Panel Session: Developments in the IHE Clinical and ...

1September, 2005 What IHE Delivers

Panel Session: Panel Session: Development in the IHE Development in the IHE

DomainsDomains

IHE Workshop 2006IHE Workshop 2006IHE Domain Co-chairsIHE Domain Co-chairs


IT InfrastructureIT Infrastructure

IHE Workshop 2006IHE Workshop 2006Glen Marshall, Siemens Glen Marshall, Siemens Co-chair ITI Technical CommitteeCo-chair ITI Technical Committee

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IHE IT InfrastructureIHE IT Infrastructure

IT Infrastructure is...IT Infrastructure is... IT that enables computer applicationsIT that enables computer applications

• Operating platformsOperating platforms• Computer languagesComputer languages• Computing hardwareComputing hardware• NetworksNetworks

IT that serves multiple applications IT that serves multiple applications • SecuritySecurity• DatabasesDatabases• InterfacesInterfaces

Infrastructure

applicationapplication




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Consistent TimeCoordinate time across

networked systems

Audit Trail & Node Authentication

Centralized privacy audit trail and node to node authentication

to create a secured domain.

Patient Demographics Query

Cross-Enterprise Document Sharing

Registration, distribution and access across health enterprises of clinical

documents forming a patient electronic health record

Patient Identifier Cross-referencing

Map patient identifiers across independent identification

domains

Emergency Referrals Format of the Document Content

and associated coded vocabulary Patient Created Summaries Format of the Document Content

and associated coded vocabulary ECG Report Document

Format of the Document Content and associated coded vocabulary

Lab Results Document Content


Scanned Documents Format of the Document Content

Cross-enterpriseDocument Point-to-Point

InterchangeMedia-CD/USB & e-mail push

Imaging Information


Medical Summary (Meds, Allergies, Pbs)

Format of the Document Contentand associated coded vocabulary

Document Digital Signature

Attesting “true-copy and origin

Notice of Document Availability

Know about new information

Support for Support for RHIOsRHIOs

Patient Consent


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Profiles - Medical InformationProfiles - Medical InformationDocument SharingDocument Sharing

• XDS – Cross-Enterprise Document SharingXDS – Cross-Enterprise Document Sharing• XDS Stored QueryXDS Stored Query XDS-SD – XDS Scanned DocumentsXDS-SD – XDS Scanned Documents XDP – Cross-Enterprise Document InterchangeXDP – Cross-Enterprise Document Interchange• NAV – Notification of Document AvailabilityNAV – Notification of Document Availability• RID – Retrieve Information for DisplayRID – Retrieve Information for Display

Patient ManagementPatient Management• PAM – Patient Administration ManagementPAM – Patient Administration Management• PDQ – Patient Demographics QueryPDQ – Patient Demographics Query• PIX – Patient Identifier Cross-referencingPIX – Patient Identifier Cross-referencing• PSA – Patient Synchronized ApplicationsPSA – Patient Synchronized Applications

RFD – Retrieve Form for Data CaptureRFD – Retrieve Form for Data Capture


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Profiles - SecurityProfiles - Security ATNA – Audit Trial and Node AuthenticationATNA – Audit Trial and Node Authentication CT – Consistent TimeCT – Consistent Time DSG – Document Digital SignatureDSG – Document Digital Signature EUA – Enterprise Use AuthenticationEUA – Enterprise Use Authentication PWP – Personnel White PagesPWP – Personnel White Pages



Patient Care Patient Care CoordinationCoordination

IHE Workshop 2006IHE Workshop 2006John Donnelly, Intepro SolutionsJohn Donnelly, Intepro SolutionsCo-chair, PCC Technical CommitteeCo-chair, PCC Technical Committee

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Primary MembershipPrimary Membership

Physician Associations & CollegesPhysician Associations & Colleges ACP, AAP, AAFP, FACEPACP, AAP, AAFP, FACEPEMR & Other Department System VendorsEMR & Other Department System Vendors Ambulatory, Inpatient, Emergency DeptAmbulatory, Inpatient, Emergency DeptPHR VendorsPHR Vendors PC-based systems, Portal solutionsPC-based systems, Portal solutionsOther Stakeholders in HITOther Stakeholders in HIT Clinical research initiatives, Public health agenciesClinical research initiatives, Public health agencies

