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Document Sample
IHE ITI & PCC Update
to DICOM Committee
DICOM Committee–Yokohama, April 10-11, 2006
IHE IT Infrastructure Technical Committee Co-chair
Charles Parisot - GE Healthcare
September, 2005 1 What IHE Delivers
Achievements and Expanding Scope
Over 100 vendors involved world-wide, 5 Technical Frameworks
38 Integration Profiles, Testing at Connectathons
Demonstrations at major conferences world-wide
Electronic Health Record
Radiology Cardiology
15 Integration Profiles 4 Integration Profiles
IHE Patient Care
Laboratory
IT Infrastructure Coordination
5 Integration Profiles
13 Integration Profiles 1 Integration Profile
Future Patient Care
Domains Devices
Pathology Oncology
Eye Care
2
HIMSS 2006 Interoperability Showcase
More than 3,000 attendees visited the 2006 HIMSS Interoperability
Showcase.
37 vendors demonstrated 48 health information technology (IT)
systems.
700 attendees created and tracked their own electronic health record
(EHR).
63 educational sessions presented.
5 international delegations visited the interoperability showcase.
Three HIMSS 2006 keynote speakers toured the showcase.
16 clinical scenarios demonstrated interoperability across multiple
products, EHR and personal health record (PHR) systems, and care
delivery settings.
3
Interoperability Showcase Layout
4
What has been shown in the HIMSS showcase
Real-world implementations. Effective IHE interoperability
36 vendor products: EHR & Ancillary IT systems, PHR systems,
Registries, Repositories, MPIs, etc.
4 Federal entities or grantees (VA, DoD, NIST, CDC/UW)
All implementations passed IHE Connectathon tests
Scenario focused on health information exchange:
Within the enterprise (Cardiology, Radiology, etc.)
Across inpatient and physician offices care settings in a RHIO for health
status information (meds, allergies, pbs, etc.), reports, images, legacy
docs
Empowered with your own health record:
Show-wide record submission and access (11 vendor booths)
“HIMSS RHIO” Infrastructure: secured access and communications,
distributed repositories, document registries, patient Id X-referencing
5
HIMSS IHE Interoperability Showcase
February 2006 Participants
Leadership Level Implementer Level
Allscripts HX Technologies
Blue Ware Canon INFINITT Technology
Cerner CapMed Kryptiq
GE Healthcare +IDX Cardiac Science McKesson
CGI-AMS MedAccess Plus
IBM CompassCare Medical Informatics
Initiate Systems CPSI MediNotes
InterSystems Dictaphone MNI
DR Systems National Institute of Sci & Tech
MiSys Healthcare
Eastman Kodak NextGen Healthcare
Quovadx Eclipsys Philips Medical
Siemens Epic Systems ScImage
HIPAAT Witt Biomedical
Supporter Level: Organizational participant: DMP–French Natl. Personal EHR
Dairyland Medkey Health Level 7 HTP IEEE
Acuo American Coll. of Clinical Eng.
EMC Motion Comp. Midmark Diagostics Group
Bond Catholic Healthcare West
Identrus Picis HIMSS RHIO Federation
Carefx US Dept of Defense
Intel Pulse Liberty Alliance
Clearcube US Dept of Veterans Affairs
Mediserve Sentillion Univ. of Washington
HIMSS 06 IHE Interoperability Showcase
Distributed Demonstration Vendor Participants
Allscripts McKesson
CapMed Medical Informatics
CGI-AMS MediNotes
Eclipsys Misys Healthcare
GE Healthcare +IDX Siemens
InterSystems
7
IHE Integration Profiles for Health Info Nets
What is available and has been added in 2005 and is for 2006
Emergency Referrals
Patient Created Summaries
Format of the Document Content Patient Demographics
ECG Report Document
and associated coded vocabulary
Format of the Document Content Cross-enterprise User Query
and associated coded vocabulary
Lab Results Document Authentication
Format of the Document Content Authentication & Auditing:
Content
Scanned Documents
and associated coded vocabulary Patient Identifier
V3
Format of the Document Content Enhanced Access Control
Imaging Information Cross-referencing
Format of the Documentvocabulary
and associated coded Content Option
Medical Summary Map patient identifiers across
Format of the Document Content Document Digital independent identification
and(associated coded vocabulary
Meds, Allergies, Pbs)
Signature domains
Format of the Document Content
Attesting “true-copy and origin
and associated coded vocabulary
Request Form
for Data Capture
Cross-Enterprise Audit Trail & Node External form with custom
Authentication import/export scripting
Document Sharing
Registration, distribution and access Centralized privacy audit trail
XDS/RLS Stored
across health enterprises of clinical and node to node authentication
to create a secured domain.
