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Transcript of September, 2005What IHE Delivers 1 IHE for Product Planners Ellie Avraham - Carestream Health...
1September, 2005 What IHE Delivers
IHE for Product PlannersIHE for Product Planners
Ellie AvrahamEllie Avraham - - Carestream HealthCarestream Health
Co-Chair IHE Radiology, Technical CommitteeCo-Chair IHE Radiology, Technical Committee
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Learning ObjectivesLearning ObjectivesClinical and Economic benefitsClinical and Economic benefits of Integration for your of Integration for your customers – customers – IHE RadiologyIHE Radiology Users HandbookUsers Handbook
Improve Product FunctionalityImprove Product Functionality by using the by using the IHEIHE Technical Technical FrameworkFramework
Improve Integrated System Solutions WorkflowsImprove Integrated System Solutions Workflows by using by using IHE IHE Integration ProfilesIntegration Profiles
IHE Success storiesIHE Success stories and other information to refine the and other information to refine the Products “Business case”Products “Business case” evaluation evaluation
IHE ProcessIHE Process to Synchronize it with the Product Planning & to Synchronize it with the Product Planning & DevelopmentDevelopment
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Discussion AreasDiscussion Areas
IHE Deployment ProcessIHE Deployment Process
IHE Integration Profiles IHE Integration Profiles
The Value Proposition from Planning Products and The Value Proposition from Planning Products and Integrated Solutions using IHEIntegrated Solutions using IHE
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Integration Solutions Available Today fromIntegration Solutions Available Today fromSeveral Medical Systems Vendors – Several Medical Systems Vendors – BUTBUT ... ...
Modern Healthcare Enterprises AreModern Healthcare Enterprises AreStill Confronted with Problems:Still Confronted with Problems:((In Spite of IT Standards and Advanced Technology)In Spite of IT Standards and Advanced Technology)
Lack of Access to Complete Medical InformationLack of Access to Complete Medical Information Inconsistent or Redundant Medical InformationInconsistent or Redundant Medical Information
Across Departments and InstitutionsAcross Departments and Institutions Inadequate Communicating of Medical DataInadequate Communicating of Medical Data
Across Multiple Systems from Different VendorsAcross Multiple Systems from Different Vendors Risky Investments in Risky Investments in Proprietary SolutionsProprietary Solutions Clinical Workflows are not OptimizedClinical Workflows are not Optimized
Challenges of Integration
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Prof. Societies Sponsorship
Healthcare Providers & Vendors
Healthcare IT Standards HL7, DICOM, etc.
General IT Standards Internet, ISO, etc.
Interoperable Healthcare IT Solution Specifications
IHE Integration Profile Interoperable Healthcare IT
Solution Specifications IHE Integration Profile
Interoperable Healthcare IT Solution Specifications
IHE Integration Profile Interoperable Healthcare IT
Solution Specifications IHE Integration Profile
IHE Process
IHE drives healthcare standards based-integrationIHE drives healthcare standards based-integration
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IHEIHE Process Process - Annual Cycle- Annual Cycle
IHEIntegrationProfiles B
IHEIntegrationProfile A
Easy toIntegrateProducts
IHEConnectathon
ProductWith IHE
IHEDemonstration
User Site
RFPRFP
Standards
IHETechnical
Framework
Product IHE IntegrationProduct IHE IntegrationStatementStatement
IHE IHE ConnectathonConnectathonResultsResults
IHE Technical Framework – IHE Technical Framework – DefinDefine Standard Integration Solutionse Standard Integration Solutions
IHE Connectathon Results – Most implemented and tested IHE SolutionsIHE Connectathon Results – Most implemented and tested IHE Solutions
IHE Integration Statements – Most Comertialized IHE SolutionsIHE Integration Statements – Most Comertialized IHE Solutions
IHE Success Story – Most Successful Used IHE SolutionsIHE Success Story – Most Successful Used IHE Solutions
IHE Users Handbook – IHE Solutions, Economical and Clinical benefitsIHE Users Handbook – IHE Solutions, Economical and Clinical benefits
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IHE Calendar Annual Events for IHE Calendar Annual Events for Synchronization with Product PlanningSynchronization with Product Planning
Feb. 2007 – IHE Supplements Profiles for Public CommentFeb. 2007 – IHE Supplements Profiles for Public Comment
May – IHE Supplements Profiles for Trial ImplementationMay – IHE Supplements Profiles for Trial Implementation
Aug. – IHE Participation WorkshopAug. – IHE Participation Workshop
Sept. – IHE Participation Registration: Sept. – IHE Participation Registration: Connectathon & DemosConnectathon & Demos
