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Integrating the Healthcare Enterprise. What Does IHE Offer?. Kevin O’Donnell, Toshiba Corp. Co-chair, IHE Radiology Planning Cmte. What Does IHE Offer?. Systems Integration To achieve clinical goals Using non-proprietary methods
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Integratingthe Healthcare Enterprise What Does IHE Offer? Kevin O’Donnell, Toshiba Corp.Co-chair, IHE Radiology Planning Cmte
What Does IHE Offer? • Systems Integration • To achieve clinical goals • Using non-proprietary methods • Improve the efficiency and effectiveness of clinical practice by: • Improved Information Flow • Advanced Multi-System Functions SCAR 2003
Scheduled Workflow Profile report Registration Film Lightbox Image Manager & Archive Orders Filled Film Folder Diagnostic Workstation Film Report Repository Orders Placed AcquisitionModality acquisitioncompleted acquisitionin-progress imagesprinted Modality acquisitioncompleted SCAR 2003
Scheduled Workflow Benefits • Reduced Manual Data Entry • Increased efficiency, decreased error rates • Digital Scheduling, Tracking & Data • Managed workflow • Order loop closure, better billing • Paperless • Up to the minute status, distributed access • Filmless • Rapid distribution, rapid access SCAR 2003
Patient Information Reconciliation Profile • Extends Scheduled Workflow • Handle unidentified/emergency patient • Handle demographic information updates • Changes propagated to all affected systems, affected data updated SCAR 2003
Patient Information Reconciliation Benefits • Reduction of errors • Reduces incorrectly identified or “lost” studies • More complete medical record • Supports maintenance of demographics to maintain database correspondence • Flexible Trauma Workflow SCAR 2003
Account Management ADT Terminal Report Generated / Signed CAD *Workstation 3-D *Workstation ReportRepository 3-D Performed CAD Performed AcquisitionModality Charge Posting Profile Post Charges *Billing System Charge Poster Study Performed / Materials Used … SCAR 2003
Charge Posting Benefits • Reduces Billing Errors • less manpower required in billing cycle • More timely billing, shorter billing cycle • Detailed performed procedure information • Billing more accurately reflects what was actually done: more details, fewer errors SCAR 2003
Original Image & Presentation State Area Of Interest Area Of Interest The Radiologist’s Transformations Are Saved Flip Zoom Prepared Image Annotate Original Image Original Image Window Level Original Image The Radiologist’s Transformations Are Lost Consistent Presentation of Images Profile What the Radiologist Displays: What the Reviewing Physician Sees: SCAR 2003
Consistent Presentation of Images Benefits • More Consistent Views • Referring sees same thing as Radiologist • Softcopy matches Hardcopy • Less Work • don’t have to repeat manipulations • don’t have to calibrate every imaging device to every display device SCAR 2003
Report:CHEST Report:AB/PELVIS Ab/Pelvis View Chest View Chest View MODALITY Performs a single exam Operator groups 2 procedures Ab/Pelvis View Presentation of Grouped Procedures Profile Requested Procedure:CHEST RIS / PACS Requested Procedure:AB/PELVIS SCAR 2003
Presentation of Grouped Procedures Benefits • Improved patient experience (time/comfort) • Improved acquisition throughput • Improved reporting process • images are grouped & sorted correctly and ready for display • Improved billing • multiple order/accession chains are preserved • Reduced load on Network and PACS SCAR 2003
Note1 Note2 For referring physician: This image shows the renal rupture. For referring physician: This image has the hematoma. Study & Key Image Notes Note2 Note1 for refering physician This image shows the renal rupture. Note1 Note2 for refering physician This image has the hematoma. for refering physician This image has the hematoma. for refering physician This image shows the renal rupture. Key Image Notes Profile Radiologist Flags Images: Referring PhysicianSees Key Images First: SCAR 2003
Key Image Note Benefits • Improved communication • key image display reduces clutter • note contents provide clarifications • Improved workflow • enables automatic display & routing • Improved Study & Image Handling • Key Images for Referring • Teaching Files • QA Issues • etc SCAR 2003
Images and Examdata presented fordiagnosis Verified Report Preliminary Report Image Manager & Archive ReportVerification Reports storedforNetwork Access Report & ImageReview forPatient Care Report & Images Retrieved Images Retrieved Simple Image & Numeric Reports Profile SCAR 2003
Simple Image and Numeric Reports Benefits • Coded Values • enables data mining, decision support • Flexible Report Presentation • rich text with embed images and measurements • DICOM Management • Query/retrieve/archiving • Distribute reports through DICOM infrastructure SCAR 2003
Source Data Worklist PACS System CAD *Workstation 3-D *Workstation Workstation ReportRepository WorkStatus Results AcquisitionModality Post-Processing Workflow Profile Post-Proc. Workflow Manager WorkStatus … Results SCAR 2003
Post-Processing Workflow Benefits • Worklist Management • Provides todo list • Direct references to input data • Reduced Manual Data Entry • Increased efficiency, decreased error rates • Electronic Status • Status available quickly, Distributed access, Trigger interpretation, better workflow • Electronic Results • Post-processed images / objects get associated with the correct study SCAR 2003
Emergency Department Referring Physician Radiology Department – Images and Reports Remote Clinics Other Departments:- Oncology- Surgery- Neurology- Pediatrics- etc. Electronic Medical Record Access to Radiology Information Profile SCAR 2003
Access to Radiology InformationBenefits • Improved Access to Images, Reports, etc • More complete, timely patient views • Fewer requests to radiology staff SCAR 2003
Image Manager & Archive Diagnostic Workstation ReportRepository Report & ImageReview Basic Security Profile Audit Record Repository … … “Images Queried / Retrieved” “Reports Retrieved” “Reports Printed” “Images Printed” “Reports Stored” “Reports Queried / Retrieved” SCAR 2003
Basic Security Benefits • Centralized Activity Auditing • Monitor/Audit HIPAA policy conformance • Measure Departmental performance • Improved Security SCAR 2003
What Do You Get for All This? • Fewer errors, improved data accuracy • Greater access to information • Reduced study loss, retakes • Fewer tedious tasks • Better scheduling and tracking • Increased modality throughput • Freedom to acquire components from multiple manufacturers SCAR 2003