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September, 2005 What IHE Delivers
Andrew M. Keller, MD, FACC, FACP, FASEAndrew M. Keller, MD, FACC, FACP, FASE
Chief of Cardiology, Danbury HospitalChief of Cardiology, Danbury Hospital
Danbury, CT, USADanbury, CT, USA
Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise
IIHE: Meeting Global needs HE: Meeting Global needs for Integrated Healthcarefor Integrated HealthcareJapanese Circulation Society (JCS)Japanese Circulation Society (JCS)
Kobe, JapanKobe, JapanMarch 16March 16thth, 2007, 2007
22
Thank you for the opportunity to beThank you for the opportunity to beat the Japanese Circulation Societyat the Japanese Circulation Society
Annual Scientific Meeting.Annual Scientific Meeting.
33
IHE’s vision and purposeIHE’s vision and purpose
To apply the knowledge of physician, hospital, and office workflow in order to link and integrate modalities (actors) passing information from application to application seamlessly across the entire health care system.
44
Workflow that must be IntegratedWorkflow that must be Integrated
Order entry
Pre-authorization
Patient Scheduling
Transportation
Registration and payer verification
Reconciliation of patient demographics
Coordination with physicians
Study acquisition
Notification study completed
Study archiving and storage
Image retrieval system
Preliminary reporting
Professional review
Transcription, reporting, and electronic signature
Report dissemination
Quality assurance
Statistical analysis
Billing and auditing
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Integrate Clinical InformationIntegrate Clinical Information
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Information from many placesInformation from many places
HospitalHospital
HomeHome
Doctor’s officeDoctor’s office
Extended CareExtended Care
Data pointersData pointers
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Information is difficult to integrate!Information is difficult to integrate!
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How can we integrate these system?How can we integrate these system?
Today, at least in U.S. and Europe, each two Today, at least in U.S. and Europe, each two systems that are connected are an “IT integration systems that are connected are an “IT integration project”.project”. Very expensive Very time consuming Very resource intensive Never works quite right Usually involves third party May break if software is upgraded on either system
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How to integrate?How to integrate?
Use existing standards: DICOM HL7 XML
Define use of standards in Technical Framework
Have common testing plan in order to have vendors work together
Vendors implement Technical Framework in products
1010
IHE is formedIHE is formed
IHE is a consortium of professional societies and vendors working together to facilitate the integration of healthcare information 1997: IHE Radiology established; sponsored by RSNA 2000: First European Connectathon 2003: IHE Cardiology established; sponsored by ACC 2004: ESC joins IHE Cardiology 2007: IHE International formalized 2007: We are excited to have JCS join IHE Cardiology
in expanding support to Asia
1111
Proven Standards Adoption ProcessProven Standards Adoption Process
Document Use Document Use Case Case RequirementsRequirements
Document Use Document Use Case Case RequirementsRequirements
Identify available Identify available standards (standards (e.g. HL7, e.g. HL7, DICOM, IETF, OASIS)DICOM, IETF, OASIS)
Identify available Identify available standards (standards (e.g. HL7, e.g. HL7, DICOM, IETF, OASIS)DICOM, IETF, OASIS)
Develop Develop technical technical
specificationsspecifications
Develop Develop technical technical
specificationsspecifications
Testing at Testing at ConnectathonsConnectathonsTesting at Testing at ConnectathonsConnectathons
IHE IHE DemonstrationsDemonstrationsIHE IHE DemonstrationsDemonstrations
Products Products with IHEwith IHEProducts Products with IHEwith IHE
Timely access to Timely access to informationinformationTimely access to Timely access to informationinformation
Easy to integrate Easy to integrate productsproductsEasy to integrate Easy to integrate productsproducts
1212
Growth in IHE DomainsGrowth in IHE Domains
Radiology (18)
IT Infrastructure for Healthcare (17)
Cardiology (7)
Laboratory (6)
Radiation Oncology (1)
Patient Care Coordination (5)
Patient Care Devices (1)
Quality
Eye Care (3)
Veterinary
Endoscopy
Pathology
Pharmacy
IHE Global DevelopmentsIHE Global DevelopmentsIntegration Profiles (# X) – Solutions to Real-World Interoperability Integration Profiles (# X) – Solutions to Real-World Interoperability
Needs & Problems:Needs & Problems:
Within Clinical Departments e.g.:Within Clinical Departments e.g.:RadiologyRadiologyCardiologyCardiologyLabLab ......
