1September, 2005 What IHE Delivers

Chris Lindop Chris Lindop , GE Healthcare GE Healthcare Co-chair, IHE Radiology Planning CommitteeCo-chair, IHE Radiology Planning Committee

RadiologyRadiology

2007 Update2007 Update

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An Incremental Multi-Year ProjectAn Incremental Multi-Year ProjectLaunched in 1998Launched in 1998

Goal:Goal:

Enhance the Access to Clinical InformationEnhance the Access to Clinical Information Ensure Continuity and Integrity of Patient InformationEnsure Continuity and Integrity of Patient Information Speed Up the Integration in Healthcare EnvironmentsSpeed Up the Integration in Healthcare Environments Fosters Communication Between Vendors ofFosters Communication Between Vendors of

Medical Information TechnologyMedical Information Technology

ProveProve that that IntegrationIntegration is Attainable is Attainable Based on StandardsBased on Standards

Participants:Participants:

Representatives of Healthcare Providers Representatives of Healthcare Providers Information Systems VendorsInformation Systems Vendors Imaging Systems VendorsImaging Systems Vendors Standardization GroupsStandardization Groups

The IHE Initiative

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IHE RadiologyIHE Radiology

Scope: Scope: Radiology including Nuclear Medicine, MammographyRadiology including Nuclear Medicine, Mammography

VendorsVendors Acquisition Modalities, RIS, PACS, Workstations, Displays, PrintersAcquisition Modalities, RIS, PACS, Workstations, Displays, Printers

Established 1998 (first IHE domain)Established 1998 (first IHE domain)

Sponsor: RSNASponsor: RSNA

Supporters: COCIR, DRG, EAR, ECR, EuroPACS, Supporters: COCIR, DRG, EAR, ECR, EuroPACS, GMSIH, JIRA, JAHIS, JRS, JSRT, METI, MEDIS-DC, GMSIH, JIRA, JAHIS, JRS, JSRT, METI, MEDIS-DC, SFR, SIRM SFR, SIRM

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IHE Radiology - AchievementsIHE Radiology - AchievementsNow entering 10th yearNow entering 10th year Robust Vendor Participation at ConnectathonsRobust Vendor Participation at Connectathons Over 200 IHE Integration Statements published Over 200 IHE Integration Statements published Over 1000 Actors in Radiology implementedOver 1000 Actors in Radiology implemented IHE Profiles appearing in User Purchasing ProcessesIHE Profiles appearing in User Purchasing Processes

Have addressed basic radiology workflowsHave addressed basic radiology workflows Acquisition, Post-Processing, Reporting, Teaching Files/Clinical TrialsAcquisition, Post-Processing, Reporting, Teaching Files/Clinical Trials

Have addressed imaging content handlingHave addressed imaging content handling Measurements, CAD Results, NM, Mammo, Presentation States, Reports, Measurements, CAD Results, NM, Mammo, Presentation States, Reports,

Key Image NotesKey Image Notes

Have addressed distribution of imaging informationHave addressed distribution of imaging information on CDs, to enterprise, to EHRs, keeping Audit Trails on CDs, to enterprise, to EHRs, keeping Audit Trails

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IHE Radiology – Recent Development ActivitiesIHE Radiology – Recent Development ActivitiesExpand focus to integration and workflow Expand focus to integration and workflow spanningspanning departments/enterprises/regionsdepartments/enterprises/regions XDS-I **XDS-I ** Import Reconciliation Workflow **Import Reconciliation Workflow **

Expand support for specialtiesExpand support for specialties NM Image Cardiology Option *NM Image Cardiology Option * Image Fusion *Image Fusion * Mammography **Mammography **

International Focus - National ExtensionsInternational Focus - National Extensions Spain **Spain ** Canada **Canada **

** Carried over for Trial Implementation in 2008Carried over for Trial Implementation in 2008

** ** Approved for release in Technical Framework V8.0Approved for release in Technical Framework V8.0

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Strategic/DeploymentStrategic/Deployment

Clinical deploymentClinical deployment

Mammography Users Handbook (New for 2007)Mammography Users Handbook (New for 2007) RSNA 2007 Product Showcase (TCE)RSNA 2007 Product Showcase (TCE) RSNA 2007 Imaging Interoperability Demonstration (TCE & XDS-I)RSNA 2007 Imaging Interoperability Demonstration (TCE & XDS-I) HIMSS 2008 Interoperability ShowcaseHIMSS 2008 Interoperability Showcase

StrategicStrategic

Cross-domain Integration Profile ReviewCross-domain Integration Profile Review• Adopted cross-domain extensions with CP process

