PM 11/2006 IHE

Johannes Gutenberg-University Department of Radiology , Mainz,

GermanyPeter Mildenberger

User Success StoriesUser Success Stories

PM 11/2006 IHE

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University Hospital Mainz and Department of Radiology

• 1500 beds, ~100 wards• 55.000 inpatients/year, 190.000 outpatients

• >30 examination rooms in Radiology• ~ 500 exams / d• ~ 15 clinical conferences / d• RIS since 1988• PACS since 1996 (Rad, Neurorad, NUK, Cardio, Endo, Dent..)

– >80 modalities (e.g. 5 CTs, 5 MRs, 5 CRs, 3 DRs..) hospital wide– 70 - 100 GB / d new data– ~ 45 TB online (>70 million images)

PM 11/2006 IHE

The IHE Radiology Workflow

N, Wisrz, PhD, Siemens

X

PM 11/2006 IHE

Status Nov 2006 Integration Profile

Scheduled Workflow

System/Vendor

IHE Actor(s) IHE Transactions New or upgrade?

SAP IS-H Not IHEcompatible

Not tested in Conncetathons (HL7 communication available)

RISGAPGap it, V4

-Order Filler-DepartmentSystemDatabase

-Procedure scheduled -Modality Worklist provided-Modality Procedure Step in Progress-Modality Procedure Step Completed-Images Availability Query

Upgrade

PACSImageDevices IDPACSVers. 3.6

-ImageManager-ImageArchive

-Procedure scheduled -Modality Images Stored-Modality Presentation State Stored-Storage Commitment-Images Availability Query-Query Images-Retrieve Images-Creator Images Stored

Upgrade

*Testing and Implementation Phase

PM 11/2006 IHE

Status Nov 2005

*Testing and Implementation Phase

CT Modality/Siemens SOMATOM Volume Zoom Vers. VA41

Acquisition Modality

-Modality Worklist Provided -Modality Procedure Step in Progress -Modality Procedure Step Completed -Modality Images Stored -Storage Commitment

New (Installed Dec. 2000)

CT Modality/Philips Philips Brilliance 64 Vers. 2

Acquisition Modality

-Modality Worklist Provided -Modality Images Stored -Storage Commitment

New (Nov 2005)

CT Modality/Philips Philips IDT 16 Vers. 2

Acquisition Modality

-Modality Worklist Provided -Modality Images Stored -Storage Commitment

New (Nov 2005)

MR Modality/Siemens Magnetom Sonata Vers. VA15

Acquisition Modality

-Modality Worklist Provided -Modality Procedure Step in Progress -Modality Procedure Step Completed -Modality Images Stored -Storage Commitment

New (Dec 2001)

Angio Modality Philips Integris 3000

Acquisition Modality

-Modality Worklist -MPPS in Progress -MPPS Completed -Modality Images Stored -Storage Commitment

Upgrade (Nov 2000)

PM 11/2006 IHE

Status Nov 2005

Ultrasound GE Logic 9

Acquisition Modality

-Modality Worklist -MPPS in Progress -MPPS Completed -Modality Images Stored -Storage Commitment -DICOM SR Vascular Supplement

New (Dec 2005)

Ultrasound GE Logic 7

Acquisition Modality

-Modality Worklist -MPPS in Progress -MPPS Completed -Modality Images Stored -Storage Commitment -DICOM SR Vascular Supplement

New (Dec 2005)

Workstation ConVis DICOM Viewer V2.8

Diagnostic and Clinical Image Display

Patient update Query images Retrieve images

Upgrade (April 2002)

Some more Systems Philps CR / DR Agfa CR Toshiba US

Acquisition Modality

Modality Worklist MPPS in Progress MPPS Completed Modality Images Stored Storage Commitment Support of GSDF (CPI)

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Clinical wide PACS Access

PM 11/2006 IHE

Clinical wide PACS Data Sources

US21%

CR10%

XA6%

MR6%

OT4%

CT53%

US

CR

XA

MR

OT

CT

PM 11/2006 IHE

Image Sources

• Radiography, CT, MRT, DSA• Sonography• Szintigraphy, PET• Visible Light

– Endoscopy, Pathology, Ophthalmology, Digital Photography, microscopic slides)

• Cardiology

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Integrated Presentation

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IHE on the National Level

• The idea of IHE is recognised by the „Deutsche Forschungsgemeinschaft“(DFG), which is responsible for funding medical equipment and IT-Infrastructure in Universities

• Strategic Paper in 2005: „..Zur Erleichterung der Kommunikation zwischen verschiedenen IT-Anwendungssystemen einschließlich der Medizintechnik werden die Inhalte der IHE-Initiative unterstützt und müssen bei Beschaffungen zunehmend Bestandteil von Ausschreibungen werden…“

– > Means IHE-Profiles should be respected for interoperability and must be used for proposals

PM 11/2006 IHE

Conclusions

• flexible implementation, less independant from a vendor

• MWL, MPPS, StComm improve clinical workflow, data consistency, quality of documentation,...

• IHE is a pragmatic model for the clinical scenarios

• IHE profiles should become regular part of RFPs

• IHE Process fits also outside Radiology (e.g. Lab, Card.)

• IHE-PDI part of a national activity of the DRG regarding interoperability of Patient-CDs

• Acceptance of IHE on a national level