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IHE_domain_overview

VIEWS: 21 PAGES: 27

									IHE Radiology


           Kevin O’Donnell
         Toshiba Medical Systems
  Co-chair, IHE Radiology Planning Cmte.
                           IHE Radiology
                            Achievements
Status:
• Now finishing 7th year
   – Robust Vendor Participation at Connectathons
   – IHE Profiles appearing in User Purchasing Processes

• Have addressed basic workflows
   – Acquisition, Post-Processing, Reporting, Routing Teaching Files/Clinical
     Trials

• Have addressed imaging content handling
   – Measurements, CAD Results, NM, Presentation States, Reports,
     Key Image Notes

• Have addressed distribution of imaging info
   – on CDs, to EHRs, keeping Audit Trails

   June 28-29, 2005                    2                 Interoperability Strategy Workshop
                        IHE Radiology
                   Current Activities/Direction
• Facilitate deployment of IHE Profiles in the
  Market
     – Users Handbook (2005 Edition)
     – Considering more depth to Connectathon tests

• Start addressing integration and workflow
  spanning departments/enterprises/regions
     – XDS-I

• Expand support for specialties
     – Address Mammography
     – Support Radiation Oncology Domain

June 28-29, 2005                3            Interoperability Strategy Workshop
IHE Radiation Oncology

            Bruce Curran
       University of Michigan
Co-chair, IHE-RO Technical Committee
                   IHE-RO
                           INTEGRATING THE HEALTHCARE ENTERPRISE (IHE) –
                                   RADIATION ONCOLOGY (RO)


                         Participants in IHE-RO
                                                                  International Atomic Energy
                                                                   Agency (IAEA)
                         Advanced Technology Consortium
                                                                  Impac
                           (ATC)
                                                                  Japanese Society for
                         American Association of Physicists
                                                                   Therapeutic Radiology and
                           in Medicine (AAPM)
                         American College of Radiology             Oncology (JASTRO)

                           (ACR)                                  Miranda Solutions

                         American Society for Therapeutic         National Cancer Institute
                           Radiology and Oncology (ASTRO)          (NCI)
                         Association of Radiation                 National Electrical
                           Oncologists of India (AROI)             Manufacturers Association
                         Canadian Association of Radiation         (NEMA)
                           Oncologists (CARO)                     Nucletron
                         Chinese Society of Radiation             Philips
                           Oncologists (CSRO)                     Tomotherapy
                         CMS                                      Radiological Society of North
                         Egyptian Cancer Society – Radiation       America (RSNA)
                           Oncology                               Siemens
                         Elekta                                   Varian
                         European Society for Therapeutic
                           Radiology and Oncology (ESTRO)




June 28-29, 2005     5                                   Interoperability Strategy Workshop
                   IHE-RO
                         INTEGRATING THE HEALTHCARE ENTERPRISE (IHE) –
                                 RADIATION ONCOLOGY (RO)


                      Participants in IHE-RO
                                                                 International Atomic Energy
                                                                  Agency (IAEA)
                      Advanced Technology Consortium
                                                                 Impac
                         (ATC)
                                                                 Japanese Society for
                      American Association of Physicists
                                                                  Therapeutic Radiology and
                         in Medicine (AAPM)
                      American College of Radiology               Oncology (JASTRO)

                         (ACR)                                   Miranda Solutions

                      American Society for Therapeutic           National Cancer Institute
                         Radiology and Oncology (ASTRO)           (NCI)
                      Association of Radiation                   National Electrical
                         Oncologists of India (AROI)              Manufacturers Association
                      Canadian Association of Radiation           (NEMA)
                         Oncologists (CARO)                      Nucletron
                      Chinese Society of Radiation               Philips
                         Oncologists (CSRO)                      Tomotherapy
                      CMS                                        Radiological Society of North
                      Egyptian Cancer Society – Radiation         America (RSNA)
                         Oncology                                Siemens
                      Elekta                                     Varian
                      European Society for Therapeutic
                         Radiology and Oncology (ESTRO)




June 28-29, 2005     6                                    Interoperability Strategy Workshop
                            IHE-RO
         • ASTRO Leadership
               – Prabhakar Tripuranemi, IHE Co-chair
                 Scripps Clinic
               – Jatindar Palta, IHE Co-chair
                 U Florida
               – Jennifer Padberg, Staff Liaison
                 ASTRO

