1September, 2005 What IHE Delivers

Charles Parisot, GECharles Parisot, GE

Nikolaus Wirsz, SiemensNikolaus Wirsz, Siemens

Integrating the Healthcare Integrating the Healthcare Enterprise (IHE)Enterprise (IHE)

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A Framework for InteroperabilityA Framework for Interoperability

Integrating the Healthcare Enterprise:Integrating the Healthcare Enterprise: An initiative that improves patient care by An initiative that improves patient care by

harmonizing healthcare information exchange harmonizing healthcare information exchange Provides a common standards-based framework Provides a common standards-based framework

for seamlessly passing health information among for seamlessly passing health information among care providers, enabling local, regional and care providers, enabling local, regional and national health information networksnational health information networks

Promotes the coordinated use of established Promotes the coordinated use of established standards–Health Level 7, ASTM, DICOM, W3C, standards–Health Level 7, ASTM, DICOM, W3C, IEEE, etc.—to address specific clinical needsIEEE, etc.—to address specific clinical needs

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Who is IHE?Who is IHE?

IHE is a joint initiative among:IHE is a joint initiative among:

American College of Cardiology (ACC)American College of Cardiology (ACC) Radiological Society of North America (RSNA)Radiological Society of North America (RSNA) Healthcare Information Management Systems Society (HIMSS)Healthcare Information Management Systems Society (HIMSS) GMSIH, HPRIM, JAHIS (laboratory)GMSIH, HPRIM, JAHIS (laboratory) American Society of OphthalmologyAmerican Society of Ophthalmology American College of Physicians (ACP)American College of Physicians (ACP) American College of Clinical Engineering (ACCE)American College of Clinical Engineering (ACCE) And many more….And many more….

Began in 1997 in Radiology (RSNA) and IT (HIMSS)Began in 1997 in Radiology (RSNA) and IT (HIMSS)

International effort: IHE- Europe and IHE-AsiaInternational effort: IHE- Europe and IHE-Asia

Additional sponsors for Cardiology including ASE, ESC, ASNC, SCA&I, Additional sponsors for Cardiology including ASE, ESC, ASNC, SCA&I, HRS and moreHRS and more

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IHE Organizational Structure Multi-Domain & Multi-NationalIHE Organizational Structure Multi-Domain & Multi-National

Participants

contribute

Global Development:Radiology,IT Infrastructure,Cardiology,Lab, etc.

Delegates

IHE Europe

IHE North America

IHE Asia/Oceania

Regional &NationalDeployment

supervises reports

IHE (International) Strategic Development Committee

SponsorsCo-Chairs

Global

Interoperability

IHE Domain-related Planning Committee and

Technical Committee

National Extensions

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Electronic Health Record

Cardiology

Laboratory

Radiology

Oncology

Future

Domains

IHE

IT Infrastructure

14 Integration Profiles

5 Integration Profiles

4 Integration Profiles

1133 IInntteeggrraattiioonn PPrrooffiilleess

Patient Care Coordination

1 Integration Profile

Patient Care

Devices

Pathology

Eye Care

IHE 2006 – Nine Active Domains IHE 2006 – Nine Active Domains Over 100 vendors involved world-wide,Over 100 vendors involved world-wide, 5 Technical Frameworks5 Technical Frameworks

37 Integration Profiles, Testing at Connectathons37 Integration Profiles, Testing at ConnectathonsDemonstrations at major conferences world-wideDemonstrations at major conferences world-wide

15 Active national chapters on 4 continents15 Active national chapters on 4 continents

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Connecting standards to careConnecting standards to care

Care providers work with vendors to Care providers work with vendors to coordinate the implementation of standards coordinate the implementation of standards to meet their needsto meet their needs Care providers identify the key interoperability Care providers identify the key interoperability

problems they faceproblems they face Drive industry to develop and make available Drive industry to develop and make available

standards-based solutionsstandards-based solutions Implementers follow common guidelines in Implementers follow common guidelines in

purchasing and integrating systems that deliver these purchasing and integrating systems that deliver these solutionssolutions

What is the effective way to establish “standards” for how to implement standards ?

