Integrating%20the%20Healthcare%20Enterprise

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Integrating the Healthcare Enterprise

• IHE Update to DICOM

Charles Parisot, GE Healthcare IHE IT
Infrastructure Technical Committee Co-chair
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IHE 2004 achievements and expanding scope
Over 80 vendors involved world-wide, 4 Technical
Frameworks 31 Integration Profiles, Testing at
yearly Connectathons, Demonstrations at major
exhibitions world-wide
Provider-Vendor cooperation to accelerate
standards adoption
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Laboratory Integration Profiles
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IHE Cardiology Profiles

• Cardiac Catheterization Workflow
• Based on IHE Radiology Scheduled Workflow and
  Patient Information Reconciliation Profiles
• Echocardiography Workflow
• Based on IHE Radiology Scheduled Workflow and
  Patient Information Reconciliation Profiles
• Retrieve ECG for Display
• Based on IHE IT Infrastructure Retrieve
  Information for Display Profile

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Cardiac Catheterization Workflow

• Management of cath exams
• Similar to IHE-Radiology SWF
• Multi-modality, multiple procedure steps
• Handle multiframe images (XA and IVUS)
• Reconciliation of patient information
• Similar to IHE-Radiology PIR
• Unscheduled cath is the norm, not the exception
• Time synchronization
• Modalities must support IHE-ITI Consistent Time
• Out of scope year 1
• Pre-cath and post-cath activity, Hemo waveforms
  and reports, Procedure logs, QCA/QVA, Final cath
  reports

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Echocardiography Workflow

• Management of echo exams (TTE, TEE, stress)
• Similar to IHE-Radiology SWF
• Handle multi-stage tests (stress echo)
• Workflow management, image labeling, and display
• Handle multiframe and compressed images
• Reconciliation of patient information
• Similar to IHE-Radiology PIR
• Out of scope year 1
• Preliminary and final reports, Physician
  scheduling, Counter-indication/clinical decision
  support, Fetal and pediatric echo

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Retrieve ECG for Display

• Provide ECGs and related reports to enterprise
• Extension to IHE-ITI RID
• ECGs served in ready-to-display format
• Requirements on displayable quality
• Includes XML-based ECG/report list
• Out of scope year 1
• ECG acquisition and reading workflow
• ECG raw data interchange
• Export of reports to external repository

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IHE Radiology

• RSNA 2004 show-wide demonstration of Portable
  Data for Imaging
• January 2005 Connectathon - 4 new supplements
• Instance Availability Notification (SWF Option)
• Appointment Notification (SWF Option)
• Nuclear Imaging (New Integration Profile)
• And PDI (already introduced at RSNA 2004)

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IHE IT Infrastructure 2004-2005
Patient Synchronized Applications
Synchronize multiple applications on a desktop to
the same patient
Patient Identifier Cross-referencing for MPI
Patient Identifier Cross-referencing for MPI
Map patient identifiers across independent
identification domains
Map patient identifiers across independent
identification domains
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IHE IT Infrastructure 2004-2005
Patient Synchronized Applications
Synchronize multiple applications on a desktop to
the same patient
Patient Identifier Cross-referencing for MPI
Map patient identifiers across independent
identification domains
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Introduction EHR Cross-Enterprise Document
Sharing
First step towards the longitudinal dimension of
the EHR Focus Support document sharing
between EHRs in different care settings and
organizations
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Typically, a patient goes through a sequence of
encounters in different Care Settings
Long Term Care
Acute Care (Inpatient)
Other Specialized Care(incl. Diagnostics
Services)
GPs and Clinics (Ambulatory)
Continuity of Care Patient Longitudinal Record
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Finding the records of a patient-Manual tedious
The challenge Finding and accessing
easily documents from other care providers
In the community.
Clinical IT System
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Sharing records that have been published
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Building and accessing Documents
Documents Registry
EHR-LRLongitudinal Recordas usedacross-encount
ers
Long Term Care
Acute Care (Inpatient)
Other Specialized Careor Diagnostics Services
PCPs and Clinics (Ambulatory)
EHR-CR Care Record systemssupporting care
delivery
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XDS Value Proposition

• Foundation for Health IT Infrastructures Shared
  Electronic Health Record, in a community, region,
  etc.
• Effective means to contribute and access clinical
  documents across health enterprises.
• Scalable sharing of documents between private
  physicians, clinics, long term care, pharmacy,
  acute care with different clinical IT systems.
• Easy access Care providers are offered means to
  query and retrieve clinical documents of interest.

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XDS - Value Proposition

• Distributed Each Care delivery organization
  publishes clinical information for others.
  Actual documents may remain in the source EHR-CR.
• Cross-Enterprise A Registry provides an index
  for published information to authorized care
  delivery organizations belonging to the same
  clinical affinity domain (e.g. an LHII).
• Document Centric Published clinical data is
  organized into clinical documents. using
  agreed standard document types (HL7-CDA,
  ASTM-CCR, PDF, DICOM, etc.).
• Document Content Neutral Document content is
  processed only by source and consumer IT systems.
• Standardized Registry Attributes to ensure
  deterministic document searches.

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XDS Conclusion

• Foundation for EHR Health IT Infrastructures
• Effective contribution and access to shared
  documents across all types of health enterprises
• Scalable, Flexible and Easy access

• XDS to be one of the major highlights of 2005
  Annual HIMSS Conference Exhibition. Dallas,
  Tex., Feb. 13-17
• used as a foundation for an on-site demonstration
  of interoperability in support of a National
  Health Information Networks.
• Attendees at the conference will be able to
  create and share their own health records across
  vendor booths as well as in the ambulatory and
  acute care settings on the conference exhibit
  floor.

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XDS Development

• Specification work since Nov 2003
• Under Public Comments June-July 2004
• 600 constructive comments received,
• Stable XDS specification IHE TF Aug 15th, 2004

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HIMSS 2005 Three participation opportunities

• Vendor Systems
• Conditions Apply before Oct 15th system pass
  IHE connect-a-thon
• Vendor chose among 15 existing integration
  profiles (out of 29, see slide 15)
• May participate from own vendor booth in addition
  to Showcase booths

Interoperability Showcase Booth
laboratory
ITInfrastructure
Vendor Booth
cardiology
Vendor Booth
Cross-enterprisedoc sharing (Choice of
XDS,PWP,RID,PDQ)
radiology
Ambulatory Showcase Booth
radiology
laboratory
Pharma ?
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IHE Events

• September 13-15th Conference and
  Worshop-Oakbrook (IL-USA)
• January 2005 Connectathon - 4 domains
• IT Infrastructure
• Cardiology
• Radiology
• Laboratory
• HIMSS IHE Demos February 2005
• February 7-10th Conference and Participant
  Workshop (Netherland)
• February 2005 IHE Japan Connectathon (Radiology)
• ACC IHE Demo March 2005
• April 25th-29th IHE Europe Connectathon

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More information.

• Web sites www.himss.org/ihe
• www.rsna.org/ihe
• www.ihe-europe.org