The Future of IHE

The Future of IHEThe Future of IHE

Linking Domains Across the Enterprise

Dr. Nikolaus Wirsz – IHE Planning CommitteeSiemens Medical Solutions

HIMSS/RSNA HIMSS 2003

Introduction The Vision IHE Over Time IHE Success IHE Future Plans IHE Vision for Growth Shaping the Future of IHE IHE Benefits

The Future of IHEThe Future of IHE


Integration solutions available today - BUT:Proprietary departmental solutions leave many problems unresolved:

• Communicating Medical Data Across Multiple Systems from Different Vendors

• Access to the Complete Information• Consistency of Information

Across Departments and Institutions• No Long-term Guarantee of Viability or

Evolutionary Path

IntroductionIntroduction


Nov. 1998

HIMSS & RSNA Launch a New Initiative:

Integrating the Healthcare Enterprise (IHE)

An Incremental Multi-Year Project

The VisionThe Vision



Speed up the integration in healthcare environments

Foster communication between vendors

Prove that integration is attainable based on standards



Participants:

Representatives of Healthcare Providers: HIMSS, RSNA, …

Users: Radiologists, Medical Staff, Administrators, CIOs, …

Information Systems Vendors: RIS & HIS Vendors

Imaging Systems Vendors: Modality & PACS Vendors

Standards Committee Members: HL7, DICOM


Year 1Initial Functional System Architecture

Integrate Radiology with HIS

• Patient Registration & ADT• Order Entry & Scheduling• Image Communication:

- Image Acquisition- Image Storage- Image Retrieval

IHE Over TimeIHE Over Time


Year 2Expand Radiology Transactions

Interdepartmental Information Sharing

• Image Availability Information ( Location ) toEnable Subsequent Process Steps ( Reporting )

• Access to Radiology Information ( Reports and Images) within Radiology and within Other Departments

• Patient Information Reconciliation (“John Doe” / Trauma)



Year 2Expand Radiology Transactions

Interdepartmental Information Sharing

• Consistent Presentation of Images

• Report Management

• Enable Access to Non-Radiology Information(e.g. Lab data)



Year 3Consolidation Year for Radiology

Drive IHE into Market and into Real World• Improvements Based on Year 1 and 2 Experience:

- Order Tracking ( Order Status Updates )- Clinical Data and Alerts Available to Medical Staff- Templates for Structured Reports- Rules to Link Reports to Studies / Images

• Include Other Clinical Specialties

• Advance Integration with Enterprise Information Systems

• Encourage IHE Initiative Worldwide



Year 4Radiology Resumes Vertical Growth

• Post-Processing Workflow:Using DICOM General Purpose Worklist

• Initial Security Features:Audit & Authentication Controls

• Charge Posting:Billing / Financial Transactions

• Error Management:Fixing operator errors and other exception cases using DICOM Modality Worklist



Year 4

The Vision is REAL

• IHE is no longer just a demonstration

• IHE expands its presence on the exhibit floor

• 13 poster presentations and user success stories are featured



RIS

HIS

PACS

imagesstored

Filmimagesprinted

reportRegistration

patientinformation

Orders Placed

examination orders

Orders Filled

imagesretrieved

FilmFolder

ReportRepository

Image Managerand Archive

procedurescheduled

Prefetch any relevantprior studies

modalityworklist

Patient and procedureinformation retrievedby the modality

Modality

DiagnosticWorkstation

report

report

acquisitionin progress /completed

IHE Success – Closing LoopIHE Success – Closing Loop

FilmLightbox

acquisitionin progress /completed


Access to Radiology InformationRetrieve & view images and reports

Consistent Presentation of Images

Hardcopy and softcopy grayscale presentation state

Key ImageNotes

Flag & search for significant images

Simple Image and Numeric Reports

Simple reports with image links and measurements

Basic SecurityAudit Trail Consolidation & Node Authentication

Presentation of Grouped Procedures

Manage subsets of a single acquisition

Post- Processing Workflow

Schedule, perform, & notify image processing

& CAD steps

Charge Posting

Collection of billable procedure details

Scheduled Workflow

Admit, order, schedule, acquire & store images with notification of

completed steps

Patient Information Reconciliation

Unknown patients and unscheduled orders

IHE Success – Integration ProfilesIHE Success – Integration Profiles


IHE Future PlansIHE Future PlansYear 5

Boost Evolution and Acceptance of IHEExpansion to other Clinical Specialties

• Support for Interpretation / Reporting Workflow:

- Radiologist’s Worklist:Using DICOM General Purpose Worklist

- Evidence Documents:Measurements, Waveforms, Procedure Documentation,


IHE Future PlansIHE Future PlansYear 5

Boost Evolution and Acceptance of IHEExpansion to other Clinical Specialties

• Support IHE Efforts Evolving in Other Domains:- Cardiology- Overall Healthcare IT Infrastructure:

MPI, Desktop Integration, …

• Concepts for Extended Archiving:- Centralized / Decentralized Archiving Solutions in

Multi-Institution Environments


IHE Future PlansIHE Future Plans

Integration Beyond Radiology Boundaries

• Encourage Other Clinical Fields to Attain Internal Vertical Integration:

- Cardiology- Laboratory / Pathology- Pharmacy / Medication Management

• Expand Enterprise IT Infrastructure in Healthcare

• Goals:- Integration of Multiple Clinical Specialties- Incorporate IT Infrastructure Features


A Multidimensional Expansion of IntegrationIHE Vision for GrowthIHE Vision for Growth

DeptSched.

