1. September, 2005What IHE Delivers IHE Eye Care February 28, 2008 Mike Schmidt Medflow Inc. Co-Chair IHE Eye Care Planning Committee

2. 1 Eye Care Domain Ophthalmology, Optometry Market dominated by small clinics, group practices, and solo providers  Lack IT infrastructure of hospital environment Broad spectrum of modalities  Digital fundus cameras, digital slit-lamp cameras  Visual field analyzers  OCT scanners, Scheimpflug cameras  Ophthalmic ultrasound  Corneal topographers  Lensometers, auto-refractors, keratometers, other refractive devices  Etc. Rapid adoption of large-data-volume imaging modalities  Spectral domain OCT: 3-D, 4-D imaging of retinal structures Early adoption phase of PACS, DICOM, IHE  Analogous to radiology in the 1990’s

3. 2 IHE Eye Care Roots in DICOM Working Group 9 (Ophthalmology) AAO sponsorship; recent ASCRS support Leadership by clinical committee members Increasing vendor support (Modality, EMR, Image Management, Practice Management) Initiative started in 2005; currently in 3 rd year Separate October Connectathons (at RSNA headquarters) IHE Showcases at AAO meetings (typically in November) Planning IHE Showcases also at ASCRS meetings (typically April)

4. 3 Technical Framework 4 Integration Profiles: EYE CARE Workflow (EYECARE ) establishes the continuity and integrity of basic patient and procedure data in the context of an eye care clinic and/or an integrated hospital workflow scenario; derived from radiology scheduled workflow Charge Posting (CHG) specifies the exchange of information from department ordering systems to billing systems regarding charges associated with particular procedures Eye Care Evidence Documents (ECED) defines ways for evidence documents such as procedure observations and image measurements to be stored and displayed Eye Care Displayable Reports (ECDR) defines ways for display-ready eye care reports such as interpretation reports to be stored and displayed

5. 4 Parallel DICOM WG9 Efforts Current DICOM Modality Support  OP – digital fundus photography, digital slitlamp photography Supplement approved in 2004  US – ophthalmic B-scan ultrasound  OPT – ophthalmic OCT and Scheimpflug imaging Supplement 110 approved in 2007  Refractive SOP classes – lensometers, autorefractors, etc. Supplement 130 approved late 2007  Encapsulated PDF for other modalities DICOM modality support work in progress  Visual field analyzers  Ophthalmic mapping devices  Biometers  OCT retinal measurements (structured report)

6. 5 Future Plans 2008 is catch-up year – little new Technical Framework development  Constrain DICOM Enc PDF to PDF/A-1a Current Mission:  Significantly increase professional community awareness of and participation in IHE Eye Care  Develop a significantly more effective IHE Eye Care showcase  Broaden vendor participation in IHE Eye Care  Foster real life IHE Eye Care implementations to meet clinical needs  Broaden participation of eye care organizations in the US and internationally

7. September, 2005What IHE Delivers