documents forming a patient
Federation Queries
electronic health record Notification of
Document Availability
Cross-enterprise Consistent Time Notification of a remote
Document Interchange Coordinate time across provider/ health enterprise
Media-CD/USB & e-mail push networked systems
8
Federation of XDS and non-XDS Domains
Leverage Connecting for Health RLS – 2006-2007 Development
Cross-state IDN State RHIO
Cancer Treatment XDS Affinity Domain (NHIN sub-network)
A87631
Patie
M8354673993 A87631
Patie
M8354673993
M8354673993
nt 14355 M8354673993
nt 14355
Registry
L-716
L-716Identi A87631 L-716
L-716Identi A87631
Affinity Domain Patient
ty Affinity Domain Patient
ty
EHR System Identity Source EHR System Identity Source
XRef
M8354673993 XRef
M8354673993
ED ED
Mgr Mgr
Applica Applica
tion tion
Locator service
A87631
Patie
M8354673993 PAC A87631
Patie
M8354673993 A87631
Patie
M8354673993 PAC
M8354673993
nt 14355 Patient A87631 M8354673993
nt 14355 M8354673993
nt 14355 Patient A87631
L-716 S L-716 S
L-716
L-716Identi A87631 Identity L-716
L-716Identi A87631 L-716
L-716Identi A87631 Identity
Affinity Domain Patient
ty Feed PIX Query Affinity Domain Patient
ty Affinity Domain Patient
ty Feed PIX Query
EHR System Identity Source EHR System Identity Source EHR System Identity Source
XRef
M8354673993 EHR System XRef
M8354673993 XRef
M8354673993 EHR System
PAC ED ED ED
PAC
Mgr Mgr A87631
Patie
M8354673993 Mgr
PAC
S Applica
Lab Applica PAC
S Applica Lab
M8354673993
nt 14355
S tionInfo. tion S tion Info.
L-716
L-716IdentiA87631
A87631
Patie
M8354673993 PAC Sys PAC Affinity Domain Patient PAC Sys
M8354673993 Patient A87631 Patient A87631 ty Patient A87631
nt 14355 L-716 S tem L-716 S EHR System Identity Source L-716 S tem
L-716
L-716Identi A87631 Identity Identity XRef
M8354673993 Identity
ED
Affinity Domain Patient
ty Feed PIX Query Feed PIX Query Mgr
Applica Feed PIX Query
EHR System Identity Source
XRef
M8354673993 EHR System
XDS Affinity Domain (NHIN sub-network) EHR System tion EHR System Affinity Domain (NHIN sub-network)
XDS
EDPAC PAC PAC
Mgr PAC A87631
Patie
M8354673993
PAC
Applica
S Lab PAC
S Lab Patient PAC
S Lab
L-716 A87631 M8354673993
nt 14355
tionS Info. S Info. S S Info.
Identity L-716
L-716Identi A87631
XDS Affinity Domain (NHIN sub-network)
PAC Sys XDS Affinity Domain (NHIN sub-network)
Sys Feed PIX Query Affinity Domain (NHIN sub-network)
XDS Sys Affinity Domain Patient
ty
Patient A87631 tem tem tem EHR System Identity Source
L-716 S EHR System XRef
M8354673993
Identity PAC ED
Feed PIX Query PAC
S Lab
XDS Affinity Domain (NHIN sub-network) Mgr
Applica
EHR System XDS Affinity Domain (NHIN sub-network) XDS Affinity Domain (NHIN sub-network) S Info. XDS Affinity Domain (NHIN sub-network) tion
PAC
PAC Sys PAC
S Lab Patient A87631
S tem L-716 S
Info. Identity
Sys Feed PIX Query
tem EHR System
XDS Affinity Domain (NHIN sub-network)
PAC
PAC
S Lab
XDS Affinity Domain (NHIN sub-network) S Info.
