Methods and systems for protocol management

#Embodiments of the subject matter disclosed herein relate to management of workflow in healthcare and diagnostic protocols.

#Medical imaging diagnostic workflows typically include multiple protocols for a given suspected clinical issue. During an active scan, a technologist has to pick an initial protocol to start with, and at a decision point of the protocol, may have to update subsequent action items of the protocol or switch to another protocol. The switch may be defined by clinical rules which may be site specific, issue specific, imaging modality specific, etc. The technologist has to refer to manuals and handbooks during the active scan to identify the decision points, an appropriate response, and identify a subsequent protocol to execute. In addition, the technologist has to select settings for the imaging system being operated based on the protocol selection. In some cases, the initial protocol may be a default protocol that includes details from all related protocols, to cover all possible scenarios, and the technologist has to identify and manually remove the inapplicable steps from the protocol during the active scan.

#In one embodiment, a system comprises a display; and a computing device operably coupled to the display and storing instructions executable to: output, to the display, a protocol manager interface including a default protocol for an imaging system, the default protocol including one or more action items to be executed in a sequence during an imaging scan by the imaging system, at least a portion of the one or more action items specifying imaging system parameters for the imaging scan; responsive to input from an authenticated user, modify the default protocol including modifying the one or more action items and/or the sequence; store the modified protocol in a memory of the computing device; and responsive to a subsequent request to perform the imaging scan, retrieve the modified protocol and operate the imaging system in accordance with the imaging system parameters defined in the modified protocol.

#The present invention will be better understood from reading the following description of non-limiting embodiments, with reference to the attached drawings, wherein below:

#FIG. 1 shows a pictorial view of an imaging system according to an embodiment;

#FIG. 2 shows a block schematic diagram of an exemplary imaging system according to an embodiment;

#The following description relates to various embodiments of protocol management and clinical decision support systems. In particular, systems and methods are provided for enabling modification of a manufacturer-installed default protocol, associated with an imaging system, by an authenticated user. The systems and method further enable the modified protocol to be retrieved for providing a guided workflow to a non-authenticated scan technologist operating the imaging system when scanning for a suspected clinical disorder. During the operation of certain imaging modalities, such as computed tomography (CT) imaging, a scan technologist may not know ahead of time what the final scan protocol will be. The scan technologist may start with a default protocol for the suspected clinical disorder, and then, in-flight, manually select one of a plurality of exam protocol branches for the patient based on clinical rules. This may include the technologist having to retrieve information, guidance, and/or other imaging data for the given patient from other sources (e.g., another group of the healthcare system, another imaging modality, etc.) and then making a decision as to which protocol branch to subsequently select based on the retrieved information. As an example, the technologist may have to rely on the results of an angiogram being analyzed by a cardiologist before deciding whether to proceed with perfusion imaging. Errors in protocol selection by the scan technologist can result in a medical issue not being diagnosed correctly. As an example, if the technologist does not correctly categorize the size of the patient, an incorrect protocol may be selected, and the imaging system settings may be incorrectly applied. With reference to a computed tomography (CT) imaging system, table position settings, gantry position settings, and X-ray source voltage and current settings, may be incorrectly applied. For example, table and gantry settings for an abdominal scan may be different for a patient deemed to be “small” versus “large” or “medium”. As a result, the decision making process may be subjective and inconsistent from technologist-to-technologist, as well as patient-to-patient for the same technologist. As such, the process adds significant cognitive load on the technologist, especially in trauma use cases where there may be a limited amount of time in which to make critical medical decisions.

#Thus, according to embodiments disclosed herein, a guided diagnostic workflow can be automatically generated, reducing the cognitive load on a scan technologist at the time of an active scan. An authorized lead technologist can modify a default protocol for an imaging system, such as one provided by a manufacturer, customizing the protocol for the site, the imaging modality, and/or other parameters. The modifications may be enabled via interactions with a protocol manager interface executed on a computing device. The modifications may not only specify a type of scan to be executed, but also a sequence of actions to be performed at the time of the scan, as well as imaging systems settings such as power settings, position settings, motor speed settings, etc. At the time of a scan, the protocol manager interface may retrieve the modified protocol and provide a guided workflow to the scan technologist with each action item of the modified protocol representing a corresponding action item to be performed during the workflow. The modifications to the protocol may be in the form of prompts that pop-up during the workflow to provide step-by-step instructions for executing a linked action item. In addition, the prompts may assist in scouting a patient, such as for size and issue, so that protocol selection is facilitated. The modifications may also be in the form of a decision point with predefined responses, each response linked to a downstream protocol with a distinct set of action items. Selection of a response by the scan technologist during the active scan automatically updates the workflow with the appropriate actions items to be subsequently performed. In other words, a pre-built workflow is delivered to the scan technologist once a decision is made, and the scan technologist can complete the active scan in accordance with the provided workflow. In addition, the protocol manager interface may automatically apply (or define) the imaging system settings defined in the protocol or protocol branch that was selected. As a result, subjectivity in decision making (e.g., technologist selection of patient size category) as well as inconsistencies in a workflow, such as human-to-human variability in manually updating a protocol and selection of appropriate imaging system settings, are reduced. This may be of particular interest in trauma use cases where protocol section and imaging settings can be expedited without affecting scan reliability.

#For example, a computing device of an imaging system may be configured with a protocol manager which outputs a protocol manager interface on a display. A first interface may be displayed to an authenticated user (such as a user whose authentication is received and confirmed) to enable the user to modify a default protocol for an imaging system, the default protocol selected from a library, and the protocol including one or more action items to be executed in a sequence during an imaging scan by the imaging system. At least a portion of the one or more action items may specify imaging system parameters for the imaging scan. Responsive to input from the authenticated user (that is, a person who does have permission to modify a protocol), such as a lead technologist at an imaging site (e.g., healthcare facility), the protocol manager modifies the default protocol including modifying the one or more action items and/or the sequence. The modified protocol is then stored in a memory of the computing device. Responsive to a subsequent request to perform a new imaging scan task, such as requested by the authenticated user or another non-authenticated user (such as a user whose authentication is received and who does not have permission to modify the protocol, e.g., a scan technologist at the site), the protocol manager may retrieve the modified protocol and display a workflow to be executed during the imaging scan. The workflow comprises the one or more action items of the modified protocol. In addition, the imaging system may be operated in accordance with the imaging system parameters defined in the modified protocol, such as power settings and motor settings defined in the modified protocol.