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Image Sharing- the NIBIB/RSNA image sharing project employing IHE solutions

Image Sharing- the NIBIB/RSNA image sharing project employing IHE solutions. Fourth China-U.S. Roundtable Meeting on Scientific Data Cooperation:. IHE-Providing the Foundation for Interoperability. David S. Mendelson, M.D. Professor of Radiology Chief of Clinical Informatics

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Image Sharing- the NIBIB/RSNA image sharing project employing IHE solutions

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  1. Image Sharing- the NIBIB/RSNA image sharing project employing IHE solutions Fourth China-U.S. Roundtable Meeting on Scientific Data Cooperation: IHE-Providing the Foundation for Interoperability David S. Mendelson, M.D. Professor of Radiology Chief of Clinical Informatics The Mount Sinai Medical Center Co-chair IHE International Board

  2. Presentation Objectives • Integrating the Healthcare Enterprise (IHE) • Overview- How is IHE organized? • Healthcare Interoperability in the United States • Challenges • ARRA (American Recovery and Reinvestment Act) • Image Sharing • Via HIE • Image Sharing Project- Personal Health Records (PHRs)

  3. Integrating the Healthcare EnterpriseThe state of IHE - 2010 David S. Mendelson, M.D. Chief of Clinical Informatics The Mount Sinai Medical Center Co-chair IHE Board

  4. Germany Holland Norway Canada Austria Taiwan France Japan Korea China Spain USA Italy UK Year 7 (2005) Year 8 (2006) Year 1 (1999) Year 2 (2000) Year 3 (2001) Year 4 (2002) Year 5 (2003) Year 6 (2004) International Adoption of IHE • Local Deployment • National Extensions (Local Adaptions) • Promotional & Live Demonstration Events • Funding Pragmatic global standards harmonization + best practices sharing

  5. Lower Austria Austria National and Regional Projects Using IHE Profiles Netherland Amsterdam Italy (Conto Corrente Salute) UK CfH (Radiology WF) Denmark (Funen) Italy (Veneto) Spain (Aragon) FranceDMP Quebec, Toronto,Alberta, British ColumbiaCanada Infoway VITL-Vermont Boston Medical Center - MA Philadelphia HIE CPHIC – Pennsylvania CareSpark – TN & VA South Africa THINC- New York NCHICA – N. Carolina Malaysia CHINA-MoH Lab results sharing JAPAN-Nagoya Imaging Info Sharing CHINA-Shanghai Imaging Info Sharing

  6. IHE International Board Global Development IHE North America IHE Asia-Oceania China Japan Radiology IT Infrastructure Laboratory Canada USA Korea Taiwan Cardiology Patient Care Coordination Pathology IHE Europe Radiation Oncology Patient Care Devices Eye Care Austria France Germany Netherlands Italy Norway Spain UK Sweden Professional Societies / Sponsors ACC ACCE ACEP ACP GMSIHIMSS Contributing & ParticipatingVendors COCIR EAR-ECR DRG SIRM BIR EuroRec RSNA SFRSFIL ESC JAHISJIRAJRS METI-MLHW MEDIS-DCJAMI IHE Organizational Structure Regional Deployment

  7. IHE China: http://www.ihe-c.org Thank You for Your Attention Prof. Jianping Dai, MD

  8. Events: Promotion Education and Promotion by Journals Education and Promotion by Workshop

  9. Events: Connectathon Dr. Zhu, Chairman of IHE China, past vice Minister of Healthcare attended There are 7 companies attended The IHE-C Connectathon was held at April 26, 2008 in Beijing Tiantan Hospital

  10. Events: Connectathon The IHE-C Connectathon was held at April 26, 2008 in Beijing Tiantan Hospital

  11. IHE – the process • Identify Interoperability issues • Develop Integration Profiles • Actors and Transactions • Workflow • Gather relevant standards • Connectathon Testing • Publish Integration Statements • Vendors list tested profiles

  12. Problem to Profile

  13. Interoperability in the US-Challenges • Privacy rights • HIPAA • No Single identifier

  14. Office of the National Coordinator for Healthcare IT (ONC) • Health Information Technology Standards Panel (HITSP) • Certification Commission for HIT (CCHIT) • American Recovery and Reinvestment Act (ARRA) • Includes financial incentives for adoption of the Electronic Health Record throughout the US • Interoperability is a cornerstone • Funding for related research- NIH • Quality -Comparative Effectiveness • EHR

  15. XDS (Cross-Enterprise Document Sharing) • XDS.a • XDS- I.a • XDS.b • ?? XDS-I.b • a vs. b • Related to web standards and transactions

  16. XDS

  17. XDS-I

  18. NIBIB contract summary • Consumer Control • Employ IHE solutions whenever possible • IHE generally has not focused on consumer driven solutions but rather on institutional and enterprise workflow • 5 Academic Institutions • Mayo Clinic • Mount Sinai Medical Center • University of California San Francisco • University of Chicago • University of Maryland • Establish a clearinghouse • Engage PHRs • 300,000 patients over 2 years

  19. Elements of Solution • Edge Server • Register a patient • Listens to a Radiology Information System (RIS)- looking for a complete exam • Retrieves Image set from PACS and Report from RIS • Send both to clearinghouse • Clearinghouse – functions as a secure router • Transiently hold encrypted patient data • PHR • Consumer controls upload and future access • Develop web based viewers • Download full DICOM data set

  20. XDS (Cross-Enterprise Document Sharing) • XDS.a • XDS- I.a • XDS.b • ?? XDS-I.b

  21. Software architecture

  22. Future Directions • Refine Workflow • Initial workflow is to replace a CD • Exam updates • Download DICOM data and archive in a local PACS • Edge server as a platform • Radiation Monitoring • Peer Review • Quality Metrics

  23. Radiation Exposure Monitoring Profile -REM • Supplement to Technical Framework for Trail Implementation • Acquisition modalities inlcudes information regarding dose exposure • Estimates • Permits communication of that information to other systems • Useful for Individual lifetime estimates as well as Population analysis

  24. Radiation Exposure Monitoring (REM) • Includes • CT • Plain X-Ray • Mammography • Current Exclusions • Nuclear Medicine • RT • Brachytherapy

  25. DICOM Dose SR objects • DICOM 2008 PS 3.3: A.35.8 X-Ray Radiation Dose SR IOD

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