• Planning Committee                  • Technical Committee
  – Jay Cooper, Co-chair                – Bruce Curran, Co-chair
    NYU                                   U Michigan
  – Keith LaPlain, Co-chair             – Stuart Swerdloff, Co-
    Varian Medical Systems                chair
 June 28-29, 2005                 7       IMPACInteroperability Strategy Workshop
                           IHE-RO
                    Basic Interoperability

Imaging Study                             Contouring
                                           System
Imaging Study

Imaging Study                             Simulation
                                            System

                    Rad Onc
                     IMS                   Planning
                                          Workstation
 Treatment
Verification                  Treatment
                              Delivery
 June 28-29, 2005                  8      Interoperability Strategy Workshop
                             IHE-RO
                          Standards Used

• DICOM
     – Significant interoperability issues
           • Un-equally spaced Image Sets
           • 3D Contouring
                   – Bifurcations
                   – Auto-segmentation „leftovers‟
           • Limits on Size of Structure Set / Dose Objects
     – Workflow issues to be addressed in 2007
           • Query/Retrieve for RT Objects
           • General Purpose / Modality Worklists
June 28-29, 2005                         9           Interoperability Strategy Workshop
                       IHE-RO
                        Actors
• Proposals circulating between Planning
  Committee and Technical Committee
     – Many applications combine actors
                                                         Planning Application

                                                           Patient Registrar
                                       DICOM           Multi-Media Registration
                    Image
                   Archive                                   Contouring
                                                      Reference Point Generation
                                       RT Plan G          Prescription Entry
                                                        Beam Placer / Shaper
                             RT SSet                       Dose Calculator
                                        RT Dose             Plan Evaluator
                                                             Fractionator
                                                       Reference Image Creator
                     RT        RT SSet RT Plan
                   Archive        RT Dose Reference Images




June 28-29, 2005             10                          Interoperability Strategy Workshop
                 More information….
• IHE Web site: http://www.ihe.net
       http://www.himss.org/IHE
       http://www.rsna.org/IHE
       http://www.acc.org/quality/ihe.htm
• Technical Frameworks
• Technical Framework Supplements – Trial Implementation
• Non-Technical Brochures :
   – Calls for Participation
   – IHE Fact Sheet and FAQ
   – IHE Integration Profiles: Guidelines for Buyers
   – IHE Connect-a-thon Results
   – 28-29, 2005
  June Vendor Products Integration Statements
                            11          Interoperability Strategy Workshop
IHE Cardiology


            Harry Solomon
             GE Medical Systems
  Co-chair, IHE Cardiology Technical Cmte.
            IHE Cardiology Roadmap
• 2004-5 – three profiles with “success path”, addressing
  broad range of integration problems
   – Cath Lab Workflow management, including angio, hemo, and IVUS,
     especially for emergent cases
   – Echocardiography Workflow management, including mobile echo
   – Ability to view an ECG from any location - quickly and easily
     integrated into other applications
• 2005-6 – focus on reporting
   – Evidence Documents specialized for cardiology logs and
     measurements
   – Displayable Reports for PDF-based clinical reports, RID and XDS
     for report distribution
• 2006-9 – additional subspecialties, focus on quality
  initiatives

 June 28-29, 2005                 13                Interoperability Strategy Workshop
                                                      Cardiology – 5 Year Roadmap


                                                Year 1               Year 2                 Year 3                Year 4                  Year 5
                                                (2005)               (2006)                 (2007)                (2008)                  (2009)

                                             Multi-modality      Measurements &          Procedure log,      Supplies, inventory,     Precision time
                                 Cath
                                           workflow & imaging       evidence             coded reports        & charge capture       synchronization
Cardiology Technical Framework




                                           Workflow & imaging,    Measurements                Coded              Pediatric
                                 Echo
                                            stress protocols                                  reports
                                              Retrieve ECG                               Stress testing       ECG/Stress/Holter      ECG waveform
                                 ECG
                                               for display                                 workflow               orders             interoperability
                                                                                          Workflow &
                                 Nuclear
                                                                                        stress protocols
                                                                                       Multi-modality lab Implantable device           Home health
                                 EP
                                                                                      workflow & reporting parameters & events          monitoring
                                                                 Reporting & report
                                 General
                                                                    distribution
                                                                                       Retrieve guidelines     Registry data        Retrieve structured
                                 Quality
                                                                                           for display          harvesting              guidelines




                                   June 28-29, 2005                                      14                          Interoperability Strategy Workshop
Clinical Laboratory Domain

