The many paths of the MIO
In the future, the exchange of images and findings is to be performed using small digital information modules (MIO) and, as far as possible, automatically. A group of experts led by our Head of Innovation, Dr. Marc Kämmerer, is defining use cases for this purpose.
Will digital interoperability succeed? This is undoubtedly one of the key issues for a more efficient healthcare system. In Germany, MIO is intended to be part of the solution. The acronym stands for Medical Information Objects and refers to small digital information elements that can be read and edited by any system, making them virtually universally applicable and combinable.
Six years ago, the National Association of Statutory Health Insurance Physicians (KBV), which developed the MIO concept, established the first of these documents: The immunization passport, the dental bonus booklet, the maternity passport, and the child health checkup booklet. These can be stored in the electronic patient medical record (ePA). mio42 GmbH is working on further information objects that are intended to be easily shared between the various stakeholders in the healthcare sector in the future. In doing so, it collaborates with the KBV as well as numerous experts from the relevant professional associations and industries.
More than 50 experts are involved
There is also a project group for the radiological findings report, consisting of 49 people from 14 user institutions and manufacturers, as well as mio42 GmbH. The „MIO Image and Report Exchange (MIO-X)“ is led by our Head of Innovation, Dr. Marc Kämmerer, in his capacity as representative of the IT Working Group of the German Radiological Society.
Marc Kämmerer would have liked to announce that the project is already complete, but over the course of the past year it has become clear that more detailed work needs to be done than originally anticipated. “The task of the MIO-X working group is to determine the data transmission path. And the biggest challenge lies in the multitude of paths that a MIO image and medical report can take.”
The ideal scenario sounds very promising: The data, which are structured and formatted in the MIO, can be imported directly into practice or hospital systems, whereby seamless transmission reduces the burden of documentation and eliminates unnecessary duplicate tests which improves the basis for medical decisions and facilitates the flow of information across departments.
The goal is to automate the use of DLX
However, this will ultimately require defining about half a dozen use cases for radiological image and diagnostic data. In principle, the objective is always to send and store radiological image data via DICOM Link Exchange (DLX) - in other words, as a replacement for the patient CDs that are still widely used today - together with the image findings. As things stand at the moment, this involves three levels or systems: A PACS, which is typically the source of the image data; a RIS, which contains the diagnostic report; and the provider of the DLX link. “To ensure they interact seamlessly, we need automated communication between the systems,” explains Marc Kämmerer.
To determine the necessary specifications, the DLX working group he leads at the DIN Radiology Standards Committee (NAR) is working on expanding the existing DIN/TS 19455 (DLX). The new features will supplement the standard, in particular with use cases for the fully automated use of DLX.
Three birds with one stone?
Ideally, the “iterative loop” that Marc Kämmerer and his colleagues are currently working on will prove to be very practical - namely, if they succeed in describing three approaches as one: Data exchange via KIM (the gematik [National Agency for Digital Medicine] email standard), data exchange via the ePA – and exchange within the framework of the European Health Data Space (EHDS). This is because, starting in 2031, medical imaging data and related findings are to be able to be shared across Europe.