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Connectathon StatusConnectathon StatusNorth AmericanNorth American Jan 28 – Feb 1, Chicago, ILJan 28 – Feb 1, Chicago, IL 70 Vendors, 136 products70 Vendors, 136 products

JapanJapan 5-9 February 2007, Tokyo, Japan5-9 February 2007, Tokyo, Japan 36 Vendors, 60 systems36 Vendors, 60 systems

EuropeEurope 20-26 April 2007, Berlin , Germany20-26 April 2007, Berlin , Germany 72 Vendors, 120 products72 Vendors, 120 products

ChinaChina November 2007, ShanghaiNovember 2007, Shanghai

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Radiology ProfilesRadiology Profiles

Access to Radiology Information

-

ConsistentPresentation

of Images

EvidenceDocument

KeyImageNotes

Simple Image & Numeric Reports

Presentation of

Grouped Procedures

Post-Processing Workflow

Reporting Workflow

Charge Posting

Patien

t Info

. Reco

nciliatio

n

Scheduled Workflow

Portable Data for Imaging

NMImage

MammographyImage

Audit Trail & Node Authentication – Radiology Option

Image Fusion

Teaching Files & Clinical Export

Import Reconciliation

Workflow

Cross-Enterprise Document Sharing for Imaging

Card Option

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IHE Radiology – Integration ProfilesIHE Radiology – Integration ProfilesWorkflow

Scheduled Workflow

Patient Information Reconciliation

Post-Processing Workflow

Reporting Workflow

Import Reconciliation Workflow

Infrastructure

Access to Radiology Information

Portable Data for Imaging

Cross-Enterprise Data Sharing for Images

Security: Audit Trails & Node Authentication

Charge Posting

Teaching Files & Clinical Trials Export

Presentation & ContentConsistent Presentation of Images

Key Image Notes

Image Fusion **

Presentation of Grouped Procedure

Evidence Documents

Simple Image & Numeric Reports

NM Image*

Mammography Image

* Cardiology Option – in Trial Implementation* Cardiology Option – in Trial Implementation** in Trial Implementation** in Trial Implementation

Publications

Radiology Users Guide

Mammography Users Guide

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Radiology – Demonstrated @ HIMSS 2008Radiology – Demonstrated @ HIMSS 2008 Scheduled Workflow – Additional Clinical Information at ModalityScheduled Workflow – Additional Clinical Information at Modality

• Order Contact information (who and how)Order Contact information (who and how)• Pregnancy AlertPregnancy Alert• Specified Contrast InstructionsSpecified Contrast Instructions

Scheduled Workflow – Assisted Protocol OptionScheduled Workflow – Assisted Protocol Option• RIS-driven Protocol selection using common protocol codesRIS-driven Protocol selection using common protocol codes

Scheduled Workflow – Image availability NotificationScheduled Workflow – Image availability Notification• Auto-verify of images from Modality to PACS and to RISAuto-verify of images from Modality to PACS and to RIS

Consistent Presentation of ImagesConsistent Presentation of Images• Modality defined text annotation displayed on PACSModality defined text annotation displayed on PACS

Portable Data for Imaging – Web OptionPortable Data for Imaging – Web Option• Image Presentation for Clinicians (Outpatient EMR)Image Presentation for Clinicians (Outpatient EMR)

Cross-Enterprise Document Sharing for Imaging - WADOCross-Enterprise Document Sharing for Imaging - WADO• Image Presentation for Clinicians (Outpatient EMR)Image Presentation for Clinicians (Outpatient EMR)

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New Profile Development for 2008New Profile Development for 2008

PDI – DVD/USB OptionPDI – DVD/USB Option

Dose ReportingDose Reporting

Mammography Acquisition WorkflowMammography Acquisition Workflow

Scheduled Workflow II (Volume 1 only)Scheduled Workflow II (Volume 1 only)

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MediaCreator

Printer[Media Reader]

Image Display[Media Reader]

PACS[Media Importer]

CD DVD*USB*

John DoeDICOM Data

Web Data(Optional)

DICOM

DICOM

DICOM

PC BrowserWeb Data

Required to cleanup Patient ID, Acc#, etc.

Portable Data for ImagingPortable Data for Imaging

* New Option

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Dose ReportingDose Reporting

Facilitates the collection and distribution of reports detailing patient radiation exposure resulting from imaging procedures.

Retrieve Dose Information

Query Dose Information

PerformStudy 

Submit Dose Information

Prepare Monthly Submission 

Store Dose Information (CT)

Store Dose Information (XR)

Retrieve Dose Information

Query Dose Information

Generate Weekly Reports 

. . .

