Integrating the Healthcare Enterprise How to Purchase IHE Conformant Systems John Paganini Guardian Healthcare

Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise

How to Purchase IHE Conformant Systems

John PaganiniGuardian Healthcare

IHE-Europe Workshop 2005

TELEMEDICINE SYSTEMSpecialists outside the OR consult and control the surgical robot.

IN-ROOM NETWORKTouchscreen runs all equipment, reconfigures the setup, shifting new equipment into place.

SURGICAL ROBOTProvides better precision, increasing dexterity, filtering out hand tremors, and allowing for the smallest of incisions.

ENDOSCOPIC CAMERAFully digital endoscopic camera, crunches 1.14 billion calculations per second.

HOSPITAL-WIDE NETWORKDoctors get hospital data (like patient test results and medication lists) and send it to any monitor in the room.

Copyright © 1994-2002 Wired Digital, Inc. All rights reserved.

Dr. RobotoDr. Roboto


Improve the efficiency and effectiveness of clinical practice:

Improve Workflow Improve Information Accuracy Improve Information AvailabilityEnable Cross-System Functionality

IHE Integration IHE Integration GoalsGoals


ConsiderationsConsiderations

Cost - Look at whole pictureFlexibility - Integratable, ScalableFunctionality - Standard, customizable Implementability - Mature, ComplexityStability - Revenue, Market SegmentUsability - Hides complexity,Productive


What are our goals? What are the steps and investments needed What are the critical IT capabilities needed to

achieve our goals? How will we measure whether we have achieved

our goals? How much of an improvement are we seeking?

Integration Questions Integration Questions WorthyWorthy of Asking… of Asking…


What Does IHE What Does IHE Provide?Provide?

Without IHE, A Gap Exists – Between The Standards That Make

Interoperability Possible And Actual Implementation.

– Standards Compliance Does Not Mean Interoperability

IHE Bridges The Gap – Reliable Method To Acquire or Upgrade Systems – Sufficient To Achieve Truly Efficient

Interoperability.


IHE IHE Technical ApproachTechnical ApproachIdentify the transactions required to

integrate information flow between information systems

For each transaction, select a single standard for use in implementing the transaction

Specify in detail the use of the standard in implementing the transaction


What is IHE?What is IHE?

IHE is a specification of transactions between systems.

IHE describes only integration features.

IHE is not a product itself, but…

IHE is very useful in purchasing products that integrate into workflow


Integration ProfilesIntegration Profiles--Solutions Packaged For Solutions Packaged For

PurchasingPurchasing--

Easy-to-understand, coherent, functional sets and

a convenient way for users and vendors to communicate precisely

about integration requirements and required functionality in products.


Using Using Integration ProfilesIntegration Profiles in in ProcurementProcurement

IHE specifies Integration Profiles which reflect typical Healthcare workflow models

Step 1: Identify the Integration Profiles which satisfy your Customer’s needs


Using Using ActorsActors in Procurement in Procurement

IHE identifies the transactions for each actor required to make integration work.

Specifying the integration profile and the actor implies support of the transactions.

Step 2: For each Integration Profile, identify which actors need to be implemented by each product


Using Using TransactionsTransactions in in ProcurementProcurement

For clarity, you may want to specify the transactions individually.

Step 3: Optionally, For each actor specified, identify the transactions needed to be implemented by each product


A PACS ExampleA PACS Example One company might implement a PACS to

include:– Image Manager + Image Archive + Performed

Procedure Step Manager + Image Display + Print Composer + Report Creator + Report Manager + Report Repository + Report Reader

Another vendor might implement a PACS to include only:– Image Manager + Image Archive + Performed

Procedure Step Manager + Image Display


Integration Profiles and Integration Profiles and Transactions for an RISTransactions for an RIS

Integration Profile: Scheduled Workflow Actors: Order Filler and Performed Procedure

Step Manager Required Transactions:

– 1, 2, 3, 4, 5, 6, 7, 11, 12, 20, and 21 Note: Each actor has different requirements

in each Integration Profile. Profiles are easier to specify than

transactions, and they guarantee integration.


Shall-language ExamplesShall-language Examples

The product shall implement the following IHE actors: …

The actors required above shall support the following IHE Integration Profiles: …

The upgrade shall meet the requirements of the IHE Technical Framework for the following IHE actors … and the following IHE Transactions: …


Example: New ModalityExample: New Modality

Print Composer

Capability Actor Integration ProfileAcquisition Modality Scheduled Workflow/Patient Reconciliation

Presentation of Grouped Procedures

Consistent Presentation of Images

Key Image Note

Consistent Presentation of Images

Report Creator Simple Image and Numeric Report

Required

Required

Required

Required

Required

Required

Ultrasound Imaging SystemThe product shall meet the requirements of the IHE Technical Framework, Version 4.7, for the integration profiles and the actors, as specified in the following table:


ConnectathonConnectathonQuestionsQuestions

Do you know what the IHE Connectathon is?

Has this product been tested at the IHE Connectathon?

What actors and IHE Integration Profiles were tested on this product at the IHE Connectathon?


Key QuestionsKey Questionsfor Vendorsfor Vendors

What IHE actors does this product implement?

What IHE Integration Profiles does each actor in this product support?

Is support for these actors and IHE Integration Profiles included in the released software for this product?


IHE Integration StatementIHE Integration Statement


Vendor IHE ClaimsVendor IHE Claims

Product X supports the IHE Y Integration Profile as the IHE a, b, and c Actors.

Use IHE Integration Profiles when writing RFPs and purchasing specifications


Level 0: Level 0: Modalities connected to Modalities connected to printerprinter

No RIS integrationNo RIS integration

Laser Printer

DICOM Basic Print Service


Level 1: Level 1: Modalities connected to Modalities connected to printerprinter

No RIS integrationNo RIS integrationPost-processing workstationsPost-processing workstations

Laser Printer

IHE Integration Profile:Consistent Presentationof Images

Sameperception??


Level 2: Modalities with RIS ConnectionLevel 2: Modalities with RIS Connection

IHE Integration Profile:Scheduled Workflow

(DICOM Modality Worklist)


Level 3:Level 3: Modalities with RIS Modalities with RIS ConnectionConnection

PACSPACS

IHE Integration Profiles:•Scheduled Workflow (full)•Patient Information Reconciliation•Presentation of Grouped Procedures•Access to Radiology Information


Level 4:Level 4: More than images: More than images: Measurements, Key images, CAD Measurements, Key images, CAD

objectsobjects

IHE Integration Profiles:•Key Image Note•Evidence Documents•Post-processing workflow


Level 5: Reporting and billingLevel 5: Reporting and billing

IHE Integration Profiles:•Simple Image and Numeric Report•Reporting Workflow•Charge Posting

HIS


Summary & ConclusionSummary & Conclusion

IHE Should Be Part Of The Proposed SolutionDevelop A Well-planned Integration Strategy IHE Integration Delivers Value When It Is

Managed To Deliver Value And ROI IHE Benefits Users, Providers And Vendors