Presentation on theme: "0 RSNA2007. 1 Impact of Single Sign-on and Synchronized Patient Selection by IHE-ITI EUA (Enterprise User Authentication) and PSA (Patient Synchronized."— Presentation transcript:
1 Impact of Single Sign-on and Synchronized Patient Selection by IHE-ITI EUA (Enterprise User Authentication) and PSA (Patient Synchronized Applications) at Implementing Existing PACS and CPOE/EMR Y Ando, M Mukai, T Tanikawa, T Nakashima (1),H Sonoda (2), N Suzuki (3), Y Hayatsu (4), Y Hayashi (5), S Takada (6), H Tsujii Medical Informatics Section, National Institute of Radiological Sciences, Chiba, Japan, (1) Hitachi Medical Corporation, (2) TechMatrix Corporation, (3) INFOCOM CORPORATION, (4) Nippon Telegraph and Telephone Corporation, (5) Fujitsu Limited, (6) Fuji Photo Film Co, Ltd RSNA2007
2 Research Center for Charged Particle Therapy National Institute of Radiological Sciences, JAPAN Located at Chiba, JAPAN Inpatient: 100 beds Outpatients: patients/day Specialized for a radiation therapy with a Carbon heavy particle Film-less Environment (2005 )
3 Purpose To understand the concept of coordination on Sign-On/Patient Selection and its merits and demerits To experience the effectiveness of the single-sign-on and synchronized patient selection by using the IHE-ITI EUA and PSA function To realize how to login and change the patient in the EUA/PSA environment
4 Content Necessity of single sign-on and synchronized patient selection Explanation of IHE ITI and CCOW How to organize the EUA/PSA function Pitfall of the implementation (analysis of each application) Guidelines for the EUA/PSA implementation (icons and annotation) Demonstration of EUA/PSA function on multiple information systems Merit and Demerit (time comparison with and without CCOW)
5Introduction Our hospital is specially designed for the heavy particle radiation therapy. Systems (EMR, PACS, clinical database and schedule management system) are running. Some systems were recently replaced. Then we made a modification to use the IHE ITI profiles. We planed to study the effectiveness and availability of IHE IT-Infrastructure profiles in the Japanese environment. The final aim is to evaluate the availability of the integration profiles in Japanese environment. We expand the function of the EUA and PSA, because one clinical unit includes 2 personal computers in the outpatient clinic and the ward. We defined the context area for the context manager defined by the HL7 CCOW (Clinical Context Management Specification). We developed the middleware to realize the function of the EUA (Enterprise User Authentication) and PSA (Patient Synchronized Applications).
7 Context Area Requirement At least two PCs are required to perform context area. because… EMR Client PC with a suitable monitor for textual information PACS Viewer Client PC with a High resolution gray scale monitor for viewing images.
8 Doctor Uses multi-PCs
9 Methods Library: We developed three types of EUA/PSA middle-wares (ActiveX application, Java applet and Servlet). We use this middle-ware to communicate the context area manager each other. We analyzed the flow of the applications. We implemented the function of the EUA and PSA into the existing applications. Guideline: Next we established guidelines for the implementation of the EUA/PSA. The venders of the existing systems modified their applications according these guidelines. We evaluate the functionality of the EUA and PSA by using the each application.
10 CAM Function PC1PC2 CAM: Context Area Manager AP: Application 1,2 … PC: Personal Computer 1,2 … CAM EMR AP1 Report Viewer AP PACS Viewer AP2 Context Area User-ID, Patient-ID
11 CAM Function PC1PC2 CAM: Context Area Manager AP: Application 1,2 … PC: Personal Computer 1,2 … CAM EMR AP1 Report Viewer AP PACS Viewer AP2 Context Area User-ID, Patient-ID User-id logIn Auto-logIn User-id
12 Target Systems Our hospital has too many systems; EMR HOPE/EGMAIN-EX C/S Edition®, HOPE/DrABLE- EX®, HOPE/LAINS-PC® (Fujitsu) PACS-1 SDS-DicomViewer® (TechMatrix) PACS-2 SYNAPSE® (Fujifilm) Reporting System F-REPORT® (INFOCOM) Radiation schedule management system RSS (Nippon Telegraph and Telephone East) Electronic radiation record/RO-RIS RIGIA (Global-for) Physicians must login and select patients at each system.
