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Integrating the Healthcare Enterprise. IHE for Product Planners. Ellie Avraham Kodak Health Imaging IHE Planning and Technical Committees Member. Learning Objectives. The Clinical and Economic benefits of Integrating the Healthcare Enterprise
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Integrating the Healthcare Enterprise IHE for Product Planners • Ellie Avraham • Kodak Health Imaging • IHE Planning and Technical Committees Member
Learning Objectives • The Clinical and Economic benefits of Integrating the Healthcare Enterprise • Improve Product Functionality by using the IHE Technical Framework • Improve Integrated System Solutions by using IHE Integration Profiles • Learn from IHE Users Success Stories and other IHE information to refine the Products “Business Case” evaluation IHE Classroom Sessions – RSNA 2004
Discussion Areas • The IHE Deployment Process • IHE Integration Profiles • The Value Proposition from Planning Products and Integrated Solutions using IHE IHE Classroom Sessions – RSNA 2004
Challenges of Integration • Integration Solutions Available Today fromMedical Systems Vendors – BUT ... • Modern Healthcare Enterprises in All Countries Are Still Confronted with Problems:(In Spite of IT Standards and Advanced Technology) • Lack of Access to Complete Medical Information • Inconsistent Medical InformationAcross Departments and Institutions • Inadequate Communicating of Medical DataAcross Multiple Systems from Different Vendors • Risky Investments in Proprietary Solutions IHE Classroom Sessions – RSNA 2004
IHE drives healthcare standards based-integration IHE Classroom Sessions – RSNA 2004
Product IHE IntegrationStatement IHEConnectathon IHEDemonstration Product With IHE Easy to Integrate Products Standards IHEIntegration Profiles B IHEIntegration Profile A RFP IHE Process- Annual Cycle IHE ConnectathonResults IHETechnicalFramework User Site • IHE Technical Framework – Define Standard Integration Solutions • IHE Connectathon Results – Most implemented and tested IHE Solutions • IHE Integration Statements – Most Comertialized IHE Solutions • IHE Success Story – Most Successful Used IHE Solutions IHE Classroom Sessions – RSNA 2004
Using IHE for Product Planning • IHE Aid for Global Product Planning • IHE Technical Framework (TF) > Vol 1: Defines Global Integration Profiles > Vol 2,3: Defines the TF Transactions details for Development > Vol 4: Defines the Local National specialization details • IHE Connectathon Results – Learn what IHE solutions are developed • IHE User Success Stories – Learn the Clinical and Economic benefits of using products with IHE capabilities. • IHE Integration Statements – The Commercialized products with IHE capabilities • RFP’s from customers IHE Classroom Sessions – RSNA 2004
IHE Connectathon Resultshttp://www.rsna.org/IHE/connectathon.shtmlhttp://www.ihe-europe.org/con_result/ IHE Classroom Sessions – RSNA 2004
IHE User Success Stories • http://www.rsna.org/IHE/participation/success_stories/index.shtml • Cleveland Clinic Foundation • Detroit Medical Center • Grossman Imaging Centers • Hôpitaux Universitaires de Genèv • IHE McKay-Dee Hospital • Johannes Gutenberg University Hospital • Magic Valley Regional Medical Center • Mayo Clinic Jacksonville • Our Lady Of The Lake Regional Medical Center (OLOL) • VA Puget Sound Health Care System • St. Vincent Hospital and Health Services • Steinberg Diagnostic Medical Imaging • University of Pisa • University of Wisconsin IHE Classroom Sessions – RSNA 2004
