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Meeting Minutes
for the
DICOM WG-09 Meeting
Friday, October 17, 2014
Hyatt Regency McCormick Place
2233 S Dr Martin Luther King Jr Dr, Chicago, IL 60616 (adjacent to the Convention Center)
CC21AB/Dusable AB Room
7:30 a.m. – 10:00 a.m.
Mark Horton
Yijun Huang
Rich Amador
Allison Bajo
Michael Chiang
Karl-Heinz Fleischer
Theodore Ingis
Artur Kowalski
Tomasz Licznerski
Patrick Nast
Robert Orsino
Ken Pearson
Enrique Pulido
Brad Savon
Ippei Shiohata
Peter Scherer
Michael Schmidt
Donald van Syckle
Joseph Warnicke
Linda Wedemeyer
Gunther Wiest
Joyce Yan
Thomas Zosel
User Co-Chair of WG9, Indian Health Service
User Co-Chair of WG9, University of Wisconsin
University of Oregon Casey Eye Institute
Carl Zeiss Meditec
Ingis Eye Center
Topcon Medical Systems
Optopol Technology
Carl Zeiss Meditec
Topcon Medical Systems
ifa united i-tech
ifa united i-tech Inc.
DVS Consulting, Consultant for the Academy
DARC Reading Center
Veterans Health Administration
Carl Zeiss Meditec
Clarity Medical Systems
Flora Lum
American Academy of Ophthalmology
I. Welcome and Introductory Remarks; Introduction of Participants
Dr Horton and Dr. Huang welcomed the participants. Everyone introduced themselves
and their affiliation.
II. Review of Meeting Agenda
The group approved the agenda without additions. The group was also informed of the
new WG-06 summary on the DICOM Home Page. ‘DICOM News.” An announcement
was also made that nominations, including self-nominations, were invited for a VendorCo-Chair position.
Review of Antitrust Rules
The group reviewed together the Antitrust rules provided as an agenda attachment.
Review of Previous Meeting Minutes
The minutes of the November 15 2013 WG9 meeting in New Orleans were reviewed.
These have already been approved by DICOM. WG-09 affirmed the election M Horton
and Y Huang as Clinical Co-Chairs.
Major discussion items:
Review of progress since November 2013
1. Supp 173 Wide Field Ophthalmic Photography Image Storage SOP Classes,
Donald Van Syckle
Mr. Van Syckle described the origin and progress of Supplement 173. Last
year, the WG determined that there was a valid use case for a new supplement
and initiated a work item and workgroup. The major impetus was that the
current OP supplement would not provide accurate measurements for wide
field fundus images. The supplement should provide for accurate and
reproducible measurements. The supplement was approved for Public
Comment in September 2014, and individuals were urged to review and
provide comments before the end of the comment period. The timeline for
2015 is expected to be achievement of Letter Ballot in January 2015, and
hopefully, achievement of Final Text in March 2015.
2. Discussion on Supp 130 Ophthalmic Refractive Measurements Storage and
SR SOP Classes, Artur Kowalski
Mr. Kowalski had described the difficulties with DICOM standard
implementation previously last year. These were the chief problems
encountered: lack of patient demographics information in the devices’ output;
partial incompatibility of the SOP classes with the actual output of Topcon
devices; and lack of other systems supporting this type of DICOM object
because of the overhead involved in DICOM implementation for small
devices without significant computing capability. Many do not support the
input of patient data, so they cannot produce results that include patient
demographics. There are several potential options that could be considered,
including combination of refractive data devices that address more than one of
the SOP classes, creation of devices with patient data input capabilities, device
enhancements allowing patient data to be “injected” into the stored exam data,
and using Acquisition Modality Importers to match legacy device output with
the proper patient data. Issues related to support of the standard include: reallife implementations have not been identified by EHRs, EHR systems
typically implement custom interfaces to integrate legacy devices, and other
approaches using XML by the JOIA in Japan. Potential solutions include the
modification of the DICOM standard or choice of a different mechanism to
store refractive data, such as the General Eye Evaluation c-CDA, which has a
comprehensive listing of refractive data elements. Increased adoption of
DICOM and HL7 have been shown suitable for exchange of medical
information, and the Modality Worklist would address the issue of not having
to input patient data. There is growing market demand for uniform data
representations, and government regulations will favor solutions based on
established standards. In addition, institutions are now asking for all data to
be stored in archives or PACS, including the refractive data.
The Working Group 9 discussed the various concerns and options. The
Working Group voted to pass this item for IHE Eye Care Planning Committee
to consider.
3. Discussion of color eye model subgroup of the medical imaging workgroup
DICOM staff forwarded WG9 information about a Medical Imaging
Workgroup of the International Color Consortium developing a color eye
model. The impetus was that the FDA has identified that there is a lack of
standardization of color in medical imaging, and that this might affect the
reliability of diagnosis, thus having an impact on patient safety. There does
appear to be variability across individual observers in color interpretation, as
well as variability from the beginning to the end of the imaging process with
issues of illumination, and other issues not under control of the physician or
device manufacturer. Despite this variability in the process, there might be
ultimate benefit in color calibration for future computer-aided diagnosis. The
workgroup has requested clinical input in the form of images to identify the
key colors that then could be used for calibration, in order to provide
consistency and reproducibility. Rich Amador will ask the chair of the Color
Model Eye Working Group exactly what input is requested. The Working
Group 9 determined that this was an important concern, and referred this to
the Academy to provide clinical input as appropriate. At this point in time,
there is no action relevant to the DICOM Working Group 9.
4. How to increase implementation of DICOM standards
The Academy has been working to advocate the identification of DICOM
standards for ophthalmology, similar to what was proposed for radiology and
cardiology, within Meaningful Use criteria in order to increase
implementation. The Academy recently met with staff of the Office of the
National Coordinator to continue its support for DICOM standards in the
Meaningful Use Stage 3 criteria. It seems that the federal government is
concerned about the interoperabiloity of imaging and electronic health records,
and the need to associate correct patent demographics with the imaging, which
DICOM can address.
New work items
A) The group discussed past topics, Wavefront, and Glaucoma Structured Report, but
there were no volunteers. No other new work items were proposed.
Next Meetings of the Working Group 9
A) Friday, November 13 2014, Academy Annual Meeting, Las Vegas
Reported by:
Flora Lum, Secretary
October 17, 2014
Reviewed by counsel:

WG-09-2014-10-17-Minutes - dicom