_Interface

1.1.26 Special Instructions

1.1.27 Description The Modality and Image Manager test their interfaces for these actions:  Append-to-Normal Case (RAD-TF-2: 4.6.4.1.2.3.3 and Table A.1-3) – a Patient is registered, an Order is created and a Procedure is scheduled. Additional PPSs are performed on the Modality that were not scheduled at the DSS/OF.  Abandoned Case (RAD-TF-2: 4.6.4.1.2.3.5) – a Patient is registered, an Order is created and a Procedure is scheduled, started, then discontinued.  Storage Commitment

Note that the ability of the Image Manager to forward MPPS messages as a PPS Manager is not exercised in this test.

1.1.28 Evaluation For the APPEND CASE, the Connectathon Monitor will ask the Image Manager to show evidence that:  The images for patient MOD-IM^APPEND are successfully stored  The images received from the modality contain attributes received in the modality worklist, including the Study Instance UID (0020,000D), and RP and SPS info in the Requested Attributes Seq (0040,0275).  (0040,0244) Performed Procedure Step ID is different for the two procedure steps performed on the modality (original and appended steps).

 The values in the following fields are the same in the IODs from the original PPS, and in those appended. Check the Study Instance UID for the first and last image in the study. o Study Instance UID (0020,000D) should be that received from the DSS/OF (RIS Mall). o Also Study Date, Study Time and Study Description attributes are the same in image IODs for the original PPS, and those appended.  Storage Commitment was successful (N-EVENT-REPORT was sent).

For the ABANDONED CASE, the Connectathon Monitor will ask the Image Manager to show evidence that:  It received MPPS Discontinued from the Modality in the Abandoned case.

1.1.29 Actors Image Manager Acquisition Modality

1.1.30 Steps NULL The following steps test the APPEND CASE. NULL On the RIS Mall (or OP) system, place a single order for patient MOD-IM ^APPEND. NULL On the DSS/OF, schedule 1 SPS for this order. NULL On the Modality, query the DSS/OF for worklist. RAD-6 MPPS In-Progress from Modality to IM. RAD-8 On the Modality, acquire images for this SPS. Store the images to the IM. RAD-8 On the Modality, perform an additional Procedure Step that was not scheduled; acquire and store additional images to the IM. If the Modality cannot perform a different SPS, perform the first SPS a second time. (Some modalities may send another MPPS msg here.) RAD-7 N-SET PPS Complete from the Modality to the IM. RAD-10 Storage Commit N-ACTION from the Modality to the Image Manager. RAD-10 Storage Commit N-EVENT-REPORT from the Image Manager to the Modality NULL This completes the APPEND CASE. The next steps test the ABANDONED case. ______13 2006.01.31 Copyright © 2006: HIMSS/RSNA SWF Connectathon Test Cases ______

NULL Modality Actor: Use the RIS Mall to register one outpatient for this test. The patient name should be a combination of the Modality under test and Image Manager under test. Use this format: MOD-IM^ABANDON. NULL Modality Actor: Use the RIS Mall to send an order for one procedure recognized by your system to the RIS Mall. Use the system to schedule that procedure for your modality. RAD-5 Modality queries the RIS Mall (DSS/OF) for worklist. RAD-6 Modality selects the correct item off the worklist, starts the procedure and sends MPPS N-CREATE to the Image Manager. RAD-8 Modality starts sending images to the Image Manager. RAD-7 Modality abandons the procedure before it is complete and sends MPPS N-SET DISCONTINUED to the Image Manager . NULL This ends the ABANDONED case.

2.7MOD_GROUP_CASE: Modality Group Case Option

1.1.31 Special Instructions Modalities which support this option run one instance of this test.

1.1.32 Description The PPS Group Case allows an Acquisition Modality supporting the MODALITY GROUP CASE option to select two or more Scheduled Procedure Steps (SPS) from a Modality Worklist and perform a single acquisition. The PPS messages from the modality indicate the multiple scheduled steps and the single acquisition (RAD-TF-2:4.6.4.1.2.3.6 and A.1-4).

1.1.33 Evaluation Examine the saved MPPS message. The accession number (0008,0050) and the Study Instance UID (0020,000D) for the single PPS are the same as recorded in the Kudu chat window (and provided in the MWL).