Oct. - IHE Vendor Workshop for the ConnectathonOct. - IHE Vendor Workshop for the Connectathon
Oct. – Dec. IHE MESA Testing Validations for Oct. – Dec. IHE MESA Testing Validations for ConnectathonConnectathon
Nov. - RSNA – IHE Radiology DemoNov. - RSNA – IHE Radiology Demo
Jan. 2008 – IHE ConnectathonJan. 2008 – IHE Connectathon
Feb. 2008 – HIMSS IHE ITI DemoFeb. 2008 – HIMSS IHE ITI Demo
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Using IHE for Product Planning
IHE Aid for Global / IHE Aid for Global / International Product PlanningInternational Product Planning IHE Technical FrameworkIHE Technical Framework (TF) (TF)
> Vol 1: Defines Global Integration Profiles> Vol 1: Defines Global Integration Profiles
> Vol 2,3: Defines the TF Transactions details for Development> Vol 2,3: Defines the TF Transactions details for Development
> Vol 4: Defines the Local National specialization details> Vol 4: Defines the Local National specialization details
IHE Connectathon ResultsIHE Connectathon Results – Learn what IHE solutions are – Learn what IHE solutions are developeddeveloped
IHE User Success Stories & IHE Users HandbookIHE User Success Stories & IHE Users Handbook – Learn the – Learn the Clinical and Economic benefits of using products with IHE capabilitiesClinical and Economic benefits of using products with IHE capabilities
IHE Integration StatementsIHE Integration Statements – The Commercialized products with IHE – The Commercialized products with IHE capabilitiescapabilities
RFP’s from customersRFP’s from customers
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IHE Connectathon Results http://www.ihe.net/Events/connectathon_results.cfm
Consolidated Earlier Progress &Consolidated Earlier Progress &Push for Market AdoptionPush for Market Adoption
More Robust ConnectathonMore Robust Connectathon Results Recorded and PublishedResults Recorded and Published
Increased Industry ParticipationIncreased Industry Participation 31 companies31 companies 70 systems70 systems 21 Additional Companies in21 Additional Companies in
IHE EuropeIHE Europe
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IHE User Success Story http://www.ihe.net/resources/user_success_stories.cfm
•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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Deployment of IHE Profiles – Most Used:Deployment of IHE Profiles – Most Used:- Scheduled Workflow (SWF)- Scheduled Workflow (SWF)
- Patient Information Reconciliation (PIR)- Patient Information Reconciliation (PIR)
- Consistent Presentation of Images (CPI)- Consistent Presentation of Images (CPI)
- Reporting Workflow (RWF)- Reporting Workflow (RWF)
- Basic Security for HIPAA regulations (ATNA)- Basic Security for HIPAA regulations (ATNA)
Clinical and Economics AccomplishmentsClinical and Economics Accomplishments
- - Improve the Patient CareImprove the Patient Care – Improved data accuracy and Safety, Image – Improved data accuracy and Safety, Image Quality & Consistency and time saving due to optimized Workflows and Quality & Consistency and time saving due to optimized Workflows and integrated systemsintegrated systems
- - Improve the clinical practice productivityImprove the clinical practice productivity - - reduced manual data reduced manual data entry using the ADT registration in one place and propagate it to all the other entry using the ADT registration in one place and propagate it to all the other systems (PACS, RIS Modality) and reduced errors. systems (PACS, RIS Modality) and reduced errors.
- - Optimize the Radiological WorkflowOptimize the Radiological Workflow (SWF) (SWF) Reduced the incorrectly or lost studies, using DICOM MWL, MPPSReduced the incorrectly or lost studies, using DICOM MWL, MPPS
IHE User Success Story & HandbookIHE User Success Story & Handbook
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IHE Integration Statement http://www.ihe.net/resources/ihe_integration_statements.cfmIHE 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
13
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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IHE Technical FrameworkIHE Technical FrameworkOrganized in sections that provide an Organized in sections that provide an
increasing level of detailincreasing level of detail
Integration ProfilesIntegration Profiles:: Defines a Problem and the Solution in terms of Actors and communication in terms of Actors and communication transactionstransactionsActorsActors:: Identify specific kinds of operational Identify specific kinds of operational participants in the healthcare enterprise.participants in the healthcare enterprise.
IHE FoundationIHE Foundationhttp://www.ihe.net/Technical_Framework/index.cfm
TransactionsTransactions: : Describe particular interactions Describe particular interactions between actors to perform between actors to perform specific operationsspecific operations..
