Cor Loef, Philips Medical Systems Implementation of IHE in a Radiology Department.

Cor Loef, Cor Loef, Philips Medical SystemsPhilips Medical Systems

Implementation of IHE in a Implementation of IHE in a Radiology DepartmentRadiology Department

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA2

Content:Content:

• Objective: Objective: Integrating (part of) the Healthcare EnterpriseIntegrating (part of) the Healthcare Enterprise

• ApproachApproach• How to specify and judge vendor offeringsHow to specify and judge vendor offerings• Examples of how to use IHE in practiceExamples of how to use IHE in practice• ConclusionConclusion

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA3

The objectiveThe objective

• Integrating (part of) the Healthcare EnterpriseIntegrating (part of) the Healthcare Enterprise• Optimal support for workflowOptimal support for workflow• Integrated IT solutionsIntegrated IT solutions• Seamless information flowSeamless information flow• Enable the EPREnable the EPR

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA4

The Healthcare Information The Healthcare Information System ComplexSystem Complex

MPI

ADT

RIS

PACS

Modality

Display

HIS

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA5

The approachThe approach• Focus on Operational Workflow analysis, Focus on Operational Workflow analysis,

information flow required for applications, information flow required for applications, current situation of products and transactions, current situation of products and transactions, desired situation, gap analysis, resulting in desired situation, gap analysis, resulting in requirements for new products and upgradesrequirements for new products and upgrades

• Expectation managementExpectation management

• IHE supports this process with a common IHE supports this process with a common framework all involved parties can understand framework all involved parties can understand and commit to.and commit to.

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA6

Integration ProfilesIntegration Profiles

• IHE is not a product itself.

• Functions are grouped in a set of Integration Profiles, Actors, and Transactions. Need to map integration solution requirements on these IHE concepts.

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA7

The Product World…..The Product World…..

Poduct XYZfrom Vendor T

ADT

MPI

HIS

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA8

The IHE The IHE WWorld….orld….

IHE Actor

ActorActor

Actor

IHEIHETransactionTransactionIHEIHE

TransactionTransaction

IHEIHETransactionTransaction

IHE Actor

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA9

ADT

MPI

HIS

Mapping IHE to ProductsMapping IHE to Products

Poduct XYZfrom Vendor T

IHE Actor

ActorActor

Actor

IHEIHETransactionTransactionIHEIHE

TransactionTransaction

IHEIHETransactionTransaction

IHE Actor

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA10

Integration ProfilesIntegration Profiles

• Examples:– SWF(Scheduled WorkFlow),KIN(Key Image Note)– Consistent presentation of images

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA11

IHE IHE : : An Integration ProfileAn Integration Profile

24: Report Submission

Structured Report Export: 28

25: Report Issuing

Report Creator

26: Query Reports27: Retrieve Reports

Report Repository

Report Reader

External Report Repository Access

Report Manager

Enterprise Report Repository

A set of Actors cooperating

through TTransactionransactionss to perform a specific task

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA12

Integration profiles, the easy way to Integration profiles, the easy way to deal with transactionsdeal with transactions

• easy-to-understandeasy-to-understand, , coherent coherent functionalfunctional sets and sets and

• a a convenient wayconvenient way for users and for users and vendors to communicate vendors to communicate

• about about integration requirementsintegration requirements and and needed functionalityneeded functionality in daily life. in daily life.

