Integrating the Healthcare Enterprise Achievements & Future Goals Introduction Current Status Achievements Future Directions Next Steps Dr. Nikolaus Wirsz Siemens Medical Solutions Member of IHE North America - IHE Europe - IHE Germany 6. DICOM Treffen in Mainz 4. Juli 2003
Introduction Integration Solutions Available Today from Several Medical Systems Vendors - BUT: Modern Healthcare Enterprises Are Still Confronted with Problems: 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 2 6. DICOM Treffen in Mainz 4. Juli 2003
Introduction Nov. 1998 HIMSS & RSNA Launch a New Initiative: Integrating the Healthcare Enterprise (IHE) An Incremental Multi-Year Project Speed Up the Integration in Healthcare Environments Foster Communication Between Vendors of Medical IT Prove that Integration is Attainable Based on Standards Participants: Representatives of Healthcare Providers Information Systems Vendors Imaging Systems Vendors Standardization Groups 3 6. DICOM Treffen in Mainz 4. Juli 2003
IHE Participation Societies / Associations: Who Is IHE? Healthcare IT:... HIMSS, COCIR, GMSIH,... Radiology:... RSNA, EAR, ECR, DRG, SFR,... Other Clinical Specialties:... The Appropriate Societies Vendors: Healthcare IT:... IS Vendors Radiology:... RIS Vendors, Imaging: Modalities, IHE Germany PACS,... Other Clinical Specialties:... Suppliers of Departmental IHE Systems/Products Italy Users: Healthcare IT:... CIOs, Administrators Radiology:... Radiologists Other Clinical Specialties:... Clinicians, Medical Staff IHE International IHE North America IHE Europe: IHE France IHE UK... IHE Japan 4 6. DICOM Treffen in Mainz 4. Juli 2003
IHE Radiology Workflow 5 6. DICOM Treffen in Mainz 4. Juli 2003
IHE System Transactions Overview HIS RIS IMAGING: PACS Workstations Modalities 6 6. DICOM Treffen in Mainz 4. Juli 2003
IHE System Transactions Overview Patient Registration ADT Patient Registration Order Placer HIS Patient Update Storage Commit Image Creator Filler Order Management Department System Scheduler Order Filler Placer Order Management RIS PPS In-Progress / Completed Modality Worklist Procedure Scheduled Images Availability Query Performed Procedure Step Manager Patient Update Procedure Update PPS In-Progress / Completed Image Manager Image Display Q /R Key IMAGING: Image Q /R Note Presentation Sates PACS Workstations Image Archive Modalities Q /R Images Storage Commit Images Stored Acquisition Modality Images Stored Present. State Stored Present. State Stored Key Image Note Stored Key Image Note Stored PPS In-Progress / Completed 7 6. DICOM Treffen in Mainz 4. Juli 2003
HE = A Standards Harmonization Approach HIS RIS PACS Mo d ality HIS HL7 HL7 RIS HL7 HL7 HL7 / DICOM DICOM PACS HL7 / DICOM DICOM DICOM Modality DICOM DICOM DICOM IHE Goes Beyond Standards IHE = + Multi-Vendor + Workflow-Driven + INTEGRATION based on established medical IT Standards 8 6. DICOM Treffen in Mainz 4. Juli 2003
ntegration Profiles Actors Transactions Standards Integration Profile Integration Profile User Focus: Solutions to Clinical Problems Actors Actor Actor Actor Transactions Trasaction Trasaction Trasaction Trasaction Trasaction Trasaction Trasaction Trasaction Trasaction Implementation: Technical Details (Standards) Referenced Standards: DICOM & HL7 Role Detailed Messaging Info 9 6. DICOM Treffen in Mainz 4. Juli 2003
Integration Profiles - Group related transactions and associate them with real-world functions Integration Profiles allow the customer to focus on high-level integration while vendor products handle the details Reduce Ambiguities Manage Customer Expectations IHE Integration Profiles: http://www.rsna.org/ihe/iheyr3_integration_profiles.shtml IHE FAQ: http://www.rsna.org/ihe/ihe_faq.shtml 10 6. DICOM Treffen in Mainz 4. Juli 2003