IHE Success Stories • Deployment of IHE Profiles – Most Used: - Scheduled Workflow (SWF) - Patient Information Reconciliation (PIR) - Consistent Presentation of Images (CPI) - Reporting Workflow (RWF) - Basic Security for HIPAA regulations (SEC) • Clinical and Economics Accomplishments - Improve the Patient Care– Improved data accuracy and Safety, Image Quality & Consistency and time saving due to optimized Workflows and integrated systems - Improve the clinical practice productivity - reduced manual data entry using the ADT registration in one place and propagate it to all the other systems (PACS, RIS Modality) and reduced errors. - Optimize the Radiological Workflow (SWF) Reduced the incorrectly or lost studies, using DICOM MWL, MPPS IHE Classroom Sessions – RSNA 2004
IHE Integration Statements • IHE Integration Statements document the product IHE capabilities in terms of IHE: Actors and Integration Profiles. • Promote your products with the Integration Statements • Learn from other Vendors Integration Statements the IHE Profiles • and Actors supported • The RSNA links to IHE Integration Statements published by the companies: • - Agfa HealthCare - Philips Medical Systems • - Cerner Corporation - Sectra • - Eastman Kodak Company - Siemens Medical Solutions • - Emageon - Softmedical • - Fujifilm Medical Systems USA - Stentor • - GE Medical Systems - StorCOMM, Inc • - INFINITT Co., Ltd. - Tiani Medgraph AG • - McKesson Information Solutions - Toshiba America Medical Systems • - Medcon - Voxar Limited IHE Classroom Sessions – RSNA 2004
IHE Integration Statement Date 12 May 2004 Vendor Product Name Version Any Medical Systems Co. IntegrateRAD V2.3 This product implements all transactions required in the IHE Technical Framework to support the IHE Integration Profiles, Actors and Options listed below: Integration Profiles Implemented Actors Implemented Options Implemented Scheduled Workflow Image Manager/Image Archive none Image Display none Internet address for vendor’s IHE information:www.anymedicalsystemsco.com/ihe Links to Standards Conformance Statements for the Implementation HL7 www.anymedicalsystemsco.com/hl7 DICOM www.anymedicalsystemsco.com/dicom/integrateRAD.pdf Links to general information on IHE North America:www.rsna.org/IHE In Europe: www.ihe-europe.org In Japan: www.jira-net.or.jp/ihe-j IHE Classroom Sessions – RSNA 2004
www.rsna.org/ihe IHE Foundation IHE Technical Framework • Organized in sections that provide an increasing level of detail • Integration Profiles: Establish broad categories of compatible function. • Actors: Identify specific kinds of operational participants in the healthcare enterprise. • Transactions: Describe particular interactions between actors to perform specific operations. IHE Classroom Sessions – RSNA 2004
Charge Posting Presentation of Grouped Procedures Reporting Workflow KeyImageNotes Simple Image & Numeric Reports NMImage Consistent Present-ation of Images EvidenceDocs Access to Radiology Information Portable Data for Imaging IHE Radiology Integration Profiles Scheduled Workflow - Patient Info. Recon-ciliation Post-Processing Workflow Basic Security IHE Classroom Sessions – RSNA 2004
report Registration Film Lightbox Image Manager & Archive Orders Filled Film Folder Diagnostic Workstation Film Report Repository Orders Placed AcquisitionModality acquisitioncompleted acquisitionin-progress imagesprinted Modality acquisitioncompleted Scheduled Workflow Profile IHE Classroom Sessions – RSNA 2004
Patient Information Reconciliation IHE Classroom Sessions – RSNA 2004
Consistent Presentation of Images Area Of Interest Area Of Interest Achieving Consistent Presentation Flip Zoom Annotate Original Image Without Consistent Presentation Window Level Referring Physician or Reviewing Radiologist Reporting Radiologist Presentation State Presentation LUT Grayscale Standard IHE Classroom Sessions – RSNA 2004
TLS authentication of remote node (digital certificates) • with/without encryption • Audit PHI trail with: • Real-time access • Time synchronization Secured System Secured System Secure network System B System A Central Audit TrailRepository BASIC Security IHE Classroom Sessions – RSNA 2004
