Its an abstraction of a task with description of what should be done, when it should be done and who should do it.Modality worklist (MWL) is one of DICOMs workflow services that really make a difference.Its the difference between grocery store workflow with notes on little pieces of paper and a true modern accountable workflow.But for the imaging center or RAD department the advantages are enormous.
The most obvious benefit is that theres no need to reconcile all kind of misspelled names in the PACS because the patient name is no longer keyed in on the modality workstation but received electronically via the MWL query. The fact that the requested procedure is also received electronically reduces the chance for doing the wrong procedure to the wrong patient. Combined with Modality Performed Procedure step (MPPS), that allows the modality to report the task status, take ownership over the task and checkmark it as done when completed, the up side is obvious. No wonder then, that many HMOs require Modality Worklist as a mandatory feature for every imaging device they purchase. The most basic abstraction of a task is a short description of what should be done and a checkbox. Thats all it takes. The MWL data model is a bit more complicated and has two levels. ![]() The procedure can be described as text using attribute (0032,1060) Requested Procedure Description or in a more sophisticated manner using the (0032,1064) Requested Procedure Code Sequence where static tables of codes and meanings can be used to configure and maintain procedures in the RIS or HIS. The child level is called Scheduled Procedure Step (SPS) and holds attributes relevant to the modality and the actual procedure to be made. A single requested procedure may hold more than one SPS if the request is for a multi-modality study, for example a chest X-Ray and a CT or whatever combination, or if for example two protocols should be applied (e.g. Chest and Abdomen). As a modality, we will use the data in the RP to identify the patient and eliminate re-typing of the name and ID and the SPS to determine what exactly to do. The DICOM images that the modality will create should use the attributes received from the MWL. Dicom Modality Worklist Series And AttachWhen MWL is implemented, the Study Instance UID is generated in the RIS so if a multi-modality procedure is done, each modality will create a series and attach it to the Study by using the Study Instance UID received in the MWL query. The Modality Worklist Server is responsible for managing the tasks. On one hand it provides means to schedule new tasks (e.g. HL7 or using a web form) and on the other hand it provides means to get the list of scheduled tasks (via DICOM). In this post, were going to write a simple MWL client using RZDCX DICOM Toolkit and discuss the details of the service and how the workflow is implemented. ![]() For example it can arrive as a HL7 message from the HIS (Hospital Information System), or it can be that the patient walks in an the order is made at the reception desk. In either case, a new record is created in the worklist manager with the information for the service. If there are many X-Ray machines, the order may be assigned to one of them. The assignment is made by setting the AE title on the order and setting a date. The exact way it is done, is very much the business of the worklist manager implementation.
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