1 RSNA 2004 Christoph Dickmann – Member IHE Rad TC Glen Marshall – Co-chair IHE IT-I PC Charles Parisot – Co-chair IHE IT-I TC Image-enabled Health Records: IHE Progress and Plans Integrating the Healthcare Integrating the Healthcare Enterprise Enterprise
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Image-enabled Health Records: IHE Progress and Plans
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1RSNA 2004
Christoph Dickmann – Member IHE Rad TC
Glen Marshall – Co-chair IHE IT-I PC
Charles Parisot – Co-chair IHE IT-I TC
Image-enabled Health Records:IHE Progress and Plans
Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise
RSNA 20042
Pragmatic definition of “EHR”Pragmatic definition of “EHR”
Integrated data and workflow functionality– Multimedia data access
text, image, waveform, …
– Communication among stakeholders clinicians, caregivers, consumers, …
Support different views of data– Clinical records
Details: episode, visit, study
– Longitudinal records Summaries: episode, visit
cross-department or cross-enterprise users
Linking summaries and clinical details
RSNA 20043
What an EHR can do for youWhat an EHR can do for you
Combine multiple sources of patient data Enhance functionality by
– Connecting to specialized systems – Augmenting the data sources by combining them
Provide timely, relevant, comprehensive data– Surgeon preparing an operation by viewing an
abdomen CT and lab values– General practitioner receiving cardiac films via CD– Neurologist reading a brain MR report and viewing
an EKG
RSNA 20044
EHR goals in IHEEHR goals in IHE(compatible with U.S. NHII goals)(compatible with U.S. NHII goals)
Informed Clinical Practice– Leverage existing IHE basis to ease EHR adoption
Interconnected Clinicians– Beyond the department: community or regional scope
Personalized Care– Web-based data access and summary data
Support for higher-level goals– Better outcomes– Increased patient safety– More efficient healthcare operations
RSNA 20045
EHR complexityEHR complexity
Business dilemmas– Significant, long-term investment – Investors may not be main beneficiaries
Coordination and cooperation– Active collaboration among multiple stakeholders– Identify and work out commonalities and barriers
Integration and interoperability– Implement existing standards– Develop additional standards
Focus on selected aspects
RSNA 20046
Focus: Image-enabled EHRFocus: Image-enabled EHR(connect two “worlds”)(connect two “worlds”)
Textual data & functions– Patient data– Clinical data
Laboratory results Surgery reports Prescriptions, meds Letters or notes
Integrate with imaging data and related processes
Imaging data & functions– Patient data– Images and evidence
Radiology Cardiology Nuclear Medicine
Integrate with clinical data and related processes
RSNA 20047
Potential use cases of an Potential use cases of an image-enabled EHRimage-enabled EHR
Neurologist: reviewing stroke patient transfer to ward
Nurse: preparing GI ward round for Dr. X
Surgeon: planning gall bladder surgery
GP: seeing a post-MI patient after hospital discharge
Patient: preparing an obstetric visit
Cardiologist: during catheter intervention
Radiologist: starting an abdomen CT
Physician: counseling at diabetes outpatient clinic
Lab technologist: for immune-deficiency testing
Ophthalmologist: during history-taking with a new patient
Information need may include current or longitudinal evidence.
Ordering, scheduling and tracking of image acquisition steps Appointment Notification (Rad SWF option): report back to the order
placing system the date and time of the scheduled steps– Reporting Workflow (Rad RWF)
Scheduling and tracking of report creation tasks
Patient data integration– Patient Information Reconciliation (Rad PIR, Card CATH/ ECHO)
Modification and matching of patient data and imaging evidence
Overall concept (Rad whitepaper)– Departmental workflow and interfaces to enterprise
RSNA 200421
Planned IHE developmentPlanned IHE development
Harmonize IHE domain-specific work Extend XDS’ document content (Rad, Card) Additional EHR contents Code sets and master files Realize overall workflow concept Configuration support Security details, e.g. access control
RSNA 200422
Image-enabled EHR – IHE Image-enabled EHR – IHE progress and plansprogress and plans
IHE Integration Profiles from different domains can be combined
Combinations of current profiles can cover many EHR scenarios– Information integration (imaging, textual)– Enhanced functionality beyond one department– Intra- and cross enterprise communication
Scenarios enable system evolution(organizational change management not to be forgotten)
IHE ensures integration testing and future Integration Profile development