1.1.34 Actors DSS/Order Filler (optional participant; could use RIS Mall) Acquisition Modality

1.1.35 Steps

NULL On DSS/OF schedule study 20110 (1 RP, 2 SPSs) for the Modality. Record the accession number ______in the Kudu chat window. NULL On the DSS/OF, prepare to capture in the Kudu chat window a copy of the Set PPS Complete message, for example in a log file named [test-case-no]-group- pps.txt, for later evaluation. RAD-5 Modality queries for worklist containing Protocol Code Items. RAD-6 Modality sends MPPS In Progress to DSS/OF (group case, 2 SPS in one study). RAD-7 Modality sends MPPS Complete to DSS/OF (This is a message to capture on the OF.) NULL Modality can send images to Central Archive.

2.8 MOD_ASSIST_ACQ: Assisted Aquisition Protocol Setting Option

1.1.37 Description This test demonstrates support for the ASSISTED ACQUISITION PROTOCOL SETTING option (RAD-TF-2:4.6.4.1.2.4.2). A Modality supports use of the protocol codes specified in the SPS selected from the MWL.

1.1.38 Evaluation This test shall be evaluated real-time. The modality operator demonstrates for the Connectathon Monitor that he/she can accept the protocol proposed by the set of Protocol Codes provided for the SPS selected from the worklist. The operator shall not manually enter the attributes of the acquisition protocol.

1.1.39 Actors DSS/Order Filler Acquisition Modality

1.1.40 Steps NULL DSS/OF schedules 1 SPS for modality RAD-5 Modality queries for worklist containing Protocol Code Item.

NULL Modality demonstrates to Evaluator that acquisition protocol is automatically set when SPS is chosen from the worklist returned. NULL Modality can send images to Central Archive.

2.9 MOD_BILLING_MATERIAL: Modality Billing Material Management Option

1.1.42 Description The Billing and Material Management option allows an Acquisition Modality to communicate that information to an Order Filler (RAD-TF-2:4.7.4.1.2.3).

1.1.43 Evaluation The Order Filler shall demonstrate that the Billing and Material content was received. This can be done via the User Interface or database, or by capturing a copy of the MPPS message from the Modality. If a message is captured, the evaluator will check the contents of:  (0040,0320) Billing Procedure Step Sequence  (0040,0321) Film Consumption Sequence  (0040,0424) Billing Supplies and Devices Sequence

1.1.44 Actors DSS/Order Filler Acquisition Modality

1.1.45 Steps NULL DSS/OF schedules 1 SPS for modality. RAD-5 Modality queries for worklist containing Protocol Code Item. RAD-6 Modality sends MPPS In Progress to DSS/OF. RAD-7 Modality sends MPPS Complete to DSS/OF. NULL Modality can send images to Central Archive.

2.10 SWF_OF_IM: OF and Image Manager Interaction

1.1.46 Special Instructions This test exercises the exchange of HL7 messages between DSS/OF and IM actors. It also tests the ability of these actors to act as a PPS Manager. During the Connectathon, each DSS/OF and Image Manager must execute at least one instance of this test where it assumes the role of PPS Manager and successfully forwards PPS messages to its partner. A Modality actor is needed to assist with the first part of this test. It will generate PPS Messages to be sent to whichever system is the PPS Manager. (No Modality functionality is evaluated in this test – any Modality may be used; contents of PPS messages and Modality C-STORE are evaluated elsewhere.)

1.1.47 Description This test verifies interoperability between DSS/OF and Image Manager/Archive actors, specifically for these transactions: o [RAD-6] (or [CARD-1]) PPS In Progress (forwarding this message) o [RAD-7] PPS Completed (forwarding this message) o [RAD-12] Patient Update (name change) o [RAD-4] Procedure Scheduled o [RAD-13] Procedure Updated

1.1.48 Evaluation Verify that the system performing the role of PPS Manager:  Properly forwarded both PPS In Progress and PPS Complete to its partner. These messages should be captured on the receiving (non-PPS-Mgr) system. On the Image Manager verify:  It received an ADT^A08 message with a patient name change from OF_XYZ- IM_ABC^OLD-NAME to OF_XYZ-IM_ABC^NEW-NAME  The images stored on the Image Manager are updated with this new name.  It received an ORM to indicate a procedure was scheduled. In the ORM: o ORC-1 is “NW” o ORC-2 contains a Placer Order number from RIS Mall

o ORC-3 contains a Filler Order number generated by the DSS/OF o ORC-5 is “SC” o ORC-7 contains a value for the Date/Time of the SPS (in the 4th component) o OBR-18 contains accession number o OBR-19 contains RP ID o OBR-20 contains SPS ID o OBR-24 contains the DICOM Modality (defined terms) o XDS-1 contains Study Instance UID of the form: ^^Application^DICOM  It received an ORM to indicate the procedure was cancelled. The ORM contains: o a value of “CA” in ORC-1 and ORC-5  the ORC and OBR elements are unchanged from the previous Procedure Scheduled message, especially: o OBR-2 and ORC-2 Placer Order Number (RIS Mall value) o OBR-3 and ORC-3 Filler Order Number o ORC-4 Placer Group Number o ZDS-1 Study Instance UID