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Profile RoadmapProfile Roadmap

Year 2005-2006 (Trial Implementation)Year 2005-2006 (Trial Implementation) Medical Summary [MS] – Acute Care Discharge to PCP, PCP Medical Summary [MS] – Acute Care Discharge to PCP, PCP

Referral to SpecialistReferral to Specialist Unstructured Document – CDA-wrapped pdfUnstructured Document – CDA-wrapped pdf

Year 2006-2007 (Development & Testing)Year 2006-2007 (Development & Testing) Medical Summary [MS] – ED Referral [EDR]Medical Summary [MS] – ED Referral [EDR] Pre-procedure H&P [PPHP]Pre-procedure H&P [PPHP] Basic Patient Privacy Consents [BPPC]Basic Patient Privacy Consents [BPPC] Exchange Personal Health Record [XPHR] Exchange Personal Health Record [XPHR]

Future (Profile Document / White Paper) Future (Profile Document / White Paper) Medical Summary [MS] – Discharge to LTCMedical Summary [MS] – Discharge to LTC Forms Display for Data Capture (e.g. clinical research)Forms Display for Data Capture (e.g. clinical research)

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Domain Visibility & SupportDomain Visibility & Support

HIMSS Annual ConferenceHIMSS Annual Conference 2006 HIMSS ‘RHIO’ Showcase – 30+ vendors exchanged 2006 HIMSS ‘RHIO’ Showcase – 30+ vendors exchanged

XDS-MS, XDS-pdf documentsXDS-MS, XDS-pdf documents Informational Presentations from Providers & HIT VendorsInformational Presentations from Providers & HIT Vendors

ACC Annual ConferenceACC Annual Conference 2006 ACC Interoperability Showcase – vendors exchanged 2006 ACC Interoperability Showcase – vendors exchanged

XDS-pdf documentsXDS-pdf documents Informational Presentations from HIT VendorsInformational Presentations from HIT Vendors

Physician Association Annual MeetingsPhysician Association Annual Meetings Informational Presentations PlannedInformational Presentations Planned

Real-world RHIO ParticipationReal-world RHIO Participation NHIIN “Pilot” RHIO’sNHIIN “Pilot” RHIO’s Independent Community-sponsored RHIO’s Independent Community-sponsored RHIO’s


CardiologyCardiology

IHE Workshop 2006IHE Workshop 2006Bob Baumgartner, McKessonBob Baumgartner, McKesson

Co-chair, Co-chair, IHE Cardiology Technical CommitteeIHE Cardiology Technical Committee

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Primary Membership SponsorsPrimary Membership Sponsors

Physician Associations & CollegesPhysician Associations & Colleges Primary: ACC, ESCPrimary: ACC, ESC Specialty: ASE, ASNC, HRS, SCAI, CTASpecialty: ASE, ASNC, HRS, SCAI, CTA

Vendor Participation– ACC Demonstrators 2006:Vendor Participation– ACC Demonstrators 2006: Leadership Level:Leadership Level:

• GE HealthcareGE Healthcare• Heartlab, An Agfa CompanyHeartlab, An Agfa Company• McKessonMcKesson

Implementer Level:Implementer Level:• Camtronics – An Emageon Camtronics – An Emageon

CompanyCompany• Cardiac Science CorporationCardiac Science Corporation• Medical Informatics Engineering, IncMedical Informatics Engineering, Inc• MediNotes CorporationMediNotes Corporation• Medis medical imaging systems, bvMedis medical imaging systems, bv• Philips Medical SystemsPhilips Medical Systems

Implementer Level: (cont)Implementer Level: (cont)• ProSolv CardioVascularProSolv CardioVascular• Siemens Medical SolutionsSiemens Medical Solutions• Toshiba Medical SolutionsToshiba Medical Solutions• Witt Biomedical CorporationWitt Biomedical Corporation

Supporter Level:Supporter Level:• Cerner CorporationCerner Corporation• GOODMAN Healthcare IT GOODMAN Healthcare IT

