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1September, 2005 What IHE Delivers
User Success Stories User Success Stories
HIMSS Interoperability Showcase February 2006HIMSS Interoperability Showcase February 2006
David Piraino, M.D.David Piraino, M.D.
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Standards are critical but alone are not enoughStandards are critical but alone are not enough
Standards offer generality, ambiguity and Standards offer generality, ambiguity and alternativesalternatives
Standard Implementation Guides are Standard Implementation Guides are focused on a single standardfocused on a single standard
Increasing complexityIncreasing complexity
IHE provides a standard process for IHE provides a standard process for
implementing multiple standards!implementing multiple standards!
3
Connecting standards to careConnecting standards to care
Care providers work with vendors to Care providers work with vendors to coordinate the implementation of standards coordinate the implementation of standards to meet their needsto meet their needs Care providers identify the key interoperability Care providers identify the key interoperability
problems they faceproblems they face Drive industry to develop and make available Drive industry to develop and make available
standards-based solutionsstandards-based solutions Implementers follow common guidelines in Implementers follow common guidelines in
purchasing and integrating systems that deliver these purchasing and integrating systems that deliver these solutionssolutions
What is the effective way to establish those What is the effective way to establish those
“standards” for how to implement standards ?“standards” for how to implement standards ?
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Electronic Health Record
Cardiology
Laboratory
Radiology
Oncology
Future
Domains
IHE
IT Infrastructure
15 Integration Profiles
5 Integration Profiles
4 Integration Profiles
1133 IInntteeggrraattiioonn PPrrooffiilleess
Patient Care Coordination
1 Integration Profile
Patient Care
Devices
Pathology
Eye Care
IHE 2006 – Nine Active Domains IHE 2006 – Nine Active Domains Over 100 vendors involved world-wide,Over 100 vendors involved world-wide, 5 Technical Frameworks5 Technical Frameworks
38 Integration Profiles, Testing at Connectathons38 Integration Profiles, Testing at ConnectathonsDemonstrations at major conferences world-wideDemonstrations at major conferences world-wide
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IHE User Success StoriesIHE User Success Stories
Case studies from sites that have used IHE integration profiles to integrate systems and achieve interoperability
Identify what systems were implemented, describes the integration process and the impacts on clinical care
22 published online from institutions of all sizes from around the world
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IHE User Success Storieshttp://www.rsna.org/IHE/participation/success_stories/index.shtml
•Cleveland Clinic Foundation•Detroit Medical Center•Grossman Imaging Centers•Hôpitaux Universitaires de Genèv•IHE McKay-Dee Hospital•Johannes Gutenberg University Hospital•Magic Valley Regional Medical Center•Mayo Clinic Jacksonville•Our Lady Of The Lake Regional Medical Center (OLOL)•VA Puget Sound Health Care System•St. Vincent Hospital and Health Services•Steinberg Diagnostic Medical Imaging•University of Pisa•University of Wisconsin
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IHE ModelIHE Model
Actors in precisely defined rolesActors in precisely defined roles Abstracts a specific function of information systemAbstracts a specific function of information system
……Executing precisely defined transactionsExecuting precisely defined transactions Using existing standardsUsing existing standards
…………To solve real world interoperabilityTo solve real world interoperability problems problems Select Integration Profile for implementationSelect Integration Profile for implementation
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IHE Technical FrameworksIHE Technical FrameworksImplementation Guide for each Integration ProfileImplementation Guide for each Integration Profile
