2Retrieve ECG for Display ACCA IHE Workshop 2007Jon Elion MD, FACCAssociate Professor of Medicine, Brown UniversityCo-Chair, IHE-Cardiology Planning Committee
3ECG 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.High-quality ECG documents. Avoid artifacts on zoomed ECGs and arbitrary display geometries.Vector images required (not rasterized)Facilitate apps for serial comparison (side-by-side synchronized display).
4ECG 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 single document, including an ECGECGs served in displayable format (PDF, SVG)Compatibility with existing RID clients
5ECG for Display Profile Scope Make ECG-specific extensions to RIDPlace 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 SVG (vector graphics) as allowed ECG document format.
6PDFECG 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.Rasterized (e.g. scanned, bitmapped) ECG “images” not allowed.
9ECG Profile ActorsDisplay – 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
10ECG Profile Transaction Diagram Retrieve ECG List [CARD-5]Retrieve Specific Info for Display [ITI-11]InformationDisplaySourceRetrieve ECG Document for Display [CARD-6]
12Formatted with Style sheet ECG List XML ExampleFormatted with Style sheet
13Use 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.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.
17Nuclear Cardiology ACCA IHE Workshop 2007 Jon Elion MD, FACC Associate Professor of Medicine, Brown UniversityCo-Chair, IHE-Cardiology Planning Committee
18Nuclear Cardiology Image formats Color maps Stress and Rest raw data reviewStress and Rest processed dataGated SPECT dataQuantitative dataScreen captures, “snap shots”Color mapsGray scale is defaultColor overlays can be applied
29Implantable Device Cardiac Observations (IDCO) Profile ACCA IHE Workshop 2007Jon Elion MD, FACCAssociate Professor of Medicine, Brown UniversityCo-Chair, IHE-Cardiology Planning Committee
30Device Interrogations The act of retrieving data from implanted cardiac devices. Done at implant or during patient follow-ups.ImplantClinicInformation includes Patient and Device Observations, and Therapy SettingsHome
31Implantable Cardiac Device Follow-up Problems and Opportunities Electrophysiologists follow patients with implantable cardiac devices from multiple vendorsInformation stored in the device is collected by an “interrogating” device (vendor proprietary)In-Clinic – ProgrammerRemote – Communicator / Data CollectorAccess to follow-up information often requires clinicians to use multiple vendor specific systems, complicating efficiency and quality of workflowsAggregation of data into a clinical management system or EMR requires manual (paper) processes
32IDCO Value Proposition Enable management of follow-up information in a central system such as an Device Clinic Management System or EMRImprove efficiency and quality of related clinical processesSingle point of access for informationAutomation of current manual processes for data collection, aggregation and analysisStandardization of workflow processesEnabling of analytics