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October, 11th 2006WHOIT1 Integrating the Healthcare Enterprise IHE Pathology Karima BOURQUARD USER COCHAIR- FRANCE

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Presentation on theme: "October, 11th 2006WHOIT1 Integrating the Healthcare Enterprise IHE Pathology Karima BOURQUARD USER COCHAIR- FRANCE"— Presentation transcript:

1 October, 11th 2006WHOIT1 Integrating the Healthcare Enterprise IHE Pathology Karima BOURQUARD USER COCHAIR- FRANCE

2 WHOIT2 October, 11th 2006 Integrating the Healthcare Enterprise (IHE) Objective : stimulate the integration of the Healthcare informations exchanging between systems that support modern healthcare institutions all required informations for medical decisions is both correct and available to healthcare professionals IHE is a process and a forum for encouraging integration efforts, based on Technical framework for the implementation of established messaging standards to achieve specific clinical goals specifications Rigorous testing process for the implementation of this framework connect-a-thon Educational sessions & exhibits at major meetings of medical professionals demonstration

3 WHOIT3 October, 11th 2006 IHE-Pathology: the beginning… Starting in 2005 : Pathologists have expressed their interest to develop interoperability in Pathology domain : Integration of the pathology systems in HIS Sharing information with others pathologists Development of the software in this domain Development of the Images inside and outside Development of National EHRs ….

4 WHOIT4 October, 11th 2006 The user needs An order for the pathological examination is communicated to the pathologist In the pathology department environment, the set of procedures and sub- procedures (procedure steps) are identified and have to be performed in the process of fulfilling the order by one or multiple pathologists Each Order is identified by an Order ID For each Requested Procedure, the basic or special techniques involved in the processing of the corresponding specimen(s) may require different devices (automatons, image acquisition modality, etc). Each Requested Procedure may contain one or more Procedure Steps. A Procedure Step is the smallest unit of work in the workflow that is scheduled (work to do) and/or performed (work done) by a person or a machine (automaton, image acquisition modality, etc) on an object (specimen, tissue sample, tissue section, etc) Observation results progress through different steps of validation (non validation,technically validation, pathologist validation) Complex diagnostic structured reports include numeric quantitative measurement, images or graphs, image annotation and links between image (and/or evidence) information and textual information …

5 WHOIT5 October, 11th 2006 Care department Pathology department Admission Discharge Transfer Order entry Order management Tissue bank management Pre analytical process Images and/or virtual slides acquisition Report editing, diagnostic coding Billing Results (reports and/or images) visualization Images and/or reports archiving and management Pathology workflow

6 WHOIT6 October, 11th 2006 Specimen, parts, blocks Specimen description requires a controlled vocabulary including the list of Harvest procedure (biopsy, operating specimen (described according to the surgical procedure), cytological liquid, smear, etc) Conservative conditions (fixative, fresh tissue, etc) Origin of specimen (breast, colon, etc) Precise localization (side, part of the organ (fundus,antrum, etc)) Requested technical procedure step (histopathological examination, cytopathological examination, frozen section, tissue banking, etc). A controlled vocabulary is required for this specimen description.

7 WHOIT7 October, 11th 2006 Specimen, part, block and slide We distinguish specimen collected in care department (Parts) and tissue samples resulting from sampling processes within the pathology department (Blocks). Tissue sections or smearare called Slides. Each Part, Block, Slide is identified and described. The pathology department Part(s) ID, Block(s) ID and Slide(s) ID are shared with Report Creator and Image Acquisition Modalities, (Automation managers in the future), etc).

8 WHOIT8 October, 11th 2006 Description of the specimen Order (by Sammy Surgeon) : OR-321 Requested Procedure 1 : Breast surgical specimen with axillary lymph node - Frozen sections & pathological examination : DP (Study Accession Number) DP : Tumorectomy (Specimen Accession Number) DP : Block for frozen sections DP a : H&S DP b : Toluidine blue DP ; DP ; DP : fresh samples DP ; DP ; DP : mirror paraffin blocks DP : tumor DP : tumor DP : tumor DP a : H&S DP b : H&S DP c : IHC DP to DP : margins DP to DP : adjacent breast tissue DP : Additional tissue (Specimen Accession Number) DP to DP : margins of the initial tumorectomy DP to DP : margins of the additional breast tissue excision DP : Axillary lymph node (Specimen Accession Number) Requested Procedure 2 : Nevus - Pathological examination : DP (Study Accession Number) DP : nevus DP DP Order Slides Blocks Part Requested Procedure

9 WHOIT9 October, 11th 2006 Overview of the workflow Patient Demographic Source Order Placer Order Filler Report Manager Report Creator Acquisition Modality Image Archive Image Manager Performed Procedure Step Manager Enterprise Report Manager Evidence Creator Report Reader Image Display Report Depository RAD-26: Query report RAD-27: Retrieve report RAD-26: Query report RAD-27: Retrieve report PAT-3 : Report Management RAD-25: Report issuing ITI-30: ITI-31: PAT-4: Work Report Mgmt PAT-5: Report Result Mgmt PAT-1: Placer Order Management PAT-2: Filler Order Management Query Images Modality Worklist Provided Modality Image Stored Storage Commitment Creator Image Stored Image Availability Query PPS Modality PPS Creator PPS Storage Commitment Procedure Scheduled /Updated Yellow: HL7 Messages Green: DICOM Messages

10 WHOIT10 October, 11th 2006 PAM : Patient administration Management Patient Demographic Source Order Placer Enterprise Report Manager ITI-30: ITI-31: The profile PAM is completly on line with the needs of pathology :PAM Patient Demographics Consumer Patient Demographics Source ITI-030 Patient Identity Feed Patient Encounter Consumer Patient Encounter Source ITI-031 Patient Encounter Management

11 WHOIT11 October, 11th 2006 Order Placer Order Filler Report Manager Report Creator Enterprise Report Manager Report Reader Report Depository RAD-26: Query report RAD-27: Retrieve report RAD-26: Query report RAD-27: Retrieve report PAT-3 : Report Management RAD-25: Report issuing PAT-4: Work Report Mgmt PAT-5: Report Result Mgmt PAT-1: Placer Order Management PAT-2: Filler Order Management PPS Yellow: HL7 Messages Green: DICOM Messages Order/report workflow

12 WHOIT12 October, 11th 2006 Acquisition Modality Image Archive Image Manager Performed Procedure Step Manager Evidence Creator Image Display Query Images Modality Image Stored Storage Commitment Creator Image Stored PPS Modality PPS Creator PPS Storage Commitment Imaging workflow

13 WHOIT13 October, 11th 2006 Next steps The technical Framework(vol1 and vol 2) is already written Work to do : Spécification of identification of specimen In liaison with DICOM ad HL7 Finalize the transactions TF for Public Comments : end of the year On March :WG for PC Pulication in April at the next HL7 meeting in Köln

14 WHOIT14 October, 11th 2006 More information…. IHE Web sites http ://www.ihe.net Europe http ://www.gmsih.fr/IHE Thank for your attention Questions?


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