1.1.49 Actors DSS/OF Image Manager/Image Archive PPS Manager (either the DSS/OF or IM assumes this role)

1.1.50 Steps NULL In the Kudu chat window, record which system is the PPS Manager for this test: either the DSS/OF or Image Manager. The Modality must be configured to send its PPS messages to this system. NULL The Image Manager should prepare to capture a copy of each HL7 message it will receive from the DSS/OF. NULL The following steps test PPS message forwarding and Patient Update. NULL The system which is NOT the PPS Manager should prepare to capture a copy of the PPS messages which are forwarded from the PPS Manager.

NULL In the descriptions to follow the patient last name should be a combination of both the DSS/OF and Image Manager systems under test, for example OF_XYZ- IM_ABC^OLD-NAME. (Use a first name of OLD-NAME because the patient will be renamed during this test.) NULL On RIS Mall, register this patient, then create an order for this patient. RIS Mall sends the Order to the DSS/OF. DSS/OF schedules the order. RAD-6 The Modality queries for worklist, starts the procedure and sends PPS In Progress to the PPS Manager system for this test (DSS/OF or IM). RAD-6 (or CARD-1) PPS In Progress is forwarded by PPS Manager. RAD-8 C-STORE images to the Image Manager. RAD-7 Modality sends PPS Complete to the PPS Manager. RAD-7 PPS Complete is forwarded by the PPS Manager. RAD-12 On the RIS Mall, change the patient name, eg from OF_XYZ-IM_ABC^Old- name to OF_XYZ-IM_ABC^NEW-NAME. DSS/OF sends Patient Update message to DSS/OF NULL This ends the PPS message forwarded and Patient Update steps. The Modality assisting with this test has no further transactions in this test. NULL The following steps test Procedure Scheduled and Procedure Update. NULL In the descriptions to follow the patient last name should be a combination of both the DSS/OF and Image Manager systems under test, for example OF_XYZ- IM_ABC^SCHEDULE. NULL On RIS Mall, register this patient, then create an order for this patient. RIS Mall sends the Order to the DSS/OF. RAD-4 DSS/OF schedules the order. Capture a copy of the Procedure Scheduled ORM in the Kudu chat window or in a log file on the IM. RAD-13 DSS/OF cancels the order. Capture a copy of the Procedure Updated ORM in the Kudu chat window or in a log file on the IM.

2.11 SWF_EC_IM: Workflow - Evidence Creator & IM

1.1.51 Special Instructions Evidence Creators should test all SOP classes it is capable of generating.

1.1.52 Description

This tests workflow transactions between an Evidence Creator and an Image Manager/Archive. The Evidence Creator creates evidence objects and sends them to the Image Manager. The Evidence Creator will also perform MPPS and Storage Commitment (required for Cardiology STRESS, CATH & ECHO profiles; optional for Radiology SWF profile). The Q/R and display capabilities are tested in test SWF_ID_IM.

1.1.53 Evaluation On the Image Manager:  Verify that all created objects were successfully stored.  If applicable, verify that the derived objects were created in a new series, and not extended from the series containing the source images.  View a copy of the PPS (optional) and Storage Commitment message from the Evidence Creator, captured on the IM.

1.1.54 Actors Evidence Creator Image Manager/Image Archive

1.1.55 Steps NULL Use the patient naming convention of: CREATOR-SYSTEM^IM_SYSTEM, e.g., CREATOR_WS_ABC^PACS_XYZ NULL Complete post-procedure processing/measurements, and create evidence objects. NULL On the IM, prepare to capture a copy of the N-SET PPS Complete and Storage Commitment N-ACTION messages from the Evidence Creator in the Kudu chat window, for example in a log file named [test-case-no]-creator-pps-complete.txt and [test-case-no]-creator-storage-commit.txt, for later evaluation. RAD-20 (optional transaction) PPS In Progress to the Image Manager. Image Manager is not required to forward PPS message. RAD-8 Store new evidence objects to the Image Manager. RAD-21 (optional transaction) PPS Complete. (This is a message to capture on the IM.) RAD-10 Storage Commitment N-ACTION from Evidence Creator. (This is a message to capture on the IM.) RAD-10 SC N-EVENT-REPORT from IM to Evidence Creator. NULL Repeat the steps in this test for all different DICOM IOD-types the Evidence Creator actor supports. In the Kudu chat window, record the patient name and IOD for all additional images created and tested.

