JJ1017 image examination order codes: standardized codes supplementary to DICOM for imaging modality, region, and direction

The DICOM standard includes non-image data information such as image study ordering data and performed procedure data, which are used for sharing information between HIS/RIS/PACS/modalities, which is essential for IHE. In order to bring such parts of the DICOM standard into force in Japan, a joint committee of JIRA and JAHIS (vendor associations) established JJ1017 management guideline. It specifies, for example, which items are legally required in Japan while remaining optional in the DICOM standard. Then, what should be used for the examination type, regional, and directional codes? Our investigation revealed that DICOM tables do not include items that are sufficiently detailed for use in Japan. This is because radiology departments (radiologists) in the US exercise greater discretion in image examination than in Japan, and the contents of orders from requesting physicians do not include the extra details used in Japan. Therefore, we have generated the JJ1017 code for these 3 codes for use based on the JJ1017 guidelines. The stem part of the JJ1017 code partially employs the DICOM codes in order to remain in line with the DICOM standard. JJ1017 codes are to be included not only in IHE-J specifications, also in Ministry recommendations of health data exchange.