September, 2005 What IHE Delivers

IHE Cardiology Profiles IHE Cardiology Profiles for Electronic Healthcare for Electronic Healthcare

Record systemsRecord systems

ITI Meeting Dec 5ITI Meeting Dec 5thth, 2006, 2006

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Some factsSome facts

Cardiac related events comprise more than 25% of all hospital admissions in the U.S.!!Cardiology is typically (still) a profit center and not a cost center in a hospitalAlmost all cardiologists maintain both a private office practice and hospital affiliationsAs the population ages and with increased obesity issues, cardiovascular issues are rising dramatically

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IHE Cardiology Profiles Y1-Y4IHE Cardiology Profiles Y1-Y4

Cath Lab Workflow and Measurements

Intra-departmentalIntra-departmentalWorkflow ProfilesWorkflow Profiles

Inter-Inter-departmentaldepartmentalProfilesProfiles

Aggressively Aggressively adopted/adopted/Promoted ITI Promoted ITI And PCC ProfilesAnd PCC Profiles

Echo Lab Workflow and Measurements

Stress Lab Workflow and Measurements

Nuclear Medicine Imaging

Retrieve ECG for Display (based on RID)

Electrophysiology Lab Workflow and Measurements

Implantable Device Cardiac Observations (IDCO)

Displayable Reports

Urgent Implantable Device Query (based on PDQ)

Data Harvesting (Year 5)

Retrieve Information for Display (RID)

PIX/PDQ

Many variants of XDS and PCC content profiles

Consistent Time

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Example - Displayable ReportsExample - Displayable Reports

Cardiology reports typically PDF with lots of graphics – how to get them into an EMR?

Solved with IHE Solved with IHE Displayable Reports Displayable Reports

ProfileProfileSubmitting reports Submitting reports encapsulated in encapsulated in

HL7 v2 MDM messageHL7 v2 MDM message

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DRPT to XDSDRPT to XDS

<insert Harry’s diagram of DRPT ERR to XDS here if only I could find it again>

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ITI creates an “Appendix H”?ITI creates an “Appendix H”?

In the IHE Cardiology Technical Framework, we have an Appendix which explicitly calls out Profiles from other Domains which we want the Cardiology vendors to implement (perhaps ITI could do the same for PCD and Cardiology!?!)

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Appendix H ExampleAppendix H Example

Appendix H:Cardiology Summary of Relevant Profiles from Other Domains H.1 Consistent Time (CT)

• H.1.1 CT Actors• H.1.2 CT Transactions• H.1.3 Cardiology Use Cases

H.2 Scheduled Workflow (SWF) and Patient Information Reconciliation (PIR)

• H.2.1 Cardiology Use Case for SWF and PIR H.3 Retrieve Information for Display (RID)

• H.3.1 RID Process Flow• H.3.2 Cardiology Use Cases

H.4 Cross-Enterprise Document Sharing (XDS)• H.4.1 XDS Process Flow• H.4.2 Cardiology Use Cases• H.4.3 XDS Content Profiles• H.4.3.1 XDS-MS Medical Summary• H.4.3.2 XDS-I Imaging

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Appendix H IntroductionAppendix H Introduction

Appendix H: Cardiology Summary of Relevant Profiles from Other Domains

This appendix calls out specific Integration Profiles defined in the IHE Radiology and IT Infrastructure Technical Frameworks. These Integration Profiles are sufficiently important to the cardiology domain that they have been explicitly included in the IHE Cardiology Technical Framework. However, they are specified only by reference to their original definition in the other Technical Frameworks, with notes and use cases on their applicability to cardiology. There are no additional technical requirements defined in this Appendix.

The full specification of the Profiles identified in this Appendix can be found in the IHE Technical Framework documents of other domains. These descriptions are provided for reference related to their use in the Cardiology domain.

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In SummaryIn Summary

We need a more bi-directional, active dialogue with the ITI and PCC domains to: get feedback on IHE Cardiology Technical

Framework implementation plans (e.g., IDCO) A way to promote Cardiology and PCD (and

other?) Profiles to the EHR vendors because you are missing the Departmental content