Across Departmental &Across Departmental &Institutional Boundaries – XDSInstitutional Boundaries – XDS
RHIOsRHIOs (Regional Healthcare Information Organizations) (Regional Healthcare Information Organizations)
EHR EnablersEHR Enablers
Yea
r 1
(199
9)
Yea
r 2
(200
0)
Yea
r 3
(200
1)
Yea
r 4
(200
2)
Yea
r 5
(200
3)
Yea
r 6
(200
4)
Yea
r 7
(200
5)
Yea
r 8
(200
6)
Yea
r 9
(200
7)
1313
IHE Cardiology Profiles (9)IHE Cardiology Profiles (9)
Cath Lab WorkflowCath Lab Workflow Echocardiography WorkflowEchocardiography Workflow Retrieve ECG for DisplayRetrieve ECG for Display
Echocardiography Measurement
Patient: Doe, John Technologist: der Payd, N
Measurements:
Mitral valve diameter 3.1cm
- shown in image at [ ]
Ventricular length, diastolic 5.97 cm
- shown in image at [ ]
Ventricular volume, diastolic 14.1 ml
- inferred from [ ]
- inferred from VLZ algorithm
Evidence Documents (Measurements)Evidence Documents (Measurements)
Displayable ReportsDisplayable Reports
Cross-Enterprise Document Cross-Enterprise Document Sharing (EHR to EHR)Sharing (EHR to EHR)
Stress Testing WorkflowStress Testing Workflow Nuclear MedicineNuclear MedicineImplantable CardiacImplantable CardiacDevice ObservationDevice Observation
1414
Brigham and Women’s HospitalBrigham and Women’s Hospital
Patient infoPatient infoand ordersand orders
Philips Allura x6Philips Allura x6
Witt hemo x6Witt hemo x6
Patient info,Patient info,Order, schedule,Order, schedule,and procedure statusand procedure status
Secure Secure StorageStorage
Cath Workflow Profile:Cath Workflow Profile:
1515
Stress Echo IntegrationStress Echo Integration
Views defined; stages definedViews defined; stages definedConsistent display of different vendor stress examsConsistent display of different vendor stress exams
Toshiba AplioToshiba Aplio(or Philips or GE)(or Philips or GE)
Goodman Goodman PACS (or 5PACS (or 5other vendors)other vendors)
viewsviewsstagesstages
1616
Stress testing integrationStress testing integration
One patient; one order; one procedure across systems;One patient; one order; one procedure across systems;Consistently defined Protocols and stagesConsistently defined Protocols and stages
1717
Integration benefitsIntegration benefits
For users across the healthcare enterprise, IHE: allows faster access to information, reduces errors, streamlines workflow, simplifies interface projects, optimizes resource utilization.
Spend time with patients; not chasing information.Spend time with patients; not chasing information.
1818
Working together with JCSWorking together with JCS
How can IHE Cardiology and IHE-Japan work together more closely: Come to the IHE Interoperability Workshop at ACC.07 if you
are attending (booth #2251) Work together to understand differences in clinical workflow
Encourage additional direct involvement in the Planning
Committee Web-ex/tcon in May, 2007, to explain new Year 4 Profiles
and gain direct feedback Direct involvement in annual IHE Cardiology prioritization
process for new Profiles (usually August/September timeframe)
Bi-annual joint tcons at mutually agreed upon times
1919
More Resources - More Resources - www.ihe.netwww.ihe.net
Frequently Asked QuestionsFrequently Asked Questions
Integration Profiles in Technical Frameworks:Integration Profiles in Technical Frameworks: CardiologyCardiology IT InfrastructureIT Infrastructure LaboratoryLaboratory Patient Care CoordinationPatient Care Coordination Patient Care DevicesPatient Care Devices Radiation OncologyRadiation Oncology RadiologyRadiology
Connectathon ResultsConnectathon Results
Vendor Products Integration StatementsVendor Products Integration Statements
Participation in Committees and ConnectathonsParticipation in Committees and Connectathons
September, 2005 What IHE Delivers