Acquisition Modality 1

(XR)

Image Archive

Dose Information

Monitor

Dose Registry 

Acquisition Modality 2

(CT)

. . .

Initiate Weekly Report Task 

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Mammography ImageMammography Image

Query Images [RAD-14] Retrieve Images [RAD-16] Query Key Image Notes [RAD-30] Retrieve key Image Notes [RAD-31]

Modality PS in Progress [RAD-6] Modality PS Completed [RAD-7]

DSS/ Order Filler

Image Display

Modality Image Stored [RAD-8] Key Image Note Stored [RAD-29]

Acquisition Modality Query Modality Worklist [RAD-5]

Image Manager

Image Archive

Modality PS in Progress [RAD-6] Modality PS Completed [RAD-7] Creator PS in Progress [RAD-20] Creator PS Completed [RAD-21]

Modality PS in Progress [RAD-6] Modality PS Completed [RAD-7] Creator PS in Progress [RAD-20] Creator PS Completed [RAD-21]

Procedure Updated [RAD-13] Instance Availability Notification [RAD-49]

Image Display Evidence Creator

Creator PS in Progress [RAD-20] Creator PS Completed [RAD-21]

Query Images [RAD-14] Retrieve Images [RAD-16]

Creator Images Stored [RAD-18] Key Image Note Stored [RAD-29] Query Key Image Notes [RAD-30]

Retrieve key Image Notes [RAD-31] Performed

Procedure Step Manager

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Scheduled Workflow IIScheduled Workflow II

Scheduled Workflow ScopeScheduled Workflow Scope Volume 1 onlyVolume 1 only PAM AdoptionPAM Adoption Use of Current HL-7 Version (v 2.5)Use of Current HL-7 Version (v 2.5) Options ReviewOptions Review

• Incorporate, remove or maintain statusIncorporate, remove or maintain status Actor EvaluationActor Evaluation

• ExamplesExamples– MPPS Mgr – is it neededMPPS Mgr – is it needed– Image Archive/Manager should they be grouped?Image Archive/Manager should they be grouped?

TransactionsTransactions• ExamplesExamples

– Image availability QueryImage availability Query

Profile Grouping Profile Grouping • Incorporate PIRIncorporate PIR

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2008 Development Schedule2008 Development ScheduleTimeframe Activity Scheduled Location

2007

Aug. Submit Brief Profile Proposals to Planning Committee (PC) by Aug 31 E-mail

Sept. PC Selects "Short List" of Proposals Sept 4 T-Con

Sept. PC Drafts Detailed Profile Proposals for "Short Listed" Proposals by Sept 14 E-mail

Oct. TC Completes technical review of Detailed Proposals T-Con

Oct. PC makes Final Selection of Proposals for this year Oct 24 T-Con

Nov. TC Profile development kickoff meeting Nov. 5-7 Chicago

2008

Jan. TC Finalizes profile supplements for public comment Feb 4-7 Chicago

Feb. Publication of Public Comment Supplements approx. Feb 27 www.ihe.net

Mar. Deadline for submission of public comments on profile supplements approx. Mar 27 www.ihe.net

Mar./Apr. TC reconciles public comments Mar 31-Apr 2 Chicago

Apr. Publication of Trial Implementation Supplements www.ihe.net

Jun. Publication of Final Text Technical Framework (if appropriate) www.ihe.net

2009

Jan. First Test implementations at Connectathon Chicago

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ParticipatingParticipatingVendorsVendors Implement IHE Profiles in your productsImplement IHE Profiles in your products Test your products at the IHE ConnectathonTest your products at the IHE Connectathon Publish IHE Integration StatementsPublish IHE Integration Statements

UsersUsers Learn about the IHE ProfilesLearn about the IHE Profiles Include specific IHE Profiles in your RFPsInclude specific IHE Profiles in your RFPs

IHE ProcessIHE Process Review Draft Profiles during Public Comment phaseReview Draft Profiles during Public Comment phase Participate on CommitteesParticipate on Committees

• Radiology Planning Committee: Radiology Planning Committee: – Kevin O’Donnell (Toshiba) & Chris Lindop (GE Healthcare)Kevin O’Donnell (Toshiba) & Chris Lindop (GE Healthcare)

• Radiology Technical Committee: Radiology Technical Committee: – Cindy Levy ( Cedara)Cindy Levy ( Cedara)

• Chris Carr (RSNA) – ihe@rsna.orgChris Carr (RSNA) – ihe@rsna.org

18September, 2005 What IHE Delivers