              Charles Parisot
                GE Healthcare
      IHE IT Technical Committee Co-chair
             François Macary
             AGFA Healthcare IT
      IHE Laboratory Committee Co-chair
           The IHE Laboratory Committee
Cochairs:      Francois Macary - Agfa Healthcare IT
               Yoshimitsu Takagi - Hitachi

                                  • Development started in 2003
Contributing countries            • First profile published in
   –     France                     November 2003
   –     Japan                    • 10 systems validated in 2004
   –     Germany                  • 12 systems validated in 2005
   –     Italy                    • Four new profiles currently
   –     The Netherlands            published for public comment
   –     UK
   –     US (CLSI - ex
         NCCLS)
June 28-29, 2005             16               Interoperability Strategy Workshop
                IHE Lab today and to-morrow
• Ordering, placing, scheduling and performing clinical
   laboratory tests both for Hospital and Ambulatory.
• Microbiology included. Anatomic pathology and blood bank
   excluded
• Five profiles:
     – Laboratory Scheduled Workflow (LSWF)
     – Laboratory Point Of Care Testing (LPOCT)
     – Laboratory Device Automation (LDA)
     – Laboratory Code Set Distribution (LCSD)
     – Laboratory Information Reconciliation (LIR)
• Future plans
     – Incorporate analyzer images in the result workflow
     – Cross-enterprise sharing of lab reports, using CDA-R2
     – Specimen labels workflow17
  June 28-29, 2005                                 Interoperability Strategy Workshop
IT Infrastructure


               Glen Marshall
            Siemens Health Solutions
    IHE IT Infrastructure Committee Co-chair
       IHE IT Infrastructure Roadmap
    Stage 0 – 2003 profile development for 2004 Connectathon



EHR                                            Security

Profiles                                       Profiles
    Retrieve Information for Display (RID)       Enterprise User Authentication (EUA)
    Patient Identifier Cross-Referencing         Consistent Time (CT)
     (PIX)
    Patient Synchronized Applications
     (PSA)
Standards & Prerequisites                      Standards & Prerequisites
    CCOW v1.4 Patient Context                    CCOW v 1.4 User Context
    HL7 v2.3.1                                   Kerberos
    HL7 v2.4                                     NTP
    HTTP                                         SNTP
    WSDL 1.1
    XHTML 1.0
    XML 1.0

June 28-29, 2005                              19                   Interoperability Strategy Workshop
       IHE IT Infrastructure Roadmap
  Stage 1 – 2004 profile development for 2005 Connectathon



EHR Support                                 Security

Profiles                                    Profiles
Cross-enterprise Document Sharing (XDS)    Audit Trail and Node Authentication
Patient Demographics Query (PDQ)           (ATNA)
                                            Personnel White Pages (PWP)
Standards & Prerequisites                   Standards & Prerequisites
Stage 0 IHE ITI profiles                   IHE Radiology Basic Security
CDA r1                                     Stage 0 IHE ITI security profiles
HL7 v2.5                                   RFC 3881 (Audit record schema)
ebXML Registry                             LDAP (RFC 2251-2256)
HTTP                                       RFC 2798 (inetOrgPerson schema)




June 28-29, 2005                           20                   Interoperability Strategy Workshop
       IHE IT Infrastructure Roadmap
  Stage 2 – 2005 profile development for 2006 Connectathon



EHR Support                               Security

Profiles                                  Profiles
Notification of Document Availability    Cross-Enterprise User Authentication
(NAV)                                     (XUA)
Patient Management (PAM                  Document Digital Signature (DSG)
Standards & Prerequisites                 Standards & Prerequisites
Stage 1 IHE ITI profiles                 Stage 1 IHE ITI security profiles
IETF SMTP / MIME                         OASIS SAML 2.0
HL7 v2.5                                 HL7 v2.6 UAC segment
                                          W3C XML Digital Signature
                                          ITU X.509
                                          ISO/TS 17090




June 28-29, 2005                         21                    Interoperability Strategy Workshop
            IHE IT Infrastructure Roadmap
        Stage 3 – 2006 profile candidates for 2007 Connectathon

