Integrating the Healthcare Enterprise

Integrating the Healthcare EnterpriseIHE for Product Planners

Ellie Avraham

Kodak Health Imaging

IHE Planning and Technical Committees Member

Learning Objectives

The Clinical and Economic benefits of Integrating the Healthcare Enterprise

Improve Product Functionality by using the IHE Technical Framework

Improve Integrated System Solutions by using IHE Integration Profiles

Learn from IHE Users Success Stories and other IHE information to refine the Products “Business Case” evaluation

IHE Classroom Sessions – RSNA 2004Discussion Areas

The IHE Deployment Process

IHE Integration Profiles

The Value Proposition from Planning Products and Integrated Solutions using IHE

IHE Classroom Sessions – RSNA 2004Challenges of Integration

Integration Solutions Available Today fromMedical Systems Vendors – BUT ...

Modern Healthcare Enterprises in All Countries Are Still Confronted with Problems:(In Spite of IT Standards and Advanced Technology)

Lack of Access to Complete Medical Information

Inconsistent Medical InformationAcross Departments and Institutions

Inadequate Communicating of Medical DataAcross Multiple Systems from Different Vendors

Risky Investments in Proprietary Solutions

IHE Classroom Sessions – RSNA 2004IHE drives healthcare standards based-integrationIHE Classroom Sessions – RSNA 2004Product IHE IntegrationStatementIHEConnectathonIHEDemonstrationProductWith IHEEasy toIntegrateProductsStandardsIHEIntegrationProfiles BIHEIntegrationProfile ARFPIHE Process- Annual CycleIHE ConnectathonResultsIHETechnicalFrameworkUser Site

IHE Technical Framework – Define Standard Integration Solutions

IHE Connectathon Results – Most implemented and tested IHE Solutions

IHE Integration Statements – Most Comertialized IHE Solutions

IHE Success Story – Most Successful Used IHE Solutions

IHE Classroom Sessions – RSNA 2004Using IHE for Product Planning

IHE Aid for Global Product Planning

IHE Technical Framework (TF)

> Vol 1: Defines Global Integration Profiles > Vol 2,3: Defines the TF Transactions details for Development > Vol 4: Defines the Local National specialization details

IHE Connectathon Results – Learn what IHE solutions are developed

IHE User Success Stories – Learn the Clinical and Economic benefits of using products with IHE capabilities.

IHE Integration Statements – The Commercialized products with IHE capabilities

RFP’s from customers

IHE Classroom Sessions – RSNA 2004IHE Connectathon Resultshttp://www.rsna.org/IHE/connectathon.shtmlhttp://www.ihe-europe.org/con_result/IHE Classroom Sessions – RSNA 2004IHE User Success Stories

http://www.rsna.org/IHE/participation/success_stories/index.shtml

Cleveland Clinic Foundation

Detroit Medical Center

Grossman Imaging Centers

Hôpitaux Universitaires de Genèv

IHE McKay-Dee Hospital

Johannes Gutenberg University Hospital

Magic Valley Regional Medical Center

Mayo Clinic Jacksonville

Our Lady Of The Lake Regional Medical Center (OLOL)

VA Puget Sound Health Care System

St. Vincent Hospital and Health Services

Steinberg Diagnostic Medical Imaging

University of Pisa

University of Wisconsin

IHE Classroom Sessions – RSNA 2004 IHE Success Stories

Deployment of IHE Profiles – Most Used:

- Scheduled Workflow (SWF) - Patient Information Reconciliation (PIR) - Consistent Presentation of Images (CPI) - Reporting Workflow (RWF) - Basic Security for HIPAA regulations (SEC)

Clinical and Economics Accomplishments

- Improve the Patient Care– Improved data accuracy and Safety, Image Quality & Consistency and time saving due to optimized Workflows and integrated systems - Improve the clinical practice productivity - reduced manual data entry using the ADT registration in one place and propagate it to all the other systems (PACS, RIS Modality) and reduced errors. - Optimize the Radiological Workflow (SWF) Reduced the incorrectly or lost studies, using DICOM MWL, MPPSIHE Classroom Sessions – RSNA 2004IHE Integration Statements

IHE Integration Statements document the product IHE capabilities in terms of IHE: Actors and Integration Profiles.

