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Buzzword Bingo

Buzzword Bingo. Retrieve ECG for Display. ACCA IHE Workshop 2007 Jon Elion MD, FACC Associate Professor of Medicine, Brown University Co-Chair, IHE-Cardiology Planning Committee. ECG Needs. ECGs Accessible Everywhere! Need broad distribution of ECGs using ubiquitous technology (Web).

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Buzzword Bingo

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  1. Buzzword Bingo

  2. Retrieve ECG for Display ACCA IHE Workshop 2007 Jon Elion MD, FACC Associate Professor of Medicine, Brown University Co-Chair, IHE-Cardiology Planning Committee

  3. ECG Needs • ECGs Accessible Everywhere! • Need broad distribution of ECGs using ubiquitous technology (Web). • Allow medical applications to easily retrieve and display ECGs in a platform/vendor neutral way. • High-quality ECG documents. Avoid artifacts on zoomed ECGs and arbitrary display geometries. • Vector images required (not rasterized) • Facilitate apps for serial comparison (side-by-side synchronized display).

  4. ECG for Display Profile Scope • Reused IHE-ITI RID as it existed: • Retrieve list of cardiology documents, including ECGs in ready-to-display format (HTML) • Retrieve single document, including an ECG • ECGs served in displayable format (PDF, SVG) • Compatibility with existing RID clients

  5. ECG for Display Profile Scope • Make ECG-specific extensions to RID • Place requirements on ECG source to ensure high-quality ECG documents. • Add ECG-specific request for list of ECGs to be returned as XML allowing more client flexibility. • Add SVG (vector graphics) as allowed ECG document format.

  6. PDF • ECG Source required to support PDF so it is compatible with existing RID clients. • PDF is a common document type and most computers already have a viewer. • ECG Source required to use vector graphics for waveforms in PDF. • Gives high quality line drawings at any screen resolution and zoom factor. • Rasterized (e.g. scanned, bitmapped) ECG “images” not allowed.

  7. Example ECG (PDF)

  8. Example 1200x Zoom ECG (PDF)

  9. ECG Profile Actors • Display – A system that can request and display preformatted (“presentation-ready”) data using Web technologies. • Information Source– A system that responds to requests for patient-related ECG data by encoding it in a presentation-ready format using Web technologies. • Same actors as RID Profile

  10. ECG ProfileTransaction Diagram Retrieve ECG List [CARD-5] Retrieve Specific Info for Display [ITI-11] Information Display Source Retrieve ECG Document for Display [CARD-6]

  11. ECG List XML Example

  12. ECG List XML Example Formatted with Style sheet

  13. Use Case D1: Simple Display • Display actor requests list of ECG documents for a specific patient ID. • RID profile SUMMARY-CARDIOLOGY request returns list as HTML. • ECG profile SUMMARY-CARDIOLOGY-ECG request returns list as XML with stylesheet. • Display actor requests a specific ECG document using a unique document ID. • The ID of the requested document may not have been obtained from the previously retrieved list.

  14. Example List as HTML

  15. Implications for RFP’s • ECG Management Systems – • Clinical “Portals” – • Remote Access – • Local Printing –

  16. Nuclear Cardiology ACCA IHE Workshop 2007 Jon Elion MD, FACC Associate Professor of Medicine, Brown University Co-Chair, IHE-Cardiology Planning Committee

  17. Nuclear Cardiology • Image formats • Stress and Rest raw data review • Stress and Rest processed data • Gated SPECT data • Quantitative data • Screen captures, “snap shots” • Color maps • Gray scale is default • Color overlays can be applied

  18. Raw Data Images

  19. Perfusion Display • Standard perfusion display • Stress/Rest • Short axis • Horizontal long axis • Vertical long axis

  20. Perfusion Display - Color • Standard perfusion display • Stress/Rest • Short axis • Horizontal long axis • Vertical long axis • Color map can be overlaid on the image

  21. Gated SPECT Display • Apical, mid and basal short axis slices • Mid-ventricle vertical and horizontal long axis slices

  22. Gated SPECT Display • The whole screen can be gated as an option

  23. Quantitative Display • Output from 3rd party quantitative perfusion software can be displayed

  24. Quantitative Display • Output from 3rd party quantitative gated software can be displayed

  25. Screen Captures • Screen captures can be displayed to show important images

  26. Implications for RFP’s • Departmental and enterprise display systems – • Cardiology PACS –

  27. Implantable Device Cardiac Observations (IDCO) Profile ACCA IHE Workshop 2007 Jon Elion MD, FACC Associate Professor of Medicine, Brown University Co-Chair, IHE-Cardiology Planning Committee

  28. Device Interrogations The act of retrieving data from implanted cardiac devices. Done at implant or during patient follow-ups. Implant Clinic Information includes Patient and Device Observations, andTherapy Settings Home

  29. Implantable Cardiac Device Follow-up Problems and Opportunities • Electrophysiologists follow patients with implantable cardiac devices from multiple vendors • Information stored in the device is collected by an “interrogating” device (vendor proprietary) • In-Clinic – Programmer • Remote – Communicator / Data Collector • Access to follow-up information often requires clinicians to use multiple vendor specific systems, complicating efficiency and quality of workflows • Aggregation of data into a clinical management system or EMR requires manual (paper) processes

  30. IDCO Value Proposition • Enable management of follow-up information in a central system such as an Device Clinic Management System or EMR • Improve efficiency and quality of related clinical processes • Single point of access for information • Automation of current manual processes for data collection, aggregation and analysis • Standardization of workflow processes • Enabling of analytics

  31. IDCO ProfileSystems Model

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