Report:CHEST Report:AB/PELVIS Ab/Pelvis View Chest View Chest View MODALITY Performs a single exam Operator groups 2 procedures Ab/Pelvis View Presentation of Grouped Procedures Profile Requested Procedure:CHEST RIS / PACS Requested Procedure:AB/PELVIS IHE Classroom Sessions – RSNA 2004
Simple Image & Numeric Reports Profile Images and Examdata presented fordiagnosis Verified Report Preliminary Report Image Manager & Archive ReportVerification Reports storedforNetwork Access Report & ImageReview forPatient Care Report & Images Retrieved Images Retrieved IHE Classroom Sessions – RSNA 2004
Access to Radiology Information Emergency Department Referring Physician Radiology Department – Images and Reports Remote Clinics Other Departments:- Oncology- Surgery- Neurology- Pediatrics- etc. Electronic Medical Record IHE Classroom Sessions – RSNA 2004
Post-Processing CAD Workflow Source Data Worklist PACS System CAD *Workstation 3-D *Workstation Workstation ReportRepository Work Status Results AcquisitionModality Post-Proc. Workflow Manager Work Status … Results IHE Classroom Sessions – RSNA 2004
Charge Posting Profile Account Management *Billing System ADT Terminal Report Generated / Signed CAD *Workstation 3-D *Workstation ReportRepository 3-D Performed CAD Performed AcquisitionModality Post Charges Charge Poster Study Performed / Materials Used … IHE Classroom Sessions – RSNA 2004
Work Item Claimed Reporting Worklist Store Reports Reporting Procedure Step STARTED Measurements CAD Reports ………………… Retrieve Images &Evidence Documents Reporting Procedure Step STARTED IHE Reporting Workflow RIS Report Manager Report Reader/Creator PACS & Archive Reporting Procedure Step COMPLETED Image Manager/ Archive Reporting Procedure Step COMPLETED IHE Classroom Sessions – RSNA 2004
Media Importer Image/ Report Display Printer John Doe Portable Data for Imaging CD Creator CD IHE Classroom Sessions – RSNA 2004
IHE Value Proposition • Product Planning • IHE Solutions are Driven by Strategic Healthcare Lead Users that collaborate with Healthcare Vendors • IHE Solutions are Generic, Reusable and Interoperable based on Healthcare Standards: DICOM, HL7, RFC • IHE Solutions Optimize the Clinical Workflows • IHE Deployment process – Connectathon, Integration Statements and Users Success Stories information helps to refine the product “Business Case” • IHE Technical Framework specification describes the Global IHE solutions at a High Level for Planning & Marketing and in details for products Architects and Engineering development IHE Classroom Sessions – RSNA 2004
IHE Benefits • Clinical Users • Greater access to consistent information • Fewer errors, fewer tedious tasks • Buyers • Specify/purchase integration capabilities easily • Freedom to acquire “Best of Breed” systems • IT Professionals • Faster, more predictable integration projects • Facilitate cooperation of competing vendors • Administrators • Increased throughput • Better scheduling and tracking IHE Classroom Sessions – RSNA 2004
Picking IHE Profiles Considerations • Customer RFP’s • Product positioning in the market with a Good Business Case • IHE Technical Framework Volume 1 • Healthcare Institution Needs: > Optimized Clinical Workflow : SWF, PIR, RWF > Improve the Patient Health Care: SWF, PIR, CPI, PGP,KIN > Economy - Reduce Healthcare cost: SWF, CHG > Protect the Patient Health Information: SEC IHE Classroom Sessions – RSNA 2004
IHE for Product Planners Questions? IHE North America: http://www.rsna.org/IHE orhttp://www.himss.org/IHE IHE Canada: http://www.ihe-canada.com IHE Europe: http://www.IHE-Europe.org IHE France: http://www.gmsih.fr/IHE IHE Germany: http://www.IHE-D.org IHE Italy: http://www.rad.unipd.it/IHE IHE UK: http://www.IHE-UK-org IHE Japan: http://www.jira-net.or.jp/ihe-j/en/index.html IHE Classroom Sessions – RSNA 2004