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA13

IHE Integration ProfilesIHE Integration Profiles

Access to Radiology InformationConsistent access to images and reports

Consistent Presentation of Images

Hardcopy and softcopy grayscale presentation state

Key ImageNotes

Flag significant images

Simple Image and Numeric Reports

Simple reports with image links and, optionally,

measurements

Basic SecurityAudit Trail Consolidation & Node Authentication

Presentation of Grouped Procedures

Subset 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 images, notify of completed steps

Patient Information Reconciliation

Unknown patients and unscheduled orders

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA14

General Integration Profile tableGeneral Integration Profile table

ActorIntegration Profile

SWF PIR CPI PGP ARI KIN SINR SEC CHG PWF

Modality

Image Creator

Image Display

Image Manager/Archive

DSS/Order Filler

ADT

Report Creator

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA15

Vendor should provideVendor should provide IHE Claims IHE Claims

ProductProduct U UVWVW supports the supports the

IHE IHE KK Actor Actor withwith thethe

IHE IHE XX and and YY Integration Profiles Integration Profiles

IHE IHE JJ ActorActor with the with the

IHE IHE TT Integration ProfileIntegration Profile

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA16

Example: PACS X, vendor YExample: PACS X, vendor YActor SWF PIR CPI PGP ARI KIN SINR SEC CHG PWF

Image Display

Image Manager/Archive

Report Creator

Secure Node

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA17

Example: PACSExample: PACS

• StandardStandard: :

– Actors: Actors: Image Manager, Image Archive, and Image Manager, Image Archive, and Image DisplayImage Display

– Integration Profiles: Scheduled Workflow and Integration Profiles: Scheduled Workflow and Patient Information ReconciliationPatient Information Reconciliation

• Display and Printing Quality:Display and Printing Quality:– Actors: Image Display and Print ComposerActors: Image Display and Print Composer– Integration Profile: Consistent Presentation of Integration Profile: Consistent Presentation of

ImagesImages

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA18

Example: PACS, part 2Example: PACS, part 2

• Modalities with Procedure grouping:Modalities with Procedure grouping:– Actors: Image ArchiveActors: Image Archive– Integration Profile: Presentation of Grouped ProceduresIntegration Profile: Presentation of Grouped Procedures

• Flagging specific images:Flagging specific images:– Actors: Image Archive and/or Image DisplayActors: Image Archive and/or Image Display– Integration Profile: Key Image NoteIntegration Profile: Key Image Note

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA19

Example: RIS UpgradeExample: RIS Upgrade

• Standard: Standard: – Actors: Actors: Order FillerOrder Filler– Integration Profiles: Scheduled Workflow and Integration Profiles: Scheduled Workflow and

Patient Information ReconciliationPatient Information Reconciliation• DICOM Structured ReportingDICOM Structured Reporting

– Actors: Report Manager, Report Repository, Actors: Report Manager, Report Repository, Report Creator and Report ReaderReport Creator and Report Reader

– Integration Profile: Simple Image and Integration Profile: Simple Image and Numerical ReportsNumerical Reports

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA20

Example: other systems:Example: other systems:- Workstations- Workstations- Modalities- Modalities- Printers- Printers- Patient Registration- Patient Registration- Order Entry- Order Entry

• Just think about Just think about ActorsActors

and and Integration ProfilesIntegration Profiles

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA21

Will IHE do it all?Will IHE do it all?A lot, but:A lot, but:• Current scope is Radiology, first important step Current scope is Radiology, first important step

towards EPRtowards EPR• Need to address performance requirementsNeed to address performance requirements• Clinical applications requiredClinical applications required• Services are neededServices are needed

– Project managementProject management– TrainingTraining– Implementation/transition managementImplementation/transition management– Operational supportOperational support

MIR 2002Implementation of IHE in a Radiology Department

HIMSS / RSNA22

ConclusionConclusion

• Using IHE Integration Profiles when writing Using IHE Integration Profiles when writing specifications will make systems integration specifications will make systems integration faster, more efficient, less expensive and faster, more efficient, less expensive and successful.successful.

• Can go for a bigbang approach, but also for a Can go for a bigbang approach, but also for a focus on a specific smaller area.focus on a specific smaller area.

• Ask your vendors about the IHE Actors and Ask your vendors about the IHE Actors and Profiles they support in their products.Profiles they support in their products.

• Success stories will be presented at the RSNASuccess stories will be presented at the RSNA