NHIN
Sys
Registry Registry tem
XDS Affinity Domain (NHIN sub-network)
Locator service Locator service
Backbone
Which regisry holds
State RHIO Registry
Locator service
records for a patient ?
Sub-Network Patient Identity XRef Mgr
Sub-Network Patient Identity XRef Mgr
Sub-Network Patient Identity XRef Mgr
Sub-Network
A87631 A87631 A87631
M8354673993 M8354673993 M8354673993
M8354673993 14355 M8354673993 14355 M8354673993 14355
L-716 L-716 A87631 L-716 L-716 A87631 L-716 L-716 A87631
EHR System Affinity Domain Patient EHR System Affinity Domain Patient EHR System Affinity Domain Patient
Identity Source Identity Source Identity Source
Physician M8354673993 ED Application Physician M8354673993 ED Application Physician M8354673993 ED Application
Office Office Office
Patient
Identity
Feed
L-716
XDS
Docu
ment
Repo
Docu
ment
Regi
stry
PACS
A87631
Patient
Identity
Feed
L-716
XDS
Docu
ment
Repo
Docu
ment
Regi
stry
PACS
A87631
Patient
Identity
Feed
L-716
XDS
Docu
ment
Repo
Docu
ment
Regi
stry
PACS
A87631
Integrated
Delivery
sitor sitor sitor
y XDS y XDS y XDS
PIX Query Docu PIX Query Docu PIX Query Docu
ment EHR System ment EHR System ment EHR System
Repo Repo Repo
PACS PACS PACS
sitor sitor sitor
PACS y PACS y PACS y
Lab Info. Lab Info. Lab Info.
System System System
Network
Teaching Teaching Teaching
Community Hospital Community Hospital Community Hospital
Clinic Clinic Clinic
ATNA ATNA ATNA
Audit CT Time server Audit CT Time server Audit CT Time server
record record record
reposito reposito reposito
ry ry ry
XDS Affinity Domain (NHIN sub-network) XDS Affinity Domain (NHIN sub-network) XDS Affinity Domain (NHIN sub-network) XDS Affinity Domain (NHIN sub-network)
9
Cross-Enterprise Sharing of Medical Summaries
(XDS-MS)
Patient Examination Discharge or Referral
or Discharge Document Created Referred Physician
Notification
EMR
Document
EMR Registry
Review of
Report Repository Medical Summary
Medical
Summary
The Cross-Enterprise Sharing of Medical Summaries Integration
Profile solves the problem of transferring summary patient
information between providers in different clinical settings.
10
XDS-MS Medical Summary
Structured and Coded Header
Patient, Author, Authenticator, Institution,
Level 1 Header always structured and coded
Time of Service, etc.
St r u c t u r ed Co n t en t w i t h c o d ed s ec t i o n s :
Level 2
Reason for Referral Title-coded sections with non-structured
nor coded content (text, lists, tables).
Vital Signs Simple Viewing (XML Style sheet)
Medication
Text Structure Coded Section Level 3 Med, Problems and Allergies
Entry Entry required as highly structured
text. Text easy to import/parse
Studies
Allergies
Level 3 Med Problems and
Text Structure Coded Section Allergies have a required
Entry Entry
fine-grain structure with
Social History optional coding. Coding
Scheme not standardized,
Problems
but explicitly identified.
Text Structure Coded Section
Entry Entry XDS-MS enables both semantical
Care Plan interoperability and simple viewing !
11
Use of a shared XDS infrastructure to access
Radiology Reports and Images (XDS-I)
Between Radiology and :
• Imaging specialists Hospital
• Non-imaging clinicians PACS Y
Radiology -to-
Radiology
Radiology -to-
Physicians
PACS Z
Imaging Center
Physician Practice
Same XDS Infrastructure (Registry and Repositories)
for medical summaries and imaging information !
Demo at HIMSS Feb. 2006 and RSNA Dec. 2006
12
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