An Integration Profile :An Integration Profile : A Set of A Set of ActorsActors Exchanging Exchanging TransactionsTransactions
Query Modality Worklist [RAD-5]
ADT Order Placer
Register J.Doe
AcquisitionModality
Placer OrderManagement –New [RAD-2]
Patient Reconciliation
Department System Scheduler/Order Filler
Schedule Procedure
Procedure Scheduled [RAD-4]
Modality Procedure Step Completed [RAD-7]J.Doe ->
J.Smith
Patient Update/Merge [RAD-12]
Modality Procedure Step Completed [RAD-7]
PatientRegistration [RAD-1]
Patient Update/
Merge [RAD-12]
Modality Procedure Step In Progress [CARD-1]
Modality Procedure Step In Progress [CARD-1]
Perform Acquisition
Filler Order Mgmt - Status Update [RAD-3]
Filler Order Mgmt - Status Update [RAD-3]
ImageManager/
PPS Manager
Filler Order Management -New [RAD-3]
One or the other methods of creating an order is used
Query Modality Worklist [RAD-5]
ADT Order Placer
Register J.Doe
AcquisitionModality
Placer OrderManagement –New [RAD-2]
Patient Reconciliation
Department System Scheduler/Order Filler
Schedule Procedure
Procedure Scheduled [RAD-4]
Modality Procedure Step Completed [RAD-7]J.Doe ->
J.Smith
Patient Update/Merge [RAD-12]
Modality Procedure Step Completed [RAD-7]
PatientRegistration [RAD-1]
Patient Update/
Merge [RAD-12]
Modality Procedure Step In Progress [CARD-1]
Modality Procedure Step In Progress [CARD-1]
Perform Acquisition
Filler Order Mgmt - Status Update [RAD-3]
Filler Order Mgmt - Status Update [RAD-3]
ImageManager/
PPS Manager
Filler Order Management -New [RAD-3]
One or the other methods of creating an order is used
Use casesUse casesProcess FlowsProcess Flows
For each transaction:For each transaction: Std referencedStd referenced Options specifiedOptions specified Mapping requiredMapping required
Pt. Registration [RAD-1] Patient Update [RAD-12]
Pt. Registration [RAD-1] Patient Update [RAD-12]
Placer Order Management [RAD-2] Filler Order Management [RAD-3]
ADT
Query Images [RAD-14] Retrieve Images/Evidence [CARD-4]
Image Display
Modality Image/Evidence Stored [CARD-2]
Storage Commitment
[CARD-3]
Procedure Scheduled [RAD-4]
Procedure Updated [RAD-13]
Query Modality Worklist [RAD-5]
Performed Procedure
Step Manager
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Order Placer
Acquisition Modality
ImageManager
ImageArchive
DSS/ Order Filler
Patient Update [RAD-12]
Modality Image/Evidence Stored [CARD-2]
Storage Commitment
[CARD-3]
Evidence Creator Modality PS in Progress [CARD-1]
Modality PS Completed [RAD-7]
Instance Availability Notification [RAD-49]
Pt. Registration [RAD-1] Patient Update [RAD-12]
Pt. Registration [RAD-1] Patient Update [RAD-12]
Placer Order Management [RAD-2] Filler Order Management [RAD-3]
ADT
Query Images [RAD-14] Retrieve Images/Evidence [CARD-4]
Image Display
Modality Image/Evidence Stored [CARD-2]
Storage Commitment
[CARD-3]
Procedure Scheduled [RAD-4]
Procedure Updated [RAD-13]
Query Modality Worklist [RAD-5]
Performed Procedure
Step Manager
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Order Placer
Acquisition Modality
ImageManager
ImageArchive
DSS/ Order Filler
Patient Update [RAD-12]
Modality Image/Evidence Stored [CARD-2]
Storage Commitment
[CARD-3]
Evidence Creator Modality PS in Progress [CARD-1]
Modality PS Completed [RAD-7]
Instance Availability Notification [RAD-49]
ActorsActors TransactionsTransactions
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IHE Integration StatementsIHE Integration Statements document the product IHE capabilities in terms of IHE: Actors and Integration Profiles.- Promote your products with the Integration Statements - Learn from other Vendors Integration Statements the IHE Profiles and Actors supportedThe RSNA links to IHE Integration Statements published by the companies:
- Agfa HealthCare - Philips Medical Systems- Cerner Corporation - Sectra- Eastman Kodak Company - Siemens Medical Solutions - Emageon - Softmedical- Fujifilm Medical Systems USA - Stentor- GE Medical Systems - StorCOMM, Inc- INFINITT Co., Ltd. - Tiani Medgraph AG- McKesson Information Solutions - Toshiba America Medical Systems- Medcon - Voxar Limited
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IHE Radiology Integration ProfilesIHE Radiology Integration Profiles
Patient Info.
