1. Planning Committee Focus Group 8:00 - 17:00, Friday, September 24, 2010 8:00 - 10:00, Saturday, September 25, 2010 ASTRO HQ, Fairfax, VA

2. 1) Welcome and Introductions PC Radiation Oncologists PC Medical Physicists PC VendorsTC Representatives Kevin Albuquerque Charles Able Adam Earwicker (Varian) Walter Bosch (ATC) Tony Quang Sha Chang Nick Linton (Elekta) Bruce Curran (TC Co-chair) Akkamma Ravi Colin Field (PC Co-chair) Martin Pellinat (Vision Tree) Rishabh Kapoor (U of Florida) Prabhakar Tripuraneni (Co-chair) Todd McNutt Jacob Philip (Elekta) Stuart Swerdloff (TC Co-chair, Elekta) ASTRO Representatives Jatinder Palta (Co-chair) Norman Trapp (Siemens) Sidrah Abdul Harold Beunk (Nucletron) Barbara MuthKevin Riddell Regrets: May Wahab (PC Co-chair), Mika Miettinen (PC co-chair, Varian), Ramesh Rengen, Christopher Rose

3. 2) Meeting Goals Quick overview of IHE and IHE-RO Quick overview of IHE and IHE-RO Establish directions & goals for IHE-RO PC Establish directions & goals for IHE-RO PC Have brief joint TC and PC meeting Have brief joint TC and PC meeting Changes to Agenda ? Changes to Agenda ?Agenda

4. 3a) Overview of IHE Integrating the Healthcare Enterprise, formed in 1998 Integrating the Healthcare Enterprise, formed in 1998 Global initiative to facilitate sharing of health information Global initiative to facilitate sharing of health information from application to application from application to application system to system system to system across multiple healthcare enterprises across multiple healthcare enterprises Brings together health information technology stakeholders to implement standards for communicating patient information efficiently throughout and among healthcare enterprises by developing a framework of interoperability Brings together health information technology stakeholders to implement standards for communicating patient information efficiently throughout and among healthcare enterprises by developing a framework of interoperability Because of its proven process of collaboration, demonstration and real world implementation of interoperable solutions, IHE is in a unique position to significantly accelerate the process for defining, testing, and implementing standards-based interoperability among electronic health record systems Because of its proven process of collaboration, demonstration and real world implementation of interoperable solutions, IHE is in a unique position to significantly accelerate the process for defining, testing, and implementing standards-based interoperability among electronic health record systems (from http://www.ihe.net/News/ihe_intl_expands_incorporates_2009-12-31.cfm )http://www.ihe.net/News/ihe_intl_expands_incorporates_2009-12-31.cfm

5. IHE Organizational Structure ASTRO AAPM ACR AROI CARO CSRO ESTRO JASTRO PharmacyQuality, Research & Public Health Anatomic Pathology

6. About IHE-RO 2004: Prabhakar Tripuraneni and Jatinder Palta formed IHE-RO at RSNA 2004: Prabhakar Tripuraneni and Jatinder Palta formed IHE-RO at RSNA 2004: Bruce Curran and Stuart Swerdloff spear-headed the TC 2004: Bruce Curran and Stuart Swerdloff spear-headed the TC 2006: First IHE-RO Domain Pre-testing 2006: First IHE-RO Domain Pre-testing 2007: First Connectathon (Aug) 2007: First Connectathon (Aug) 2007: PC became more active 2007: PC became more active 2007: First Public demonstration (Oct) 2007: First Public demonstration (Oct)

7. How Does This All Happen ? ASTRO Significant Support ASTRO Significant Support Since 2006, spent well over US$ 1.0M Since 2006, spent well over US$ 1.0M Test Tools and Administrative support Test Tools and Administrative support RT Vendors Significant Resources RT Vendors Significant Resources Domain Pre-testing Domain Pre-testing Connectathons Connectathons Product Development and Documentation Product Development and Documentation End Users End Users Volunteer time and energy Volunteer time and energy Florida grant (Jatinder and May) Florida grant (Jatinder and May)

8. Acknowledgements IHE-RO Connectathon Vendors Accuray (2009/10) BrainLAB (2007/8/9/10) Candelis (2010) Elekta (2007/8/9/10) GE Healthcare (2009) MIMVista (2008/9) Nucletron (2007/8/9/10) Philips (2007/8/9/10) Siemens (2008/9/10) Third Way Software (2010) Tomotherapy (2007/8/9/10) Varian (2007/8/9/10) Numerous Volunteers Other IHE-RO Members ASTRO AAPM ATC Bogardus Medical Systems Brigham & Womens Hospital Cogent Health Solutions Inc. Cross Cancer Institute ESTRO IBA Particle Therapy Loyala University Medical Centre Radion, Inc SEFM SJS Targeted Solutions Sun Nuclear TSG Integrations University of Florida VisionRT VisionTree Software, Inc Wake Forest

