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September, 2005 What IHE Delivers
Andrew M. Keller, MD, FACC, FASEAndrew M. Keller, MD, FACC, 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
Scientific Sessions.Scientific Sessions.
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.
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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
Goal: optimal patient careGoal: optimal patient care
To attain optimal patient care, we need clinical To attain optimal patient care, we need clinical informationinformation When we need it Wherever we need it In a meaningful manner Without repeating tests (time and money) Originating from many different locations Cardiology data is especially complex
Proper integration of clinical information means Proper integration of clinical information means better patient care.better patient care.
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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?
Instead, use 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 comes inIHE comes in
A consortium of professional societies and vendors to facilitate the integration of healthcare information 1997: IHE founded by RSNA 1998: Becomes global project in radiology 1999: Moves beyond radiology 2003: IHE Cardiology formed with ACC/ESC 2007: IHE Cardiology is excited to join with JCS and
become a truly global organization
1212
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
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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)
1515
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
1616
Cath Lab Integration Cath Lab Integration
One patient; one order; one procedure; consistent time stampsOne patient; one order; one procedure; consistent time stamps
Procedure LogProcedure Log
1717
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
1818
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
1919
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.
2020
Working together with JCSWorking together with JCS
How can IHE Cardiology North America, Europe, and Japan work together more closely: Understand differences in clinical workflow Japan 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 voting process for new Profiles
(usually August/September timeframe) Bi-annual joint tcons at mutually agreed upon times
2121
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