SolutionsSolutions• LUMEDXLUMEDX• St. Jude MedicalSt. Jude Medical

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Year 2004-2006 (Final Text)Year 2004-2006 (Final Text) Cath Workflow (Cath)Cath Workflow (Cath) Echo Workflow (Echo)Echo Workflow (Echo) Retrieve ECG for Display (ECG)Retrieve ECG for Display (ECG) Evidence Documents (ED) for Cath and EchoEvidence Documents (ED) for Cath and Echo Displayable Reports (DRPT) <<withdrawn for modifications>>Displayable Reports (DRPT) <<withdrawn for modifications>>

Year 2006-2007 (Trial Implementation)Year 2006-2007 (Trial Implementation) Stress Test Workflow (STRESS)Stress Test Workflow (STRESS) Implanted Device Cardiac Observations (IDCO)Implanted Device Cardiac Observations (IDCO) Nuclear Medicine (NM) Cardiology OptionNuclear Medicine (NM) Cardiology Option Cross Enterprise Document Sharing (XDS) Cross Enterprise Document Sharing (XDS) Cross Enterprise Document Sharing – Imaging (XDS-I) Cross Enterprise Document Sharing – Imaging (XDS-I) Cross Enterprise Document Sharing – Medical Summary (XDS-MS) Cross Enterprise Document Sharing – Medical Summary (XDS-MS)

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FutureFuture Finalize Displayable Reports (DRPT)Finalize Displayable Reports (DRPT) Evidence Document TemplatesEvidence Document Templates

• Stress MeasurementsStress Measurements• Nuclear Cardiology MeasurementsNuclear Cardiology Measurements

Data HarvestingData Harvesting Portable Data for Imaging (PDI – DVD Support)Portable Data for Imaging (PDI – DVD Support) EP Urgent Implantable Device Cardiac EP Urgent Implantable Device Cardiac

Identification (PDQ-IDC)Identification (PDQ-IDC)

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ACC Annual ConferenceACC Annual Conference 2005 and 2006 ACC Interoperability Showcase 2005 and 2006 ACC Interoperability Showcase Educational Workshops and SessionEducational Workshops and Session

ESC Annual ConferenceESC Annual Conference 2005 and 2006 ACC Interoperability Showcase 2005 and 2006 ACC Interoperability Showcase Educational Workshops and SessionEducational Workshops and Session

Specialty Hands-On DemonstrationsSpecialty Hands-On Demonstrations ASE 2006ASE 2006 ASNC 2007 and 2008ASNC 2007 and 2008 HRS 2007HRS 2007

Additional Conference RepresentationAdditional Conference Representation CT AngiographyCT Angiography SCAISCAI Computers in CardiologyComputers in Cardiology American College of Cardiology Administrators (ACCA)American College of Cardiology Administrators (ACCA)


Eye CareEye Care

IHE Workshop 2006IHE Workshop 2006Jim Riggi, Medflow, Inc.Jim Riggi, Medflow, Inc.Co-Chair IHE Eye Care Technical CommitteeCo-Chair IHE Eye Care Technical Committee

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Introducing IHE Eye Care • Targeting all eye care providersTargeting all eye care providers

• Ophthalmology and OptometryOphthalmology and Optometry

• Roots in DICOM WG9 (Ophthalmology)Roots in DICOM WG9 (Ophthalmology)• OP and Stereo modules approvedOP and Stereo modules approved• OTM and Refractive SR work items in progressOTM and Refractive SR work items in progress

• AAO is the sponsoring organizationAAO is the sponsoring organization• Dr. Flora Lum, AAO, coordinatorDr. Flora Lum, AAO, coordinator• Don Van Syckle, DVS ConsultingDon Van Syckle, DVS Consulting

• Planning CommitteePlanning Committee• Mike Schmidt, Carl Zeiss MeditecMike Schmidt, Carl Zeiss Meditec• Dr. Mark Horton, U.S. Indian Health ServicesDr. Mark Horton, U.S. Indian Health Services

• Technical Committee co-chairsTechnical Committee co-chairs• Jim Riggi, MedflowJim Riggi, Medflow• Peter Kuzmak, U.S. Dept. of Veteran AffairsPeter Kuzmak, U.S. Dept. of Veteran Affairs

