Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise
How to Purchase IHE Conformant Systems
John PaganiniGuardian Healthcare
IHE-Europe Workshop 2005
TELEMEDICINE SYSTEMSpecialists outside the OR consult and control the surgical robot.
IN-ROOM NETWORKTouchscreen runs all equipment, reconfigures the setup, shifting new equipment into place.
SURGICAL ROBOTProvides better precision, increasing dexterity, filtering out hand tremors, and allowing for the smallest of incisions.
ENDOSCOPIC CAMERAFully digital endoscopic camera, crunches 1.14 billion calculations per second.
HOSPITAL-WIDE NETWORKDoctors get hospital data (like patient test results and medication lists) and send it to any monitor in the room.
Copyright © 1994-2002 Wired Digital, Inc. All rights reserved.
Dr. RobotoDr. Roboto
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Improve the efficiency and effectiveness of clinical practice:
Improve Workflow Improve Information Accuracy Improve Information AvailabilityEnable Cross-System Functionality
IHE Integration IHE Integration GoalsGoals
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ConsiderationsConsiderations
Cost - Look at whole pictureFlexibility - Integratable, ScalableFunctionality - Standard, customizable Implementability - Mature, ComplexityStability - Revenue, Market SegmentUsability - Hides complexity,Productive
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What are our goals? What are the steps and investments needed What are the critical IT capabilities needed to
achieve our goals? How will we measure whether we have achieved
our goals? How much of an improvement are we seeking?
Integration Questions Integration Questions WorthyWorthy of Asking… of Asking…
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What Does IHE What Does IHE Provide?Provide?
Without IHE, A Gap Exists – Between The Standards That Make
Interoperability Possible And Actual Implementation.
– Standards Compliance Does Not Mean Interoperability
IHE Bridges The Gap – Reliable Method To Acquire or Upgrade Systems – Sufficient To Achieve Truly Efficient
Interoperability.
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IHE IHE Technical ApproachTechnical ApproachIdentify the transactions required to
integrate information flow between information systems
For each transaction, select a single standard for use in implementing the transaction
Specify in detail the use of the standard in implementing the transaction
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What is IHE?What is IHE?
IHE is a specification of transactions between systems.
IHE describes only integration features.
IHE is not a product itself, but…
IHE is very useful in purchasing products that integrate into workflow
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Integration ProfilesIntegration Profiles--Solutions Packaged For Solutions Packaged For
PurchasingPurchasing--
Easy-to-understand, coherent, functional sets and
a convenient way for users and vendors to communicate precisely
about integration requirements and required functionality in products.
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Using Using Integration ProfilesIntegration Profiles in in ProcurementProcurement
IHE specifies Integration Profiles which reflect typical Healthcare workflow models
Step 1: Identify the Integration Profiles which satisfy your Customer’s needs
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Using Using ActorsActors in Procurement in Procurement
IHE identifies the transactions for each actor required to make integration work.
Specifying the integration profile and the actor implies support of the transactions.
Step 2: For each Integration Profile, identify which actors need to be implemented by each product
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Using Using TransactionsTransactions in in ProcurementProcurement
For clarity, you may want to specify the transactions individually.
Step 3: Optionally, For each actor specified, identify the transactions needed to be implemented by each product
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A PACS ExampleA PACS Example One company might implement a PACS to
include:– Image Manager + Image Archive + Performed
Procedure Step Manager + Image Display + Print Composer + Report Creator + Report Manager + Report Repository + Report Reader
Another vendor might implement a PACS to include only:– Image Manager + Image Archive + Performed
Procedure Step Manager + Image Display
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Integration Profiles and Integration Profiles and Transactions for an RISTransactions for an RIS
Integration Profile: Scheduled Workflow Actors: Order Filler and Performed Procedure
Step Manager Required Transactions:
– 1, 2, 3, 4, 5, 6, 7, 11, 12, 20, and 21 Note: Each actor has different requirements
in each Integration Profile. Profiles are easier to specify than
transactions, and they guarantee integration.
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Shall-language ExamplesShall-language Examples
The product shall implement the following IHE actors: …
The actors required above shall support the following IHE Integration Profiles: …
The upgrade shall meet the requirements of the IHE Technical Framework for the following IHE actors … and the following IHE Transactions: …
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Example: New ModalityExample: New Modality
Print Composer
Capability Actor Integration ProfileAcquisition Modality Scheduled Workflow/Patient Reconciliation
Presentation of Grouped Procedures
Consistent Presentation of Images
Key Image Note
Consistent Presentation of Images
Report Creator Simple Image and Numeric Report
Required
Required
Required
Required
Required
Required
Ultrasound Imaging SystemThe product shall meet the requirements of the IHE Technical Framework, Version 4.7, for the integration profiles and the actors, as specified in the following table:
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ConnectathonConnectathonQuestionsQuestions
Do you know what the IHE Connectathon is?
Has this product been tested at the IHE Connectathon?
What actors and IHE Integration Profiles were tested on this product at the IHE Connectathon?
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Key QuestionsKey Questionsfor Vendorsfor Vendors
What IHE actors does this product implement?
What IHE Integration Profiles does each actor in this product support?
Is support for these actors and IHE Integration Profiles included in the released software for this product?
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IHE Integration StatementIHE Integration Statement
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Vendor IHE ClaimsVendor IHE Claims
Product X supports the IHE Y Integration Profile as the IHE a, b, and c Actors.
Use IHE Integration Profiles when writing RFPs and purchasing specifications
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Level 0: Level 0: Modalities connected to Modalities connected to printerprinter
No RIS integrationNo RIS integration
Laser Printer
DICOM Basic Print Service
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Level 1: Level 1: Modalities connected to Modalities connected to printerprinter
No RIS integrationNo RIS integrationPost-processing workstationsPost-processing workstations
Laser Printer
IHE Integration Profile:Consistent Presentationof Images
Sameperception??
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Level 2: Modalities with RIS ConnectionLevel 2: Modalities with RIS Connection
IHE Integration Profile:Scheduled Workflow
(DICOM Modality Worklist)
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Level 3:Level 3: Modalities with RIS Modalities with RIS ConnectionConnection
PACSPACS
IHE Integration Profiles:•Scheduled Workflow (full)•Patient Information Reconciliation•Presentation of Grouped Procedures•Access to Radiology Information
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Level 4:Level 4: More than images: More than images: Measurements, Key images, CAD Measurements, Key images, CAD
objectsobjects
IHE Integration Profiles:•Key Image Note•Evidence Documents•Post-processing workflow
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Level 5: Reporting and billingLevel 5: Reporting and billing
IHE Integration Profiles:•Simple Image and Numeric Report•Reporting Workflow•Charge Posting
HIS
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Summary & ConclusionSummary & Conclusion
IHE Should Be Part Of The Proposed SolutionDevelop A Well-planned Integration Strategy IHE Integration Delivers Value When It Is
Managed To Deliver Value And ROI IHE Benefits Users, Providers And Vendors