2.12 SWF_MOD_Store: Acquisition Modality & Evidence Creator Stores Images to Central_Archive

1.1.56 Special Instructions Evidence Creator and Acquisition Modality actors perform ONE instance of this test. This should be done on the first day of the Connectathon. The Modality system should arrive at the Connectathon with images for this test PRE- OBTAINED and PRE-LOADED or you will waste a great deal of time!

1.1.57 Description All Acquisition Modalities and Evidence Creators participating in the SWF profile should store images of all SOP classes it is capable of generating to the Connectathon CENTRAL_ARCHIVE. This will enable Image Manager and Image Display actors to access these images for their testing. Modalities and Evidence Creators could also find time to test directly sending their images to Image Manager actors.

1.1.58 Evaluation There is no formal evaluation for this test. The purpose is to provide images to the CENTRAL_ARCHIVE for others' testing.

1.1.59 Actors Evidence Creator Acquisition Modality

1.1.60 Steps NULL On the Modality or Evidence Creator, configure the Connectathon Image Repository (CENTRAL_ARCHIVE) as an Image Manager/Archive. RAD-8 Generate different studies and store the images to the CENTRAL_ARCHIVE. RAD-18 Evidence Creators should store all SOP classes it is capable of generating. NULL Verify that the images/objects were successfully stored.

2.13 SWF_IM_Store: Image Manager Accepts/Stores Image and Evidence Objects

1.1.61 Special Instructions This test should be run on the 1st or 2nd day of the Connectathon to enable Image Displays to do a follow-up test to Q/R these images and evidence objects.

1.1.62 Description The purpose of this test is to verify that an Image Manager can accept and store real world vendor images and evidence objects which are available. Q/R is tested in another test.

1.1.63 Evaluation Verify that all images and evidence objects from several Acquisition Modality and Evidence Creator actors in the SWF profile are received at IM under test. Verify the total number of SOP instances stored and total number of studies stored. Verify that the objects are stored as full- fidelity objects (ie., no DICOM data elements are deleted). Image Managers must support storage of multiple SOP classes (RAD TF-2:4.8.4.1.3.1):

SOP Class UID SOP Class Name 1.2.840.10008.5.1.4.1.1.1 Computed Radiography Image Storage 1.2.840.10008.5.1.4.1.1.2 CT Image Storage 1.2.840.10008.5.1.4.1.1.4 MR Image Storage 1.2.840.10008.5.1.4.1.1.20 Nuclear Medicine Image Storage 1.2.840.10008.5.1.4.1.1.128 Positron Emission Tomography Image Storage 1.2.840.10008.5.1.4.1.1.481.1 RT Image Storage 1.2.840.10008.5.1.4.1.1.7 Secondary Capture Image Storage 1.2.840.10008.5.1.4.1.1.6.1 Ultrasound Image Storage 1.2.840.10008.5.1.4.1.1.3.1 Ultrasound Multi-frame Image Storage 1.2.840.10008.5.1.4.1.1.12.1 X-Ray Angiographic Image Storage 1.2.840.10008.5.1.4.1.1.12.2 X-Ray Radiofluoroscopic Image Storage 1.2.840.10008.5.1.4.1.1.1.1 Digital X-Ray Image Storage – For Presentation 1.2.840.10008.5.1.4.1.1.1.1.1 Digital X-Ray Image Storage – For Processing 1.2.840.10008.5.1.4.1.1.1.2 Digital Mammography Image Storage – For Presentation 1.2.840.10008.5.1.4.1.1.1.2.1 Digital Mammography Image Storage – For Processing 1.2.840.10008.5.1.4.1.1.1.3 Digital Intra-oral X-Ray Image Storage – For Presentation 1.2.840.10008.5.1.4.1.1.1.3.1 Digital Intra-oral X-Ray Image Storage – For

Processing 1.2.840.10008.5.1.4.1.1.77.1. VL Endoscopic Image Storage 1 1.2.840.10008.5.1.4.1.1.77.1. VL Microscopic Image Storage 2 1.2.840.10008.5.1.4.1.1.77.1. VL Slide-Coordinates Microscopic Image Storage 3 1.2.840.10008.5.1.4.1.1.77.1. VL Photographic Image Storage 4

1.1.64 Actors Image Manager/Image Archive

1.1.65 Steps RAD-8 Either query for or have the Connectathon Image Repository (CENTRAL_ARCHIVE) send available images from Modality vendors and Evidence Documents from Evidence Creators in the SWF profile to the Image Manager. NULL Verify that the objects are stored as full-fidelity objects (ie., no DICOM data elements are deleted).