ADT

Order Mgt

ImageMgr

Modality

11stst Dimension: Dimension:Vertical Integration for RadiologyVertical Integration for RadiologyIHE Years 1, 2, 3, 4, ...IHE Years 1, 2, 3, 4, ...


22ndnd Dimension: Dimension:Growing the HorizontalGrowing the HorizontalHealthcare Enterprise IntegrationHealthcare Enterprise Integration

Master Patient Index

Clinical Patient Record

Ordering Process

. . .Dept

Sched.

ADT

OrderMgt

ImageMgr

Modality

Patient Registration



33rdrd Dimension: Dimension:Increasing the Number ofIncreasing the Number ofVertically IntegratedVertically IntegratedDepartmentsDepartments

Master Patient Index

Clinical Patient Record

Ordering Process

. . .

Patient RegistrationR

a d

i o

l o g

y

C a

r d

i o

l o g

y

Lab

orat

ory

/ Pat

hol

ogy

Ad

d’l

Cli

nic

al F

ield

s

Ph

arm

acy

/ Med

. Ad

m.



IHE Vision for GrowthIHE Vision for Growth

ADT/Reg.

Lab/Path. Radiology

Cardiology

Int. Med.

Endoscopy

Ophthalm Dental

ER


IHE Strategic Development Committee Est. August 2001

• Expansion of IHE process to meetintegration needs of entire enterprise

• Engage leading medical professionals and associations from other key domains to helpmove IHE beyond Radiology

Shaping the Future of IHEShaping the Future of IHE


Objectives:

• Identify and recommend clinical and operational domains

• Identify steps in the typical patient care workflow

• Identify integration needs and barriers within and across domains

• Populate domain specific planning and technical committees



IT Infrastructure Issues

• Enterprise Master Patient Index ( EMPI )

• Advanced Security & Access Privileges

• Single Sign-On &Desktop Applications Synchronization

• Liaison & Coordination with the HL7 Organization



Strategic DevelopmentCommittee

RadiologyPlanning Committee

RadiologyTechnical Committee

IHE EuropePlanning Committee

IT InfrastructurePlanning Committee

IT InfrastructureTechnical Committee

IHE JapanPlanning Committee

……

Sub-CommitteePharmacy

Sub-CommitteeLaboratory

CardiologyCommittee

IHE FrancePlanning Committee

IHE GermanyPlanning CommitteeIHE Italy

Planning CommitteeIHE UKPlanning CommitteeIHE …

Planning Committee

IHE Steering Committee

JAPAN EUROPE North America

JIRA COCIR EAR ECR HIMSSJRS SFR DRG SIRM RSNA… GMSIG ZVEI BIR … …

Professional Societies / Sponsors

IHE Organizational StructureIHE Organizational Structure


IHE Expands ScopeIHE Expands Scope Recruiting Participants in New Committees

Enterprise Master Patient Index Advanced Security Query/Display/Synchronized Patient View

Special Panel Session in IHE Theatre Overview of new IHE enterprise initiatives Learn how to participate

– Tuesday, February 11, 9:15 – 10:00 a.m.– Wednesday, February 12, 12:15 – 1:00 p.m


Special IHE Panel SessionSpecial IHE Panel Session IHE - IT Infrastructure: The Value Proposition

– Find out how you can benefit from participating in IHE committees and Connectathons

– Learn how IHE fills the interoperability gap – Hear the status of new enterprise initiatives

Software vendors, developers and interested parties invited to attend special panel session


• Continuity and Integrity of Patient Information

• Clinical Workflow Optimization

• Fostering Communication Among Diverse Information Systems

• Avoid Repeating Tasks

• Eliminating Gaps and Redundancies in Data Access

• Driving the Use and Evolution ofHealthcare Communication Standards

Benefits of IHEBenefits of IHE

Improving the Patient Care ProcessImproving the Patient Care Process


Questions?Questions? Information Available On the Web at:

http://www.rsna.org/IHEhttp://www.rsna.org/IHE

Home Page of IHE Europe:

http://www.IHE-Europe.orghttp://www.IHE-Europe.org

Home Page of IHE Japan:

http://www.jira-net.or.jp/ihe-j/en/index.htmlhttp://www.jira-net.or.jp/ihe-j/en/index.html

The Future of IHE

Documents

Transcript of The Future of IHE