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Integration Profiles - Overview
Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise
G. ClaeysAgfa Healthcare R&D, Technology Manager
Vendor co-chair
IHE Europe
Courtesy of IHE Committees
7 February 2005 IHE Europe Educational Event2
Integration Profiles - ObjectiveIntegration Profiles - Objective
Address real-world interoperability problems (bottom-up approach)
Leverage same integration solutions over multiple domains (top-down) Generalized solutions Example : Scheduling exams, display `exam results
Integration Profiles are orthogonal IPs are independent of each other Applications may combine multiple Integration Profiles
• E.g. Information access + security
7 February 2005 IHE Europe Educational Event3
Integration Profile - structureIntegration Profile - structure
Referenced standard (HL7) Detailed
messaging info --------------------------Roles
Integration Profile
Actor Actor Actor…
Tra
nsac
tion
Tra
nsac
tion
Tra
nsac
tion
Tra
nsac
tion
Tra
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tion
………
Solves an Integration Problem: A collection of real world information exchange capabilities supported by a set of specific Actors using Standards-based Transactions
7 February 2005 IHE Europe Educational Event4
IHE RoadmapIHE Roadmap
CardiologyCardiologyLabora-Labora-ttoryory
Pharmacy,…..Pharmacy,…..RadiologRadiologyy
Patient Identifier Linkage, Registries, SecurityPatient Identifier Linkage, Registries, Security
Access to clinical information; Electronic Health RecordAccess to clinical information; Electronic Health Record
Other (e.g. Acces Control, eHealthWorkflows)Other (e.g. Acces Control, eHealthWorkflows)
Patient ManagementPatient Management
Order ManagementOrder Management
7 February 2005 IHE Europe Educational Event5
IHE
EHR- Longitudinal Record
IHE Cardiology
IHE Laboratory
IHE Radiology
IHE
Future Domain
IHE
Future Domain
IHE
IT Infrastructure Intra-Enterprise
Cross-Enterprise
1 Integration Profile
3 New Integration Profiles
5 Existing / 4 New
Integration Profiles
12 Existing / 2+2 New
Integration Profiles
IHE ScopeIHE Scope
7 February 2005 IHE Europe Educational Event6
IHE Radiology – Focus PointsIHE Radiology – Focus Points
Streamline the workflow sub-processes Upstream : Patient ADT – Ordering – Data creation & processing Downstream : Reporting – Treatment – Billing Exception management : e.g. update unknown patient IDs
Quality control Consistent presentation of images on displays & printers
Improve communication with referring physicians Access to information, generated in radiology (images, reports) Image notes (post-its)
Improve machine-machine communication (automatic processing) Structured reports Measurements and coded data
Security : Adhere to (parts of) existing Security&Privacy regulation authentication, auditing
Off-line medium distribution (new)
7 February 2005 IHE Europe Educational Event7
PatientInformation
Reconciliation
ReconcileWorklists,
Statusand
Data Objects For
UnknownPatients
andDemographics
Changes
Access to Radiology Information
Consistent Presentation of
Images Create, store,
manage, retrieve & use objects for hardcopy and
softcopy grayscale presentation states
Key Image Notes
Create, store, manage, retrieve & use objects to flag significant images
Simple Image and Numericc
Reports Create, store,
manage, retrieve & use simple
diagnostic reports with optional image
links &
Scheduled Workflow
Presentation of Grouped
Procedures Manage individual procedure image subsets from a multi -procedure acquisition for
viewing & reporting
Basic Security
ChargePosting
Reporting Workflow
Manage worklists, track status, perform
& notify diagnostic
reporting steps
Evidence Documents
Create, store, manage, retrieve & use objects to
record study evidence
Manage worklists, track status, perform & notify image processing &
CAD steps
Post-Processing Workflow
Create,Store,
Manage,Retrieve &
UseImages
Admission, Order Management, Scheduling, Store, Retrieve
ManageWorklists,
Track Status,Perform &
NotifyAcquisition
Related Steps
Radiology – Integration ProfilesRadiology – Integration Profiles
New
NMImage
Portable Data for ImagingNew
7 February 2005 IHE Europe Educational Event8
IHE IT Infrastructure – Focus PointsIHE IT Infrastructure – Focus Points
Enterprise interoperability issues, common to multiple departments
Improve information consistency among applications & departments : Cross referencing patient IDs among hospitals (MPI) Patient synchronisation of multiple desktop applications
Simple access to patient’s clinical information from workstations and browsers Reports, images,
Simple access to administrative information of patient and staff Patient’s demographic information, personnel directory
Security : Single sign-on (shared user context) Centralized user management Audit trails on enterprise level
Sharing of clinical information among healthcare providers (e.g. regional health networks)
7 February 2005 IHE Europe Educational Event9
IT Infrastructure – Integration ProfilesIT Infrastructure – Integration Profiles
Enterprise User AuthenticationEnterprise User Authentication
Provide users a single nameand centralized authentication
processacross all systems
Retrieve Information for Display
Access a patient’s clinical information and documents in a
format ready to be presentedto the requesting user
Retrieve Information for Display
Access a patient’s clinical information and documents in
a format ready to be presented
to the requesting user
Patient Identifier Cross-referencing
for MPIMap patient identifiers
across independent identification domains
Patient Identifier Cross-referencing for
MPI
Map patient identifiers across independent
identification domains
Synchronize multiple applications on a desktop to the
same patient
Patient Synchronized Applications
Consistent TimeCoordinate time across
networked systems
Audit Trail & Node Authentication
Centralized privacy audit trail and node to node authentication
to create a secured domain.