2.14 SWF_ID_IM: Image Display & Image Manager Interoperability

1.1.66 Special Instructions The Image Manager/Archive must complete test SWF_IM_Store before this test can be run with the Image Display actor.

1.1.67 Description The test verifies the ability of the Image Display and Image Manager actors for the [RAD-14], [RAD_16] and [RAD-45] transactions.

1.1.68 Evaluation On the Image Display  The Connectathon Monitor will ask the operator to demonstrate its support for the DICOM Study Root Q/R Information Model and Hierarchical Search.

It will demonstrate on its User Interface the ability to offer its user the following

attributes as selection criteria (ie these required query keys for the Image Displays SCU (RAD TF-2 Table 4.14-1). Query the Image Manager for combinations of: STUDY LEVEL Query Keys: . Study Date (0008,0020) . Study Time (0008,0030) . Accession Number (0008,0050) . Patient Name (0010,0010) . Study ID (0020,0010) . Study Instance UID (0020,000D) . Modalities in Study (0008,0061) . Referring Physician’s Name (0008,0090) SERIES LEVEL Query Keys: . Modality (0008,0020) . Series Number (0020,0011) . Series Instance UID (0020,000E) . Requested Procedure ID (0040,1001) . Scheduled Procedure Step ID (0040,0009) . PPS Start Date (0040,0244) . PPS Start Time (0040,0245) IMAGE LEVEL Query Keys: . Instance Number (0020,0013) . SOP Instance UID (0008,0016)

 Verify the ability to retrieve by study, by series and by image.  Verify that studies are fully retrieved. (Correct rendering of the images is verified in a different test -- SWF_DISPLAY).

1.1.69 Actors Image Display Image Manager

1.1.70 Steps RAD-14 Query the IM for images and evidence objects. Use a variety of query criteria – see list in the Evaluation section. RAD-16 Retrieve all image and evidence objects. RAD-16 Retrieve by Study, by Series and by Image. RAD-45 Retrieve Evidence Documents. NULL Note any Query or Retrieve failures.

2.15 SWF_DISPLAY: Image Display of all Vendors’ Waveforms, Images & Evidence Documents

1.1.71 Special Instructions The Image Display may use the Connectathon CENTRAL_ARCHIVE as a source of different vendors', images, reports and evidence objects.

1.1.72 Description The test verifies that the Image Display can retrieve and display a variety of image sets and evidence objects from various vendors.

1.1.73 Evaluation On the Image Display  verify that images and reports from each Modality vendor can be accurately stored and displayed. The Connectathon Monitor may ask a representative of the originating Modality to verify the accuracy of the rendering of its study on the Image Display.  The Connectathon Monitor should observe its ability to interpret/render the objects (derived images, SRs, or measurements, ie Evidence Documents) from the Evidence Creator actors. The Connectathon Monitor may ask a representative of the originating Evidence Creator to verify the accuracy of the rendering of its data, or observe the originals at the Evidence Creator and spot-check that they are displayed correctly and completely.  Verify the ability to display the value of Series Description for each series displayed (RAD-TF:4.16.4.2.3)

1.1.74 Actors

Image Display

1.1.75 Steps NULL Configure the Connectathon Image Repository (CENTRAL_ARCHIVE) as an Image Manager on the Image Display system. RAD-14 Query the IM (CENTRAL_ARCHIVE) for images from several Acquisition Modalities in the SWF profile. Query for objects stored by Evidence Creator actors in the SWF profile. RAD-16 Retrieve these objects. NULL Display the objects every study and verify the image encoding and patient demographics are accurate.

2.16SWFPIR: Group test for PIR and Scheduled Workflow

1.1.76 Description Typically, this test may be run on the last day of the Connectathon, after the previous tests have been successfully completed. It is run under the supervision of a Connectathon Monitor who checks the results of the transactions as the test is executed. Walk through SWF/PIR scenarios with as complete a complement of actors in the SWF profile as possible. (ADT, Placer, Filler, Image Mgr, Modality, Image Display).

1.1.77 Actors ADT Order Placer DSS/Order Filler Acquisition Modality Evidence Creator Image Manager/Archive Image Display

1.1.78 Steps RAD-1 Registration patient in Emergency – ADT to Order Placer. RAD-1 Registration patient in Emergency – ADT to Order Filler.

RAD-2 Order Radiology examination. RAD-4 Procedure scheduled. RAD-5 Query worklist. RAD-6 Acquisition started (PPS start). RAD-7 Acquisition completed. RAD-8 Archive images. RAD-10 Storage commitment. RAD-14 Q/R of patient images. RAD-12 Patient Update. RAD-14 Q/R and check patient name as changed.