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Standards Adoption ProcessStandards Adoption Process

Document Use Case RequirementsDocument Use Case Requirements

Identify available standards (e.g. HL7, DICOM, IETF, OASIS)

Identify available standards (e.g. HL7, DICOM, IETF, OASIS)

Develop technical

specifications

Develop technical

specifications

Testing at ConnectathonsTesting at Connectathons IHE

DemonstrationsIHE Demonstrations

Products with IHEProducts with IHE

Timely access to Timely access to informationinformationTimely access to Timely access to informationinformation Easy to integrate

productsEasy to integrate products

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Simple Image and Numeric ReportsSimple Image and Numeric Reports

Integration Profile Defining Simple Reports that Include Measurements

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SINR Value PropositionSINR Value Proposition

Reports’ content is more than words…Reports’ content is more than words…

Based on DICOM SRBased on DICOM SR

Allows to include without transcription:Allows to include without transcription: measurementsmeasurements image linksimage links structured content structured content

Integrated with the imaging workflowIntegrated with the imaging workflow

Friendly to XML implementationsFriendly to XML implementations

Easy to export with HL7Easy to export with HL7

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Pattern – Pattern – Simple Image ReportSimple Image Report

• Minimal Structure : Coded Title and HeadingsMinimal Structure : Coded Title and Headings• Full image links from specific sections of reportFull image links from specific sections of report• Observation Context Observation Context (who, what, when)(who, what, when) may be section specific may be section specific

0-n

CONTAINS 1

CONTAINS

0-n

0-n

INFERRED FROM

Report Text

Image Reference

Observation Context

(See section 5.3.2.3) 1-n

Section Heading

Document Title

Image Reference

0-1

Observation Context

(See section 5.3.2.3)

0-n

Coded Entry

0-n

INFERRED FROM

Image Reference

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Simple Image and Simple Image and NumericNumeric Report Report

Simply adds Measurements to Image ReportsSimply adds Measurements to Image Reports

0-n

CONTAINS

HAS OBS CONTEXT

1

CONTAINS

0-n

Report Text

Image Reference

Observation Context

(See section 5.3.2.3) 1-n

Section Heading

Document Title

HAS OBS CONTEXT

0-1

Observation Context

(See section 5.3.2.3)

0-n

Coded Entry

0-n

0-n

INFERRED FROM

Image Reference

Measurement

0-n

Measurement

0-n

INFERRED FROM

Image Reference

Measurement

0-n

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An An illustrationillustration

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IHE Strategy for ImplementationIHE Strategy for Implementation

Leverages existing standards to allow rapid deployment, Leverages existing standards to allow rapid deployment, but plan for futurebut plan for futurePragmatic Course and Ease of EvolutionPragmatic Course and Ease of Evolution

Enables architectural freedom (centralized vs. Enables architectural freedom (centralized vs. decentralized, patient vs. provider centric) decentralized, patient vs. provider centric) Flexibility of ConfigurationFlexibility of Configuration

Supports breadth of use cases: variety of care settings, Supports breadth of use cases: variety of care settings, care coordination, public health, PHR, EHR, researchcare coordination, public health, PHR, EHR, researchInteroperability across spectrum of health systemInteroperability across spectrum of health system

Offers consistent, standards-based and functional record sharing for imaging and information systems

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IHE Connectathon, January 2006IHE Connectathon, January 2006

300+ participants, 120+ systems60+ vendors Four Domains:Cardiology, Radiology, IT Infrastructure, Patient Care Coordination

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Connectathon 2007Connectathon 2007

Hyatt Regency Chicago151 East Wacker Drive

January 15-19, 2007

AccentureAccenture Acuo Technologies Acuo Technologies Agfa HealthcareAgfa HealthcareAlert Life Sciences Computing Alert Life Sciences Computing AllscriptsAllscripts Axolotl Corp.Axolotl Corp.B. Braun MedicalB. Braun Medical Blueware, Inc.Blueware, Inc. Bridgeforward SoftwareBridgeforward Software Brit Systems, IncBrit Systems, IncBiosense Webster Inc. Biosense Webster Inc. Canon Medical SystemsCanon Medical SystemsCapMedCapMed Capsule TechnologiesCapsule Technologies CarefxCarefxCedara Software, Inc.Cedara Software, Inc.CernerCernerCGICGICPSICPSIDigital InfuzionDigital InfuzionDraeger Medical Systems, Inc.Draeger Medical Systems, Inc.Dynamic ImagingDynamic ImagingEastman Kodak Eastman Kodak EBM TechnologiesEBM TechnologiesEclinicalWorks, llcEclinicalWorks, llcEclipsysEclipsys

Emageon, Inc.Emageon, Inc.