Recon-ciliation
Access to Radiology Information
Consistent Present-ation of Images
Basic Security
-
EvidenceDocs
KeyImageNotes
Simple Image & Numeric Reports
Presentation of Grouped Procedures
Post-
Processing Workflow
Reporting Workflow
Charge Posting
Scheduled Workflow
Portable Data for Imaging
NMImage
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imagesstored
patientinformation
RIS
examination orders
imagesretrieved
HIS
PACS
procedurescheduled
Prefetch any relevantprior studies
modalityworklist
report
report
Registration
Orders Placed
Orders Filled
Film
FilmFolder
Image Manager& Archive
FilmLightbox
report ReportRepository
DiagnosticWorkstation
Modality
acquisitionacquisitionin-progressin-progressacquisitioncompleted
acquisitioncompleted
imagesprinted
AcquisitionModality
Scheduled Workflow ProfileScheduled Workflow Profile
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Consistent Presentation of ImagesConsistent Presentation of ImagesReporting Radiologist Referring Physician or
Reviewing Radiologist
Presentation StatePresentation LUT
Grayscale Standard
Original Image
Window Level
Flip
Zoom
Area Of
Interest
Annotate
WithoutConsistent Presentation
AchievingConsistent Presentation
Area Of
Interest
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MODALITY
Presentation of Grouped Procedures ProfilePresentation of Grouped Procedures ProfileRequested Procedure:
CHEST
Report:CHEST
Report:AB/PELVIS
Performs a single exam
Operatorgroups
2 procedures
Chest Chest ViewView
RIS / PACS
Requested Procedure:AB/PELVIS
Chest Chest ViewView
Ab/Pelvis Ab/Pelvis ViewView
Ab/Pelvis Ab/Pelvis ViewView
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Deployment of IHE Profiles – Most Used:
- Scheduled Workflow (SWF)
- Patient Information Reconciliation (PIR)
- Consistent Presentation of Images (CPI)
- Reporting Workflow (RWF)
- Basic Security for HIPAA regulations (SEC)
Clinical and Economics Accomplishments
- Improve the Patient Care – Improved data accuracy and Safety, Image Quality & Consistency and time saving due to optimized Workflows and integrated systems
- Improve the clinical practice productivity - reduced manual data entry using the ADT registration in one place and propagate it to all the other systems (PACS, RIS Modality) and reduced errors.
- Optimize the Radiological Workflow (SWF) Reduced the incorrectly or lost studies, using DICOM MWL, MPPS
IHE Success StoriesIHE Success Stories
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Want to know what new integration Want to know what new integration profiles will be developed in 2006 ?profiles will be developed in 2006 ?
Attend the IHE Domain specific Attend the IHE Domain specific sessions in these Theaters during sessions in these Theaters during HIMSS 2006 (Orange sessions)HIMSS 2006 (Orange sessions)
Contact the IHE Domain SponsorsContact the IHE Domain Sponsors
Visit the IHE Web SiteVisit the IHE Web Site
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What can you do?What can you do?
Learn about IHELearn about IHE
Insist on IHE compliance in your RFPs and Insist on IHE compliance in your RFPs and contract documents:contract documents:
Select Integration Profiles, and Appropriate Actor(s) Select Integration Profiles, and Appropriate Actor(s)
Ask vendors for their products “IHE Integration Ask vendors for their products “IHE Integration Statements”.Statements”.
Need more interoperability ? Need more interoperability ?
Contribute to IHE CommitteesContribute to IHE Committees
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IHE Web site:IHE Web site: www.IHE .netwww.IHE .net Frequently AskedFrequently Asked QuestionsQuestions
Integration Profiles in Technical Frameworks: Integration Profiles in Technical Frameworks: See Volume 1 of each TF for Use casesSee Volume 1 of each TF for Use cases
Cardiology IT Infrastructure Laboratory Patient Care Coordination Radiology
Connectathon Result: Connectathon Result: www.ihe.net/Events/connectathon_results.cfmwww.ihe.net/Events/connectathon_results.cfm
Vendor Products Integration StatementsVendor Products Integration Statements
Participation in Committees & ConnectathonsParticipation in Committees & Connectathons
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