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IHE Eye Care – Plan for 2006

• Informal Efforts 2005Informal Efforts 2005• Participation at HIMSS IHE Showcase: Participation at HIMSS IHE Showcase: February 2005February 2005• Participation at VEHU Showcase:Participation at VEHU Showcase: May 2005May 2005• AAO Showcase: AAO Showcase: October 2005October 2005

• Development ScheduleDevelopment Schedule• Planning Committee decision:Planning Committee decision: October 2005October 2005• Issue Public Comment version: Issue Public Comment version: March 2006March 2006• Public Comment Due:Public Comment Due: April 2006April 2006• Issue Trial Implementation version: Issue Trial Implementation version: May 2006May 2006• Connectathon: Connectathon: October 2006October 2006• AAO Showcase: AAO Showcase: November 2006November 2006

• Year 1 ProfilesYear 1 Profiles• Eye Care Scheduled Workflow (EYECARE)Eye Care Scheduled Workflow (EYECARE)• Charge Posting (CHG)Charge Posting (CHG)• Eye Care Evidence Documents [ECED]Eye Care Evidence Documents [ECED]

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IHE Eye Care ConnectathonIHE Eye Care Connectathon

Open invitation to vendor communityOpen invitation to vendor communityWeek of October 9Week of October 9thth

RSNA headquarters, ChicagoRSNA headquarters, ChicagoPrerequisite to participate in the AAO Prerequisite to participate in the AAO Annual Meeting Interoperability ShowcaseAnnual Meeting Interoperability ShowcaseApplication: Contact Flora Lum, Application: Contact Flora Lum, [email protected]@aao.org, (415) 561-8592, (415) 561-8592

mailto:[email protected]


LaboratoryLaboratory

IHE Workshop 2006IHE Workshop 2006François Macary, AGFA HealthCareFrançois Macary, AGFA HealthCareCo-Chair Laboratory CommitteeCo-Chair Laboratory Committee

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Primary membership (sponsors & contributors)Primary membership (sponsors & contributors)

Biomedical scientists in professional societiesBiomedical scientists in professional societies SFIL (Fr)SFIL (Fr) In discussion for the future: ACLA, AACC (US)In discussion for the future: ACLA, AACC (US)

National Healthcare IT bodiesNational Healthcare IT bodies GMSIH (Fr)GMSIH (Fr) JAHIS (Jp)JAHIS (Jp) HIMSS (US)HIMSS (US) In discussion for the future: CHCF (US)In discussion for the future: CHCF (US)

EHR vendors (France, Japan, UK, Germany, USA)EHR vendors (France, Japan, UK, Germany, USA)LIS vendors (France, Italy, UK, some in US)LIS vendors (France, Italy, UK, some in US)Automation Managers vendors (Japan, Italy, France)Automation Managers vendors (Japan, Italy, France)Analyzers & robotic devices vendors (Japan)Analyzers & robotic devices vendors (Japan)

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Laboratory domain productionLaboratory domain production

Contributing countriesContributing countries FranceFrance JapanJapan GermanyGermany ItalyItaly The NetherlandsThe Netherlands UKUK USUS

Current Co-Chairs Current Co-Chairs

elected in mid-2004: elected in mid-2004:

Yoshimitsu Takagi, HitachiYoshimitsu Takagi, Hitachi

Francois Macary, Agfa HCFrancois Macary, Agfa HC

StartStart 1st profile LSWF

Cx-thon Eur.

20032003

20042004

Cx-thon Eur., Asia, US20052005

LIR, LPOCT, LCSD, LDASept. Sept. 0505

Cx-thon Eur., Asia, US20062006

4 new IPs

“Sharing Lab reports” For Pub. Com. until Aug 15

June June 0606 CDA R2 CDA R2

basedbasedSept. Sept.