Epic Systems, Inc.Epic Systems, Inc.

Fujifilm Medical SystemsFujifilm Medical Systems

IHE Connectathon North AmericaIHE Connectathon North AmericaJanuary 2007 ParticipantsJanuary 2007 Participants

GE HealthcareGE HealthcareGoodman Health NetworkGoodman Health NetworkHitachi Medical Corp.Hitachi Medical Corp.Hologic, Inc.Hologic, Inc.Hx TechnologiesHx TechnologiesIBM Healthcare IBM Healthcare Infinitt Co., Ltd.Infinitt Co., Ltd.Initiate SystemsInitiate SystemsInsiteoneInsiteoneIntersystems Corp.Intersystems Corp.Konica Minolta Medical Konica Minolta Medical ImagingImagingLive DataLive DataLumedx Corp.Lumedx Corp.Mckesson Provider Mckesson Provider TechnologiesTechnologiesMedCommonsMedCommonsMediMatic SrlMediMatic SrlMediNotesMediNotesMedQuistMedQuistMidmark DiagnosticsMidmark DiagnosticsMisys Healthcare SystemsMisys Healthcare SystemsMortara Instrument, Inc.Mortara Instrument, Inc.Medicl Informatics Medicl Informatics EngineeringEngineeringNextGen HealthcareNextGen HealthcareNovartisNovartisNational Digital Medical National Digital Medical Archive, Inc.Archive, Inc.

NISTNISTOpen TextOpen TextOrion HealthOrion HealthOutcomeOutcomePhase ForwardPhase ForwardPhilips Medical SystemsPhilips Medical SystemsPractice PartnerPractice PartnerProsolv CardioVascularProsolv CardioVascularProtoLinkProtoLinkQuadraMedQuadraMedQUOVADXQUOVADXRADinfo SystemsRADinfo SystemsSAICSAICSASSASSectra Imtec AbSectra Imtec AbSentrxSentrxSoftmedical, Inc.Softmedical, Inc.Spacelabs MedicalSpacelabs MedicalStrykerStrykerSiemens Medical SolutionsSiemens Medical SolutionsSt. Jude Medical St. Jude Medical Tiani-Spirit, GmbhTiani-Spirit, GmbhToshiba Medical SystemsToshiba Medical SystemsUS Electronics, Inc.US Electronics, Inc.Vital ImagesVital ImagesWelch Allyn, Inc.Welch Allyn, Inc.Xwave and Bell CanadaXwave and Bell Canada

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Connectathon TourConnectathon Tour

Luncheon Event:Luncheon Event: Tuesday, Jan. 16Tuesday, Jan. 16

10:00am-3:30pm10:00am-3:30pmPublic Health and Industry LeadersPublic Health and Industry LeadersInvitation: Invitation: www.ihe.net/connectathonwww.ihe.net/connectathon

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More information….More information….

IHE Web site: http://www.ihe.netIHE Web site: http://www.ihe.net

Technical Frameworks and SupplementsTechnical Frameworks and Supplements

Non-Technical Brochures :Non-Technical Brochures : Calls for ParticipationCalls for Participation IHE Fact Sheet and FAQIHE Fact Sheet and FAQ IHE Integration Profiles: Guidelines for BuyersIHE Integration Profiles: Guidelines for Buyers IHE Connect-a-thon ResultsIHE Connect-a-thon Results Vendor Products Integration StatementsVendor Products Integration Statements

IHE WikiIHE Wiki

RSNA staff contacts: ihe@rsna.orgRSNA staff contacts: ihe@rsna.org

Questions?

Questions?