1. Charles Parisot IHE Radioology Planning & Technical Committee GE Medical Systems Information Technologies IHE - A Novel Approach IHE Methodology

2. HL7 LABPOCT – 1/2003IHE-Methodology2 What is IHE? IHE is an initiative to solve real-world integration problems between HIS, RIS, PACS, Modalities, Printers, etc.IHE is an initiative to solve real-world integration problems between HIS, RIS, PACS, Modalities, Printers, etc. IHE is users’ driven & involves active vendor participation.IHE is users’ driven & involves active vendor participation. IHE is based on existing standards, HL7, DICOM, IETF, and others as it expands.IHE is based on existing standards, HL7, DICOM, IETF, and others as it expands. IHE is not a product itself, it specifies network transactions between systems.IHE is not a product itself, it specifies network transactions between systems. IHE specifies only integration features.IHE specifies only integration features.

3. HL7 LABPOCT – 1/2003IHE-Methodology3 What IHE is not ! It is not a standardization project, although it turns good standards into practical reality.It is not a standardization project, although it turns good standards into practical reality. It is not a vendor driven initiative nor a user driven initiative, it a joint user/vendor initiative.It is not a vendor driven initiative nor a user driven initiative, it a joint user/vendor initiative. It is not a place to issue "IHE Compliance Certificates". Vendor shall remain ultimately responsible to meet their customer needs.It is not a place to issue "IHE Compliance Certificates". Vendor shall remain ultimately responsible to meet their customer needs. It is an interoperability testing (tools & process).It is an interoperability testing (tools & process). Products issue "IHE Integration Statements" It is not a "call for tender" for a product, although it greatly simplifies the interface chapter of RFPs.It is not a "call for tender" for a product, although it greatly simplifies the interface chapter of RFPs.

4. HL7 LABPOCT – 1/2003IHE-Methodology4 IHE Integration Profiles B A Proven Standards Adoption Process IHE Integration Profiles:IHE Integration Profiles: –Detailled selection of standards and options each solving a specific integration problem –A growing set of effective provider/vendor agreed solutions –Vendors can implement with ROI –Providers can deploy with stability Standards Easy to Integrate Products IHE Integration Profile A IHE Demonstration IHE Connectathon Product With IHE User Site RFP IHE Technical Framework

5. HL7 LABPOCT – 1/2003IHE-Methodology5 The IHE Vision for User Sponsors Host/Encourage Vendors' involvement in IHE.Host/Encourage Vendors' involvement in IHE. Educate users: They are part of an Healthcare Enterprise that expects teamwork from them (e.g. Radiology and IT).Educate users: They are part of an Healthcare Enterprise that expects teamwork from them (e.g. Radiology and IT). Educate users: IHE standardizes a flexible workflow that can be customized (and may differ form current habits)Educate users: IHE standardizes a flexible workflow that can be customized (and may differ form current habits) Educate Users: Standards are good. The way to get them is to request IHE Integration Profiles in purchasesEducate Users: Standards are good. The way to get them is to request IHE Integration Profiles in purchases Integrated Product User Site Promotion Education

6. HL7 LABPOCT – 1/2003IHE-Methodology6 IHE, A culture change…. A new dimension in the relationship between users and vendors This is what it takes to turn Healthcare IT standards in reality !

7. HL7 LABPOCT – 1/2003IHE-Methodology7 The Product World….. Poduct XYZ from Vendor T

8. HL7 LABPOCT – 1/2003IHE-Methodology8 The IHE World…. IHE Actor Actor IHE Transaction IHE Actor

9. HL7 LABPOCT – 1/2003IHE-Methodology9 Mapping IHE to Products Poduct XYZ from Vendor T IHE Actor Actor IHE Transaction IHE Actor

10. HL7 LABPOCT – 1/2003IHE-Methodology10 The IHE Technical Approach Identify the transactions required to integrate the information flow between several information systems/devicesIdentify the transactions required to integrate the information flow between several information systems/devices For each transaction, select a single standard (e.g.HL7 messages) for use in implementing the transactionFor each transaction, select a single standard (e.g.HL7 messages) for use in implementing the transaction Specify in detail the use of the standard in implementing the transactionSpecify in detail the use of the standard in implementing the transaction