9. Links to more info Wiki.ihe.net Wiki.ihe.net Wiki.ihe.net www.ihe.net www.ihe.net www.ihe.net http://www.astro.org/Research/ResearchHi ghlights/IHERO/index.aspx http://www.astro.org/Research/ResearchHi ghlights/IHERO/index.aspx http://www.astro.org/Research/ResearchHi ghlights/IHERO/index.aspx http://www.astro.org/Research/ResearchHi ghlights/IHERO/index.aspx

10. 3b) PC Membership Google docs Roster Google docs Roster Google docs Google docs Governance document Governance document http://www.ihe.net/governance/index.cfm http://www.ihe.net/governance/index.cfm http://www.ihe.net/governance/index.cfm Join IHE Join IHE Process is easy, and it is free ! Process is easy, and it is free ! Institutional politics may not be as easy Institutional politics may not be as easy Link to on-line application Link to on-line applicationapplication

11. 4) ASTRO IHE-RO and Research Committee a) a) EMR and Registry b) b) CCHIT and IHE-RO c) c) Patient Safety

12. ASTRO safety initiative named to 25 Most Influential list ASTRO has been named as one of RT Image's 25 Most Influential people, institutions or events that shaped radiology in 2010. ASTRO ranked sixth for its Target Safely initiative, a six-point patient protection plan that will improve safety and quality and reduce the chances of medical errors. To learn more about Target Safely, visit www.astro.org/targetsafely, or ASTRO Chairman Williamss article. www.astro.org/targetsafelyarticle

13. 5) Use Cases Process Process Review Review old, in development, on hold, new old, in development, on hold, new http://wiki.ihe.net/index.php?title=Radiation_Oncology #Use_Case_Selection http://wiki.ihe.net/index.php?title=Radiation_Oncology #Use_Case_Selection http://wiki.ihe.net/index.php?title=Radiation_Oncology #Use_Case_Selection http://wiki.ihe.net/index.php?title=Radiation_Oncology #Use_Case_Selection

14. Steps of IHE Process Identify Inter-operability problems (Use Cases) Identify Inter-operability problems (Use Cases) describe how end-users will accomplish a goal by performing a task or a series of tasks using systems (or software) includes the responses of the systems (or software) to user actions Select Use Cases to develop (process) Select Use Cases to develop (process)process Specify Integration Profiles, Develop Test Tools Specify Integration Profiles, Develop Test Tools Domain Pre-testing Domain Pre-testing Test Integration Profiles at Connectathon Test Integration Profiles at Connectathon Public Demonstration ? Public Demonstration ? Publish Integration Profiles for use in RFPs Publish Integration Profiles for use in RFPs

15. Successfully Completed Use Cases Basic RT Treatment Planning (2007) Basic RT Treatment Planning (2007) Multimodality Registration (2008) Advanced RT Objects (2009) Treatment Delivery Workflow (2010?)

16. Use Cases in Development (2010) Treatment Delivery Workflow Treatment Delivery Workflow Public comment (07-Mar-2010) Domain pre-testing (June 2-11, 2010) 2010 connectathon (Sept 20-26, 2010) Dose Compositing Dose Compositing Public comment (26-Feb-2010) Domain pre-testing (2011 ?) 2011 connectathon (2011 ?) Enterprise Schedule Integration Enterprise Schedule Integration Japan IHE-RO

17. Use Cases requiring more support Prescription Automation Prescription Automation Needs DICOM WG 7 extension of standards Structure Templates: Creation, Export and Import Structure Templates: Creation, Export and Import User Authentication and Authorization User Authentication and Authorization IHE-ITI XUA++ (Cross-Enterprise User Assertion – Attribute Extension)

18. 2010 Use Case Selection http://www.doodle.com/k62626a552iy6y6r Flesh out top 3 details for ASTRO AGM Flesh out top 3 details for ASTRO AGM Ensure problem is well defined Ensure problem is well defined Suggest how things should work Suggest how things should work Sell TC on necessity to support the Use Case Sell TC on necessity to support the Use Case Lets review each Use Case in ranked order Lets review each Use Case in ranked order Very brief summary by Champion Very brief summary by Champion Questions, comments, discussion Questions, comments, discussion Currently 15 others Use Cases on the list Currently 15 others Use Cases on the list http://wiki.ihe.net/index.php?title=Radiation_Oncology#Use_Case_Wish_List

