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Profiles for the VistA Imaging andCommercial PACS DICOM InterfaceIncluding Business and Functional RequirementsVersion:Date:1.0027 January 2009

Document HistoryDateDescription18-Nov-08 Version 0.9819-Dec-08Version 0.9927-Jan-09Version 1.00

Profiles for the VistA Imaging and Commercial PACS DICOM InterfaceTable of ContentsTable of Contents . 3List of Figures and Tables . 9Foreword . 11Organization of this Document . 11References . 12Definitions . 13Introduction . 190.1Basic DICOM Information Model – with IHE Profiles . 190.1.1VA PACS Business Requirements . 200.1.2PACS to VistA Imaging – Archive Workflow . 200.1.3PACS Study Retrieval from VistA Imaging . 210.2Mapping DICOM Operations to IHE Profile Transactions . 220.3Basic Assumptions. 220.4Common VistA Imaging DICOM Characteristics . 230.5VistA Imaging Required Storage SOP Classes . 250.6Approach and Terminology . 260.6.1IHE Profiles vs. DICOM Conformance Statements . 260.6.2IHE Profiles’ View . 270.6.3DICOM Nomenclature for DIMSE Services . 270.6.4DICOM Nomenclature for Static IOD Attribute Elements . 270.6.5IHE Notation for DICOM Static IOD Attribute Elements . 290.6.6IHE and VistA Imaging Notation for C-FIND Matching Rules. 301PACS IAN User AE – Instance Availability Notification (IAN) ConsumerProfile . 321.1Use Case . 321.2Interactions . 321.3Dynamic Definitions . 331.3.1Business Requirements . 331.3.1.1 The IAN Implementation . 331.3.1.2 Trigger Event . 341.3.1.3 PACS Declares IAN Conditions . 341.3.1.4 PACS Makes IAN Referred Object Instances Available . 341.3.1.5 PACS Can Send Follow-Up IAN Messages . 341.3.1.6 PACS Behavior on Object Change . 341.3.1.7 PACS Behavior on Failed IAN Request . 341.3.1.8 PACS Responsiveness to Retrieve Requests . 341.3.1.9 VistA Imaging Response to IAN Messages. 341.3.1.10 Retrieve AE Title Specifics . 351.3.1.11 No User Characteristics . 351.3.2Error Handling . 353

Profiles for the VistA Imaging and Commercial PACS DICOM .4.1.21.4.21.4.2.11.4.3Confirm PACS IAN Request Message . 35Return a Reject Response Message to the PACS . 35Functional Requirements . 35Message Type . 35IAN SCU. 35Presentation Context . 35Request Message. 36Response Message . 36Handling of MPPS References . 36Handling of Storage Media File Set ID . 36Persistent Storage of IAN Context . 36DICOM-Specific Definitions. 37SOP Class Level Definitions . 37Association Establishment Policies . 37Association Acceptance Policy . 37IOD Level Definitions . 38Message Attributes. 38Element Level Definitions . 392PACS Query/Retrieve Provider AE – Image Availability Query (IAQ) ProviderProfile . 422.1Use Case . 422.2Interactions . 422.3Dynamic Definition . 432.3.1Business Requirements . 432.3.1.1 The IAQ Implementation . 432.3.1.2 Trigger Event . 432.3.1.3 PACS Simultaneous Queries . 432.3.1.4 PACS Query Performance . 442.3.1.5 PACS Priority Processing . 442.3.1.6 PACS Response Message Limitations . 442.3.1.7 Retrieve AE Title Specifics . 442.3.1.8 PACS Object Serving Behavior . 442.3.1.9 No User Characteristics . 442.3.2Error Handling . 442.3.2.1 Confirm PACS IAQ Find SCP Behavior . 442.3.2.2 Confirm PACS Find Cancel Behavior . 442.3.3Functional Requirements . 442.3.3.1 IAQ Find SCP . 442.3.3.2 Expected IAQ Action . 442.3.3.3 Presentation Context . 452.4DICOM-Specific Definitions. 452.4.1SOP Level Definitions . 452.4.1.1 Association Establishment Policies . 452.4.1.2 Association Acceptance Policy . 462.4.1.3 IAQ Query SOP Specific Conformance . 462.4.2IOD Level Definitions . 484

