Multi-country Working Group on Imaging Information Sharing

Coordinators: Charles Parisot, Claudio Saccavini

Overview presentation: Multi-Country Working Group (MCWG) on Image Information Sharing: An IHE-Europe Taskforce

MCWG Welcomes additional countries engaged in imaging information sharing at the national or regional levels

MCWG Scope and Objectives

Scope: Deployment of interoperability for Imaging Exchange	National & regional level world-wide. Complements Cross-Border focus of EU Commission (eHN, xt-EHR).
Goal: Deliver design analysis for specific extensions	Extensions to effectively deploy IHE Profiles, DICOM, FHIR and other standards within countries’ ehealth services.
Benefits: Pool expertise and resources	Direct engagement of members in active national deployment. Consensus analysis of specific issues to increase consistency.
Deliverables: Analysis results as MCWG recommendations.	Mature and complete (multi-country consensus) Offered for adoption and easily included into national frameworks.

MCWG Mode of Operation, Members & Recommendations

MCWG plenary every two weeks, 1-hour T-con	Members prioritize topics for recommendations. Each one is addressed by a dedicated Focus Group including 3-4 Members or designees, committed to complete the recommendation on the topic in less than two months All members review and comment on draft recommendations and approve final recommendations
Currently includes representatives from	Netherlands, Denmark, Spain, Belgium, Norway, Finland, France, Czechia, Canada, Austria Other countries are welcome
MCWG has produced 3 sets of recommendations in four months	Intended to be sufficiently mature, complete (multi-country consensus) and stable to be offered for adoption and included into national interoperability frameworks. Initially delivered in a PowerPoint Slide Format. Publicly available documents, MCWG members to ensure rapid feedback as they apply.

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MCWG Approved Recommendations on Imaging Information Sharing:

Profile and Standards Positioning (May 2024)
Positions the role of HL7 FHIR in the sharing of imaging information architectures, choice of profiles and standards such as MHD(FHIR), XDS-I. Coexistence with XCA and FHIR/MHD, integration of Web Access to DICOM Objects (WADO-RS) in XDS-I.
Imaging Metadata and linkages (December 2023)
Strategies or metadata definitions for filtering access in queries (key filtering elements) and linkages between orders, reports and imaging studies.
Extensions to Imaging Study Manifest (March 2024)
Context of use of imaging study manifests, explain the choice of DICOM KOS, refine the content of imaging study manifest in areas such as patient IDs, accession numbers, additional content in study/series descriptions.
Flagging Significant Images in shared Imaging Studies (December 2024)
Add the capability to the above three MCWG Recommendations to implement in an interoperable way the IHE KIN Profile, thus ensuring that the source producing such a flagging of significant images is fully and easily accessible to the imaging consuming health professional.
A quick user guide for clinicians. Why do you need metadata? Finding the right patient data fast! (February 2025)
This quick guide addresses, in clinical terms, the usage of metadata associated with searching for clinical documents or objects that are shared at the regional or national levels. Health professionals need to understand the information elements that support searches in a patient record, to assist in filtering information objects, such as radiology reports, patient summaries, or laboratory reports. This will help health professionals being efficient in filtering out those imaging reports or imaging studies that are not relevant. This user guide also provides guidance on ensuring simple and reliable creation of metadata related to imaging studies and imaging reports.
Deployment tools including Image Sharing Gateaway (February 2025)
This presentation provides deployment guidance building upon the above MCWG on imaging recommendations. It identifies the real world systems that are involved in sharing imaging information and the various elements of a deployment strategy. It also introduces the concept of a common imaging gateway intended to bridge the legacy interfaces available on most PACS and RIS systems to simplify the deployment of a national or regional imaging sharing ehealth infrastructure that complies with the four sets of Recommendations made by MCWG on Imaging.

MCWG Relationship with MyHealth@EU, eHDSI cross border and the eHealth Network Guidelines on Imaging

MCWG maintains a close relationship with the relevant EU Projects (Xt-EHR, X-Share, etc.) and Actions in which the Commission and the Member States are engaged.

MCWG has adopted the Use Case defined by the EU Guidelines on Imaging Studies and Imaging Reports sharing [include link to EU WebSite].
MCWG presented its work to the eHN Imaging Task Force March 15th and April 12th 2024.
MCWG shared its recommendations with the eHN SubGroups (Semantic and Interoperability) – April 11, 2024

Several MCWG Members are also representing their country in the EU eHealth Network Imaging Task Force, the Xt-HEHR Joint Action and the eHN SubGroups.

MCWG Current Activities April-December 2024

1. MCWG recommendation checklist spreadsheet delivered and used to facilitate tracking adoption of MCWG recommendations by the countries and MCWG.

2. Create a Backlog of Issues about first three Recommendations that need further analysis resulting from country interviews

3. Additional recommendations have been developed (Use of QIDO Hub, Central Server Viewer). Integrated in the first set of recommendations.

4. Fourth recommendation on significant images approved (Dec 2024).

5. Invite non-European and European countries not yet participating to learn about MCWG and join. (England joined in November 2024).

6. MCWG Workshop at European IHE Connectathon held in Trieste (Thursday June 6 2024):

Opportunity for Countries to learn about MCWG and meet current members.
Assess the ongoing work of Focus Groups
Invite vendors for information. MCWG was only open to vendors through member countries - will be able to join directly in 2025 with the MCWG on Imaging – Community of Doers.

7. MCWG on Imaging – Community of Doers was created following IHE-Europe agreement with EU XpanDH project

Held kick-off teleconference on December 10th with about 10 first stakeholders.
Support the current 4 MCWG recommendations (see above). Provided excellent suggestions for improvements.

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