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1 Buzzword Bingo. September, 2005What IHE Delivers Retrieve ECG for Display ACCA IHE Workshop 2007 Jon Elion MD, FACC Associate Professor of Medicine,

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Presentation on theme: "1 Buzzword Bingo. September, 2005What IHE Delivers Retrieve ECG for Display ACCA IHE Workshop 2007 Jon Elion MD, FACC Associate Professor of Medicine,"— Presentation transcript:

1 1 Buzzword Bingo

2 September, 2005What IHE Delivers Retrieve ECG for Display ACCA IHE Workshop 2007 Jon Elion MD, FACC Associate Professor of Medicine, Brown University Co-Chair, IHE-Cardiology Planning Committee

3 3 ECG Needs ECGs Accessible Everywhere! Need broad distribution of ECGs using ubiquitous technology (Web). Allow medical applications to easily retrieve and display ECGs in a platform/vendor neutral way. Allow medical applications to easily retrieve and display ECGs in a platform/vendor neutral way. High-quality ECG documents. Avoid artifacts on zoomed ECGs and arbitrary display geometries. Vector images required (not rasterized) Vector images required (not rasterized) Facilitate apps for serial comparison (side-by- side synchronized display).

4 4 ECG for Display Profile Scope Reused IHE-ITI RID as it existed: Retrieve list of cardiology documents, including ECGs in ready-to-display format (HTML) Retrieve list of cardiology documents, including ECGs in ready-to-display format (HTML) Retrieve single document, including an ECG Retrieve single document, including an ECG ECGs served in displayable format (PDF, SVG) ECGs served in displayable format (PDF, SVG) Compatibility with existing RID clients Compatibility with existing RID clients

5 5 ECG for Display Profile Scope Make ECG-specific extensions to RID Place requirements on ECG source to ensure high-quality ECG documents. Place requirements on ECG source to ensure high-quality ECG documents. Add ECG-specific request for list of ECGs to be returned as XML allowing more client flexibility. Add ECG-specific request for list of ECGs to be returned as XML allowing more client flexibility. Add SVG (vector graphics) as allowed ECG document format. Add SVG (vector graphics) as allowed ECG document format.

6 6 PDF ECG Source required to support PDF so it is compatible with existing RID clients. PDF is a common document type and most computers already have a viewer. ECG Source required to use vector graphics for waveforms in PDF. Gives high quality line drawings at any screen resolution and zoom factor. Gives high quality line drawings at any screen resolution and zoom factor. Rasterized (e.g. scanned, bitmapped) ECG images not allowed. Rasterized (e.g. scanned, bitmapped) ECG images not allowed.

7 7 Example ECG (PDF)

8 8 Example 1200x Zoom ECG (PDF)

9 9 ECG Profile Actors Display – A system that can request and display preformatted (presentation-ready) data using Web technologies. Information Source – A system that responds to requests for patient-related ECG data by encoding it in a presentation-ready format using Web technologies. Same actors as RID Profile

10 10 ECG Profile Transaction Diagram Display Information Source Retrieve Specific Info for Display [ITI-11] Retrieve ECG List [CARD-5] Retrieve ECG Document for Display [CARD-6]

11 11 ECG List XML Example

12 12 ECG List XML Example Formatted with Style sheet

13 13 Use Case D1: Simple Display Display actor requests list of ECG documents for a specific patient ID. RID profile SUMMARY-CARDIOLOGY request returns list as HTML. RID profile SUMMARY-CARDIOLOGY request returns list as HTML. ECG profile SUMMARY-CARDIOLOGY-ECG request returns list as XML with stylesheet. ECG profile SUMMARY-CARDIOLOGY-ECG request returns list as XML with stylesheet. Display actor requests a specific ECG document using a unique document ID. The ID of the requested document may not have been obtained from the previously retrieved list. The ID of the requested document may not have been obtained from the previously retrieved list.

14 14 Example List as HTML

15 15 Implications for RFPs ECG Management Systems – Clinical Portals – Remote Access – Local Printing –

16 16

17 September, 2005What IHE Delivers Nuclear Cardiology ACCA IHE Workshop 2007 Jon Elion MD, FACC Associate Professor of Medicine, Brown University Co-Chair, IHE-Cardiology Planning Committee

18 18 Nuclear Cardiology Image formats Stress and Rest raw data review Stress and Rest raw data review Stress and Rest processed data Stress and Rest processed data Gated SPECT data Gated SPECT data Quantitative data Quantitative data Screen captures, snap shots Screen captures, snap shots Color maps Gray scale is default Gray scale is default Color overlays can be applied Color overlays can be applied

19 19 Raw Data Images

20 20 Perfusion Display Standard perfusion display Stress/Rest Short axis Horizontal long axis Vertical long axis

21 21 Perfusion Display - Color Standard perfusion display Stress/Rest Short axis Short axis Horizontal long axis Horizontal long axis Vertical long axis Vertical long axis Color map can be overlaid on the image

22 22 Gated SPECT Display Apical, mid and basal short axis slices Mid-ventricle vertical and horizontal long axis slices

23 23 Gated SPECT Display The whole screen can be gated as an option

24 24 Quantitative Display Output from 3 rd party quantitative perfusion software can be displayed

25 25 Quantitative Display Output from 3 rd party quantitative gated software can be displayed

26 26 Screen Captures Screen captures can be displayed to show important images

27 27 Implications for RFPs Departmental and enterprise display systems – Cardiology PACS –

28 28

29 September, 2005What IHE Delivers Implantable Device Cardiac Observations (IDCO) Profile ACCA IHE Workshop 2007 Jon Elion MD, FACC Associate Professor of Medicine, Brown University Co-Chair, IHE-Cardiology Planning Committee

30 30 Device Interrogations Implant Clinic Home The act of retrieving data from implanted cardiac devices. Done at implant or during patient follow-ups. Information includes Patient and Device Observations, and Therapy Settings

31 31 Implantable Cardiac Device Follow-up Problems and Opportunities Electrophysiologists follow patients with implantable cardiac devices from multiple vendors Information stored in the device is collected by an interrogating device (vendor proprietary) In-Clinic – Programmer In-Clinic – Programmer Remote – Communicator / Data Collector Remote – Communicator / Data Collector Access to follow-up information often requires clinicians to use multiple vendor specific systems, complicating efficiency and quality of workflows Aggregation of data into a clinical management system or EMR requires manual (paper) processes

32 32 IDCO Value Proposition Enable management of follow-up information in a central system such as an Device Clinic Management System or EMR Improve efficiency and quality of related clinical processes Single point of access for information Single point of access for information Automation of current manual processes for data collection, aggregation and analysis Automation of current manual processes for data collection, aggregation and analysis Standardization of workflow processes Standardization of workflow processes Enabling of analytics Enabling of analytics

33 33 IDCO Profile Systems Model

34 34


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