IHE Cardiology – Technical Committee Telephone Conference Sept. 14, 2009

1. IHE Cardiology – Technical Committee Telephone Conference Sept. 14, 2009 Antje Schroeder - Siemens Healthcare Harry Solomon - GE Tom Dolan - Philips

2. Agenda • Update on IHE-C Planning committee (Harry/Tom) • Chairs • Current planning and timeline • Profiles and Preliminary editors (Antje/Harry) • 3D/4D Echo Workflow • Image enabled office • Cardiology Report Content • CDA Implementation Guide for Cardiology Use of XD* • ECG Workflow • EP Lab • Urgent Implantable Rhythm control device identification • Implantable Cardiac Device Interrogation • Agenda IHE-C Tech Committee F2F (Tom) IHE Cardiology TC Meeting

3. IHE-C Planning Committee • Chairs • Alan Katz (ACC) • Dr. David Slotwiner (HRS) • Profile voting and ranking • Voting – IHE-C PC F2F Oct. 26th • Importance to physician members – Planning Committee • Development difficulty – Technical Committee • Likelihood of success – joint discussion • Profile timelines • Next TC call – Oct. 1 2009 (proposal) • DEADLINE TC initial effort – Oct. 19th • PC Profile Decision Oct. 26th 2009 • Profile Development in 2009/10 • Demonstration in Connectathon Jan. 2011 IHE Cardiology TC Meeting

4. Objectives Communicate Profile Rationale and Content Identify preliminary editors for Oct. 19th effort estimate Profile Proposals 2010 IHE Cardiology TC Meeting

5. Profile Proposals • 3D/4D Echo Workflow • Image enabled office • Cardiology Report Content • CDA Implementation Guide for Cardiology Use of XD* • ECG Workflow • EP Lab • Urgent Implantable Rhythm control device identification • Implantable Cardiac Device Interrogation IHE Cardiology TC Meeting

6. 3D/4D Echo Workflow • Address the need to exchange volumetric US data between different vendors based on DICOM Suppl. 43 • Key use case: • Exchange 3D US data between Scanner, PACS and Post Processing workstation for image review and 3D measurements • Existing Standards and Profiles • DICOM Supplement 43 • IHE Echocardiography Workflow • Discussion • Handling of the blending pipeline in order to adequately display the different data types • Lack of nD presentation state object to represent derived views • Supplement 43 was only recently approved, nevertheless it would be good to start working on this right away. IHE Cardiology TC Meeting

7. Image Enabled Office • Address integration of medical imaging equipment into an office environment, in order to fulfill the meaningful use criteria for image integration in 2015 • Key use case: • Scheduling, Image acquisition, reporting, access to EMR, document exchange with referring physicians in an ambulatory cardiology office. • Existing Standards and Profiles • IHE workflow profiles like ECHO, CATH, SWF, STRESS • IHE Evidence Document and Key Image Note profiles • IHE XDS, XDS-I, XDS-MS, PIX, PDQ profiles for cross enterprise sharing of information • DICOM WADO • Discussion • Further clarification on scope needed • Address ECG use in this context • White paper or profile • Since it is crucial for meaningful use criteria 2013/2015, it should be tested at Connectathon in 2011 IHE Cardiology TC Meeting

8. Cardiology Report Content • Based on the ‘Health Policy Statement on Structured Reporting’ and the associated ‘Key Data Element Definition for Cardiac Imaging’ from the ACC a standard template for Cardiac Imaging Reports should be developed • Key use case: • Cardiac Referral • Trigger for clinical decision support • Existing Standards and Profiles • IHE Evidence Document and DICOM SR templates (Cath, Echo, Stress, …) • XDS-MS for medical summaries for referral and consultation report content • HL7 CDA Basic Diagnostic Imaging Report Implementation guide • Discussion • Close coordination with Radiology and PCC domain necessary • Just Cardiac Imaging Report • Has to be harmonized with the EHR lexicon work of the ACC Informatics Committee. IHE Cardiology TC Meeting