IHE Year 5 (2003 / 2004) Integration Profiles Patient Information Reconciliation Scheduled Workflow Presentation of Grouped Procedures Consistent Presentation of Images Post- Processing Workflow NEW! Evidence Documents Reporting Workflow NEW! Key Image Notes Charge Posting Simple Image & Numeric Reports Access to Radiology Information Basic Security NEW! Access to Multiple Sources / Image Archives 11 6. DICOM Treffen in Mainz 4. Juli 2003
Planning for IHE Year 6 (2004 / 2005) More Candidates for New IHE Integration Profiles Extended Archiving: Multi-Institution Image Managers / Archives Splitting of Image Manager / Archive Actor Profiling Removable Media Integration of Nuclear Medicine Teaching Files & Clinical Trials 12 6. DICOM Treffen in Mainz 4. Juli 2003
USA 2001/2: 30 Vendors Europe 2002: 33 Vendors Europe 2003: ~50 Vendors! IHE Participating Vendors A.L.I. Technologies Inc. Agfa Medical Imaging Agilent Algotec Systems Ltd. Cedara Software Cerner CSIST Eastman Kodak Company Emageon Fujifilm Medical Systems GE Medical Systems Hologic - Direct Radiography IDX Systems Corporation IMCO Technologies Konica Agfa Gevaert n.v. Algotec Aycan Digitalsysteme GmbH ConVis Med. DV GmbH & Co KG Eastman Kodak Company EBIT Sanita S.p.A EDL Ferrania Fuji GAP Medical Systems GE Medical Systems GIE Convergence-Profiles GWI Research GmbH Image Devices GmbH Inovit Med2Rad Marconi Medical Systems Marotech Medical Manager Health Systems Mediface Merge Technologies Inc. Mitra Imaging Inc. Philips Medical Systems RASNA Imaging Systems Siemens Medical Solutions Softmedical StorCOMM, Inc. Swissray International, Inc. Tiani Medgraph GMBH Toshiba Vital Images, Inc. Medasys Medavis Medigration GmbH Medos AG Merge Technologies Inc. Philips Medical Systems Quadrat RASNA Sectra Imtec AB Siemens Medical Solutions Swissray Medical AG Symphonie Online Synapsis SRL Tiani Medgraph AG Toshiba Medical Systems Europe WAID XRPartner 13 6. DICOM Treffen in Mainz 4. Juli 2003
IHE Achievements / IHE Success Connectathons Proof of Concept / Validation: IHE North America:1999 2003 IHE Europe: 2001 2003 Live IHE Demonstrations: North America Europe: France, Germany, Italy, UK, (Norway, Denmark, Spain, ) Japan User Success Stories Real Products in Clinical Settings Using IHE RSNA 2002: 13 Stories Presented JFR 2003: ~ 15 Stories to be Presented 14 6. DICOM Treffen in Mainz 4. Juli 2003
IHE Achievements / IHE Success Connectathons Proof of Concept / Validation: IHE North America:1999 2003 IHE Europe: 2001 2003 Live IHE Demonstrations: North America Europe: France, Germany, Italy, UK, (Norway, Denmark, Spain, ) Japan User Success Stories Real Products in Clinical Settings Using IHE RSNA 2002: 13 Stories Presented JFR 2003: ~ 15 Stories to be Presented IHE Vision Becomes Reality! 15 6. DICOM Treffen in Mainz 4. Juli 2003
IHE Achievements / IHE Success Connectathons Proof of Concept / Validation: IHE North America:1999 2003 IHE Europe: 2001 2003 Live IHE Demonstrations: North America Europe: France, Germany, Italy, UK, (Norway, Denmark, Spain, ) Japan User Success Stories Real Products in Clinical Settings Using IHE RSNA 2002: 13 Stories Presented JFR 2003: ~ 15 Stories to be Presented IHE Integration Statements Available Products with IHE Features: http://www.rsna.org/ihe/participation/index.shtml#int_statements 16 6. DICOM Treffen in Mainz 4. Juli 2003
