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IHE for Product Planners V3.0

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					Integrating the Healthcare Enterprise

      IHE for Product Planners

               Ellie Avraham
               Kodak Health Imaging
  IHE Planning and Technical Committees Member
            Learning Objectives
   The Clinical and Economic benefits of Integrating the
    Healthcare Enterprise
   Improve Product Functionality by using the IHE
    Technical Framework
   Improve Integrated System Solutions by using IHE
    Integration Profiles

   Learn from IHE Users Success Stories and other IHE
    information to refine the Products “Business Case”
    evaluation
                      IHE Classroom Sessions – RSNA 2004   2
        Discussion Areas
   The IHE Deployment Process

   IHE Integration Profiles

   The Value Proposition from Planning Products
    and Integrated Solutions using IHE



                    IHE Classroom Sessions – RSNA 2004   3
             Challenges of Integration
 Integration Solutions Available Today from
  Medical Systems Vendors – BUT ...
 Modern Healthcare Enterprises in All Countries
  Are Still Confronted with Problems:
    (In Spite of IT Standards and Advanced Technology)
     – Lack of Access to Complete Medical Information
     – Inconsistent Medical Information
       Across Departments and Institutions
     – Inadequate Communicating of Medical Data
       Across Multiple Systems from Different Vendors
     – Risky Investments in Proprietary Solutions

                      IHE Classroom Sessions – RSNA 2004   4
IHE drives healthcare standards based-integration

                  Prof. Societies Sponsorship
                Healthcare Providers & Vendors

Healthcare IT Standards                                            General IT Standards
     HL7, DICOM, etc.                                                   Internet, ISO, etc.

                                        IHE
                                       Process

        Interoperable Healthcare IT
          Solution Specifications Healthcare IT
                       Interoperable
            IHE Integration Profile Specifications Healthcare IT
                          Solution Interoperable
                            IHE Integration Profile Specifications Healthcare IT
                                          Solution Interoperable
                                            IHE Integration Profile Specifications
                                                          Solution
                                                              IHE Integration Profile
                              IHE Classroom Sessions – RSNA 2004                              5
                     IHE Process - Annual Cycle

                                                   Product IHE Integration
                                                         Statement
                             IHE Connectathon
                                  Results

                        IHE                                                       Easy to
                                                    Product
                     Technical                                                   Integrate
                                                    With IHE
                    Framework                                                    Products

                          IHE
 Standards              IHE
                      Integration
                    Integration
                       Profiles B
                                           IHE                     IHE         User Site
                     Profile A         Connectathon            Demonstration



                                                                                     RFP
IHE   Technical Framework – Define Standard Integration Solutions
IHE   Connectathon Results – Most implemented and tested IHE Solutions
IHE   Integration Statements – Most Comertialized IHE Solutions
IHE   Success Story – Most Successful Used IHE Solutions

                                 IHE Classroom Sessions – RSNA 2004                  6
      Using IHE for Product Planning

   IHE Aid for Global Product Planning
    – IHE Technical Framework (TF)
      > Vol 1: Defines Global Integration Profiles
      > Vol 2,3: Defines the TF Transactions details for Development
      > Vol 4: Defines the Local National specialization details

    – IHE Connectathon Results – Learn what IHE solutions are developed

    – IHE User Success Stories – Learn the Clinical and Economic benefits
      of using products with IHE capabilities.

    – IHE Integration Statements – The Commercialized products with IHE
      capabilities

    – RFP’s from customers


                           IHE Classroom Sessions – RSNA 2004          7
    IHE Connectathon Results
    http://www.rsna.org/IHE/connectathon.shtml
       http://www.ihe-europe.org/con_result/





              IHE Classroom Sessions – RSNA 2004   8
         IHE User Success Stories
http://www.rsna.org/IHE/participation/success_stories/index.shtml
    •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

                                IHE Classroom Sessions – RSNA 2004   9
                     IHE Success Stories
   Deployment of IHE Profiles – Most Used:
    - Scheduled Workflow (SWF)
    - Patient Information Reconciliation (PIR)
    - Consistent Presentation of Images (CPI)
    - Reporting Workflow (RWF)
    - Basic Security for HIPAA regulations (SEC)
   Clinical and Economics Accomplishments
    - Improve the Patient Care            – Improved data accuracy and
    Safety, Image Quality & Consistency and time saving due to optimized
    Workflows and integrated systems
    - Improve the clinical practice productivity - reduced
    manual data entry using the ADT registration in one place and propagate it
    to all the other systems (PACS, RIS Modality) and reduced errors.
    - Optimize the Radiological Workflow (SWF)
       Reduced the incorrectly or lost studies, using DICOM MWL, MPPS
                             IHE Classroom Sessions – RSNA 2004         10
              IHE Integration Statements
IHE 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 supported
The 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

                           IHE Classroom Sessions – RSNA 2004              11
                   IHE Integration Statement                                       Date
                                                                                12 May 2004

