September, 2005What IHE Delivers How to purchase eye care systems using IHE IHE Showcase at the AAO Conference November 2006 Andrew Casertano, Peter Kuzmak,

September, 2005 What IHE Delivers

How to purchase eye care How to purchase eye care systems using IHEsystems using IHE

IHEIHE Showcase at the AAO Showcase at the AAO ConferenceConference

November 2006November 2006

Andrew Casertano, Peter Kuzmak, Andrew Casertano, Peter Kuzmak, and Dr. Ruth Dayhoffand Dr. Ruth DayhoffDepartment of Veterans AffairsDepartment of Veterans AffairsVistA ImagingVistA Imaging

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Learning ObjectivesLearning Objectives

How IHE can provide valuable assistance in eye care system acquisition?

What tools and education are available?

How the results of the connectathon can be used and how can they help in finding the right product to solve the integration problem?

Example of writing a Request for Proposal (RFP) using IHE

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What is IHE?What is IHE?

IHE is a specification of transactions between systems.

IHE describes only integration features.

IHE is not a product itself, but…

IHE is very useful in purchasing products that integrate into workflow

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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 Information

Across Departments and Institutions Inadequate Communicating of Medical Data

Across Multiple Systems from Different Vendors Risky Investments in Proprietary Solutions

Challenges of IntegrationChallenges of Integration

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Why Is Integration Hard?Why Is Integration Hard?

The Different Eye Care Systems Don’t Use a Common Vocabulary

The Different Eye Care Systems Don’t Use Common Communication Standards Consistently

The Flow of Information Through the Patient Encounter Changes With the Circumstances of Care

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IHE Eye Care Process

IHEIntegrationProfiles B

IHEIntegrationProfile A

Easy toIntegrateProducts

IHEConnectathon

ProductWith IHE

IHEDemonstration

User Site

RFPRFP

Standards

IHETechnical

Framework

Product IHE IntegrationProduct IHE IntegrationStatementStatement

IHE IHE ConnectathonConnectathonResultsResults

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

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Mapping to Real-World ProductsMapping to Real-World Products

The IHE Actors and transactions are abstractions of real products in the real-world eye care information system environment. The order placer may be realized in either the

practice management system or the Electronic Medical Record (EMR) products.

The Performed Procedure Step Manager may be realized in either the Picture Archive and Communications System (PACS) or the Electronic Medical Record (EMR) products.

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IPs are packaged for purchasingIPs are packaged for purchasing

Easy-to-understand, coherent, functional sets and

a convenient way for users and vendors to communicate precisely

about integration requirements and required functionality in products.

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ConnectathonConnectathon

Interoperability testing in a public arena with peers

Results are published by IHE

Vendors publish Integration Statements

Note that IHE is not a certification authority and does not validate product claims

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Connectathon Benefits to UsersConnectathon Benefits to Users

Confidence that vendor software has been tested at both detailed and interoperability levels. Reduce the costs of integration Reduce interoperability issues The end user must verify Connectathon tested

software in an appropriate product release (via RFP)

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What do Connectathon results signify?What do Connectathon results signify?

That the vendor successfully performed all the particular transactions required by an actor in a IHE Integration Profile

IHE is not a certification authority

Connectathon testing does not certify product compliance

Vendors who do not pass are not made public

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IHE Integration StatementIHE Integration StatementIHE Integration Statement

Vendor Product Name Version Date

An Eye Care Company Product V2.3 12 Oct 2006

This product implements all transactions required in the IHE Technical Framework to support the IHE Integration Profiles, Actors and Options stated below:

Integration Profiles Implemented

Actors Implemented Options Implemented

Eye Care Scheduled Workflow Image Manager/Image Archive none

Image Display none

Image Creator Performed Procedure Step

Order Filler PPS Exception Management

Simple Image and Numeric Report Report Creator none

Link to the vendor IHE page www.eyecarecompany.com/ihe

Links to Standards Conformance Statements for the Implementation

HL7 www.amedicalsystemsco.com/hl7

DICOM www.amedicalsystemsco.com/dicom/integrateRAD.pdf

For general Information on IHE In America: www.rsna.com/iheIn Europe: www.ihe-europe.orgIn Asia:

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Survey of Integration StatementsSurvey of Integration Statements

http://www.dclunie.com/iheintegration-survey/IntegrationStatements.htmlhttp://www.dclunie.com/iheintegration-survey/IntegrationStatements.html

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IHE Connectathon Resultshttp://www.rsna.org/IHE/connectathon.shtml http://www.rsna.org/IHE/connectathon.shtml

http://www.ihe-europe.org/con_result/http://www.ihe-europe.org/con_result/

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MESA ToolsMESA Tools

http://www.erl.wustl.edu/mesa/index.htmlhttp://www.erl.wustl.edu/mesa/index.html

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User’s HandbookUser’s Handbook

Integration rarely starts from scratch and usually, RFPs have to take into account the existing context.

Integration is usually performed step wise, future steps have to be considered.

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User Success StoriesUser Success Stories

Describes how IHE was used and the challenges and benefits in the real world.

Identifies how to use specific IHE features and names products.

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Writing an RFPWriting an RFP

Simplify and strengthen what you ask for

The system shall support DICOM. (too general! – thousands of pages of specs!)

The system shall support the DICOM services related to eye care (still hundreds of pages!)

The PACS shall support the IHE Eye Care Scheduled Workflow Integration Profile Image Manager/Image Archive actor.

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IHE in RFPsIHE in RFPs

IHE Integration Profiles “unambiguously” specifies integration

We have access to published information on IHE connectathon results and vendors integration statements

A RFP can require IHE Integration Profiles

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Sample RequirementsSample Requirements

The vendor shall provide DICOM Conformance Statements for the DICOM components of the system.

The vendor shall provide IHE Integration Statements for the system, and identify which actors and options the system implements.

The vendor shall provide a timeline for the implementation of IHE Integration Profiles required but are not yet available in the proposed solution.

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Profiles Benefits Profiles Benefits

IHE defines Integration Profiles to group related use cases and transactions and connects them with Real-World functions

Integration Profiles allow the customer to focus on High-level Integration while IHE handles the details

Profiles are used to write requirements, design a product, and purchase a system

Proprietary Solutions create instant legacies

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We care!We care!

The AAO, the VA, and participating vendors have made fixing the Eye Care data integration problem a priority

Use the IHE Technical Framework to purchase and deploy your eye care solution

OurOur success is measured success is measured by by youryour success success

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More information….More information….IHEIHE Showcase here at the AAO ConferenceShowcase here at the AAO Conference

IHE Web siteIHE Web site: : www.ihe.net

Technical FrameworksTechnical Frameworks

ihe_eyecare_tf_TI_vol1_2006_06_01 (Trial ihe_eyecare_tf_TI_vol1_2006_06_01 (Trial Implementation version)Implementation version)

ihe_eyecare_tf_TI_vol2_2006_06_01 (Trial ihe_eyecare_tf_TI_vol2_2006_06_01 (Trial Implementation version)Implementation version)

Standards used by IHE Eye CareStandards used by IHE Eye Care DICOM StandardDICOM Standard www.nema.medical.org HL7 StandardHL7 Standard www.hl7.org

Vendor Products Integration StatementsVendor Products Integration Statements

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