New
Patient Demographics Query New
Personnel White PageAccess to workforcecontact information
New
Cross-Enterprise Document Sharing
Registration, distribution and access across health enterprises of clinical
documents forming a patient electronic health record
New
7 February 2005 IHE Europe Educational Event10
IHE Laboratory – Focus PointsIHE Laboratory – Focus Points
Leverage schedule workflow of radiology
Ordering, scheduling and performing clinical laboratory tests
Support specimen testing on the point of care or on the patient’s bedside
Delivering the observation results to the medical staff, at various steps of validation.
Manage the sequence of operations of automated lab equipment E.g. analyzers, robotic decappers, centrifuges, conveyors
All specialties working on specimen, not on the patient itself.
7 February 2005 IHE Europe Educational Event11
Laboratory IHE Integration ProfilesLaboratory IHE Integration Profiles
Laboratory Device Automation (LDA)
In Process –TI Nov 2004In Process –TI Nov 2004
Pre-analytic process, analysis and post-analytical treatment
Laboratory Scheduled Workflow (LSWF)Completed in 2003Completed in 2003
Tests performed by a laboratory for an identified
inpatient or outpatient
Laboratory Patient Information Reconciliation (LPIR) In ProcessIn Process
Tests performed on an unidentified or misidentified patient
Laboratory Code Set Distribution (LCSD) In ProcessIn Process
Sharing the batteries and tests code sets throughout the enterprise
Laboratory Point Of Care Testing (LPOCT) In Process –TI Nov 2004In Process –TI Nov 2004
Tests performed on point of care or patient’s bedside
7 February 2005 IHE Europe Educational Event12
IHE Cardiology – Focus PointsIHE Cardiology – Focus Points
Leverage “schedule workflow” (radiology) for cath lab and echocardiography
Leverage “retrieve for display” for ECG’s
Differences with radiology :
Echo cardio modalities are not always on-line Ad-hoc scheduling is the rule, not the exception Time synchronization among multiple modalities
7 February 2005 IHE Europe Educational Event13
IHE Cardiology – Integration ProfilesIHE Cardiology – Integration Profiles
Cardiac Catheterization Workflow
NewEchocardiography
Workflow
NewRetrieve ECG for Display Integration Profile (RED)
Provide ECGs and related documents to
enterprise
New
7 February 2005 IHE Europe Educational Event14
Example ECG in SVG FormatExample ECG in SVG Format
7 February 2005 IHE Europe Educational Event15
ConclusionConclusion
Leverage existing IHE Integration Profiles in different domains
Multi-year roadmap of IHE Integration Profiles per domain
IT Infrastructure address enterprise level integration issues
7 February 2005 IHE Europe Educational Event16
More information….More information….
IHE Web sites: • www.ihe.net• http://ihe-europe.org• http://www.rsna.org/IHE• http://www.acc.org/quality/ihe.htm• http://ihe-nl.org
Technical Frameworks:• ITI V1.0, RAD V5.5, LAB V1.0, CARDIO V1.0
Non-Technical Brochures :• IHE Europe Business Case• IHE Fact Sheet and FAQ• IHE Integration Profiles: Guidelines for Buyers• IHE Connectathon Results• Vendor Products Integration Statements