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IntegratingIntegratingthe the
Healthcare EnterpriseHealthcare Enterprise
IHE IHE FundamentalsFundamentals
Kevin O’Donnell, ToshibaKevin O’Donnell, ToshibaNiki Wirsz, SiemensNiki Wirsz, Siemens
IHE IHE FundamentalsFundamentals• What is it about?What is it about?
• How do I get it?How do I get it?
• Why is it needed?Why is it needed?
• Who is IHE?Who is IHE?
• Where can I learn more?Where can I learn more?
• How does it work?How does it work?
• How do I use it?How do I use it?
• What do I get out of it?What do I get out of it?
• What about DICOM?What about DICOM?
• What does IHE create?What does IHE create?
RSNA 20023
What is IHE about?What is IHE about?
IHE is an initiative promoting and IHE is an initiative promoting and supporting the supporting the integrationintegration of of systemssystems in in the the healthcare enterprisehealthcare enterprise..
Goal: Improve the efficiency and Goal: Improve the efficiency and effectiveness of clinical practice by:effectiveness of clinical practice by: Improved Improved Information FlowInformation Flow Advanced Advanced Multi-System FunctionsMulti-System Functions
RSNA 20024
How do you Use IHE?How do you Use IHE?
• IHE “Integration Profiles”IHE “Integration Profiles”– Are Are Integration solutions in the Healthcare EnterpriseIntegration solutions in the Healthcare Enterprise to to
support specific capabilities.support specific capabilities.
• Customer – Vendor CommunicationCustomer – Vendor Communication– Review the ProfilesReview the Profiles– Decide what you Decide what you NeedNeed– Ask vendors for that profile on the relevant systemsAsk vendors for that profile on the relevant systems
““Which IHE Profiles do you support on System X as Which IHE Profiles do you support on System X as which actors? - which actors? - The IHE Product Evaluation The IHE Product Evaluation Worksheet.Worksheet.
RSNA 20025
Why is IHE needed?Why is IHE needed?
• Serious Integration Challenges in Healthcare:Serious Integration Challenges in Healthcare:
• Systems need Information other systems haveSystems need Information other systems have
• But, systems communicate poorly or not at all But, systems communicate poorly or not at all
• Result: - tedious, inefficient workflows Result: - tedious, inefficient workflows - data that is inconsistent, - data that is inconsistent, redundant redundant or or unavailable unavailable
Responsibility for information flow between systems, Responsibility for information flow between systems, and between departments, is often unclear.and between departments, is often unclear.
RSNA 20026
Who is IHE?Who is IHE? Participants:Participants:
Professional Societies Professional Societies Radiological Society of North America (RSNA)Radiological Society of North America (RSNA) Healthcare Information and Management Systems Society Healthcare Information and Management Systems Society
(HIMSS) (HIMSS) Other societies (European, Japanese, Lab HC PartnershipOther societies (European, Japanese, Lab HC Partnership
ACC, …)ACC, …) Vendors (over 30 companies)Vendors (over 30 companies) Standards Group Committee Members Standards Group Committee Members of DICOM & HL7of DICOM & HL7
RSNA and HIMSS sponsor IHE to provide a RSNA and HIMSS sponsor IHE to provide a neutral forumneutral forum for working on the for working on the Big PictureBig Picture
RSNA 20027
How Established is IHE?How Established is IHE?• Year 1 (1999):Year 1 (1999): Proof of ConceptProof of Concept
• PACS, Review Stations, Reporting SystemsPACS, Review Stations, Reporting Systems
• Printers, Imagers Printers, Imagers
RSNA 20029
Why Integrate?Why Integrate?• Interfacing products from different Vendors for Interfacing products from different Vendors for
Interoperable and effective Enterprise operation.Interoperable and effective Enterprise operation.• Integrated Systems -> cooperative exchange of Integrated Systems -> cooperative exchange of
informationinformation
• Your system receives relevant informationYour system receives relevant information– Patient DemographicsPatient Demographics– Order InformationOrder Information– Related Clinical DataRelated Clinical Data>>> More efficient workflow, reduced errors, more intelligent >>> More efficient workflow, reduced errors, more intelligent
equipment equipment
• Your system distributes relevant informationYour system distributes relevant information– Clinical Data – test results, images, measurements, reportsClinical Data – test results, images, measurements, reports>>> More valuable if it’s available anywhere, anytime>>> More valuable if it’s available anywhere, anytime>>> More valuable when combined with other data>>> More valuable when combined with other data
(No single device has all the answers) (No single device has all the answers)
RSNA 200210
Why Integrate?Why Integrate?• Cooperative Information Flow Enables ProcessesCooperative Information Flow Enables Processes
– Electronic Medical Records: Data Collection, Storage, DistributionElectronic Medical Records: Data Collection, Storage, Distribution
– Clinical Workflow: Data Access, Review, Analysis, RecordingClinical Workflow: Data Access, Review, Analysis, Recording
– Research Workflow: Clinical Studies, Evidence Based MedicineResearch Workflow: Clinical Studies, Evidence Based Medicine
– Financial Workflow: Order Authorization, Status, Billing, CollectionFinancial Workflow: Order Authorization, Status, Billing, Collection
– Collaboration for resolving problems such as Consistent Collaboration for resolving problems such as Consistent Presentation of Images or Managing Subset of single Acquisition.Presentation of Images or Managing Subset of single Acquisition.
