Purchasing & Integrating Radiology Systems Using IHE A Tutorial

1. Purchasing & IntegratingRadiology SystemsUsing IHE A Tutorial Presenter NamePresenter CompanyPresenter Role in IHE

2. Integrating the Healthcare Enterprise • facilitates integrating systems • for efficient, accurate patient care • Systems that support IHE Integration Profiles: • communicate better & integrate more easily • provide more complete and accurate information • better support care providers workflow

3. IHE = Integration Profiles • Each IHE Profile • describes a clinical information need or workflow scenario • documents how to use standards (e.g. HL7, DICOM, ...)to accomplish it • Systems that implement the same Profile address a need in a mutually compatible way • Hundreds of products support one or more IHE Radiology Profiles.

4. Your Four Step Program • Prioritize the integration problems you need solved • Select Specific IHE Profile(s) • List those Profiles in your RFP/ Tender • Check Vendors IHE Integration Statements

5. Analyzing Integration Problems • Clinical Priorities • Improvements in Department Performance • Potential Efficiency Gains • End-User Pain • Cost-Effectiveness • Vendor Readiness • Available Resources / Skillsets • Administrative Guidelines / Vision

6. Where to start... • First, recognize what systems you need to integrate • See what Actors they implement and what Profiles they support • Ensure you have the Actors based on the Profiles you want to implement • By leveraging IHE, the first part can be done easily Note: You still have to include additional integration needs not covered by IHE.

7. Selecting IHE Profiles www.ihe.net Review the Profiles : • What they do • Benefits for your situation Some Helpful Resources: • IHE User’s Handbooks • Radiology • Mammography • RSNA Demonstrations • Educational Material (e.g. Workshop Presentations) • IHE Technical Framework – Radiology • Connectathon Results

8. RFPs/ Tenders Your choice: • Be Brief? • “The system must support DICOM” • Be Effective? • “The system must support the following DICOM services according to the following 100 pages of specifications: …” • Be Both: • “The system must support the IHE Scheduled Workflow Profile as the Acquisition Modality actor.” • Vendor IHE Integration Statements • Version 2.1 of the CardioCT 5000 supports IHE Scheduled Workflow as an Acquisition Modality

9. IHE Integration Statements • Explicit claim by the vendorfor a specific product version • Lists IHE profiles, actors, options • Short & Sweet

11. Let’s look at an Example From the IHE Radiology User’s Handbook • Suppose you’re buying a modality (see Chapter 1) • Suppose your integration strategy has identified two key goals: • Reducing/Preventing Errors • Improving Throughput/Turnaround • Reviewing the Profile Benefits (see Section 1.1.1): • Scheduled Workflow Profile has a significant impact on both goals: • Prevents manual data entry errors & saves time at the modality console by downloading patient demographics and study details from the RIS (MWL) • Prevents lost studies & time wasted re-scanning by confirming PACS receipt of images to avoid accidental deletion (Storage Commitment); • And saves more time by confirming automatically and electronically • Reduces missing or irrelevantpriors by storing a full set of accurate patient and study identifiers and details in each study object (Store) • Reduces delays in the reporting process by notifying the RIS of exams in progress and ready to read (MPPS)

12. IHE 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

13. A Second Example Suppose your integration strategy has identified two key goals: • Keeping your patients’ radiation exposure “As Low As Reasonably Achievable (ALARA)” • Improving your ability to monitor compliance of local policies and procedures governing radiation exposure of patients Reviewing the Profile Benefits from the Radiation Exposure Monitoring (REM) Profile Supplement: • Estimating radiation dose delivered to patients for medical purposes can facilitate a number of important activities: • For facilities exposing patients to radiation, monitoring such exposures can help ensure their policies, procedures and protocols are adequate and being followed appropriately. • For imaging physicians, monitoring such exposures can assist them in determining how changes in techniques and protocols impact radiation dose as well as image quality. This will enable them to maintain patient doses As Low As Reasonably Achievable (ALARA).

14. IHE Radiation Exposure Monitoring Profile

15. Using IHE • Present IHE as an integration priority to your vendors. A Business goal ! • Specify appropriate Profiles, Actors, Options in your RFP/ Tender • “The system must support the IHE Scheduled Workflow Profile as the Acquisition Modality actor and support the Exception Management Option.” • Request Integration Statements from your vendors • Plan acceptance testing (see Section 1.2.2)

16. Dealing with Legacy • Prepare to identify and address legacy system issues (see Section 1.2.4) • Maximum benefit when all systems are IHE • Most of you will have some non-compliant devices and systems • Make best effort to bring them “up-to-date” • Incremental usage of IHE provides incremental benefit • It’s just clean DICOM and HL7 • Get on the Yellow Brick Road... • No sense buying New legacy equipment

17. Next Steps • Visit IHE Profile Demonstrations (Hall A, Booth 2842) • Cross-Enterprise Document Sharing for Imaging [XDS-I] • Teaching File & Clinical Trial Export [TCE] • Visit www.ihe.net- start learning about Profiles • Talk about an IHE strategy with your CIO / IT staff, and with your vendors