0606 T rial Implementation release

20072007 Cx-thon US, Eur. Asia

XDS-LABXDS-LAB

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Current projects: Future profilesCurrent projects: Future profiles

Specimen Labeling Workflow (SLW)Specimen Labeling Workflow (SLW)EHR to Lab Interoperability (In discussion with EHR to Lab Interoperability (In discussion with ELINCS)ELINCS)

Face to face meeting scheduled for early September:Face to face meeting scheduled for early September:

1.1. Process comments to XDS-LAB Process comments to XDS-LAB Trial Implementation Trial Implementation

2.2. Finalize SLW Finalize SLW Public Comment Public Comment

3.3. Launch ELINCS for Connectathon 2007Launch ELINCS for Connectathon 2007


Patient Care Devices Patient Care Devices

IHE Workshop 2006IHE Workshop 2006Todd Cooper Todd Cooper Co-chair, PCD Technical CommitteeCo-chair, PCD Technical Committee

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Physician Associations & CollegesPhysician Associations & Colleges ACCEACCE

Medical Device VendorsMedical Device Vendors Patient monitors, ventilators, pumps, home healthPatient monitors, ventilators, pumps, home health

Purchasers / ProvidersPurchasers / Providers Acute care – ED, ICU, OR (…for Year 1)Acute care – ED, ICU, OR (…for Year 1)

Other Stakeholders in HITOther Stakeholders in HIT Regulatory & Public health agenciesRegulatory & Public health agencies

Over 100 PCD members … in the first year!Over 100 PCD members … in the first year!

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Profile RoadmapProfile RoadmapYear 0: 2005 (Domain Created)Year 0: 2005 (Domain Created) Organizational meeting 2005-Sept in D.C.Organizational meeting 2005-Sept in D.C. Charter: Use Cases w/at least one regulated medical deviceCharter: Use Cases w/at least one regulated medical device

Year 1: 2006-2007 (Development & Testing)Year 1: 2006-2007 (Development & Testing) Enterprise communication of PCD data [ECPCDD]Enterprise communication of PCD data [ECPCDD] Filter PCD Data [FPCDD]Filter PCD Data [FPCDD] Patient Identification Association [PIDA]Patient Identification Association [PIDA] Content Profile: Monitors, ventilators, infusion pumpsContent Profile: Monitors, ventilators, infusion pumps Public comment starts end 2006 June Public comment starts end 2006 June

Future…Future… PCD Plug-n-Play InteroperabilityPCD Plug-n-Play Interoperability Real-time data archiving & communicationReal-time data archiving & communication Alarm management … wireless/mobile … home health … !Alarm management … wireless/mobile … home health … !

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HIMSS Annual ConferenceHIMSS Annual Conference 2005 & 2006: Booth in IHE Showcase2005 & 2006: Booth in IHE Showcase 2006: Showcase presentation … “standing room only”2006: Showcase presentation … “standing room only”

Industry SurveyIndustry Survey 2005: Survey within HIMSS / IHE re. PCD priorities2005: Survey within HIMSS / IHE re. PCD priorities 2006: Survey widened to include many other groups2006: Survey widened to include many other groups

Presentations at ConferencesPresentations at Conferences IHE PCD Presentations at conferences such as AAMI & IHE PCD Presentations at conferences such as AAMI &

APSFAPSF


Kevin O’Donnell, Toshiba Medical Systems Kevin O’Donnell, Toshiba Medical Systems Co-chair, IHE Radiology Planning CmteCo-chair, IHE Radiology Planning Cmte

RadiologyRadiology

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IHE RadiologyIHE Radiology

Scope: Scope: Radiology including Nuclear Medicine, MammographyRadiology including Nuclear Medicine, Mammography

VendorsVendors Acquisition Modalities, RIS, PACS, Workstations, Displays, PrintersAcquisition Modalities, RIS, PACS, Workstations, Displays, Printers

Established 1998 (first IHE domain)Established 1998 (first IHE domain)Sponsor: RSNASponsor: RSNASupporters: COCIR, DRG, EAR, ECR, EuroPACS, Supporters: COCIR, DRG, EAR, ECR, EuroPACS, GMSIH, JIRA, JAHIS, JRS, JSRT, METI, MEDIS-DC, GMSIH, JIRA, JAHIS, JRS, JSRT, METI, MEDIS-DC, SFR, SIRM SFR, SIRM

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IHE Radiology - DeploymentIHE Radiology - Deployment

In active use:In active use: Robust Vendor Participation at Connectathons Robust Vendor Participation at Connectathons

