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This workshop aims to address the need for broad distribution of high-quality ECG documents using ubiquitous technology. The focus is on facilitating apps for serial comparison and ensuring compatibility with existing RID clients.
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Integrating the Healthcare Enterprise Retrieve ECG for Display Profile Barry D. Brown, Mortara Instrument, Inc. ECG Profile co-editor IHE Cardiology Technical Committee
ECG Needs • Need broad distribution of ECGs using ubiquitous technology (Web). • High-quality ECG documents. Avoid artifacts on zoomed ECGs and arbitrary display geometries. • Vector images required (not rasterized) • Facilitate apps for serial comparison (side-by-side synchronized display). IHE Interoperability Workshop
Goal for Year 1 • High ROI—value added problem solutions • Standards in place (HTTP, PDF, SVG) • No “political” challenges – just technical • Restricted scope for a “quick win” • Reuse successful IHE IT Infrastructure Retrieve Information for Display (RID) profile to meet similar needs IHE Interoperability Workshop
In Scope for Year 1 • Provide ECGs and related reports to enterprise • Reuse IHE-ITI RID • Retrieve list of documents; retrieve single document • ECGs served in ready-to-display format (PDF, SVG) • Limited extension for ECG-specific needs • Add requirements on display format and quality • Include XML-based ECG report list IHE Interoperability Workshop
Out of Scope for Year 1 • ECG acquisition and reading workflow. • ECG raw data interchange. • Export of reports to external repository. • Central management and configuration of ECG devices. IHE Interoperability Workshop
Year 1 Strategy • Reuse IHE-ITI RID as it is: • Retrieve list of cardiology documents, including ECGs in ready-to-display format (HTML) • Retrieve single document, including an ECG • ECGs served in ready-to-display formats (PDF, SVG) • Compatibility with existing RID clients IHE Interoperability Workshop
Year 1 Strategy (cont.) • Make ECG-specific extensions to RID • Place requirements on ECG source to ensure high-quality ECG documents. • Add ECG-specific request for list of ECGs to be returned as XML allowing more client flexibility. • Add SVG as allowed ECG document format. IHE Interoperability Workshop
PDF • ECG Source required to support PDF so it is compatible with existing RID clients. • PDF is a common document type and most computers already have a viewer. • ECG Source required use vector graphics for waveforms in PDF. • Gives high quality line drawings at any screen resolution and zoom factor. • Rasterized (e.g. scanned, bitmapped) ECG “images” not allowed. IHE Interoperability Workshop
Example ECG in PDF Format IHE Interoperability Workshop
SVG • Scalable Vector Graphics – “XML Graphics for the Web” – a W3C standard. • Well suited for line drawings (e.g. waveforms) in a XML/Web environment. • Currently supported through web browser plug-ins. IHE Interoperability Workshop
Example ECG in SVG Format IHE Interoperability Workshop
Use Case D1: Simple Display • Display actor requests list of ECG documents for a specific patient ID. • RID profile SUMMARY-CARDIOLOGY request returns list as HTML. • ECG profile SUMMARY-CARDIOLOGY-ECG request returns list as XML with stylesheet. • Display actor requests a specific ECG document using a unique document ID. • The ID of the requested document may not have been obtained from the previously retrieved list. IHE Interoperability Workshop
Example List as HTML IHE Interoperability Workshop
Use Case D2: Advanced Display • Display actor requests list of ECG documents for a specific patient ID using ECG profile request type. • List of ECGs returned as structured XML. • Display actor parses structured document list to select related ECGs for serial comparison, for example. • Display actor requests the specific ECG documents using the unique document IDs obtained in structured list above. Display actor displays the ECGs in a meaningful way. IHE Interoperability Workshop
ECG List HL7 V3 R-MIM IHE Interoperability Workshop
ECG List XML Schema IHE Interoperability Workshop
ECG List XML Example (1/3) IHE Interoperability Workshop
ECG List XML Example (2/3) IHE Interoperability Workshop
ECG List XML Example (3/3) IHE Interoperability Workshop
ECG List XML Example Formatted with Stylesheet IHE Interoperability Workshop
Serial Comparison Example 23-April-200413:45:02 23-April-200413:47:45 IHE Interoperability Workshop
For more info: • IHE Cardiology Technical Framework Version 1.0 for Trial Implementation at: • www.rsna.org/ihe • www.acc.org/quality/ihe.htm • Submit questions and comments to: • http://forums.rsna.org IHE Interoperability Workshop