September, 2005What IHE Delivers 1 IHE Changing the Way Healthcare Connects in HOSPITALS HIMSS Interoperability Showcase February 2006 Glen Marshall (Siemens),

1September, 2005 What IHE Delivers

IHE Changing the Way IHE Changing the Way Healthcare Connects Healthcare Connects

in HOSPITALS in HOSPITALS

HIMSS Interoperability Showcase February 2006HIMSS Interoperability Showcase February 2006Glen Marshall (Siemens), Elie Avraham (Kodak), John Donnelly (IntePro) Glen Marshall (Siemens), Elie Avraham (Kodak), John Donnelly (IntePro) Chris Carr (RSNA), Chris Lindop (GE)Chris Carr (RSNA), Chris Lindop (GE)

2

IHEIHE - - Connecting standards to careConnecting standards to care

Care providers and IT professionals work with vendors to coordinate the implementation of standards to meet their needs Care providers identify the key interoperability problems

they face Drive industry to develop and make available

standards-based solutions Implementers follow common guidelines in purchasing

and integrating systems that deliver these solutions

3

Growth in IHE DomainsGrowth in IHE Domains

Radiology (18)

IT Infrastructure for Healthcare (17)

Cardiology (7)

Laboratory (6)

Radiation Oncology (1)

Patient Care Coordination (5)

Patient Care Devices (1)

Quality

Eye Care (3)

VeterinaryEndoscopyPathologyPharmacy

Ye

ar

1

(19

99

)

Ye

ar

2

(20

00

)

Ye

ar

3

(20

01

)

Ye

ar

4

(20

02

)

Ye

ar

5

(20

03

)

Ye

ar

6

(20

04

)

Ye

ar

7

(20

05

)

Ye

ar

8

(20

06

)

Ye

ar

9

(20

07

)

• Over 100 vendors involved world-wideOver 100 vendors involved world-wide• 8 Technical Frameworks8 Technical Frameworks• 48 Integration Profiles48 Integration Profiles

•Testing at “Connectathons” world-wideTesting at “Connectathons” world-wide• Demonstrations at major conferences world-wideDemonstrations at major conferences world-wide

6

IHEIHE – – The Business Case for HospitalsThe Business Case for Hospitals

Re-engineering System Integration :

Leverage standards-based, robust and innovative solutions refocus customization to value-add

Reduce RFP costs with common guidelines in purchasing and integrating systems that deliver these solutions

It works, IHE did it with your vendors !

Lets look at specific solutions….

7

IHE Solutions within the EnterpriseIHE Solutions within the Enterprise

eMPIeMPIUser AuthUser Auth

EnterpriseEnterpriseIT InfrastructureIT Infrastructure

LaboratoryLaboratory

LISLIS

Auto MgrAuto Mgr AnalyzerAnalyzer

EMR - HISEMR - HISEMR - HISEMR - HIS

CardiologyCardiology

CISCIS

CathCath ECGECG

RadiologyRadiology

RISRIS

PACSPACSImg AcqImg Acq

-Radiation-Radiation Therapy Therapy

-Patient Care-Patient Care Devices Devices

-Pathology-Pathology

-Eye Care-Eye Care

8

Cath Lab WorkflowCath Lab Workflow

1

23 4

56 7

8 9 10 11

note: IHE Cath Profile includes note: IHE Cath Profile includes Electrophysiology labElectrophysiology lab

Multiple re-entry of Patient ID

Error prone data entry

Results fragmented across systems

Results inconsistently time-tagged

Custom solutions needed for data sharing

Difficult to manage

Uncoordinated with Hospital Information System

Unidentified patients (emergency)

Un-ordered cath exams

Diagnostic and interventional procedures

Ad hoc scheduling of cath labs

Change of rooms during procedure

The Cure for:The Cure for:

9

Echo WorkflowEcho Workflow

Need to solve the “drive-by echo” ?Cardiologist to sonographer in CCU: “While you’re here, do a TTE on bed 3”

Unordered, unscheduled exam Machine disconnected from network

Stress echo, need more automation ?After exam, sonographer creates new quad displays of stages and views

No intrinsic value add Data is redundantly copied to storage

10

Stress WorkflowStress Workflow

~85% of stress tests are multi-modality (ECG + imaging)

~0% of current architectures manage ECG and imaging workflow and results in an integrated manner

Poor adherence to ACC/ASNC nuclear image display requirements

IHE Stress Testing Profile IHE Stress Testing Profile and IHE Nuclear Medicine and IHE Nuclear Medicine

Image ProfileImage Profile

Trial Implementation

Trial Implementation

11

IHE Solutions within the Enterprise IHE Solutions within the Enterprise CardiologyCardiology

RadiologyRadiology CardiologyCardiology LaboratoryLaboratory


EMR - HISEMR - HIS

RISRIS


CISCIS

CathCath ECGECG

LISLIS





Cardiology Integration ProfilesCardiology Integration ProfilesCardiac Catheterization Lab Workflow

Echocardiography Lab Workflow

Retrieve ECG for Display

Displayable Reports

Cath and Echo Evidence Documents

Implanted Device Observations


12





LISLIS




CISCIS

CathCath ECGECG

RadiologyRadiology

RISRIS





-Eye Care-Eye Care

13

Laboratory Scheduled Workflow - Value PropositionLaboratory Scheduled Workflow - Value Proposition

A comprehensive workflow approach Address specimen linkage most lab specialties: Blood gases, Chemistry, Hematology, Immunology,

Laboratory, Microbiology, Mycrobacteriology, Mycology, Serology, Toxicology, Virology.

