IHE Radiology & Radiation Oncology: Enhancing Imaging Workflow Interoperability

1. IHE Radiology Kevin O’Donnell Toshiba Medical Systems Co-chair, IHE Radiology Planning Cmte.

2. IHE RadiologyAchievements Status: • Now finishing 7th year • Robust Vendor Participation at Connectathons • IHE Profiles appearing in User Purchasing Processes • Have addressed basic workflows • Acquisition, Post-Processing, Reporting, Routing Teaching Files/Clinical Trials • Have addressed imaging content handling • Measurements, CAD Results, NM, Presentation States, Reports, Key Image Notes • Have addressed distribution of imaging info • on CDs, to EHRs, keeping Audit Trails Interoperability Strategy Workshop

3. IHE RadiologyCurrent Activities/Direction • Facilitate deployment of IHE Profiles in the Market • Users Handbook (2005 Edition) • Considering more depth to Connectathon tests • Start addressing integration and workflow spanning departments/enterprises/regions • XDS-I • Expand support for specialties • Address Mammography • Support Radiation Oncology Domain Interoperability Strategy Workshop

4. IHE Radiation Oncology Bruce Curran University of Michigan Co-chair, IHE-RO Technical Committee

5. IHE-RO Interoperability Strategy Workshop

6. IHE-RO Interoperability Strategy Workshop

7. IHE-RO Planning Committee Jay Cooper, Co-chairNYU Keith LaPlain, Co-chairVarian Medical Systems • ASTRO Leadership • Prabhakar Tripuranemi, IHE Co-chairScripps Clinic • Jatindar Palta, IHE Co-chairU Florida • Jennifer Padberg, Staff LiaisonASTRO • Technical Committee • Bruce Curran, Co-chairU Michigan • Stuart Swerdloff, Co-chairIMPAC Interoperability Strategy Workshop

8. IHE-ROBasic Interoperability Imaging Study Imaging Study Imaging Study Contouring System Simulation System Rad Onc IMS Planning Workstation Treatment Verification Treatment Delivery Interoperability Strategy Workshop

9. IHE-ROStandards Used • DICOM • Significant interoperability issues • Un-equally spaced Image Sets • 3D Contouring • Bifurcations • Auto-segmentation ‘leftovers’ • Limits on Size of Structure Set / Dose Objects • Workflow issues to be addressed in 2007 • Query/Retrieve for RT Objects • General Purpose / Modality Worklists Interoperability Strategy Workshop

10. IHE-ROActors Planning Application Patient Registrar Multi-Media Registration Contouring Reference Point Generation Prescription Entry Beam Placer / Shaper Dose Calculator Plan Evaluator Fractionator Reference Image Creator DICOM Image Archive RT Archive RT Plan G RT SSet RT Dose RT SSet RT Plan RT Dose Reference Images • Proposals circulating between Planning Committee and Technical Committee • Many applications combine actors Interoperability Strategy Workshop

11. More information…. IHE Web site: http://www.ihe.net http://www.himss.org/IHE http://www.rsna.org/IHE http://www.acc.org/quality/ihe.htm Technical Frameworks Technical Framework Supplements – Trial Implementation Non-Technical Brochures : Calls for Participation IHE Fact Sheet and FAQ IHE Integration Profiles: Guidelines for Buyers IHE Connect-a-thon Results Vendor Products Integration Statements Questions? Interoperability Strategy Workshop

12. IHE Cardiology Harry Solomon GE Medical Systems Co-chair, IHE Cardiology Technical Cmte.

13. IHE Cardiology Roadmap • 2004-5 – three profiles with “success path”, addressing broad range of integration problems • Cath Lab Workflow management, including angio, hemo, and IVUS, especially for emergent cases • EchocardiographyWorkflow management, including mobile echo • Ability to view an ECG from any location - quickly and easily integrated into other applications • 2005-6 – focus on reporting • Evidence Documents specialized for cardiology logs and measurements • Displayable Reports for PDF-based clinical reports, RID and XDS for report distribution • 2006-9 – additional subspecialties, focus on quality initiatives Interoperability Strategy Workshop