RSNA 200211
How is IHE related to Standards?How is IHE related to Standards?• Information is applied within a contextInformation is applied within a context
• Information needs to travel widelyInformation needs to travel widely>>> Workflows cross Standard borders>>> Workflows cross Standard borders
• Standards provide tools & technologiesStandards provide tools & technologies– HL7 and DICOM provide dictionariesHL7 and DICOM provide dictionaries
• IHE specifies how to apply them to real world IHE specifies how to apply them to real world scenarios & integration problemsscenarios & integration problems– IHE defines a “phrasebook”IHE defines a “phrasebook”
RSNA 200212
What Does IHE Do?What Does IHE Do?• Users and Vendors work together to identify Users and Vendors work together to identify
and design solutions for integration problemsand design solutions for integration problems
• Intensive process with Intensive process with annual cyclesannual cycles::– Identify key healthcare workflows and integration Identify key healthcare workflows and integration
problemsproblems– Research & select standards to specify a solutionResearch & select standards to specify a solution– Write, review and publish IHE Technical FrameworkWrite, review and publish IHE Technical Framework– Perform cross-testing at “Connectathon”Perform cross-testing at “Connectathon”– Demonstrations at tradeshows (HIMSS/RSNA)Demonstrations at tradeshows (HIMSS/RSNA)
RSNA 200213
What are What are Key IHE ConceptsKey IHE Concepts??• Generalized Systems Generalized Systems -> -> ActorsActors
• Interactions between Actors Interactions between Actors -> -> TransactionsTransactions
• For each Integration Profile:For each Integration Profile:
• the context is described (which real-world problem)the context is described (which real-world problem)
• the actors are defined (what systems are involved)the actors are defined (what systems are involved)
• the transactions are defined (what must they do)the transactions are defined (what must they do)
RSNA 200214
What is the Result?What is the Result?• Vendors implement selected actors and Vendors implement selected actors and
support selectedsupport selected profiles on their systems profiles on their systems
• IHE is IHE is not a productnot a product;;it is it is a software feature or upgradea software feature or upgrade
• Customers can request specific Integration Customers can request specific Integration Profiles in RFPs for clinical systemsProfiles in RFPs for clinical systems
• The systems have been pre-tested at the The systems have been pre-tested at the ConnectathonConnectathon
RSNA 200215
Who benefits?Who benefits?• Clinical UsersClinical Users
• Greater access to more consistent informationGreater access to more consistent information• Fewer errors, fewer tedious tasksFewer errors, fewer tedious tasks
• AdministratorsAdministrators• Increased throughputIncreased throughput• Better scheduling and trackingBetter scheduling and tracking
• BuyersBuyers• Specify/purchase integration capabilities easily Specify/purchase integration capabilities easily • Freedom to acquire “Best of Breed” systems Freedom to acquire “Best of Breed” systems
• IT ProfessionalsIT Professionals• Faster, more predictable integration projectsFaster, more predictable integration projects
RSNA 200216
IHE Integration ProfilesIHE Integration Profiles
Access to Radiology InformationRetrieve & view images and reports
Consistent Presentation of Images
Hardcopy and softcopy grayscale presentation state