19. Radiation Oncology Workflow Exchange Data dictionary needed Data dictionary needed

20. Closed Loop Patient Safety Categories: Categories: Handshaking check of data transfer Handshaking check of data transfer Feedback loop, plan, deliver, cf plan Feedback loop, plan, deliver, cf plan Imaging closed loop Imaging closed loop Population of a Registry Population of a Registry End to end check - phantom End to end check - phantom

21. Anonymization Anonymize specific dicom tags Anonymize specific dicom tags Template for data to send Template for data to send reader to ensure all links are preserved between related items reader to ensure all links are preserved between related items

22. Radiation Oncology Patient Portal Data dictionary required Data dictionary required Source: RT data; Destination: secured web browser Source: RT data; Destination: secured web browser Interactive record of patient data Interactive record of patient data Updating of followup data Updating of followup data 2015 requirement for meaningful use 2015 requirement for meaningful use

23. Deformable Registration

24. Instance-level Query Retrieve

25. 6) Current Issues a) Clinical Release of Connectathon software - what are IHE rules? 1 year, special rules for IHE-RO? - PC communicate rules to TC - PC/TC cross compare passed actors with released software, vendors and users check b) Use of integration profiles in RFP c) Wiki pages a) Rishabh volunteered to help with updating of Wiki d) Vote using Survey Monkey instead of Doodle a) Consensus was that Doodle was adequate

26. 7) Open Forum a) Future of IHE-RO b) Funding for IHE-RO a) IHE-RO initiative should become cost neutral to ASTRO b) PC members were encourage to obtain grants in support of IHE-RO activities c) Volunteer effort d) Election of Co-chairs a) Dr. May Wahab will be stepping down as PC Chair, and Dr. Ramesh Rengan will be assuming this role b) Some thought may need to be given to transitioning Mikas and Colins PC co-chair roles, and Bruces and Stuarts TC co-chair roles e) Other ?

27. Lunch (Connectathon, LL)

28. 8) Technical and Planning committee Joint meeting

29. IHE-RO Co-Chairs Prabhakar Tripuraneni, MD Jatinder Palta, PhD Planning Committee May Abdel-Wahab, MD, PhD May Abdel-Wahab, MD, PhD Colin Field, MSc Colin Field, MSc Mika Miettinen Mika Miettinen Recruit vendors of relevant information systems and users with clinical and operational experience Recruit vendors of relevant information systems and users with clinical and operational experience Prioritize & coordinate domain activities Prioritize & coordinate domain activities Identify, gather, review and prioritize integration and information inter- operability problems (Use Cases) Identify, gather, review and prioritize integration and information inter- operability problems (Use Cases) Approve proposals selected by the TC for Profile development Approve proposals selected by the TC for Profile development Develop educational materials for the domain and profiles Develop educational materials for the domain and profiles Technical Committee Bruce Curran, MS, ME Bruce Curran, MS, ME Stuart Swerdloff, PhD Stuart Swerdloff, PhD Recruit vendors of relevant information systems and users with technical experience Recruit vendors of relevant information systems and users with technical experience Assess the feasibility and estimated effort for PC selected Use Cases Assess the feasibility and estimated effort for PC selected Use Cases Build consensus on the appropriate standards-based solutions Build consensus on the appropriate standards-based solutions Develop Integration Profiles for Use Case solutions Develop Integration Profiles for Use Case solutions Maintain Technical Framework for domain Integration Profiles, describes solutions to inter-operability problems Maintain Technical Framework for domain Integration Profiles, describes solutions to inter-operability problems

30. 8) Technical and Planning committee Joint meeting Is more support from PC required at pre-testing and at connectathon ? Yes, clinicians with practical experience, Wednesday thru Friday. Is more support from PC required at pre-testing and at connectathon ? Yes, clinicians with practical experience, Wednesday thru Friday. Is PC input needed at TC meeting after ASTRO ? No, but questioned will need to be answered soon after TC meeting. Is PC input needed at TC meeting after ASTRO ? No, but questioned will need to be answered soon after TC meeting. Can PC help with linac configuration gold standard? NEMA MITA working on (Stuart Swerdloff). Stuart will let us know. Can PC help with linac configuration gold standard? NEMA MITA working on (Stuart Swerdloff). Stuart will let us know. Is a public demonstration needed ? No. Is a public demonstration needed ? No. What else can PC do to help TC ? Chase small companies that should be participating to get involved. What else can PC do to help TC ? Chase small companies that should be participating to get involved.