EHR                                     Security                                  Common Data
Profiles – to be decided in Nov.        Profiles – to be decided in Nov.          Profiles – to be decided in Nov.
2005                                    2005                                      2005
Templates registry                     RBAC – enterprise scope                  LDAP information sources
Patient Demographics Query - multi-                                              Transaction Failure Management (TFM)
enterprise                              Referred to IHE PCC domain                RID configurability directory
Federated XDS registries               Patient consents                         Service discovery
Harmonize XDS and RID document
retrieval capabilities                                                            Depends on other IHE domains’
                                                                                  needs
Referred to IHE PCC domain                                                        Masterfile Maintenance
Scheduling – enterprise scope                                                    Reference code set maintenance
Dynamic data for EHR
Standards & Prerequisites               Standards & Prerequisites                 Standards & Prerequisites
Stage 2 IHE ITI profiles               Stage 2 IHE ITI security profiles        Stage 2 IHE ITI Patient Management
HL7 templates standards                ISO/TS 21547-1 for certificate           profile
W3 standards for XML schemas and       archiving                                 HL7 v2 Masterfile maintenance
XSL                                     ISO/TS 22600 parts 1 & 2                 Mature/stable standards for selected
HL7 scheduling messages                ISO/TS 21298 for function & structural   masterfile information sources
W3C Semantic Web (interoperability     roles                                     Suitable LDAP schema definitions
and clinical vocabulary standards for   ASTM E31.20 Privilege Management         Web services standards
assembling dynamic data sources into    Infrastructure                            IETF infrastructure
documents)                              Stable HL7 standards for                 W3C infrastructure
                                        communicating patient consents
   June 28-29, 2005                                         22                          Interoperability Strategy Workshop
           IHE IT Infrastructure Roadmap
      Stage 4 – 2007 profile candidates for 2008 Connectathon


EHR                             Security                        Common Data
Profiles                        Profiles                        Profiles
Scheduling                     RBAC – multi-enterprise        Workflow management
Respond to national/regional   scope                           preferences
EHR mandates and initiatives,   Wide-area patient access       SNMP MIBS
TBD                             Mobile applications            LDAP equipment directory
                                Patient identification based   support
                                security
Standards &                     Standards &                     Standards &
Prerequisites                   Prerequisites                   Prerequisites
HL7 scheduling messages        Stage 3 IHE ITI security       Stable workflow management
EHR-related standards, TBD     profiles                        standards for healthcare use
                                Stable standards for cross-    cases
                                enterprise RBAC                 Suitable LDAP schema
                                Stable standards for mobile    definitions
                                access security                 IETF MIB standards
                                Stable standards for patient
                                identification
  June 28-29, 2005                             23                   Interoperability Strategy Workshop
       IHE IT Infrastructure Roadmap
 Stage 5 – 2008+ profile candidates for 2009+ Connectathon


EHR                         Security                        Common Data

Profiles                    Profiles                        Profiles
XDS composite documents    Remote service access          Equipment discovery and
from multiple clinical      Anonymization                  automatic provisioning
domains.                    Pseudoanonymization            RID and XDS
                            Patient-controlled access      configurability
Standards &                 Standards &                     Standards &
Prerequisites               Prerequisites                   Prerequisites
Stage 3 IHE ITI profiles   Stage 4 IHE ITI security       Stage 3 IHE ITI common
Clinical domains’ XDS      profiles                        data profiles
document profiles           Stable healthcare data         Stable standards for user
                            model standards                 interface optimization, e.g.,
                            Stable standards for labeled   DICOM “hanging protocols”
                            data access rules               XDS clinical application
                                                            domains’ content profiles

June 28-29, 2005                          24                     Interoperability Strategy Workshop
Patient Care Coordination


                   John Donnelly
                  IntePro Solutions, Inc.
IHE IT Infrastructure Committee and Co-chair, IHE Patient
               Care Coordination Committee
                    Patient Care Coordination
                          Domain Scope
• Facilitate the use of EHR content standards for the
  transferring or sharing of patient care services via the
  development of medical summary (MS) content
  profiles
• Specify appropriate “transfer packages” of clinical
  information for specific transfer of care use cases via
  the development of integration profiles.
• Optimize the use of the IHE ITI profiles (e.g. XDS) in
  delivering healthcare in “communities” of patient care
  settings


 June 28-29, 2005             26          Interoperability Strategy Workshop
                    Patient Care Coordination
                     Current Accomplishments
• Issued Call for Participation to vendor community and
  medical societies for Planning and Technical
  Committee formation – 2 t-cons and 1 FtoF meeting
• Finalized a Medical Summary Content Proposal
  highlighting two key transfer of care use cases
• Conducted high-level content standards evaluation
  exercise
• Promoted content standard education initiative



 June 28-29, 2005             27        Interoperability Strategy Workshop

								
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