September, 2005What IHE Delivers VA Success Story – Image Acquisition using IHE Scheduled Workflow June 6~7, 2006 Peter Kuzmak, Andrew Casertano, and.

September, 2005 What IHE Delivers

VA Success Story – Image VA Success Story – Image Acquisition using IHE Scheduled Acquisition using IHE Scheduled

WorkflowWorkflow June 6~7, 2006June 6~7, 2006

Peter Kuzmak,Peter Kuzmak, Andrew Casertano, Andrew Casertano, and Dr. Ruth Dayhoff and Dr. Ruth Dayhoff Department of Veterans AffairsDepartment of Veterans Affairs

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VA Healthcare EnterpriseVA Healthcare Enterprise

157 Medical Centers & 850+ Outpatient Clinics

Serves an active patient population of 5 million veterans

All sites acquire DICOM images

½ billion images online

½ million images acquired each day

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VistA & Computerized Patient VistA & Computerized Patient Record SystemRecord System

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Multimedia Patient RecordMultimedia Patient Record

Chart Data

Textual chart data Computable data Handwritten and

non-electronic chart data

Multimedia Data

Images, graphics, waveforms, audio, etc.

Computerized Patient Record and VistA ImagingComputerized Patient Record and VistA Imaging

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Wide Variety of Images Integrated with the Wide Variety of Images Integrated with the Online Patient RecordOnline Patient Record

Cardiology

Bronchoscopy

Gastrointestinal Endoscopy

Hematology

Pathology

Surgery

Nuclear Medicine

Dental

Radiology

Dermatology

Ophthalmology

Podiatry

Vascular

Urology

Nursing

Electrocardiography

Scanned Documents

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VA IHE Success StoryVA IHE Success Story

All VA DICOM image acquisition uses IHE Radiology Transactions to interface modalities to PACS:  #5 - Modality Worklist Provided - download patient and study #8 - Modality Images Stored - send images to the PACS.

One interface for 250 different models of instruments! Radiology, ophthalmology, dentistry, endoscopy, pathology, and

cardiology.

VA/DoD DICOM Modality requirements documents: www.va.gov\imaging

The VA will not purchase a new modality unless it supports these capabilities.

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Using Consults for Clinical Specialties Using Consults for Clinical Specialties (Simplified Workflow)(Simplified Workflow)

1. Consult Ordered

2. Schedule Appointment

3. Patient Arrives

4. Images Acquired

5. Patient Leaves

6. Diagnostic Reporting

7. Follow up Visits

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VA Hospital Information System P A C S

AcquisitionModality

WorklistQuery

WorklistResponse

Workflow TransactionsWorkflow Transactions

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VA Hospital Information System P A C S

AcquisitionModality

WorklistQuery

WorklistResponse

Storage

Workflow TransactionsWorkflow Transactions

Image Retrieval

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VA’s Role in Advancement of VA’s Role in Advancement of DICOM in OphthalmologyDICOM in Ophthalmology

Initially no Ophthalmology specification in DICOM

Could not even tell left from right

2002 - VA encouraged AAO develop new specification

2004 - Ophthalmic Photography Image DICOM Supplement 91

2005 – Organized the IHE Eye Care Showcase

2006 – VA national Diabetic Retinopathy Surveillance program

Fundus Image3072 x 2048 24-bit

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2005 IHE Eye Care Showcase2005 IHE Eye Care Showcase

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VA National Diabetic Retinopathy VA National Diabetic Retinopathy Surveillance NetworkSurveillance Network

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IHE Value to VendorsIHE Value to Vendors

IHE Technical Framework defines implementation specifications in detail

Resources needed to developed, test, and maintain just a single interface

IHE provides interface testing tools and vendor-to-vendor interoperability Connectathon.

IHE saves vendors money

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Conclusion: Follow IHE for SuccessConclusion: Follow IHE for Success

IHE enables interoperability and saves money

Using industry standards avoids having to develop custom interface methodologies

Provides smoother integration

Accelerates acceptance testing

Cost-effective for all participants

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More information….More information….IHE Web siteIHE Web site: : www.ihe.net

Technical FrameworksTechnical Frameworks ihe_eyecare_tf_TI_vol1_2006_06_01 (Trial Implementation version)ihe_eyecare_tf_TI_vol1_2006_06_01 (Trial Implementation version) ihe_eyecare_tf_TI_vol2_2006_06_01 (Trial Implementation version)ihe_eyecare_tf_TI_vol2_2006_06_01 (Trial Implementation version) ihe_tf_rev6.0ft_vol1_2005-05-18-FINAL (Radiology)ihe_tf_rev6.0ft_vol1_2005-05-18-FINAL (Radiology) ihe_tf_rev6.0ft_vol2_2005-05-18-FINAL (Radiology)ihe_tf_rev6.0ft_vol2_2005-05-18-FINAL (Radiology) ihe_CARD_tf_vol2_2.1_FT (Cardiology)ihe_CARD_tf_vol2_2.1_FT (Cardiology)

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

IHEIHE Connectathon Oct. 2006 at RSNA HQConnectathon Oct. 2006 at RSNA HQ

IHEIHE Showcase at Nov. 2006 AAO ConferenceShowcase at Nov. 2006 AAO Conference

Vendor Products Integration StatementsVendor Products Integration Statements

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Thank Thank You!You!

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