1September, 2005 What IHE Delivers

Purchasing & IntegratingPurchasing & IntegratingRadiology SystemsRadiology Systems

Using IHE Using IHE

A Tutorial A Tutorial

Presenter NamePresenter NamePresenter CompanyPresenter CompanyPresenter Role in IHEPresenter Role in IHE

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Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise facilitates integrating systemsfacilitates integrating systems for efficient, accurate patient carefor efficient, accurate patient care

Systems that support IHE Integration Profiles:Systems that support IHE Integration Profiles: communicate better & integrate more easily communicate better & integrate more easily provide more complete and accurate informationprovide more complete and accurate information better support care providers workflow better support care providers workflow

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IHE = Integration ProfilesIHE = Integration Profiles

Each IHE ProfileEach IHE Profile describes a clinical information need or workflow scenariodescribes a clinical information need or workflow scenario documents how to use standards (e.g. HL7, DICOM, ...)documents how to use standards (e.g. HL7, DICOM, ...)

to accomplish itto accomplish it

Systems that implement the same Profile Systems that implement the same Profile address a need in a mutually compatible wayaddress a need in a mutually compatible way

Hundreds of products support one or more Hundreds of products support one or more IHE Radiology Profiles. IHE Radiology Profiles.

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Your Four Step ProgramYour Four Step Program

Prioritize the integration problems you need Prioritize the integration problems you need solvedsolved

Select Specific IHE Profile(s)Select Specific IHE Profile(s)

List those Profiles in your RFP/ TenderList those Profiles in your RFP/ Tender

Check Vendors IHE Integration StatementsCheck Vendors IHE Integration Statements

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Analyzing Integration ProblemsAnalyzing Integration Problems

Clinical PrioritiesClinical Priorities

Improvements in Department PerformanceImprovements in Department Performance

Potential Efficiency GainsPotential Efficiency Gains

End-User PainEnd-User Pain

Cost-EffectivenessCost-Effectiveness

Vendor ReadinessVendor Readiness

Available Resources / SkillsetsAvailable Resources / Skillsets

Administrative Guidelines / VisionAdministrative Guidelines / Vision

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Where to start...Where to start...

First, recognize what systems you need to First, recognize what systems you need to integrate integrate

See what Actors they implement and what See what Actors they implement and what Profiles they supportProfiles they support

Ensure you have the Actors based on the Ensure you have the Actors based on the Profiles you want to implementProfiles you want to implement

By leveraging IHE, the first part can be By leveraging IHE, the first part can be done easilydone easily

Note: You still have to include additional integration needs not covered by IHE.

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Selecting IHE ProfilesSelecting IHE Profiles

Review the Profiles :Review the Profiles :

What they doWhat they do

Benefits for your situationBenefits for your situation

Some Helpful Resources:Some Helpful Resources:

IHE User’s HandbooksIHE User’s Handbooks RadiologyRadiology MammographyMammography

RSNA DemonstrationsRSNA Demonstrations

Educational Material (e.g. Workshop Presentations)Educational Material (e.g. Workshop Presentations)

IHE Technical Framework – RadiologyIHE Technical Framework – Radiology

Connectathon ResultsConnectathon Results

www.ihe.net

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RFPs/ TendersRFPs/ Tenders

Your choice:Your choice:

Be Brief?Be Brief? ““The system must support DICOM”The system must support DICOM”

Be Effective?Be Effective? ““The system must support the following DICOM services The system must support the following DICOM services

according to the following 100 pages of specifications: …”according to the following 100 pages of specifications: …”

Be Both:Be Both: ““The system must support the IHE Scheduled Workflow The system must support the IHE Scheduled Workflow

Profile as the Acquisition Modality actor.”Profile as the Acquisition Modality actor.”

Vendor IHE Integration StatementsVendor IHE Integration Statements Version 2.1 of the CardioCT 5000 supports IHE Scheduled Version 2.1 of the CardioCT 5000 supports IHE Scheduled

Workflow as an Acquisition ModalityWorkflow as an Acquisition Modality

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IHE Integration StatementsIHE Integration Statements

Explicit claim by the vendorExplicit claim by the vendorfor a specific product versionfor a specific product version

Lists IHE profiles, actors, optionsLists IHE profiles, actors, options

Short & SweetShort & Sweet

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IHE Integration Statement Date: 03/10/2006

Vendor Product Name Version

Acme Medical Systems PACS-o-Matic V3.9

This product implements all transactions required to support the IHE Integration Profiles, Actors and Options listed below:

Integration Profiles Implemented Actors Implemented Options Implemented

Scheduled Workflow Image Manager / Archive .

PPS Exception Management

Patient Information Reconciliation Image Manager / Archive .