13 EUA Single Sign-On EUA Single Sign-On User-A login to EMR/CPOE(PC1) User-A participates to PACS Auto login (PC2) ……… User-A logout from EMR/CPOE Auto logout from PACS User-B login to EMR/CPOE User-B participates to PACS Auto login
15 PSA Patient Synchronized Application PSA Patient Synchronized Application Login to EMR/CPOE(PC1) Select Patient-A from EMR/CPOE Login to PACS(PC2) Automatically selects Patient-A Select Patient-B from PACS Automatically changes to Patient-B at EMR Login to other application Automatically selects Patient-B in other application
17Discussion We wanted to reduce implementation problems and to unify the application interfaces: middle-ware could resolve these problems. We prepared guidelines for modification of the workflow. These guidelines include icons that indicate the status of an application. The validity of the enhanced context area was confirmed. In the future, the necessity of the visual integration will increase, and the unified procedure for visual integration is very important. The EUA/PSA defined by IHE ITI uses CCOW version 1.4, which defines the patient subject as the patient ID. CCOW version 1.5 defines detailed information about a patient such as DICOM objects.
18 Merit of IHE-ITI EUA/PSA EUA/PSA enhanced the effectiveness for users. Decrease of Login and Patient selection Common interface of Login and Patient selection CCOW IHE EUA/PSA URL Link SystemComplexSimple Bi-directional Function × Patient Selection× ApplicationNo limitation Browser Only
19 Conclusion We developed three types of EUA/PSA middle-ware. Each application used suitable middle-ware for running environments and also enabled the simple implementation of a single sign on and patient selection. We modified six existing information systems to use the EUA/PSA middle-ware. These modifications require the considerable effort, but otherwise we achieved good seamless operation by the EUA/PSA functions. We believe that the EUA/PSA function will be indispensable for multi-vender information systems and useful for clinical safety.
20 Reference  ITI Integration Profile, website Tecnical_Framework/index.cfm#IT. Clinical Context Management Specification Version 1.4, The Health Level Seven, ANSI/CMS, V  Best Practices and Common Mistakes, Version 1.0, HL Open Source Software We propose the EUA/PSA function by using our EUA/PSA library to Japanese hospitals. We are now developing these middle-ware as open source software.
21 Thank you!!
22 IHE ITI Infrastructure Integration ProfileImplementation
23 CCOW Mechanism Context Manager (1) Definition of Context (2) Definition of synchronization of Context Managing Process (3) Transaction Specifications on Context Manager and multi- systems systems Single Sign On & Patient Synchronization
24 CPOE/EMR Vein Pattern Authentication
25 ReportReport Medical Informatics System target HISHIS ModalityModality Clinical DB DBClinical RIS-RORIS-RO LISLIS RISRIS Implementation Schedule DB DBSchedule PACS-1PACS-1 PACS-2PACS-2
26 Use Case User-A logins to EMR at PC1 User-A also logins to PACS without login procedure at PC2 User-A selects Patient-1 by EMR at PC1 PACS selects to Patient-1 automatically at PC2 …… User-A logs off from EMR at PC1 PACS is automatically logged off at PC2 User-B logins to EMR PACS automatically logins
28 Log In
29 IHE-ITI EUA
30 IHE- ITI PSA
31 EUA Single-sign- on EUA Single-sign- on HIS A (PC1) PACS (PC2) ……… HIS A PACS HIS B PACS
32 PSA Patient selection PSA Patient selection HIS (PC1) HIS A PACS (PC2) PACS A PACS B HIS B
33 Patient Selection
34Methods Context area We expanded the mechanism of CCOW specifications to adopt multiple PCs in a single context. In a context area, multiple applications share the context (User-ID and Patient-ID). Middle-ware Enables the EUA/PSA mechanism (conformable to CCOW/IHE) Modified our existing six systems and enabled the middle-ware Context Area Manager (CAM) Library Applet Servlet Active-X
36 Conclusion EUA/PSA PSA Open Source Software
37Guideline EUA/PSA IHE IHE
38 EUA/PSA ………
39 PC/ PACS
40 EUA EUA RID RID MPI MPI ID ID PIX PIX ID ID PSA PSA CT CT ATNA ATNA PDQ PDQ PWP PWP XDS XDS DDS) NAV NAV XUA XUA PAM) XDS-SD) XDR) (XDM) RFD) IT ( IT (
43 PACS Viewer HIS Best Practices and Common Mistakes, Version 1.0 HL
44 Y Ando; M Mukai; T Tanikawa; T Nakashima (1) ;H Sonoda (2) ; N Suzuki (3) ; Y Hayatsu (4) ; Y Hayashi (5) ; S Takada (6) ; H Tsujii; National Institute of Radiological Sciences, Medical Informatics Section, ( 1) Hitachi Medical Corporation, (2) TechMatrix Corporation, (3) INFOCOM CORPORATION, (4) Nippon Telegraph and Telephone Corporation, (5) Fujitsu Limited, (6) Fuji Photo Film Co, LtdAuthors