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IHE Radiology Integration ProfilesIHE Radiology Integration Profiles
Patient Info.
Recon-ciliation
Access to Radiology Information
Consistent Presentation
ofImages
Audit Trail & Node Authentication - Radiology Option
EvidenceDocs
KeyImageNotes
Simple Image & Numeric Reports
Presentation of
Grouped Procedures
Post-
Processing Workflow
Reporting Workflow
Charge Posting
XDS for Imaging
NMImage
Scheduled Workflow
Teaching Files &
Clinical Trials Export
Portable Data for Imaging
NMImage
Cardiac NM Option
ImageFusion
ImageFusion
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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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Patient Information ReconciliationPatient Information Reconciliation
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Consistent Presentation of ImagesConsistent Presentation of Images
Reporting RadiologistReferring Physician orReviewing 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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Radiology Option for Audit Trail and Node Radiology Option for Audit Trail and Node Authentication (ATNA)Authentication (ATNA)
System A System B
Secured SystemSecure network
• TLS authentication of remote node (digital certificates)• with/without encryption
Secured System
• Audit PHI trail with:• Real-time access • Time synchronization
Central Audit TrailRepository
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MODALITY
Presentation of Grouped Procedures ProfilePresentation of Grouped Procedures Profile
Requested 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
21
Portable Data for Imaging Portable Data for Imaging (PDI)(PDI)
Distribute Imaging Information Distribute Imaging Information on Mediaon Media
CDCreator
Printer
Image/ Report Display
Media Importer
John Doe
CD
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Document Consumer
Retrieve Document
Query Documents
Patient Identity Source
Patient Identity Feed
Document Source
Document Registry
Document Repository
Provide & Register Document Set
Register Document Set
Cross-enterprise Document Cross-enterprise Document Sharing for Imaging (XDS- I)Sharing for Imaging (XDS- I)
Image ManagerImage Archive
Retrieve Images
Retrieve Presentation StatesRetrieve Key Image NoteRetrieve Evidence DocumentsWADO Retrieve
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RadiologistRadiologistFlags Images:Flags Images:
Referring PhysicianReferring PhysicianSees Key Images First:Sees Key Images First:
for refering physicianThis image showsthe renal rupture.
Note1
for refering physicianThis image has the hematoma.
Note2
For referringphysician:This image showsthe renal rupture.
Note1
For referring physician:This image hasthe hematoma.
Note2
for refering physicianThis image showsthe renal rupture.
Note1
for refering physicianThis image has the hematoma.
Note2
Study & Key Image Notes
Key Image Notes ProfileKey Image Notes Profile
24
Charge Posting ProfileCharge Posting Profile
ChargeChargePosterPoster
*Billing System
CAD*Workstation
ReportRepository……
Report Generated / Signed
CADPerformed
PostCharges
AcquisitionModality
ADT Terminal
3-D*Workstation
Account Management
3-DPerformed
StudyPerformed
/ MaterialsUsed
25
IHE Reporting WorkflowIHE Reporting Workflow
ReportingReportingWorklistWorklist
Work ItemWork ItemClaimedClaimed
Retrieve Images &Retrieve Images &Evidence DocumentsEvidence Documents
MeasurementsCAD Reports…………………
ReportingProcedure Step
STARTED
ReportingProcedure Step
STARTED
StoreStoreReportsReports
ReportingProcedure Step
COMPLETED
ReportingProcedure Step
COMPLETED
ReportManager
RIS
ImageManager/Archive
PACS & Archive
Report Reader/Creator
26
IHE Value PropositionIHE Value Proposition• Product PlanningProduct Planning
• IHE Solutions are Driven by Strategic Healthcare Lead IHE Solutions are Driven by Strategic Healthcare Lead UsersUsers that that collaboratecollaborate with Healthcare with Healthcare VendorsVendors
• IHE Solutions are IHE Solutions are Generic, Reusable and InteroperableGeneric, Reusable and Interoperable based on Healthcare based on Healthcare StandardsStandards: : DICOM, HL7, RFCDICOM, HL7, RFC
• IHE Solutions IHE Solutions Optimize the Clinical WorkflowsOptimize the Clinical Workflows
