Cor Loef, Program Manager Interoperability & Security Philips Medical Systems

1. Cor Loef, Program Manager Interoperability & SecurityPhilips Medical Systems Bringing IHE to real life,where to start and how to implement

2. Content: • Objective: Integrating (part of) the Healthcare Enterprise • Approach • How to specify and judge vendor offerings • Examples of how to use IHE in practice • Conclusion HIMSS / RSNA

3. The objective • Integrating (part of) the Healthcare Enterprise • Optimal support for workflow • Integrated IT solutions • Seamless information flow HIMSS / RSNA

4. The approach • Focus on Operational Workflow analysis, information flow required for applications, current situation of products and transactions, desired situation, gap analysis, resulting in requirements for new products and upgrades • Expectation management • IHE supports this process with a common framework all involved parties can understand and commit to. HIMSS / RSNA

5. Integration Profiles • IHE is not a product itself. • Set of Integration Profiles, Actors, and Transactions. Need to map requirements on these IHE concepts. • Examples: • SWF(Scheduled WorkFlow),KIN(Key Image Note) • Consistent presentation of images • Scan lines • Comprehensive profile table, and for a specific system an Integration Statement HIMSS / RSNA

6. Scheduled Workflow Post- Processing Workflow Patient Information Reconciliation ChargePosting Admit, order, schedule, acquire images, notify of completed steps Schedule, perform, & notify image processing & CAD steps Collection of billable procedure details Unknown patients and unscheduled orders Consistent Presentation of Images Key ImageNotes Simple Image and Numeric Reports Simple reports with image links and, optionally, measurements Hardcopy and softcopy grayscale presentation state Flag significant images Presentation of Grouped Procedures Subset of a single acquisition Access to Radiology Information Consistent access to images and reports Basic Security Audit Trail Consolidation & Node Authentication IHE Integration Profiles HIMSS / RSNA

7. Integration Profile Modality Image Creator Image Display Image Manager/ Archive DSS/Order Filler ADT Report Creator General Integration Profile table Actor HIMSS / RSNA

8. System Transactions Overview HIMSS / RSNA

9. Vendor offerings Specific integration statement for 1 product, listing: • name of the product, and version • what IHE actors this product provides • what Integration Profiles each actor in this product supports HIMSS / RSNA

10. Example: PACS X, vendor Y Actor Image Display Image Manager/ Archive Report Creator Secure Node HIMSS / RSNA

11. Ask the vendor to specify and to be responsible for the stated IHE implementation of the products. • Credible vendors will have participated in the IHE connectathon sessions. • Ask the vendors to list IHE conformant systems on a web page, also RSNA will provide a link to this page for successful connectathon participants. • Ask for the relationship between the connectathon participation and listed products. Certification? HIMSS / RSNA

12. Example: New Modality • Standard: • Actors: Acquisition Modality • Integration Profiles: Scheduled Workflow and Patient Information Reconciliation • If there’s a need for Procedure grouping: • Integration Profile: Presentation of Grouped Procedures HIMSS / RSNA

13. Example: PACS • Standard: • Actors: Image Manager, Image Archive, and Image Display • Integration Profiles: Scheduled Workflow and Patient Information Reconciliation • Display and Printing Quality: • Actors: Image Display and Print Composer • Integration Profile: Consistent Presentation of Images HIMSS / RSNA

14. Example: PACS, part 2 • Modalities with Procedure grouping: • Actors: Image Archive • Integration Profile: Presentation of Grouped Procedures • Flagging specific images: • Actors: Image Archive and/or Image Display • Integration Profile: Key Image Note HIMSS / RSNA

15. Example: RIS Upgrade • Standard: • Actors: Order Filler • Integration Profiles: Scheduled Workflow and Patient Information Reconciliation • DICOM Structured Reporting • Actors: Report Manager, Report Repository, Report Creator and Report Reader • Integration Profile: Simple Image and Numerical Reports HIMSS / RSNA

16. Will IHE do it all? A lot, but: • Current scope is Radiology, first step to CPR • Need to address performance requirements • Clinical applications required • Services are needed • Project management • Training • Implementation/transition management • Operational support HIMSS / RSNA

17. Conclusion • Using IHE Integration Profiles when writing specifications will make systems integration faster, more efficient, less expensive and successful. • Can go for a bigbang approach, but also for a focus on a specific smaller area. • Standards-based integration solutions are more flexible and easier and less expensive to maintain than proprietary methods. • Success stories will be presented at the RSNA HIMSS / RSNA

18. Conclusion • Ask your vendors about the IHE Actors and Profiles they support in their products. HIMSS / RSNA

19. Example: Modality Upgrade • New Modality Requirements, or if not possible: • Individual Transactions: • Modality Image Stored • Modality Worklist Provided • Storage Commitment • Procedure Step Complete • Procedure Step in Progress HIMSS / RSNA