IHE Achievements / IHE Success Connectathons Proof of Concept / Validation: IHE North America:1999 2003 IHE Europe: 2001 2003 Live IHE Demonstrations: North America Scheduled Workflow Image Manager/Image Archive none Europe: France, Germany, Italy, Image UK, Display (Norway, Denmark, none Spain, ) Japan Image Creator User Success Simple Stories Image and Numeric Real Products Report Creator in Clinical Settings none Using IHE RSNA 2002: 13 Stories Presented Link to the vendor IHE page JFR 2003: ~ 15 Stories to be Presented IHE Integration Statement Vendor Product Name Version Date A Medical Systems Company IntegrateRAD V2.3 12 Oct 2002 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 Report Actors Implemented Order Filler www.amedicalsystemsco.com/ihe Options Implemented Performed Procedure Step PPS Exception Managemen Links to Standards Conformance Statements for the Implementation HL7 www.amedicalsystemsco.com/hl7 IHE Integration Statements Available Products with IHE Features: DICOM www.amedicalsystemsco.com/dicom/integraterad.pdf http://www.rsna.org/ihe/participation/index.shtml#int_statements For general In America: www.rsna.com/ihe Information In Europe: www.ihe-europe.org on IHE 17 In Asia: 6. DICOM Treffen in Mainz 4. Juli 2003
IHE Roadmap A Multidimensional Expansion of Integration ADT Order Mgt Dept Sched. 1 st Dimension: Vertical Integration for Radiology IHE Years 1, 2, 3, 4,... Image Mgr Modality 18 6. DICOM Treffen in Mainz 4. Juli 2003
A Multidimensional Expansion of Integration ADT Order Mgt Dept Sched. Image Mgr Modality IHE Roadmap Patient Registration Ordering Process Master Patient Index Clinical Patient Record... 2 nd Dimension: Growing the Horizontal Healthcare Enterprise Integration 19 6. DICOM Treffen in Mainz 4. Juli 2003
A Multidimensional Expansion of Integration R a d i o l o g y C a r d i o l o g y IHE Roadmap Laboratory P h a r m a c y Patient Registration Ordering Process Master Patient Index Clinical Patient Record O t h e r s... 3 rd Dimension: Increasing the Number of Vertically Integrated Departments 20 6. DICOM Treffen in Mainz 4. Juli 2003
IHE Vision for Growth Radiology Lab/Path ADT/ Reg Cardiology Int Med ER Endoscopy Ophthalm Dental 21 6. DICOM Treffen in Mainz 4. Juli 2003
IHE Organizational Structure IHE International Steering Committee IHE Japan Planning Committee IHE Europe Planning Committee Strategic Development Committee IHE France Planning Committee IHE Germany Planning Committee IHE Italy Planning Committee IHE UK Planning Committee IHE Planning Committee Radiology Planning Committee Radiology Technical Committee IT Infrastructure Planning Committee IT Infrastructure Technical Committee JAPAN EUROPE North America Cardiology Committee Sub-Committee Laboratory Sub-Committee Pharmacy JIRA COCIR EAR ECR HIMSS JRS SFR DRG SIRM RSNA GMSIG ZVEI BIR Professional Societies / Sponsors 22 6. DICOM Treffen in Mainz 4. Juli 2003
IHE IT Infrastructure 5 Integration Profiles 1 st IHE IT Connectathon: Jan. 2004 1 st IHE IT Demonstration: Feb. 2004 Joint Demo with HL7 @ HIMSS Retrieve Information for Display Access a patient s clinical information and documents in a format ready to be presented to the requesting user HL7 CDA / PDF / JPEG Patient Synchronized Applications Synchronize multiple applications on a desktop to the same patient HL7 CCOW Enterprise User Authentication Patient Identifier Cross-referencing for MPI Consistent Time Provide users a single name and centralized authentication process across all systems Map patient identifiers across independent identification domains Coordinate time across networked systems HL7 2.x ADT Triggers / Queries NTP (RFC 1305) Kerberos (RFC 1510) / HL7 CCOW 23 6. DICOM Treffen in Mainz 4. Juli 2003
References: IHE Germany: IHE Europe: Thank You for Your Attention! http://www.ihe-d.org http://www.ihe-europe.org IHE North America: http://www.rsna.org/ihe IHE Integration Statements : http://www.rsna.org/ihe/participation/index.shtml#int_statements IHE Integration Profiles: http://www.rsna.org/ihe/iheyr3_integration_profiles.shtml IHE FAQ: http://www.rsna.org/ihe/ihe_faq.shtml 24 6. DICOM Treffen in Mainz 4. Juli 2003