• IHE Deployment process – Connectathon, Integration IHE Deployment process – Connectathon, Integration Statements and Users Success Stories information helps to Statements and Users Success Stories information helps to refinerefine the product “ the product “Business CaseBusiness Case””
• IHE Technical Framework specification describes the IHE Technical Framework specification describes the Global IHE solutionsGlobal IHE solutions at a High Level for Planning & at a High Level for Planning & Marketing and in details for products Architects and Marketing and in details for products Architects and Engineering developmentEngineering development
27
IHE BenefitsIHE Benefits • Clinical UsersClinical Users
• Greater access to consistent informationGreater access to consistent information• Fewer errors, fewer tedious tasksFewer errors, fewer tedious tasks
• AdministratorsAdministrators• Increased throughput - Better scheduling Increased throughput - Better scheduling • Reduce CostReduce Cost
• BuyersBuyers• Specify/purchase RFP’s integration capabilities Specify/purchase RFP’s integration capabilities
easily and Freedom to acquire “Best of Breed” easily and Freedom to acquire “Best of Breed” systems systems
• IT ProfessionalsIT Professionals• Faster, more predictable integration projectsFaster, more predictable integration projects• Facilitate cooperation of competing vendorsFacilitate cooperation of competing vendors
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Picking IHE ProfilesPicking IHE Profiles
Customer RFP’sCustomer RFP’s
Product positioning in the market with a Good Business Product positioning in the market with a Good Business Case – Selecting IHE ProfilesCase – Selecting IHE Profiles
IHE Technical Framework Volume 1, Users HandbookIHE Technical Framework Volume 1, Users Handbook
Healthcare Institution Needs: Healthcare Institution Needs:
> Optimized Clinical Workflow : > Optimized Clinical Workflow : SWF, PIR, RWFSWF, PIR, RWF
> Improve the Patient Health Care: > Improve the Patient Health Care: SWF, PIR, CPI, PGP,KINSWF, PIR, CPI, PGP,KIN
> Economy - Reduce Healthcare cost: > Economy - Reduce Healthcare cost: SWF, CHGSWF, CHG
> Protect the Patient Health Information: > Protect the Patient Health Information: SECSECP
atie
nt In
form
atio
n R
econ
cilia
tion
Access to Radiology Information
Consistent Presentation
of Images
Basic Security
Evidence Documents
Key Image Notes
Simple Image and Numeric
Reports
Presentation of Grouped Procedures
Post-Processing Workflow
Reporting Workflow
Charge Posting
Scheduled Workflow
Pat
ient
Info
rma
tion
Rec
onci
liatio
n
Access to Radiology Information
Consistent Presentation
of Images
Basic Security
Evidence Documents
Key Image Notes
Simple Image and Numeric
Reports
Presentation of Grouped Procedures
Post-Processing Workflow
Reporting Workflow
Charge Posting
Scheduled Workflow
Pat
ient
Info
rma
tion
Rec
onci
liatio
n P
atie
nt In
form
atio
n R
econ
cilia
tion
Access to Radiology InformationAccess to Radiology Information
Consistent Presentation
of Images
Consistent Presentation
of Images
Basic SecurityBasic Security
Evidence DocumentsEvidence
DocumentsKey Image
NotesKey Image
Notes
Simple Image and Numeric
Reports
Simple Image and Numeric
Reports
Presentation of Grouped Procedures
Presentation of Grouped Procedures
Post-Processing Workflow
Post-Processing Workflow
Reporting WorkflowReporting Workflow
Charge PostingCharge Posting
Scheduled WorkflowScheduled Workflow
ConsiderationsConsiderations
29
IHE for Product PlanersIHE for Product Planers
Questions?Questions?IHE North America:IHE North America: RSNA - RSNA - http:// http:// www.ihe.netwww.ihe.net
HIMSS -HIMSS - http://www.himss.org/IHE http://www.himss.org/IHE
ACC - ACC - http://www.acc.org/quality/ihe/ihe.htmhttp://www.acc.org/quality/ihe/ihe.htm
IHE Europe:IHE Europe: http://www.IHE-Europe.orghttp://www.IHE-Europe.org
IHE France:IHE France: http://www.gmsih.fr/fr/som_comm.htmhttp://www.gmsih.fr/fr/som_comm.htm
IHE Germany:IHE Germany: http://www.IHE-D.orghttp://www.IHE-D.org
IHE Italy:IHE Italy: http://www.rad.unipd.it/IHEhttp://www.rad.unipd.it/IHE
IHE UK:IHE UK: http://www.IHE-UK-orghttp://www.IHE-UK-org
IHE Japan:IHE Japan: http://www.jira-net.or.jp/ihe-j/en/index.htmlhttp://www.jira-net.or.jp/ihe-j/en/index.html
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