Provides workflow improvement Increases continuity and integrity of clinical data Decreases user need for manual tasks.

Spans ordering, conformity of specimens, lab automation, results delivery. Externally placed order with identified specimens Externally placed order with specimens unidentified or to be

collected by the laboratory Internally placed order with specimens identified by third party or

collected by the laboratory

14

IHE Solutions within the Enterprise IHE Solutions within the Enterprise LaboratoryLaboratory



EMR - HISEMR - HIS

RISRIS


CISCIS

CathCath ECGECG

LISLIS





-Eye Care-Eye Care

Laboratory Integration ProfilesLaboratory Integration ProfilesLaboratory Scheduled Workflow

Laboratory Information Reconciliation

Laboratory Point Of Care Testing

Laboratory Device Automation

Laboratory Code Set Distribution


15





LISLIS




CISCIS

CathCath ECGECG

RadiologyRadiology

RISRIS





-Eye Care-Eye Care

16

Scheduled Workflow & patient Info reconciliationScheduled Workflow & patient Info reconciliation

Backbone of IHE Radiology

Integrates Registration, Scheduling, Acquisition Workflow and Image Content

Bridges HL7 and DICOM Spaces

Preserve Order Continuity

Improve Demographic Integrity

Improve Workflow Efficiency – synchronized Worklists

Reliable Storage

Improve Order Tracking

Reduce Integration Effort at Site

17

IHE Solutions within the Enterprise IHE Solutions within the Enterprise RadiologyRadiology



EMR - HISEMR - HIS

RISRIS


CISCIS

CathCath ECGECG

LISLIS





-Eye Care-Eye Care


Radiology Integration ProfilesRadiology Integration ProfilesRadiology Scheduled Workflow

Patient Information Reconciliation

Access to Radiology Information

Portable Data for Imaging

Consistent Presentation of Images

Key Image Note

Presentation of Grouped Procedures

Evidence Documents

Audit trail and Node Authentication (Rad option)

Teaching Files and Clinical Trials Export

Post-processing Workflow

Reporting Workflow

Charge Posting

Simple Image and Numeric Reports

Media Import Reconciliation Workflow

How to use IHE ?How to use IHE ?

IHEIHE Radiology Radiology

HandbookHandbook

18





LISLIS




CISCIS

CathCath ECGECG

RadiologyRadiology

RISRIS





-Eye Care-Eye Care

19

Patient Administration Mgt (PAM)Patient Administration Mgt (PAM)Coordinates exchange of patient registrations, updates, and movements for all clinical areas

Information may be received and processed by consuming applications in any clinical domain

Optionally allows unambiguous updating of historic patient movement events

Demographic and encounter tracking works in both inpatient and ambulatory care settingsStandardizes on HL7 V2.5 and its conformance structures

20

Patient Administration Management Patient Administration Management Actor & Transaction: flexibility and compatibilityActor & Transaction: flexibility and compatibility

Patient Demographics Source

Patient Demographics Consumer

Patient Encounter Source

Patient Encounter Consumer

→ Patient Identity Feed [ITI-030]

→ Patient Encounter Management [ITI-031]

OR





← Patient Identity Feed [ITI-030]






→ Patient Identity Feed [ITI-030]


Flexible Flexible Actor Actor groupinggrouping

21

Patient Demographics Query – HL7 V2.5Patient Demographics Query – HL7 V2.5Adopted b y HITSPAdopted b y HITSP

Patient Demographics Supplier


Patient Demographics

Query

Patient Demographics and Visit Query

Registration system or Registration system or departmental system that is departmental system that is connected on demand to it.connected on demand to it.

Diverse systems including Diverse systems including bedside monitors, physician bedside monitors, physician office systems, lab applications, office systems, lab applications, mobile blood bank registries; mobile blood bank registries; might be any system at the point might be any system at the point of care.of care.