11. HL7 LABPOCT – 1/2003IHE-Methodology11 The Result An IHE Technical Framework (TF)An IHE Technical Framework (TF) A specification defining 30 transactions supporting: – Image acquisition – Storage – Viewing – Reporting – Registration – Admission – Order entry – Scheduling

12. HL7 LABPOCT – 1/2003IHE-Methodology12 IHE 2002 : 17 Actors and 30 Transactions  1: Pt Registration  12: Pt Update  1: Pt registration  12: Pt Update Pt Registration: 1  Pt Update: 12   2: Placer Order Management  3: Filler Order Management ADT Master Patient Index  14: Query Images  15: Query Pres. States  16: Retrieve Images  17: Retrieve Pres. States  30: Query Key Image Notes  31: Retrieve Key Image Notes Image Display Storage Commitment: 10   8: Modality Image Stored  9: Modality Pres. State Stored  29: Store Key Image Note Storage Commitment: 10   18: Creator Image Stored  19: Creator Pres. State Stored  29: Store Key Image Note  4: Procedure Scheduled  11: Image Availability Query  12: Patient Update  13: Procedure Update  5: Modality Worklist Provided Image Creator Acquisition Modality Performed Procedure Step Manager Image Manager Image Archive  6: Modality PPS in Progress  7: Modality PPS Completed  20: Creator PPS in Progress  21: Creator PPS Completed  6: Modality PPS in Progress  7: Modality PPS Completed  20: Creator PPS in Progress  21: Creator PPS Completed  6: Modality PPS in Progress  7: Modality PPS Completed  20: Creator PPS in Progress  21: Creator PPS Completed Order Placer Order Filler  23: Print Request with Presentation LUT Print Server Print Composer  24: Report Submission Structured Report Export: 28   25: Report Issuing Report Creator  26: Query Reports  27: Retrieve Reports Report Repository Report Reader External Report Repository Access Report Manager Enterprise Report Repository

13. HL7 LABPOCT – 1/2003IHE-Methodology13 IHE : An Integration Profile  24: Report Submission Structured Report Export: 28   25: Report Issuing Report Creator  26: Query Reports  27: Retrieve Reports Report Repository Report Reader External Report Repository Access Report Manager Enterprise Report Repository Transactions A set of Actors cooperating through Transactions to perform a specific task

14. HL7 LABPOCT – 1/2003IHE-Methodology14 Integration profiles, the easy way to deal with transactions easy-to-understand, coherent functional sets andeasy-to-understand, coherent functional sets and a convenient way for users and vendors to communicatea convenient way for users and vendors to communicate about integration requirements and needed functionality in daily life.about integration requirements and needed functionality in daily life.

15. HL7 LABPOCT – 1/2003IHE-Methodology15 Scheduled Workflow Admit, order, schedule, acquire images, notify of completed steps Now Focussing on….. Scheduled Workflow IHE Integration Profile Access to Radiology Information Consistent access to images and reports Consistent Presentation of Images Hardcopy and softcopy grayscale presentation state Key Image Notes Flag significant images Simple Image and Numeric Reports Simple reports with image links and, optionally, measurements Basic Security Audit Trail Consolidation & Node Authentication Presentation of Grouped Procedures Subset a single acquisition Post- Processing Workflow Schedule, perform, & notify image processing & CAD steps Charge Posting Collection of billable procedure details Scheduled Workflow Admit, order, schedule, acquire images, notify of completed steps Patient Information Reconciliation Unknown patients and unscheduled orders

16. HL7 LABPOCT – 1/2003IHE-Methodology16 Vendor should provide IHE Claims Product ABC supports the IHE KX Integration Profile as the IHE X and Y Actors IHE X and Y Actors IHE JY Integration Profile as the IHE JY Integration Profile as the IHE Z Actors IHE Z Actors

17. HL7 LABPOCT – 1/2003IHE-Methodology17 Additional Information IHE Brochures and publications:IHE Brochures and publications: –IHE Integration Profiles –IHE At-a-Glance –Reprints of IHE technical papers –IHE Integration Checklist HIMSS Primer and RSNA MonographHIMSS Primer and RSNA Monograph On www.rsna.org/IHE or www.ihe-europe.orgOn www.rsna.org/IHE or www.ihe-europe.orgwww.rsna.orgwww.ihe-europe.orgwww.rsna.orgwww.ihe-europe.org –IHE Technical Framework 5.4