Profiles for the VistA Imaging and Commercial PACS DICOM Interface2.4.2.12.4.3Message Attributes. 48Element Level Definitions . 523PACS Query/Retrieve Provider AE – Retrieve Images (RI) Provider Profile. 533.1Use Case . 533.2Interactions . 533.3Dynamic Definition . 543.3.1Business Requirements . 543.3.1.1 The RI Implementation . 543.3.1.2 Trigger Event . 543.3.1.3 PACS Simultaneous Moves . 543.3.1.4 PACS Move Performance . 553.3.1.5 PACS Priority Processing . 553.3.1.6 PACS Response Message Limitations . 553.3.1.7 Retrieve AE Title Specifics . 553.3.1.8 PACS Object Serving Behavior . 553.3.1.9 No User Characteristics . 553.3.2Error Handling . 553.3.2.1 Confirm PACS RI Move SCP Behavior . 553.3.2.2 Confirm PACS Move Cancel Behavior . 553.3.3Functional Requirements . 563.3.3.1 RI Move SCP . 563.3.3.2 Expected RI Action . 563.3.3.3 Presentation Context . 563.3.3.4 Request Message. 563.4DICOM-Specific Definitions. 563.4.1SOP Level Definitions . 563.4.1.1 RI Move SOP Specific Conformance . 573.4.2IOD Level Definitions . 583.4.2.1 Message Attributes. 583.4.3Element Level Definitions . 594PACS Storage User AE – Modality Images Stored (MIS) Consumer Profile . 604.1Use Case . 604.2Interactions . 604.3Dynamic Definition . 614.3.1Business Requirements . 614.3.1.1 MIS Implementation . 614.3.1.2 Trigger Events. 624.3.1.3 PACS Simultaneous Stores . 624.3.1.4 PACS Auto-Routing . 624.3.1.5 PACS Move Object Serving Behavior . 624.3.1.6 VistA Imaging MIS Provider Duplicate Instance Handling . 624.3.1.7 No User Characteristics . 644.3.2Error Handling . 644.3.2.1 Confirm PACS MIS Store Request Message. 645

Profiles for the VistA Imaging and Commercial PACS DICOM n Store Rejected Response Message to the PACS . 64Functional Requirements . 64MIS Store SCU . 64Persistent Storage of DICOM Object Instances. 64DICOM-Specific Definitions. 65SOP Level Definitions . 65Association Establishment Policies . 65Association Acceptance Policy . 66MIS Store SOP Specific Conformance . 66IOD Level Definitions . 67No Elements discarded on successful Store SCP Operation . 67VistA Imaging Data Coercion . 67Lossy Image Compression Attribute Policies . 68Element Level Definitions . 685PACS Storage Commit User AE – Storage Commitment (SC) Consumer Profile695.1Use Case . 695.2Interactions . 695.3Dynamic Definition . 705.3.1Business Requirements . 705.3.1.1 SC Implementation . 705.3.1.2 Trigger Events. 705.3.1.3 PACS Simultaneous Commitment Requests . 705.3.1.4 Restore AE Title . 705.3.1.5 Storage Commitment Session Duration . 715.3.1.6 No User Characteristics . 715.3.2Error Handling . 715.3.2.1 Confirm PACS SC Request Message . 715.3.2.2 Return Reject Response Message to the PACS . 715.3.3Functional Requirements . 715.3.3.1 Storage Commit User AE SCU Request. 715.3.3.2 Storage Commit SCP Response . 715.4DICOM-Specific Definitions. 725.4.1SOP Level Definitions . 725.4.1.1 Association Establishment Policies . 725.4.1.2 Association Acceptance Policy . 725.4.2IOD Level Definitions . 735.4.2.1 Commonly Used SC Message Attributes . 735.4.2.2 SC SCU N-ACTION (Request) Message . 735.4.2.3 Successful SC SCP N-EVENT-REPORT (Response) Message . 735.4.2.4 Complete with Failures SC SCP N-EVENT-REPORT (Response)Message . 745.4.2.5 SC SCP Failure Reasons . 755.4.3Element Level Definitions . 756PACS Query/Retrieve User AE – Query Images (QI) Consumer Profile . 766

Profiles for the VistA Imaging and Commercial PACS DICOM 1.46.4.26.4.2.16.4.37Use Case . 76Interactions . 76Dynamic Definition . 77Business Requirements . 77The QI Implementation . 77PACS Trigger Event . 77Simultaneous Queries . 77Priority Processing . 78Response Message Limitations . 78Retrieve AE Title Specifics . 78No User Characteristics . 78Error Handling . 78Confirm Response Handling of the PACS QI Find SCU . 78Functional Requirements . 78QI Find SCU . 78Expected QI Action. 78Presentation Context . 78Request Message. 79DICOM-Specific Definitions. 79SOP Level Definitions . 79Association Establishment Policies . 80Association Acceptance Policy . 80Association Rejection . 80QI Query SOP Specific Conformance . 81IOD Level Definitions . 83Message Attributes. 83Element Level Definitions . 87PACS Query/Retrieve User AE – Retrieve Images (RI) Consumer Profile . 887.1Use Case . 887.2Interactions . 887.3Dynamic Definition . 897.3.1Business Requirements . 897.3.1.1 The RI Implementation . 897.3.1.2 The PACS Trigger Event . 897.3.1.3 Simultaneous Moves . 897.3.1.4 Move Timing . 897.3.1.5 Priority Processing . 907.3.1.6 Response Message Limitations . 907.3.1.7 Retrieve AE Title Specifics . 907.3.1.8 Object Serving Behavior . 907.3.1.9 No User Characteristics . 907.3.2Error Handling . 907.3.2.1 Confirm the PACS RI Consumer’s Move SCU Behavior . 907.3.3Functional Requirements . 907.3.3.1 RI Move SCU . 907