(78 of 150 Systems in Chicago)(78 of 150 Systems in Chicago) Over 200 IHE Integration Statements published Over 200 IHE Integration Statements published IHE Profiles appearing in User Purchasing ProcessesIHE Profiles appearing in User Purchasing Processes

Most implemented Profiles Most implemented Profiles Scheduled WorkflowScheduled Workflow Patient Information ReconciliationPatient Information Reconciliation Consistent Presentation of ImagesConsistent Presentation of Images Portable Data for ImagingPortable Data for Imaging

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IHE Radiology - AchievementsIHE Radiology - Achievements

Year 1998-2006Year 1998-2006Basic radiology workflowsBasic radiology workflows Acquisition, Post-Processing, Reporting, Teaching Acquisition, Post-Processing, Reporting, Teaching

Files/Clinical Trials, CD/Hardcopy ImportFiles/Clinical Trials, CD/Hardcopy Import

Handling imaging contentHandling imaging content Measurements, CAD Results, NM, Mammo, Fusion, Measurements, CAD Results, NM, Mammo, Fusion,

Presentation States, Reports, Key Image NotesPresentation States, Reports, Key Image Notes

Distribution of imaging informationDistribution of imaging information on CDs, to EHRs, keeping Audit Trails on CDs, to EHRs, keeping Audit Trails

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IHE Radiology – Recent DirectionIHE Radiology – Recent Direction

Facilitate deployment of IHE Profiles in the MarketFacilitate deployment of IHE Profiles in the Market Users Handbook (2005 Edition)Users Handbook (2005 Edition) PDI Demo at RSNA 2005PDI Demo at RSNA 2005 XDS-I Demo at RSNA 2006XDS-I Demo at RSNA 2006

Expand focus to integration and workflow Expand focus to integration and workflow spanningspanning departments/enterprises/regionsdepartments/enterprises/regions XDS-IXDS-I Importation WorkflowImportation Workflow

Expand support for specialtiesExpand support for specialties Address NM, Mammography and othersAddress NM, Mammography and others

Planning/Roadmap Discussions underwayPlanning/Roadmap Discussions underway


RadiationRadiation OncologyOncology

IHE Workshop 2006IHE Workshop 2006Keith La Plain, Varian Medical SystemsKeith La Plain, Varian Medical SystemsCo-Chair, IHE-RO Planning CommitteeCo-Chair, IHE-RO Planning Committee

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Radiation Oncology VendorsRadiation Oncology Vendors Delivery Devices – Linacs, Cobalt, BrachytherapyDelivery Devices – Linacs, Cobalt, Brachytherapy SimulatorsSimulators Treatment Planning SystemsTreatment Planning Systems Oncology Information Systems Oncology Information Systems

Physician Associations & CollegesPhysician Associations & Colleges ASTROASTRO AAPM (American Association of Physicists in Medicine)AAPM (American Association of Physicists in Medicine) ATC (Advanced Technology Consortium)ATC (Advanced Technology Consortium)

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Year 2005-2006 (Initial Implementation)Year 2005-2006 (Initial Implementation) Image Set Contouring Image Set Contouring Storage & RetrievalStorage & Retrieval

• Structure SetStructure Set• Geometric PlanGeometric Plan• Dosimetric PlanDosimetric Plan• Dose Dose

Multi Series Image ReviewMulti Series Image Review Combined CT StorageCombined CT Storage

Year 2006-2007Year 2006-2007 RT Plan – enlarging scope of objects : wedges, arcsRT Plan – enlarging scope of objects : wedges, arcs Scheduling of Treatment Delivery - GPWLScheduling of Treatment Delivery - GPWL Fusion (Multi-modality)Fusion (Multi-modality) Query / RetrieveQuery / Retrieve

FutureFuture Further RT Plan enlargementFurther RT Plan enlargement 4D Support for gating, breath-hold, adaptive therapy4D Support for gating, breath-hold, adaptive therapy

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ASTRO Annual ConferenceASTRO Annual Conference 2006 ASTRO : Inaugural IHE-RO Showcase 2006 ASTRO : Inaugural IHE-RO Showcase

Other Potential ConferencesOther Potential Conferences AAPMAAPM HIMSSHIMSS RSNARSNA

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