22

Patient Identifier Cross-referencing-HL7 V2.5Patient Identifier Cross-referencing-HL7 V2.5Adopted b y HITSPAdopted b y HITSP

Registration system or eMPIRegistration system or eMPI

Registration systemRegistration systemDepartmental Departmental or Outpatient systemor Outpatient system

23

IHE Solutions within the EnterpriseIHE Solutions within the EnterpriseIT Infrastructure (Enterprise)IT Infrastructure (Enterprise)


RISRIS


CISCIS

CathCath ECGECG

LISLIS





-Eye Care-Eye Care


EMR - HISEMR - HIS

IT Infrastructure Integration ProfilesIT Infrastructure Integration Profiles

Patient Administration Management

Patient Demographics Query

Patient Identifier Cross-referencing

Retrieve Information for Display

Enterprise User Authentication

Consistent Time

Patient Synchronized Applications

Audit Trail and Node Authentication

Personnel White Pages


24

IHE Solutions for extending the EnterpriseIHE Solutions for extending the Enterprise

eMPIeMPI

User AuthUser Auth



LISLIS




CISCIS

CathCath ECGECG

RadiologyRadiology

RISRIS





-Eye Care-Eye Care

Outpatient ClinicOutpatient Clinic

EMREMR

Pactice MgtPactice Mgt

Partner ClinicPartner Clinic

EMREMR


PracticePractice

EMREMR



EMREMR



EMREMR


PracticePractice

EMREMR


Partner PracticesPartner Practices

EMREMR


Index of sharedIndex of sharedpatients recordspatients records

25

IHE Solutions for Extending the EnterpriseIHE Solutions for Extending the EnterpriseIntegrated Delivery NetworksIntegrated Delivery Networks

eMPIeMPI

User AuthUser Auth



LISLIS




CISCIS

CathCath ECGECG

RadiologyRadiology

RISRIS





-Eye Care-Eye Care

Outpatient ClinicOutpatient Clinic

EMREMR



EMREMR


PracticePractice

EMREMR



EMREMR



EMREMR


PracticePractice

EMREMR


Partner PracticesPartner Practices

EMREMR


Index of sharedIndex of sharedpatients recordspatients records

Integration Profiles for an IDNIntegration Profiles for an IDNCross-Enterprise Document Sharing

Patient Id Cross-Referencing

Patient Demographics Query

Audit Trail and Node Authentication

Consistent Time

Sharing of Medical Summaries

Sharing of Lab Reports

Sharing of Imaging Information

Sharing of Scanned Documents

See presentation: IHE Changing the Way Healthcare Connects Communities

26

Want to know what new integration Want to know what new integration profiles will be developed in 2007 ?profiles will be developed in 2007 ?

Visit the IHE Web SiteVisit the IHE Web Site

27

What can you do?What can you do?

Attend the IHE Domain specific sessions in these Attend the IHE Domain specific sessions in these Theaters during HIMSS 2007 (Orange sessions)Theaters during HIMSS 2007 (Orange sessions)

Learn about IHE, Learn about IHE, www.ihe.net

Insist on IHE compliance in your RFPs and contract Insist on IHE compliance in your RFPs and contract documents:documents:

Select Integration Profiles, and Appropriate Actor(s) Select Integration Profiles, and Appropriate Actor(s)

Ask vendors for their products “IHE Integration Ask vendors for their products “IHE Integration Statements”.Statements”.

Need more interoperability ? Need more interoperability ?

Contribute to IHE CommitteesContribute to IHE Committees

http://www.ihe.net/

28

29

As a Provider or Vendor ContributorAs a Provider or Vendor Contributor

Offer Clinical Use Case Input to Drive IHE Profile DevelopmentOffer Clinical Use Case Input to Drive IHE Profile Development

Become a member of relevant domain’s Planning or Technical Become a member of relevant domain’s Planning or Technical CommitteesCommittees

Become a member of relevant Regional/National CommitteesBecome a member of relevant Regional/National Committees

Help to shape IHE’s future directionHelp to shape IHE’s future direction

As a Vendor ParticipantAs a Vendor Participant

Respond to Public Comments of Domain SupplementsRespond to Public Comments of Domain Supplements

Attend the June Educational WorkshopAttend the June Educational Workshop

Participate in Connect-a-thons and DemonstrationsParticipate in Connect-a-thons and Demonstrations

As a Provider/Consultant ParticipantAs a Provider/Consultant Participant

Respond to Public Comments of Domain SupplementsRespond to Public Comments of Domain Supplements

Attend the June Educational Workshop Attend the June Educational Workshop

Attend Demonstrations and include IHE Integration Profiles in your RFPs Attend Demonstrations and include IHE Integration Profiles in your RFPs and Integration Projects.and Integration Projects.

How can I participate?How can I participate?

30

IHE Web site:IHE Web site: www.IHE .netwww.IHE .net Frequently AskedFrequently Asked QuestionsQuestions

Integration Profiles in Technical Frameworks: Integration Profiles in Technical Frameworks: See Volume 1 of each TF for Use casesSee Volume 1 of each TF for Use cases

Cardiology IT Infrastructure Laboratory Patient Care Coordination Radiology

Connectathon Result: Connectathon Result: www.ihe.net/Events/connectathon_results.cfmwww.ihe.net/Events/connectathon_results.cfm

Vendor Products Integration StatementsVendor Products Integration Statements

Participation in Committees & ConnectathonsParticipation in Committees & Connectathons

31September, 2005 What IHE Delivers