9. CDA Implementation Guide for Cardiology Use of XD* • Based on XD* the transfer of information between EHR systems is defined, however the content is not specified. This profile should leverage CDA to define the content exchanged, including an agreed set of document types • Key use case: • Similar to Cardiology Report Content profile • Existing Standards and Profiles • IHE ITI format codes and XDS coding system • HL7 CDA Release 2 and Basic Diagnostic Imaging Report Implementation Guide • IHE PCC CDA Release 2.0 Content modules • Discussion • Overlap between this proposal and Cardiology Report Content. • Scope clarification needed with respect to other domains • Should be discussed with HL7 IHE Cardiology TC Meeting

10. Resting ECG Workflow • Define a profile similar to Scheduled Workflow to address patient registration, ordering of a resting 12 lead ECG test, performing the test, reporting and storage of the ECG data in a standardized format • Key use case: • Similar workflows as described in scheduled workflow, but used for resting ECG • Existing Standards and Profiles • Based on actors and transactions of scheduled workflow. Intermittently connected acquisition device needs to be covered. • Discussion • Focus on resting ECG only • Was considered necessary and critical during Planning committee discussions IHE Cardiology TC Meeting

11. EP Lab • EP Lab is a multi-modality environment and uses equipment from multiple vendors, which up to now are mostly unconnected. Coordinating the different devices within the EP lab and the information exchange between them is the objective of this profile • Key use case: • Ablation Procedure • Existing Standards and Profiles • IHE workflow profiles like CATH • IHE Evidence Document • IHE XDS-MS (medical summaries) • IHE RID (Retrieve Information for Display) • Discussion • Workflow or Document exchange: It was decided that this would be a workflow profile • Scope boundary issues – might be necessary to split into two parts: Data exchange in EP lab and reporting IHE Cardiology TC Meeting

12. Urgent Implantable Rhythm control device identification • Address the problem of identifying the implantable device of patient through a single query to multiple various registries for implantable device patients • Key use case: • Identification of IRCD in an emergency scenario for immediate reprogramming • Existing Standards and Profiles • IHE PDQ • Discussion • Considered very important by the Heart Rhythm society. • Ownership of this profile. IHE Cardiology TC Meeting

13. Implantable Cardiac Device Interrogation • Define standardized method to translate and transfer summary device interrogation information (device identification, therapy settings, diagnostics, …) to the information management system • Key use case: • In clinic follow up • Device Implantation • Remote follow up • Existing Standards and Profiles • Discussion • Currently under development by PCC domain and will be tested at the connectathon in 2010. • Should be merged with NCDR in order to enable monitoring of implants. IHE Cardiology TC Meeting

14. IHE-C TC F2F AGENDA • WHEN - Oct. 27th 2009 ( following PC F2F) • WHERE – HRS Washington DC • 1400 K St NW # 500Washington, DC 20005-2422(202) 464-3400get directions • AGENDA F2F Oct. 27th 2009 • IHE-C context • Update on IHE/ARRA(US-Gov. stimulus)/HL7/DICOM • Elections • 2009/10 Business • Maintenance/CP’s on existing profiles • Volunteer for wiki update • Confirmation of profile editors/teams • Members are expected to contribute to profile development • Profile, Maintenance, Meeting Timelines • Initial Profile workshops IHE Cardiology TC Meeting

15. Next Steps! • Next Call ( proposal) • Oct. 1 10:00 AM – 11:00 AM EST (New York) • Homework for next call • (ALL) Review profiles and provide comments to preliminary editors • (preliminary editors) • indicate first-pass effort estimate for next call • Collate any clarifications/issues on profiles to be raised @ PC F2F • (ALL) nominate (via Daniel Roman) candidates for IHE-TC co-chair positions • Elections Oct. 27th • (ALL) verify that your organization is a member of IHE • Daniel can advise on process IHE Cardiology TC Meeting