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Rev 2.1 1
IHE Cardiology
5-year RoadmapRoadmap subcommittee:Bill Weintraub [email protected] Keller [email protected] Queensberry [email protected] Solomon [email protected] Schnepf [email protected] Elion [email protected] Biegel [email protected] Croke [email protected] Simon [email protected] Patel [email protected]
Rev 2.1 2
Principles• Cardiology profiles addressing clinical user needs
to be developed by IHE Cardiology committees– Prioritization by Planning Committee– Refinement and technical definition by Technical
Committee• IT Infrastructure profiles addressing general
healthcare needs available to be demo’ed in the cardiology domain ~1-2 years after adoption by IT Infrastructure committees– Vetting by Planning Committee for applicability to
critical cardiology need– Recommendations to IT Infrastructure for new profiles
in that domain
Rev 2.1 3
Timeline20 months from concept to demo
Date months Event
July -20 Roadmap Subcommittee develops proposed 2/3/5 year plan concepts (year 1 already set)
September -18 Planning Committee review of concept proposals, assignment for further development within Planning Committee
January -14 Planning Committee initial selection of profiles, assignment for feasibility assessment by Technical Committee
March -12 Technical Committee feasibility assessment, Planning Committee downscopes profiles to demonstration set
June -9 Technical Committee publishes Technical Framework detailed profiles for comment; Planning Committee publishes demo plan
July -8 Technical Committee publishes Technical Framework detailed profiles for Trial Implementation
January -2 Connectathon tests implementation of Profiles
March ! ACC Demonstration of Profiles
Rev 2.1 4
2/3/5 year plan
• Year 2 should be highest clinical priority– Including items deferred from current year
• Year 3 should be high priority items that will require >1 year vendor development– Need complete definitions of concepts, so that
vendors can start planning
• Years 4-5 are conceptual
Rev 2.1 5
Year 1(2005 demo)
Year 2(2006 demo)
Year 3(2007 demo)
Year 4(2008 demo)
Year 5(2009 demo)
Cath
Echo
ECG
Nuclear
EP
Cardiology T
echnical Fram
ework
IT Infrastructure T
F
Infra
Security
Admin
EMR
Quality
MR/CT
Multi-modality workflow & imaging
Procedure log &reporting
Hemo waveform & measures, QCA/QVA
Supplies, inventory,& charge capture
Workflow & imaging,stress protocols
Reporting workflow
Retrieve ECGfor display
ECG/Stress/Holterorders
Workflow & imaging,stress protocols
Reporting workflow
Multi-modality labworkflow & reporting
Home healthmonitoring
Timesynchronization
Audit trail Enterprise userauthentication
Retrieve infofor display
Cross-enterprisedocument sharing
Retrieve guidelinesfor display
Retrieve structuredguidelines
Registry datasubmission
Cross-enterprisereferrals/orders
Workflow, reporting,& measurements
Risk factors forclinical decision supt
Patient care plan
Patient location& transport
Device auto-configuration
Precision timesynchronization
Implantable device parameters & events
Pediatric
Personnel white pages
Measurementinteroperability
ECG waveform interoperability
Rev 2.1 6
Cardiology Year 1 Profiles (2005 demo)
• Cath lab workflow - including coordination of the multi-modality environment, access to patient demographics, and storage and display of images
• Echo workflow - including scheduling and management of digital echo exams, including multi-stage stress exams, and storage and display of images
• Retrieve ECGs for display - access to ECGs for display using web technology
Rev 2.1 7
IT Infrastructure Profiles for Cardiology Year 1 (2005 demo)
• Consistent time - specifies time synchronization to better than 1 second accuracy using NTP; supports cath lab workflow (ITI 2004)
• Retrieve info for display - access to a variety of patient info for display using web technology; supports cross-department access to data (ITI 2004)
Rev 2.1 8
Cardiology Year 2 Profiles (2006 demo)
• Cath lab reporting workflow– distributed creation of procedure log, reporting workflow, outbound reports
• Echo reporting workflow - reporting workflow, including sonographer preliminary reports and cardiologist over-reading
• Nuclear medicine - image content profile for NM, including cardiac (from IHE Radiology 2004)
• Registry data submission – standard formats for ACC NCDR 3 / ESC CARD
Rev 2.1 9
IT Infrastructure Profiles for Cardiology Year 2 (2006 demo)
• Audit trail - centralized logging of system security events and user access of patient data (ITI 2004)
• Cross-enterprise document sharing – repositories for clinical documents accessible across institutional boundaries, including ECGs and reports (ITI 2005)
• Personnel white pages – centralized directory of healthcare staff information (ITI 2005)
Rev 2.1 10
Cardiology Year 3 Profiles (2007 demo)
• Cath lab content – creation and display of interoperable QCA/QVA, hemo waveforms, and hemo measurements
• Echo measurements - creation and display of interoperable echo measurements
• Nuclear medicine reporting workflow - measurements and reporting
• EP lab workflow – adapted cath lab workflow, storage and display of images, waveforms and measurements; reporting
• MR/CT angiography – adapted radiology workflow, storage and display of images and measurements; reporting
• Retrieve guidelines for display – keyword-based retrieval of guidelines
Rev 2.1 11
IT Infrastructure Profiles for Cardiology Year 3 (2007 demo)
• Cross-enterprise referrals and orders – Referrals and Orders from physician office to specialty diagnostic facility, with clinical attachments (recommend to ITI)
• Enterprise user authentication – centralized user account management and authentication (ITI 2004)
Rev 2.1 12
Evaluation
• Do these represent the highest clinical priorities?
• Do we have the proper services to support clinical information needs for addressing patients presenting with caridac disease/syndromes?– ACS, MI, HF, Afib, hypertension, etc.
Rev 2.1 13
Potential future IHE/Cardiology profiles(December 2003 brainstorming)
• Cath Workflow Procedure Logging and Reporting
• Cath Hemodynamics Report and Waveform Display
• Cath Lab Precision Mutli-Modality Synchronization
• Echo Workflow Reporting• Nuclear Cardiology workflow• Electrophysiology workflow, waveforms,
measurements, reports, device parameters• Non-invasive Angiography workflow
(MRA/CTA)• Evidence Reporting and Display
(QCA/QVA, MRA/CTA) • Workflow step prerequisite checking (labs,
drugs, insurance)• Cath lab inventory management• Charge capture• Retrieve Guidelines for Display• Retrieve Structured/Actionable Guidelines• Outpatient imaging workflow
• Patient care plan• Outbound Reports (to longitudinal record)
(IHE IT Infrastructure)• Cross-Enterprise Patient ID Cross-
Reference (Cardiology practice / multiple hospitals)
• Cross-Enterprise Ordering and Referral• Cross-Enterprise Clinical Document
Sharing (IHE IT Infrastructure)• Registry Data submission (ACC NCDR 3 /
ESC CARD)• Scheduling (room/equipment;
physician/staff)• Summary report – discharge• Cardiac Risk Factors extract from
Longitudinal Record• Critical value alarms• Patient location tracking / transport
management• … and all IHE IT Infrastructure profiles!