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IHE Cardiology

IHE Cardiology. 5-year Roadmap. Roadmap subcommittee: Bill Weintraub wweintr@emory.edu Andrew Keller amk5@columbia.edu Kenneth Queensberry kqueensb@acc.org Harry Solomon harry.solomon@med.ge.com Bryan Schnepf bryan.schnepf@philips.com Jon Elion jle@heartlab.com

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IHE Cardiology

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  1. IHE Cardiology 5-year Roadmap Roadmap subcommittee: Bill Weintraub wweintr@emory.edu Andrew Keller amk5@columbia.edu Kenneth Queensberry kqueensb@acc.org Harry Solomon harry.solomon@med.ge.com Bryan Schnepf bryan.schnepf@philips.com Jon Elion jle@heartlab.com Joe Biegel joe.biegel@agfa.com David Croke david_croke@idx.com Ruediger Simon simon@cardio.uni-kiel.de Ashwin Patel apatel@acc.org Rev 2.1

  2. Principles • Cardiology profiles addressing clinicaluser needs to be developed by IHE Cardiology committees • Prioritization by Planning Committee • Refinement and technical definition by Technical Committee • IT Infrastructure profiles addressing general healthcare needs available to be demo’ed in the cardiology domain ~1-2 years after adoption by IT Infrastructure committees • Vetting by Planning Committee for applicability to critical cardiology need • Recommendations to IT Infrastructure for new profiles in that domain Rev 2.1

  3. Timeline20 months from concept to demo Rev 2.1

  4. 2/3/5 year plan • Year 2 should be highest clinical priority • Including items deferred from current year • Year 3 should be high priority items that will require >1 year vendor development • Need complete definitions of concepts, so that vendors can start planning • Years 4-5 are conceptual Rev 2.1

  5. Year 1(2005 demo) Year 2(2006 demo) Year 3(2007 demo) Year 4(2008 demo) Year 5(2009 demo) Cardiology Technical Framework Cath Multi-modality workflow & imaging Procedure log &reporting Hemo waveform & measures, QCA/QVA Precision timesynchronization Supplies, inventory,& charge capture Echo Workflow & imaging,stress protocols Reporting workflow Measurementinteroperability Pediatric ECG Retrieve ECGfor display ECG/Stress/Holterorders ECG waveform interoperability Nuclear Workflow & imaging,stress protocols Reporting workflow EP Multi-modality labworkflow & reporting Implantable device parameters & events Home healthmonitoring MR/CT Workflow, reporting,& measurements Quality Registry datasubmission Retrieve guidelinesfor display Retrieve structuredguidelines IT Infrastructure TF Admin Cross-enterprisereferrals/orders Patient location& transport EMR Retrieve infofor display Cross-enterprisedocument sharing Patient care plan Risk factors forclinical decision supt Infra Timesynchronization Personnel white pages Device auto-configuration Security Audit trail Enterprise userauthentication Rev 2.1

  6. Cardiology Year 1 Profiles (2005 demo) • Cath lab workflow - including coordination of the multi-modality environment, access to patient demographics, and storage and display of images • Echo workflow - including scheduling and management of digital echo exams, including multi-stage stress exams, and storage and display of images • Retrieve ECGs for display - access to ECGs for display using web technology Rev 2.1

  7. IT Infrastructure Profiles for Cardiology Year 1 (2005 demo) • Consistent time - specifies time synchronization to better than 1 second accuracy using NTP; supports cath lab workflow (ITI 2004) • Retrieve info for display - access to a variety of patient info for display using web technology; supports cross-department access to data (ITI 2004) Rev 2.1

  8. Cardiology Year 2 Profiles (2006 demo) • Cath lab reporting workflow– distributed creation of procedure log, reporting workflow, outbound reports • Echo reporting workflow - reporting workflow, including sonographer preliminary reports and cardiologist over-reading • Nuclear medicine - image content profile for NM, including cardiac (from IHE Radiology 2004) • Registry data submission – standard formats for ACC NCDR 3 / ESC CARD Rev 2.1

  9. IT Infrastructure Profiles for Cardiology Year 2 (2006 demo) • Audit trail - centralized logging of system security events and user access of patient data (ITI 2004) • Cross-enterprise document sharing – repositories for clinical documents accessible across institutional boundaries, including ECGs and reports (ITI 2005) • Personnel white pages – centralized directory of healthcare staff information (ITI 2005) Rev 2.1

  10. Cardiology Year 3 Profiles (2007 demo) • Cath lab content – creation and display of interoperable QCA/QVA, hemo waveforms, and hemo measurements • Echo measurements - creation and display of interoperable echo measurements • Nuclear medicine reportingworkflow - measurements and reporting • EP lab workflow – adapted cath lab workflow, storage and display of images, waveforms and measurements; reporting • MR/CT angiography – adapted radiology workflow, storage and display of images and measurements; reporting • Retrieve guidelines for display – keyword-based retrieval of guidelines Rev 2.1

  11. IT Infrastructure Profiles for Cardiology Year 3 (2007 demo) • Cross-enterprise referrals and orders – Referrals and Orders from physician office to specialty diagnostic facility, with clinical attachments (recommend to ITI) • Enterprise user authentication – centralized user account management and authentication (ITI 2004) Rev 2.1

  12. Evaluation • Do these represent the highest clinical priorities? • Do we have the proper services to support clinical information needs for addressing patients presenting with caridac disease/syndromes? • ACS, MI, HF, Afib, hypertension, etc. Rev 2.1

  13. Cath Workflow Procedure Logging and Reporting Cath Hemodynamics Report and Waveform Display Cath Lab Precision Mutli-Modality Synchronization Echo Workflow Reporting Nuclear Cardiology workflow Electrophysiology workflow, waveforms, measurements, reports, device parameters Non-invasive Angiography workflow (MRA/CTA) Evidence Reporting and Display (QCA/QVA, MRA/CTA) Workflow step prerequisite checking (labs, drugs, insurance) Cath lab inventory management Charge capture Retrieve Guidelines for Display Retrieve Structured/Actionable Guidelines Outpatient imaging workflow Patient care plan Outbound Reports (to longitudinal record) (IHE IT Infrastructure) Cross-Enterprise Patient ID Cross-Reference (Cardiology practice / multiple hospitals) Cross-Enterprise Ordering and Referral Cross-Enterprise Clinical Document Sharing (IHE IT Infrastructure) Registry Data submission (ACC NCDR 3 / ESC CARD) Scheduling (room/equipment; physician/staff) Summary report – discharge Cardiac Risk Factors extract from Longitudinal Record Critical value alarms Patient location tracking / transport management … and all IHE IT Infrastructure profiles! Potential future IHE/Cardiology profiles(December 2003 brainstorming) Rev 2.1

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