None

Consistent Presentation of Images Image Manager / Archive Image Display

None

Portable Data for Imaging Media Creator Media Importer

None

Audit Trail and Node Authentication Audit Record Repository None

Internet address for vendor's IHE information : http://www.acme-medical.com/IHE

Links to Standards Conformance Statements for the implementation

Dicom: http://www.acme-medical.com/DICOM

Health Level 7: http://www.acme-medical.com/HL7

Links to general information on IHE

In North America : http://www.ihe.net

In Europe : http://www.ihe-europe.org

In Japan : http://www.jira-net.or.jp/ihe-j

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Let’s look at an ExampleLet’s look at an ExampleFrom the From the IHE Radiology User’s HandbookIHE Radiology User’s Handbook

Suppose you’re buying a modality (see Suppose you’re buying a modality (see Chapter 1Chapter 1))

Suppose your integration strategy has identified two key goals:Suppose your integration strategy has identified two key goals: Reducing/Preventing ErrorsReducing/Preventing Errors Improving Throughput/TurnaroundImproving Throughput/Turnaround

Reviewing the Profile Benefits (see Reviewing the Profile Benefits (see Section 1.1.1Section 1.1.1):): Scheduled Workflow ProfileScheduled Workflow Profile has a significant impact on both goals: has a significant impact on both goals:

Prevents Prevents manual data entry errorsmanual data entry errors & & saves timesaves time at the modality console by at the modality console by downloading patient demographics and study details from the RIS (MWL)downloading patient demographics and study details from the RIS (MWL)

Prevents lost studies & time wasted re-scanning by confirming PACS receipt of images to avoid accidental deletion (Storage Commitment);

And saves more time by confirming automatically and electronically Reduces missing or irrelevant priors by storing a full set of accurate patient

and study identifiers and details in each study object (Store) Reduces delays in the reporting process by notifying the RIS of exams in

progress and ready to read (MPPS)

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imagesstored

patientinformation

RIS

examination orders

imagesretrieved

HIS

PACS

procedurescheduled

Prefetch any relevantprior studies

modalityworklist

report

report

IHE Scheduled Workflow ProfileIHE Scheduled Workflow Profile

Registration

Orders Placed

Orders Filled

Film

FilmFolder

Image Manager& Archive

FilmLightbox

report ReportRepository

DiagnosticWorkstation

Modality

acquisitionacquisitionin-progressin-progressacquisitioncompleted

acquisitioncompleted

imagesprinted

AcquisitionModality

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A Second ExampleA Second ExampleSuppose your integration strategy has identified two key Suppose your integration strategy has identified two key

goals:goals:Keeping your patients’ radiation exposure “As Low As Reasonably Keeping your patients’ radiation exposure “As Low As Reasonably Achievable (ALARA)”Achievable (ALARA)”

Improving your ability to monitor compliance of local policies and Improving your ability to monitor compliance of local policies and procedures governing radiation exposure of patientsprocedures governing radiation exposure of patients

Reviewing the Profile Benefits from the Radiation Reviewing the Profile Benefits from the Radiation Exposure Monitoring (REM) Profile Supplement:Exposure Monitoring (REM) Profile Supplement:Estimating radiation dose delivered to patients for medical Estimating radiation dose delivered to patients for medical purposes can facilitate a number of important activities:purposes can facilitate a number of important activities: For facilities exposing patients to radiation, monitoring such exposures can For facilities exposing patients to radiation, monitoring such exposures can

help ensure their policies, procedures and protocols are adequate and being help ensure their policies, procedures and protocols are adequate and being followed appropriately.followed appropriately.

For imaging physicians, monitoring such exposures can assist them in For imaging physicians, monitoring such exposures can assist them in determining how changes in techniques and protocols impact radiation dose determining how changes in techniques and protocols impact radiation dose as well as image quality. This will enable them to maintain patient doses As as well as image quality. This will enable them to maintain patient doses As Low As Reasonably Achievable (ALARA).Low As Reasonably Achievable (ALARA).

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IHE Radiation Exposure Monitoring IHE Radiation Exposure Monitoring ProfileProfile

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Using IHEUsing IHE

Present IHE as an integration priority to your vendors. Present IHE as an integration priority to your vendors. A Business goal ! A Business goal !

Specify appropriate Profiles, Actors, Options Specify appropriate Profiles, Actors, Options in your RFP/ Tenderin your RFP/ Tender ““The system must support the IHE Scheduled Workflow Profile as The system must support the IHE Scheduled Workflow Profile as

the Acquisition Modality actor and support the Exception the Acquisition Modality actor and support the Exception Management Option.”Management Option.”

Request Integration Statements from your vendorsRequest Integration Statements from your vendors

Plan acceptance testing (see Plan acceptance testing (see Section 1.2.2Section 1.2.2))

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Dealing with LegacyDealing with Legacy

Prepare to identify and address legacy system issues Prepare to identify and address legacy system issues (see (see Section 1.2.4Section 1.2.4))

Maximum benefit when all systems are IHEMaximum benefit when all systems are IHE Most of you will have some non-compliant devices and systemsMost of you will have some non-compliant devices and systems Make best effort to bring them “up-to-date”Make best effort to bring them “up-to-date”

Incremental usage of IHE provides incremental benefitIncremental usage of IHE provides incremental benefit It’s just clean DICOM and HL7It’s just clean DICOM and HL7

Get on the Yellow Brick Road...Get on the Yellow Brick Road... No sense buying No sense buying NewNew legacy equipment legacy equipment

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Next StepsNext Steps

Visit IHE Profile Demonstrations (Hall A, Visit IHE Profile Demonstrations (Hall A, Booth 2842)Booth 2842) Cross-Enterprise Document Sharing for Imaging Cross-Enterprise Document Sharing for Imaging

[XDS-I][XDS-I] Teaching File & Clinical Trial Export [TCE]Teaching File & Clinical Trial Export [TCE]

Visit Visit www.ihe.netwww.ihe.net - start learning about - start learning about ProfilesProfiles

Talk about an IHE strategy with your CIO / IT Talk about an IHE strategy with your CIO / IT staff, and with your vendorsstaff, and with your vendors

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