32. 9) Budget Planning Make test tools free. Charge for evaluation. Make test tools free. Charge for evaluation. Make per Actor cost for evaluation the same for all Actors (categorized as simple or complex) Make per Actor cost for evaluation the same for all Actors (categorized as simple or complex) How is re-testing charged ? After failed test, charge at 100%. For voluntary re-testing, at a discounted rate of 50%. How is re-testing charged ? After failed test, charge at 100%. For voluntary re-testing, at a discounted rate of 50%. Retest every year? Ask TC. Retest every year? Ask TC. With new versions of test tools, vendor can decide whether they wish to re-test and be evaluated. They can use the new version of test tools in- house for their own evaluation. With new versions of test tools, vendor can decide whether they wish to re-test and be evaluated. They can use the new version of test tools in- house for their own evaluation.

33. 10) 10) Publicity and Promotion Publish success stories from IHE-RO Publish success stories from IHE-RO

34. 11) 11) Plan of Action for the future a) Develop a list of items for the participants to mull overnight Should this meeting occur next year ? Yes. Preferably on Sunday/Monday to facilitate TC attendance ? Should this meeting occur next year ? Yes. Preferably on Sunday/Monday to facilitate TC attendance ? ASTRO has asked for a single presentation in ASTRO booth during ASTRO AGM. Bruce nominated. Ramesh Rengen tag team. ASTRO has asked for a single presentation in ASTRO booth during ASTRO AGM. Bruce nominated. Ramesh Rengen tag team. Create webinar with CME credits for IHE-RO (MD, Physics, RTT, CMD). Tony to investigate. Interoperability and patient safety. Create webinar with CME credits for IHE-RO (MD, Physics, RTT, CMD). Tony to investigate. Interoperability and patient safety. Create annual report showing passed actors with product releases. Verified by vendors and users Create annual report showing passed actors with product releases. Verified by vendors and users Standardize information on www.ihe.net and wiki.ihe.net. Rishabh Standardize information on www.ihe.net and wiki.ihe.net. Rishabhwww.ihe.net

35. Use Cases Prioritize new Use Cases with prior tabled Use Cases Prioritize new Use Cases with prior tabled Use Cases How do we close the loop from Use Case to Integration profile to RFP to Clinical Use ? Test tool versions. Poll users, allowing reporting of failures. Contact initial customers. Mini complaint system ? How do we close the loop from Use Case to Integration profile to RFP to Clinical Use ? Test tool versions. Poll users, allowing reporting of failures. Contact initial customers. Mini complaint system ? Take Use cases to ASTRO Corporate Advisory Board for support. Jatinder. Prepared after TC has vetted. Needed by Take Use cases to ASTRO Corporate Advisory Board for support. Jatinder. Prepared after TC has vetted. Needed by

36. Tasks Develop Data Dictionary. PC role? Provided data needed to support user cases. Todd and Walter Develop Data Dictionary. PC role? Provided data needed to support user cases. Todd and Walter Develop Standard Testing facility (or resource centre) for all vendors (outside scope of IHE-RO). Jatinder to ask ASTRO Executive Develop Standard Testing facility (or resource centre) for all vendors (outside scope of IHE-RO). Jatinder to ask ASTRO Executive Develop scope of facility Develop scope of facility FDA implications FDA implications Create ASTRO IHE-RO Task force to provide recommendations to RO community. Evidence based info needed. Interoperability Errors Create ASTRO IHE-RO Task force to provide recommendations to RO community. Evidence based info needed. Interoperability Errors Publications subcommittee: Publications subcommittee: Publish success stories Publish success stories Continue to obtain funding in support of TC. Everyone Continue to obtain funding in support of TC. Everyone Correct Nucletron representative on PC. Colin, Harold. Correct Nucletron representative on PC. Colin, Harold. Every issue of ASTRO news to have IHE-RO content. Barbara Every issue of ASTRO news to have IHE-RO content. Barbara Document Budget cycle for each IHE-RO vendor. Sidrah Document Budget cycle for each IHE-RO vendor. Sidrah Use PLUNC as IHE-RO test platform ? Use PLUNC as IHE-RO test platform ? Update PC and TC membership roster in consistent manner. Sidrah Update PC and TC membership roster in consistent manner. Sidrah

38. Planning Committee Focus Group 8:00 - 10:00am, Saturday, September 25, 2010 ASTRO HQ, Fairfax, VA

39. 1)Finalize the plan of action for the future a) Identify tasks and create timelines b) Identify outstanding unresolved Issues c) Set deliverables for ASTRO meeting