14. Cardiology – 5 Year Roadmap Year 1(2005) Year 2(2006) Year 3(2007) Year 4(2008) Year 5(2009) Multi-modality workflow & imaging Measurements &evidence Procedure log,coded reports Supplies, inventory,& charge capture Precision timesynchronization Cardiology Technical Framework Cath Workflow & imaging,stress protocols Measurements Coded reports Pediatric Echo Retrieve ECGfor display ECG/Stress/Holterorders ECG waveform interoperability ECG Stress testing workflow Workflow & stress protocols Nuclear Multi-modality labworkflow & reporting Implantable device parameters & events Home healthmonitoring EP Reporting & reportdistribution General Retrieve guidelinesfor display Registry dataharvesting Retrieve structuredguidelines Quality Interoperability Strategy Workshop

15. Clinical Laboratory Domain Charles Parisot GE Healthcare IHE IT Technical Committee Co-chair François Macary AGFA Healthcare IT IHE Laboratory Committee Co-chair

16. Contributing countries France Japan Germany Italy The Netherlands UK US (CLSI - ex NCCLS) Development started in 2003 First profile published in November 2003 10 systems validated in 2004 12 systems validated in 2005 Four new profiles currently published for public comment The IHE Laboratory Committee Cochairs: Francois Macary - Agfa Healthcare IT Yoshimitsu Takagi - Hitachi Interoperability Strategy Workshop

17. IHE Lab today and to-morrow • Ordering, placing, scheduling and performing clinical laboratory tests both for Hospital and Ambulatory. • Microbiology included. Anatomic pathology and blood bank excluded • Five profiles: • Laboratory Scheduled Workflow (LSWF) • Laboratory Point Of Care Testing (LPOCT) • Laboratory Device Automation (LDA) • Laboratory Code Set Distribution (LCSD) • Laboratory Information Reconciliation (LIR) • Future plans • Incorporate analyzer images in the result workflow • Cross-enterprise sharing of lab reports, using CDA-R2 • Specimen labels workflow Interoperability Strategy Workshop

18. IT Infrastructure Glen Marshall Siemens Health Solutions IHE IT Infrastructure Committee Co-chair

19. IHE IT Infrastructure RoadmapStage 0 – 2003 profile development for 2004 Connectathon Interoperability Strategy Workshop

20. IHE IT Infrastructure RoadmapStage 1 – 2004 profile development for 2005 Connectathon Interoperability Strategy Workshop

21. IHE IT Infrastructure RoadmapStage 2 – 2005 profile development for 2006 Connectathon Interoperability Strategy Workshop

22. IHE IT Infrastructure RoadmapStage 3 – 2006 profile candidates for 2007 Connectathon Interoperability Strategy Workshop

23. IHE IT Infrastructure RoadmapStage 4 – 2007 profile candidates for 2008 Connectathon Interoperability Strategy Workshop

24. IHE IT Infrastructure RoadmapStage 5 – 2008+ profile candidates for 2009+ Connectathon Interoperability Strategy Workshop

25. Patient Care Coordination John Donnelly IntePro Solutions, Inc. IHE IT Infrastructure Committee and Co-chair, IHE Patient Care Coordination Committee

26. Patient Care CoordinationDomain Scope • Facilitate the use of EHR content standards for the transferring or sharing of patient care services via the development of medical summary (MS) content profiles • Specify appropriate “transfer packages” of clinical information for specific transfer of care use cases via the development of integration profiles. • Optimize the use of the IHE ITI profiles (e.g. XDS) in delivering healthcare in “communities” of patient care settings Interoperability Strategy Workshop

27. Patient Care CoordinationCurrent Accomplishments • Issued Call for Participation to vendor community and medical societies for Planning and Technical Committee formation – 2 t-cons and 1 FtoF meeting • Finalized a Medical Summary Content Proposal highlighting two key transfer of care use cases • Conducted high-level content standards evaluation exercise • Promoted content standard education initiative Interoperability Strategy Workshop