    Vendor                            Product Name                               Version
Any Medical         IntegrateRAD                                           V2.3
Systems Co.
This product implements all transactions required in the IHE Technical Framework to
support the IHE Integration Profiles, Actors and Options listed below:
   Integration               Actors Implemented                             Options
     Profiles
  Implemented
                                                                          Implemented
Scheduled           Image Manager/Image Archive                          none
Workflow
                    Image Display                                        none
Internet address for vendor’s IHE information: www.anymedicalsystemsco.com/ihe
 Links to Standards Conformance Statements for the Implementation
      HL7           www.anymedicalsystemsco.com/hl7
    DICOM           www.anymedicalsystemsco.com/dicom/integrateRAD.pdf
                     Links to general information on IHE
North America:      In Europe: www.ihe-europe.org                 In Japan: www.jira-
www.rsna.org/IHE             IHE Classroom Sessions – RSNA 2004   net.or.jp/ihe-j         12
                                                      www.rsna.org/ihe
IHE Foundation
IHE Technical Framework
Organized in sections that provide an
  increasing level of detail
      Integration Profiles: Establish broad categories of
                            compatible function.

           Actors: Identify specific kinds of operational
                   participants in the healthcare
                   enterprise.
                     Transactions: Describe particular interactions
                                            between actors to perform
                                            specific operations.
                   IHE Classroom Sessions – RSNA 2004                 13
   IHE Radiology Integration Profiles
                                                                    Charge
            Scheduled Workflow
                                                                    Posting
                                                      -
Patient
  Info.                Presentation             Post-
                        of Grouped                           Reporting
Recon-                                       Processing
                       Procedures                            Workflow
ciliation                                     Workflow




                              Consistent                     Key       Simple
                   NM                            Evidence   Image     Image &
                               Present-
                  Image                            Docs     Notes     Numeric
                               ation of
                               Images                                 Reports



                     Access to Radiology Information

                       Portable Data for Imaging
                               Basic Security

                       IHE Classroom Sessions – RSNA 2004                     14
                      Scheduled Workflow Profile

                                                                                     report
                                                                                report
  Registration                                                      Report
                                       report
                                                                   Repository

HIS patient                                                                       Diagnostic       Film
     information                                                                  Workstation    Lightbox
                                                                                          images
                                                                        PACS             retrieved



     Orders Placed
                                                 procedure
                                                 scheduled                                        Film
                                                                                Image Manager
                                             Prefetch any relevant                               Folder
examination orders                                                                 & Archive
                                             prior studies
                                                            Acquisition
                                        modality                        images
                                                              Modality
                   Orders Filled        worklist                         stored
       RIS                                                               acquisition
                                                                         completed
                                     acquisition
                                      acquisition                                                    Film
                                     in-progress
                                       completed                               images
                                                                               printed
                                                          Modality
                                   IHE Classroom Sessions – RSNA 2004                           15
Patient Information Reconciliation




            IHE Classroom Sessions – RSNA 2004   16
      Consistent Presentation of Images
            Reporting Radiologist                                       Referring Physician or
                                                                        Reviewing Radiologist

                                              Presentation State
                        Area Of               Presentation LUT                Area Of
                        Interest                                              Interest

                                              Grayscale Standard


                           Annotate                                            Achieving
                                                                         Consistent Presentation
                        Zoom


                 Flip


     Window Level
                                                                                Without
                                                                         Consistent Presentation
Original Image

                                   IHE Classroom Sessions – RSNA 2004                      17
                   BASIC Security
• TLS authentication of remote node (digital certificates)
• with/without encryption
 • Audit PHI trail with:
    • Real-time access
    • Time synchronization

Secured System                                         Secured System
                        Secure network

  System A                                                  System B



                               Central
                              Audit Trail
                              Repository

                  IHE Classroom Sessions – RSNA 2004                    18
Presentation of Grouped Procedures Profile
Requested                                        Chest                    Report:
Procedure:                                       View                     CHEST
 CHEST

                 RIS / PACS
   Requested
   Procedure:                                                              Report:
   AB/PELVIS
                                                              Ab/Pelvis
                                                               View       AB/PELVIS



             MODALITY                         Chest
                Performs a                    View
                single exam

                    Operator
                     groups
                  2 procedures
                                                            Ab/Pelvis
                                                             View

                              IHE Classroom Sessions – RSNA 2004                    19
    Simple Image & Numeric Reports Profile

                                                                        Report
                                                                      Verification




                                                                 Verified Report

                      Preliminary Report
Images and Exam
data presented for
                                                                      Report & Images
    diagnosis
                                                                         Retrieved
                                           Reports stored
                                                for
                                           Network Access
          Images
          Retrieved                                                                  Report & Image
                                                                                       Review for
                                                                                      Patient Care
       PACS           Image Manager
                        & Archive

                                 IHE Classroom Sessions – RSNA 2004                           20
Access to Radiology Information
Referring                                    Emergency
Physician                                    Department

                Radiology
              Department –
               Images and
                 Reports

 Remote                                          Other Departments:
 Clinics                                         - Oncology
                                                 - Surgery
                                                 - Neurology
                                                 - Pediatrics
                Electronic
                                                 - etc.
                 Medical
                 Record