40. Closed Loop Patient Safety Other patient safety use cases: Other patient safety use cases: Compare what was treated with what was planned (dynalog, gantry, etc). MU currently checked. Compare what was treated with what was planned (dynalog, gantry, etc). MU currently checked. Handshaking check of data transfer from OIS to treatment workstation Handshaking check of data transfer from OIS to treatment workstation 3 MITA propositions 3 MITA propositions Feedback loop, plan, deliver, cf plan Feedback loop, plan, deliver, cf plan Imaging closed loop Imaging closed loop Population of a Registry Population of a Registry End to end check - phantom End to end check - phantom Focus on one aspect Focus on one aspect Working group consisting of: Working group consisting of: Kevin, May, Stephen, Nick, Akkamma, Adam Kevin, May, Stephen, Nick, Akkamma, Adam When: 15-Oct fully fleshed out; poll posted on 18-Oct, voting completed 28-Oct When: 15-Oct fully fleshed out; poll posted on 18-Oct, voting completed 28-Oct

41. Prioritize new Use Cases with prior tabled Use Cases TC provides status on tabled Use Cases Information distributed to PC Rank vote on 3 new and 3 tabled Use Cases Results for ASTRO AGM When: When: 10-Oct info received from TC 10-Oct info received from TC 15-Oct info distributed to PC 15-Oct info distributed to PC 18-Oct poll posted 18-Oct poll posted 28-Oct voting completed 28-Oct voting completed

42. Create annual report showing passed actors with product releases Verified by vendors and users Verified by vendors and users ask users for confirmation ask users for confirmation Survey tool for test Survey tool for test Who: Who: Colin to ask Bruce for passed actors and software versions from previous connectathons Colin to ask Bruce for passed actors and software versions from previous connectathons Colin, Jacob to create table Colin, Jacob to create table When: draft table to be shown at ASTRO AGM When: draft table to be shown at ASTRO AGM

43. How do we close the loop from Use Case to Integration profile to RFP to Clinical Use ? Add Test tool version number Add Test tool version number Poll users, allowing reporting of failures. Poll users, allowing reporting of failures. Contact initial customers to validate clinical release. Contact initial customers to validate clinical release. Establish Mini complaint system for tracking issues? Establish Mini complaint system for tracking issues? Aside: End to end scripting test to verify RT process Aside: End to end scripting test to verify RT process Who? Who? When? Table to AGM after matrix is available When? Table to AGM after matrix is available

44. Publicity and Promotions Success Stories Wait for use case / software version matrix, talk to vendors to get users to approach Wait for use case / software version matrix, talk to vendors to get users to approach Set timelines for ASTROnews publications and AAPM newsletter, PRO Set timelines for ASTROnews publications and AAPM newsletter, PRO

45. Create webinar with CME credits for IHE-RO (MD, Physics, RTT, CMD Interoperability and patient safety Interoperability and patient safety Who: Who: Tony to investigate/create (Lynn Brown ASTRO) Tony to investigate/create (Lynn Brown ASTRO) With assistance from Publications and Promotions ? With assistance from Publications and Promotions ? Everyone to bombard Tony with facts. Dick Fraass Everyone to bombard Tony with facts. Dick Fraass 1 hour presentation ? 1 hour presentation ? When: update at ASTRO AGM When: update at ASTRO AGM

46. Create a ASTRO IHE-RO Task force to provide recommendations to RO community Evidence based info needed Evidence based info needed Errors resulting from interoperability Errors resulting from interoperability Cost of not having interoperability Cost of not having interoperability Who ? Akkamma, Kevin, Jacob, Charles Who ? Akkamma, Kevin, Jacob, Charles When ? Table (tie to webinar) When ? Table (tie to webinar)

47. Develop Standard Testing facility (or resource centre) for all vendors Develop scope of facility Develop scope of facility FDA implications FDA implications Jatinder to ask ASTRO Executive Jatinder to ask ASTRO Executive Who? Jatinder, Adam, Nick, Tony, Todd, Sha, Martin Who? Jatinder, Adam, Nick, Tony, Todd, Sha, Martin When? Create a separate working group outside of IHE-RO. When? Create a separate working group outside of IHE-RO.

48. 2) ASTRO PC & TC Meetings PC PC 7:00-10:00am, Tues, 02-Nov-2010 7:00-10:00am, Tues, 02-Nov-2010 Where: TBD Where: TBD TC TC Potentially noon-1:00pm, Tues, 02-Nov-2010 in room used for NEMA meeting 7:30am-noon Potentially noon-1:00pm, Tues, 02-Nov-2010 in room used for NEMA meeting 7:30am-noon Where: TBD Where: TBD

49. 3) Meeting Wrap Up

50. Comments, Questions