Profiles for the VistA Imaging and Commercial PACS DICOM .27.4.1.37.4.27.4.2.17.4.38Presentation Context . 90Request Message. 91Expected PACS Storage Provider AE Behavior . 91DICOM-Specific Definitions. 91SOP Level Definitions . 91Association Establishment Policies . 92Association Acceptance Policy . 92RI Move SOP Specific Conformance . 92IOD Level Definitions . 94Message Attributes. 94Element Level Definitions . 95PACS Storage Provider AE – Modality Images Stored (MIS) Provider Profile968.1Use Case . 968.2Interactions . 968.3Dynamic Definition . 978.3.1Business Requirements . 978.3.1.1 MIS Implementation . 978.3.1.2 Trigger Events. 978.3.1.3 PACS Simultaneous Stores . 978.3.1.4 PACS Store Performance . 978.3.1.5 PACS Priority Processing . 978.3.1.6 Move Object Serving Behavior . 978.3.1.7 No User Characteristics . 988.3.2Error Handling . 988.3.2.1 Confirm PACS Store Response Message . 988.3.2.2 Send Badly Formed Store Request Message to the PACS . 988.3.3Functional Requirements . 988.3.3.1 MIS Store SCP . 988.4DICOM-Specific Definitions. 988.4.1SOP Level Definitions . 988.4.1.1 MIS Store SOP Specific Conformance . 988.4.2IOD Level Definitions . 998.4.2.1 Privately Defined Functional Groups . 998.4.2.2 Referenced Pixel Data Use . 998.4.3Element Level Definitions . 998

Profiles for the VistA Imaging and Commercial PACS DICOM InterfaceList of Figures and TablesFigure 0-1: VistA Imaging – PACS DICOM Implementation Model with IHE Profiles 19Table 0-1: PACS Application Entity Requirements . 20Table 0-2: Mapping DICOM Operations to IHE Profile Transactions. 22Table 0-3: DICOM E-R Model Terms vs. VistA Imaging Terms . 24Table 0-4: VistA Imaging DICOM Implementation Class and Version . 24Table 0-5: Required VistA Imaging Storage SOP Classes . 26Table 1-1: IAN Consumer -- Presentation Context . 36Table 1-2: IAN Consumer – SOP Classes . 37Table 1-3: IAN Consumer -- IAN SOP Class N-CREATE Attributes . 38Table 1-4: IAN Consumer -- Behavior on VistA Imaging IAN SCP Response Codes . 39Table 2-1: IAQ Provider – Presentation Context. 45Table 2-2: IAQ Provider – SOP Classes . 45Table 2-3: IAQ Provider -- VistA Imaging Behavior on PACS SCP Response Status. 47Table 2-4: IAQ Provider– Composite Object Instance Access Time Levels . 48Table 2-5: IAQ Provider – Study Root Query Level Related Instance UID Settings . 49Table 2-6: IAQ Provider – Study Root/Study Level Matching Keys . 50Table 2-7: IAQ Provider – Study Root/Study Level VistA Imaging Required Keys. 50Table 2-8: IAQ Provider – Study Root/Series Level Matching Keys . 51Table 2-9: IAQ Provider – Study Root/Series Level VistA Imaging Required Keys . 51Table 2-10: IAQ Provider – Study Root/Object Instance Level Matching Keys . 51Table 2-11: IAQ Provider – Study Root/Instance Level, Image Specific VistA ImagingRequired Keys . 51Table 3-1: RI Provider – Presentation Context . 56Table 3-2: RI Provider – SOP Classes . 57Table 3-3: RI Provider – C-MOVE SCU Behavior on SCP Response Status . 58Table 3-4: RI Provider – Supported Study Root Move Attributes . 59Table 4-1: MIS Consumer – MIS Provider Duplicate Instance Handling Matrix . 64Table 4-2: MIS Consumer – SOP Classes . 65Table 4-3: MIS Consumer – C-STORE SCP Response Status and Behavior . 66Table 4-4: MIS Consumer – DICOM Elements Subject to Data Coercion . 67Table 5-1: SC Consumer – SOP Classes . 72Table 5-2: SC Consumer – Storage Commitment N-ACTION Request Attributes . 73Table 5-3: SC Consumer – Successful N-EVENT-REPORT Response Attributes . 74Table 5-4: SC Consumer – Complete /w Failures N-EVENT-REPORT ResponseAttributes. 74Table 5-5: SC Consumer – Storage Commitm

0.1 Basic DICOM Information Model - with IHE Profiles . 19 0.1.1 VA PACS Business Requirements . 20 0.1.2 PACS to VistA Imaging - Archive Workflow . 20 0.1.3 PACS Study Retrieval from VistA Imaging.