ihe radiology –2007what ihe delivers 1 ellie avraham ihe technical committee may 23, 2007 cross...

1IHE Radiology –2007 What IHE Delivers

Ellie AvrahamEllie Avraham

IHE Technical CommitteeIHE Technical Committee

May 23, 2007May 23, 2007

Cross Domain Review Cross Domain Review LaboratoryLaboratory

2IHE Cross-Domain ReviewIHE Cross-Domain Review

Other IHE Other IHE Domains used in Domains used in LaboratoryLaboratory

Radiology (RAD)

IT Infrastructure (ITI)

Patient Care Coordination (PCC)


IHE Laboratory Scheduled Workflow (LSWF) IHE Laboratory Scheduled Workflow (LSWF) Integration ProfileIntegration Profile

LSWF Based on the foundation of the radiology SWF actors,

the LSWF defines the continuity and integrity of clinical laboratory testing and observation data throughout the healthcare enterprise. It maintain the consistency of ordering and patient information, to control the conformity of specimens, and to deliver the results at various steps of validation.

It enables automation of pre-analytical, analytical and post-analytical processes within the laboratory.


LSWFLSWF FeaturesFeaturesMost of the LSWF features are similar to Radiology, except the unique Lab management and tracking of LAB Test results.

The LSWF profile defines the interoperable process flow for managing the Lab Tests Orders, the Lab test equipments and the Lab tests results.

Features extensively the same as Radiology Patient Registration Patient Update

Features extensively similar to Radiology Placer Order Management Filler Order Management


IHE Laboratory Information Reconciliation (LIR) IHE Laboratory Information Reconciliation (LIR) Integration ProfileIntegration Profile

Similar to the Radiology PIR profile, the LIS profiles reconcile the Patient Information on the Lab Tests Orders, Test Procedures, Lab Observations and Test results.


LIR FeaturesLIR Features

The LIR Patient reconciliation is similar to Radiology, except the unique Lab Orders, Lab Procedures tracking and managing of LAB Test results.

The LSWF profile defines the interoperable process flow for managing the Lab Tests Orders, the Lab test equipments and the Lab tests results.

Features extensively the same as Radiology Patient Registration Patient Update

Features extensively similar to Radiology Placer Order Management Filler Order Management


IHE Laboratory Device Automation (LDA) IHE Laboratory Device Automation (LDA) Integration ProfileIntegration Profile

LDA defines the automated workflow for managing the Lab work orders that get split in to a series of Work Order Steps (WOS) that are performed on the Lab Test equipments. In addition the Test results received from the Lab Test Equipment are managed.


LDA FeaturesLDA Features

The LDA profile is unique to Laboratory domain and it manage the workflow of the Lab Test Equipments.

Features extensively the same as Radiology are:

None

Features extensively similar to Radiology

None


LONIC Test Codes Subset (LTCS)LONIC Test Codes Subset (LTCS)

LTCS introduces a subset of the LONIC Lab codes, to be used in the Lab Test results reports.


LTCS FeaturesLTCS Features

LTCS is a unique LAB profile that introduces the LAB Vocabularies for the test codes.

This profile do not add any new actor or transaction.


Sharing Lab Reports (XDSharing Lab Reports (XD**-LAB)-LAB)

XD*-LAB defines an electronic human readable Clinical Lab report that can be shared in the large Regional Health Information Organization (RHIO). The Lab report will include the various test results that have been ordered for a patient.

The Lab report is defined as an HL7 CDA R2 document that is constrained and limited to Laboratory test results, structure reports.


XDXD**-LAB Features-LAB FeaturesThe XD*-LAB profile is an XDS specialization content profile that defines the content of the Lab reports for being shared in a Cross-enterprise utilizing the XDS solution.

The XD*-LAB profile is using the other IT profiles to share the Lab reports as follows: NAV to notify after the registration the Lab Reports availability. XDR to distribute the Lab reports through the email. XDM to distribute the Lab reports through the CD or USB media interchange.

Features extensively similar as in the PCC XDS-MS are:

Content Creator Content Consumer

Features extensively the same to ITI XDS are:

All the other XDS Actors


IHE Laboratory ActorsIHE Laboratory ActorsActor(s) that are extensively the same as Radiology ADT Patient Registration, Order Placer, DSS/Order Filler.

Actor(s) that are extensively the same as ITI: NAV – Notification Sender XDR - Document Source XDM – Portable Media Creator

Actors that are unique to PCC:

Content Creator Content Consumer

Actors that are unique to Laboratory Order Result Tracker Automation Manager


IHE Laboratory TransactionsIHE Laboratory Transactions

List of new LAB transactions: LAB-1, LAB-2, LAB-3, LAB-4, LAB-5 (LSWF, LIR) LAB-21, LAB-22, LAB-23, LAB-26 (LDA)

Re-used transactions from ITI: All transactions from: XDS, XDM, XDR, NAV

Re-used Transactions from Radiology: RAD-1, RAD-12


Standards Used in LaboratoryStandards Used in LaboratoryStandard Std. Version Profile(s) Used

HL7

CDA R2, CCD, Laboratory, Specimen

v3 XD*-LAB

HL7 v2.5 LDA

HL7 v2.5 & v2.3.1 LSWF, LIR

LOINC LTCS


Summary of LaboratorySummary of Laboratory

Profile Issue Description How to Handle (see Key)

LSWF/LIR Using mixed of HL7 v2.3.1 & v2.5

Transition Radiology TF to HL7 v2.5 – Mapping the HL7 v2.3.1 messages to HL7 v2.5

XD*-LAB Do we need to add the support of the Lab reports in the XDS-I ?


Key to Domain issuesKey to Domain issues

1. Issue should result in CP in Radiology

2. Consider addition in Radiology

3. Conflict between Radiology and other Domain

4. Radiology Profile should be handed-off to other Domain

5. Gap has been identified that may result in New Opportunity

ihe radiology –2007what ihe delivers 1 ellie avraham ihe technical committee may 23, 2007 cross...

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