Overcoming Barriers to Interoperability Using IHEOvercoming Barriers to

Interoperability Using IHE

Jonathan L. Elion, Co-Chair

Cardiology Planning Committee - IHE

Medical Director & Co-Founder, Heartlab, Inc.

ACC 1995: DICOM ImagesACC 1995: DICOM Images

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ACC 2001: Data InterchangeACC 2001: Data Interchange

ACC 2005: IHE “Connect the Docs”ACC 2005: IHE “Connect the Docs”

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Who is IHE?Who is IHE?

• IHE is a joint initiative among:American College of Cardiology (ACC)Radiological Society of North America (RSNA)Healthcare Information Management Systems Society (HIMSS) GMSIH, HPRIM, JAHIS (laboratory), IHE-Europe, IHE-Japan,

and many more….

• Began in 1997 in Radiology and IT

• Within IHE-Cardiology additional sponsors including ASE, ASNC, HRS, ESC, and more

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IHE ParticipantsIHE Participants

• Societies Representing Healthcare Segments: RSNA, HIMSS, ACC, ASE, ESC, ASNC, HRS…

• Users: Clinicians, Medical Staff, Administrators, CIOs, …

• Information and Imaging Systems Vendors

• Standards Development Organizations: DICOM, HL7, ASTM, …

Participating & Contributing Vendors (U.S.)Participating & Contributing Vendors (U.S.)Agfa HealthCareAlgotec Systems, Ltd.BerdyCamtronicsCanon Medical SystemsCarefxCedara Software

CorporationCerner CorporationCSISTDictaphoneDR SystemsDynamic ImagingEastern InformaticsEastman Kodak

CompanyEmageonEclipsysFujifilm Medical Systems

ProcomPhilips Medical SystemsRASNA Imaging SystemsSectraSentillionSiemens Medical SolutionsSoftmedicalStentor, IncStorCOMM, IncSwissray International, IncTiani Medgraph AGToshiba America Medical

SystemsUltraVisual Medical

SystemsVital Images, Inc.Voxar LimitedWebMDXIMIS

GE HealthcareHeartlabHitachi Medical

CorporationHologic, IncIDX Systems CorporationIMCO TechnologiesInSiteOneINFINITTKonica Minolta Marotech, Inc.McKesson Information

SolutionsMedconMedical Manager Health

SystemsMediface Co., Ltd.Merge eFilmMortara

In yellow, companies with IHE Committees Chairs (Summer 2004)

Participating & Contributing Vendors (Europe)Participating & Contributing Vendors (Europe)AGFA HealthcareAISoftw@re Medical SolutionsAlgotec ARES SA aycan Digitalsysteme ConVisDEDALUSDianoemaEastman Kodak Company Ebit SanitaEDL ELFIN s.r.l. Engineering Sanità Enti LocaliESAOTEETIAM Ferrania Fujifilm GE HealthcareGMD GIE Convergence-ProfilsGWI Research

Rogan-DelftSago spa Sectra Imtec AB Siemens Medical Solutions Soluzioni Informatiche srl Stentor Inc. Swissray Medical AG Symphonie On Line Synapsis TELEMIS S.A. TIANI MEDGRAPH AG TOREX GAP MedicalToshiba Medical Systems TSI groupe europMedica VEPRO AG VISUS Technology Transfer WAIDXR PARTNER

IASI Srl IdeoPass Image Device-Cerner Company INFINITT INOVITMcKesson MED2RAD MEDASYS SAMedavisMedigration GmbH MEDIMON Ltd. MEDOS AG Merge eFilm METAFORA Minolta Europe Omnilab Philips Medical SystemsRasna Imaging SystemsRAYPAX INC.

In yellow, companies with IHE Committees Chairs (Summer 2004)

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What is IHE?What is IHE?

• IHE is a systems integration process

• Consists of a Planning Committee and a Technical Committee of cardiologists and vendors

• Develops a detailed document called the “Technical Framework”

• Incorporates and refines existing standards such as DICOM and HL7

• Goal: Quality healthcare delivery

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IHE Annual Cycle IHE Annual Cycle 1. Clinicians identify clinical problems to be

addressed -“Integration Profiles”

2. Engineers from vendors collaborate to define technical specification (using existing standards such as DICOM and HL7)

3. Vendors implement the technical specification and participate in the “Connectathon”

4. Demonstrations at trade shows (ACC, HIMSS, etc.)

5. Vendors publish IHE Integration Statements

6. Customers reference IHE profiles in RFP’s

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IHE Cardiology Year 1IHE Cardiology Year 1

• The ability to view an ECG from many locations - quickly and easily

• Echo workflow integration of patient, order and procedure information, including mobile echo

• Cath Lab workflow integration of patient, order and procedure information, including angiography, hemodynamics, IVUS…

Cath and Echo WorkflowCath and Echo Workflow

Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]

Procedure Scheduled [RAD-4] Patient Update [RAD-12] Procedure Updated [RAD-13]

DSS/Order Filler

Query Modality Worklist [RAD-5]

Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]

Order Placer

Image Archive

Acquisition Modality

Image Manager

Performed Procedure

Step Manager

Image Display

Pt. Registration [RAD-1] Pt. Update [RAD-12]

Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]

Query Images [RAD-14] Retrieve Images/Evidence [CARD-4]

Modality Image/Evidence Stored [CARD-2] Storage Commitment [CARD-3]

Placer Order Management [RAD-2] Filler Order Management [RAD-3]

Pt. Registration [RAD-1] Patient Update [RAD-12]

ADT

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IHE ConnectathonIHE Connectathon

• Open invitation to vendor community

• Advance testing tools (MESA)

• Testing organized and supervised by project management team

• Thousands of cross-vendor tests performed

• Results recorded and published

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Connectathon, January 2005Connectathon, January 2005

43 vendors (14 Cardiology)43 vendors (14 Cardiology)From palettes to pals in less than 4 hoursFrom palettes to pals in less than 4 hours300 participants, 110 systems (31 Cardiology)300 participants, 110 systems (31 Cardiology)Cardiac CatheterizationCardiac Catheterization

Connectathon, January 2005Connectathon, January 2005EchocardiographyEchocardiographyEKG’s AnywhereEKG’s Anywhere2,800 Tests2,800 TestsPacking Up Packing Up

Computers in Cardiology16

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Total ACC’05 attendance was over 28,000.Total ACC’05 attendance was over 28,000.

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Over 1,000 visitors from 47 countries attended theOver 1,000 visitors from 47 countries attended theIHE presentations and demonstrations.IHE presentations and demonstrations.

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Commitment to EHRCommitment to EHR

David J. Brailer, MD, PhDNational Coordinator for Health Information Technology, US Department of

Health and Human Services (HHS)

Directive: Execute the Presidential Order for widespread deployment of Health Information Technology within 10 years.

“The capacity to share clinical data is generally not available in the market, and I have placed a high priority on ensuring that it does come to exist before widespread EHR adoption is underway.”

“IHE… is becoming the obvious thing to do. It is our goal to make it the inevitable thing to do.”

HIMSS Conference, February 2005

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W W W . I H E . N E TW W W . I H E . N E T

Providers and VendorsWorking Together to Deliver

Interoperable Health Information Systemsin the Enterprise

and Across Care Settings