            IHE Classroom Sessions – RSNA 2004                        22
         Post-Processing CAD Workflow

       Acquisition         Source Data
        Modality
                                              PACS System



                     Worklist

                                              Post-Proc.
      3-D
  *Workstation
                                              Workflow              Work Status
                                               Manager                                      Workstation
                            Work Status

   CAD
*Workstation

 …                        Results
                                                                                  Results


                                                Report
                                               Repository


                                         IHE Classroom Sessions – RSNA 2004                           23
           Charge Posting Profile

ADT Terminal
                Account                          Post
                 Management                     Charges
                                                                          *Billing System



                                     Charge
                                     Poster

      Study                                                        Report Generated /
    Performed                                                               Signed
                / Materials
                   Used          3-D                   CAD
                              Performed              Performed
  Acquisition

                                                                   …
                                                                              Report
   Modality                                                                  Repository

                          3-D                  CAD
                      *Workstation          *Workstation


                              IHE Classroom Sessions – RSNA 2004                            24
                 IHE Reporting Workflow
                  Work Item
                  Claimed                                                          RIS
                              Reporting                                        Report
                               Worklist                                       Manager
Report Reader/Creator                                 Store
                                                     Reports

                        Measurements                                     Reporting
                        CAD Reports                                    Procedure Step
                        …………………                                           STARTED
                                                PACS & Archive                       Reporting
                   Retrieve Images &                                               Procedure Step
                                                     Image                          COMPLETED
                  Evidence Documents
                                                    Manager/
                                                    Archive
                                                                    Reporting
                                                                  Procedure Step     Reporting
                                                                     STARTED       Procedure Step
                                                                                    COMPLETED
                             IHE Classroom Sessions – RSNA 2004                          26
          Portable Data for Imaging



                                     Image/ Report Display


                  John Doe
  CD
Creator

                  CD                          Printer




                                            Media Importer


                IHE Classroom Sessions – RSNA 2004           27
          IHE Value Proposition
• Product Planning
   • IHE Solutions are Driven by Strategic Healthcare Lead
     Users that collaborate with Healthcare Vendors
   • IHE Solutions are Generic, Reusable and Interoperable
     based on Healthcare Standards: DICOM, HL7, RFC
   • IHE Solutions Optimize the Clinical Workflows

   • IHE Deployment process – Connectathon, Integration
     Statements and Users Success Stories information helps to
     refine the product “Business Case”
   • IHE Technical Framework specification describes the
     Global IHE solutions at a High Level for Planning &
     Marketing and in details for products Architects and
     Engineering development
                      IHE Classroom Sessions – RSNA 2004    28
               IHE Benefits
• Clinical Users
  • Greater access to consistent information
  • Fewer errors, fewer tedious tasks
• Buyers
  • Specify/purchase integration capabilities easily
  • Freedom to acquire “Best of Breed” systems
• IT Professionals
   • Faster, more predictable integration projects
   • Facilitate cooperation of competing vendors
• Administrators
   • Increased throughput
   • Better scheduling and – tracking
                  IHE Classroom Sessions RSNA 2004 29
                                                                                                Scheduled Workflow                             Charge




                                                           Patient Information Reconciliation
                                                                                                                                               Posting



    Picking IHE Profiles                                                                                 Presentation  Post-
                                                                                                         of Grouped Processing
                                                                                                         Procedures Workflow
                                                                                                                               Reporting
                                                                                                                               Workflow




          Considerations                                                                              Consistent
                                                                                                     Presentation
                                                                                                      of Images
                                                                                                                   Evidence
                                                                                                                  Documents
                                                                                                                              Key Image
                                                                                                                                Notes
                                                                                                                                           Simple Image
                                                                                                                                           and Numeric
                                                                                                                                              Reports




 Customer RFP’s                                                                                  Access to Radiology Information

                                                                                                           Basic Security



 Product positioning in the market with a Good
  Business Case
 IHE Technical Framework Volume 1
 Healthcare Institution Needs:
  > Optimized Clinical Workflow : SWF, PIR, RWF
  > Improve the Patient Health Care: SWF, PIR, CPI, PGP,KIN
  > Economy - Reduce Healthcare cost: SWF, CHG
  > Protect the Patient Health Information: SEC
                      IHE Classroom Sessions – RSNA 2004                                                                       30
     IHE for Product Planners
            Questions?
IHE North America: http://www.rsna.org/IHE or
                   http://www.himss.org/IHE
IHE Canada:        http://www.ihe-canada.com
IHE Europe:        http://www.IHE-Europe.org
IHE France:        http://www.gmsih.fr/IHE
IHE Germany:       http://www.IHE-D.org
IHE Italy:         http://www.rad.unipd.it/IHE
IHE UK:            http://www.IHE-UK-org
IHE Japan:        IHE Classroom Sessions – RSNA 2004
                   http://www.jira-net.or.jp/ihe-j/en/index.html
                                                             31

				
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