Promote your products with the Integration Statements

Learn from other Vendors Integration Statements the IHE Profiles

and Actors supported

The RSNA links to IHE Integration Statements published by the companies:

- Agfa HealthCare - Philips Medical Systems

- Cerner Corporation - Sectra

- Eastman Kodak Company - Siemens Medical Solutions

- Emageon - Softmedical

- Fujifilm Medical Systems USA - Stentor

- GE Medical Systems - StorCOMM, Inc

- INFINITT Co., Ltd. - Tiani Medgraph AG

- McKesson Information Solutions - Toshiba America Medical Systems

- Medcon - Voxar Limited

IHE Classroom Sessions – RSNA 2004IHE Integration StatementDate12 May 2004VendorProduct NameVersionAny Medical Systems Co.IntegrateRAD V2.3This product implements all transactions required in the IHE Technical Framework to support the IHE Integration Profiles, Actors and Options listed below:Integration Profiles ImplementedActors ImplementedOptions ImplementedScheduled WorkflowImage Manager/Image ArchivenoneImage DisplaynoneInternet address for vendor’s IHE information:www.anymedicalsystemsco.com/iheLinks to Standards Conformance Statements for the ImplementationHL7www.anymedicalsystemsco.com/hl7 DICOMwww.anymedicalsystemsco.com/dicom/integrateRAD.pdfLinks to general information on IHENorth America:www.rsna.org/IHEIn Europe: www.ihe-europe.orgIn Japan: www.jira-net.or.jp/ihe-jIHE Classroom Sessions – RSNA 2004www.rsna.org/iheIHE FoundationIHE Technical Framework

Organized in sections that provide an increasing level of detail

Integration Profiles: Establish broad categories of compatible function.

Actors: Identify specific kinds of operational participants in the healthcare enterprise.

Transactions: Describe particular interactions between actors to perform specific operations.

IHE Classroom Sessions – RSNA 2004Charge PostingPresentation of Grouped ProceduresReporting WorkflowKeyImageNotesSimple Image & Numeric ReportsNMImageConsistent Present-ation of ImagesEvidenceDocsAccess to Radiology InformationPortable Data for ImagingIHE Radiology Integration ProfilesScheduled Workflow-Patient Info. Recon-ciliationPost-Processing WorkflowBasic SecurityIHE Classroom Sessions – RSNA 2004reportRegistrationFilmLightboxImage Manager& ArchiveOrders FilledFilmFolderDiagnosticWorkstationFilmReportRepositoryOrders PlacedAcquisitionModalityacquisitioncompletedacquisitionin-progressimagesprintedModalityacquisitioncompletedScheduled Workflow ProfileIHE Classroom Sessions – RSNA 2004Patient Information ReconciliationIHE Classroom Sessions – RSNA 2004Consistent Presentation of ImagesArea OfInterestArea OfInterestAchievingConsistent PresentationFlipZoomAnnotateOriginal ImageWithoutConsistent PresentationWindow LevelReferring Physician orReviewing RadiologistReporting RadiologistPresentation StatePresentation LUTGrayscale StandardIHE Classroom Sessions – RSNA 2004TLS authentication of remote node (digital certificates)

with/without encryption

Audit PHI trail with:

Real-time access

Time synchronization

Secured SystemSecured SystemSecure networkSystem BSystem ACentral Audit TrailRepositoryBASIC SecurityIHE Classroom Sessions – RSNA 2004Report:CHESTReport:AB/PELVISAb/Pelvis ViewChest ViewChest ViewMODALITYPerforms a single examOperatorgroups2 proceduresAb/Pelvis ViewPresentation of Grouped Procedures ProfileRequested Procedure:CHESTRIS / PACSRequested Procedure:AB/PELVISIHE Classroom Sessions – RSNA 2004 Simple Image & Numeric Reports ProfileImages and Examdata presented fordiagnosisVerified ReportPreliminary ReportImage Manager& ArchiveReportVerificationReports storedforNetwork AccessReport & ImageReview forPatient CareReport & Images RetrievedImages RetrievedIHE Classroom Sessions – RSNA 2004Access to Radiology InformationEmergency DepartmentReferring PhysicianRadiology Department – Images and ReportsRemote ClinicsOther Departments:- Oncology- Surgery- Neurology- Pediatrics- etc.Electronic Medical RecordIHE Classroom Sessions – RSNA 2004Post-Processing CAD WorkflowSource DataWorklistPACS SystemCAD*Workstation3-D*WorkstationWorkstationReportRepositoryWork StatusResultsAcquisitionModalityPost-Proc.WorkflowManagerWork Status…ResultsIHE Classroom Sessions – RSNA 2004Charge Posting ProfileAccount Management*Billing SystemADT TerminalReport Generated / SignedCAD*Workstation3-D*WorkstationReportRepository3-DPerformedCADPerformedAcquisitionModalityPostChargesChargePosterStudyPerformed/ MaterialsUsed…IHE Classroom Sessions – RSNA 2004Work ItemClaimedReportingWorklistStoreReportsReportingProcedure StepSTARTEDMeasurementsCAD Reports………………… Retrieve Images &Evidence DocumentsReportingProcedure StepSTARTED IHE Reporting WorkflowRISReportManagerReport Reader/CreatorPACS & ArchiveReportingProcedure StepCOMPLETEDImageManager/ArchiveReportingProcedure StepCOMPLETEDIHE Classroom Sessions – RSNA 2004Media ImporterImage/ Report DisplayPrinterJohn DoePortable Data for ImagingCDCreatorCDIHE Classroom Sessions – RSNA 2004IHE Value Proposition

Product Planning

IHE Solutions are Driven by Strategic Healthcare Lead Users that collaborate with Healthcare Vendors

IHE Solutions are Generic, Reusable and Interoperable based on Healthcare Standards: DICOM, HL7, RFC

IHE Solutions Optimize the Clinical Workflows

IHE Deployment process – Connectathon, Integration Statements and Users Success Stories information helps to refine the product “Business Case”

IHE Technical Framework specification describes the Global IHE solutions at a High Level for Planning & Marketing and in details for products Architects and Engineering development

IHE Classroom Sessions – RSNA 2004IHE Benefits

Clinical Users

Greater access to consistent information

Fewer errors, fewer tedious tasks

Buyers

Specify/purchase integration capabilities easily

Freedom to acquire “Best of Breed” systems

IT Professionals

Faster, more predictable integration projects

Facilitate cooperation of competing vendors

Administrators

Increased throughput

Better scheduling and tracking

IHE Classroom Sessions – RSNA 2004Picking IHE Profiles Considerations

Customer RFP’s

Product positioning in the market with a Good Business Case

IHE Technical Framework Volume 1

Healthcare Institution Needs:

> Optimized Clinical Workflow : SWF, PIR, RWF > Improve the Patient Health Care: SWF, PIR, CPI, PGP,KIN > Economy - Reduce Healthcare cost: SWF, CHG> Protect the Patient Health Information: SECIHE Classroom Sessions – RSNA 2004IHE for Product PlannersQuestions?IHE North America: http://www.rsna.org/IHE orhttp://www.himss.org/IHEIHE Canada: http://www.ihe-canada.comIHE Europe: http://www.IHE-Europe.orgIHE France: http://www.gmsih.fr/IHEIHE Germany: http://www.IHE-D.orgIHE Italy: http://www.rad.unipd.it/IHEIHE UK: http://www.IHE-UK-orgIHE Japan: http://www.jira-net.or.jp/ihe-j/en/index.htmlIHE Classroom Sessions – RSNA 2004