Integrating the Healthcare Enterprise How to Purchase IHE Conformant Systems John Paganini Guardian Healthcare

IHE-Europe Workshop 2005 TELEMEDICINE SYSTEM Specialists outside the OR consult and control the surgical robot. IN-ROOM NETWORK Touchscreen runs all equipment, reconfigures the setup, shifting new equipment into place. SURGICAL ROBOT Provides better precision, increasing dexterity, filtering out hand tremors, and allowing for the smallest of incisions. ENDOSCOPIC CAMERA Fully digital endoscopic camera, crunches 1.14 billion calculations per second. HOSPITAL-WIDE NETWORK Doctors get hospital data (like patient test results and medication lists) and send it to any monitor in the room. CopyrightCopyright © Wired Digital, Inc. All rights reserved. Dr. Roboto

IHE-Europe Workshop 2005 Improve the efficiency and effectiveness of clinical practice:  Improve Workflow  Improve Information Accuracy  Improve Information Availability  Enable Cross-System Functionality IHE Integration Goals

IHE-Europe Workshop 2005 Considerations Cost - Look at whole picture Flexibility - Integratable, Scalable Functionality - Standard, customizable Implementability - Mature, Complexity Stability - Revenue, Market Segment Usability - Hides complexity,Productive

IHE-Europe Workshop 2005 What are our goals? What are the steps and investments needed What are the critical IT capabilities needed to achieve our goals? How will we measure whether we have achieved our goals? How much of an improvement are we seeking? Integration Questions Worthy of Asking…

IHE-Europe Workshop 2005 What Does IHE Provide? Without IHE, A Gap Exists – Between The Standards That Make Interoperability Possible And Actual Implementation. – Standards Compliance Does Not Mean Interoperability IHE Bridges The Gap – Reliable Method To Acquire or Upgrade Systems – Sufficient To Achieve Truly Efficient Interoperability.

IHE-Europe Workshop 2005 IHE Technical Approach Identify the transactions required to integrate information flow between information systems For each transaction, select a single standard for use in implementing the transaction Specify in detail the use of the standard in implementing the transaction

IHE-Europe Workshop 2005 What is IHE? IHE is a specification of transactions between systems. IHE describes only integration features. IHE is not a product itself, but… IHE is very useful in purchasing products that integrate into workflow

IHE-Europe Workshop 2005 Integration Profiles - Solutions Packaged For Purchasing- Easy-to-understand, coherent, functional sets and a convenient way for users and vendors to communicate precisely about integration requirements and required functionality in products.

IHE-Europe Workshop 2005 Using Integration Profiles in Procurement IHE specifies Integration Profiles which reflect typical Healthcare workflow models Step 1: Identify the Integration Profiles which satisfy your Customer’s needs

IHE-Europe Workshop 2005 Using Actors in Procurement IHE identifies the transactions for each actor required to make integration work. Specifying the integration profile and the actor implies support of the transactions. Step 2: For each Integration Profile, identify which actors need to be implemented by each product

IHE-Europe Workshop 2005 Using Transactions in Procurement For clarity, you may want to specify the transactions individually. Step 3: Optionally, For each actor specified, identify the transactions needed to be implemented by each product

IHE-Europe Workshop 2005 A PACS Example One company might implement a PACS to include: – Image Manager + Image Archive + Performed Procedure Step Manager + Image Display + Print Composer + Report Creator + Report Manager + Report Repository + Report Reader Another vendor might implement a PACS to include only: – Image Manager + Image Archive + Performed Procedure Step Manager + Image Display

IHE-Europe Workshop 2005 Integration Profiles and Transactions for an RIS Integration Profile: Scheduled Workflow Actors: Order Filler and Performed Procedure Step Manager Required Transactions: – 1, 2, 3, 4, 5, 6, 7, 11, 12, 20, and 21 Note: Each actor has different requirements in each Integration Profile. Profiles are easier to specify than transactions, and they guarantee integration.

IHE-Europe Workshop 2005 Shall-language Examples The product shall implement the following IHE actors: … The actors required above shall support the following IHE Integration Profiles: … The upgrade shall meet the requirements of the IHE Technical Framework for the following IHE actors … and the following IHE Transactions: …

IHE-Europe Workshop 2005 Example: New Modality Print Composer CapabilityActorIntegration Profile Acquisition ModalityScheduled Workflow/Patient Reconciliation Presentation of Grouped Procedures Consistent Presentation of Images Key Image Note Consistent Presentation of Images Report CreatorSimple Image and Numeric Report Required Ultrasound Imaging System The product shall meet the requirements of the IHE Technical Framework, Version 4.7, for the integration profiles and the actors, as specified in the following table:

IHE-Europe Workshop 2005 Connectathon Questions Do you know what the IHE Connectathon is? Has this product been tested at the IHE Connectathon? What actors and IHE Integration Profiles were tested on this product at the IHE Connectathon?

IHE-Europe Workshop 2005 Key Questions for Vendors What IHE actors does this product implement? What IHE Integration Profiles does each actor in this product support? Is support for these actors and IHE Integration Profiles included in the released software for this product?

IHE-Europe Workshop 2005 IHE Integration Statement

IHE-Europe Workshop 2005 Vendor IHE Claims Product X supports the IHE Y Integration Profile as the IHE a, b, and c Actors. Use IHE Integration Profiles when writing RFPs and purchasing specifications

IHE-Europe Workshop 2005 Level 0: Modalities connected to printer No RIS integration Laser Printer DICOM Basic Print Service

IHE-Europe Workshop 2005 Level 1: Modalities connected to printer No RIS integration Post-processing workstations Laser Printer IHE Integration Profile: Consistent Presentation of Images Same perception??

IHE-Europe Workshop 2005 Level 2: Modalities with RIS Connection IHE Integration Profile: Scheduled Workflow (DICOM Modality Worklist)

IHE-Europe Workshop 2005 Level 3:Modalities with RIS Connection PACS IHE Integration Profiles: Scheduled Workflow (full) Patient Information Reconciliation Presentation of Grouped Procedures Access to Radiology Information

IHE-Europe Workshop 2005 Level 4:More than images: Measurements, Key images, CAD objects IHE Integration Profiles: Key Image Note Evidence Documents Post-processing workflow

IHE-Europe Workshop 2005 Level 5: Reporting and billing IHE Integration Profiles: Simple Image and Numeric Report Reporting Workflow Charge Posting HIS

IHE-Europe Workshop 2005 Summary & Conclusion IHE Should Be Part Of The Proposed Solution Develop A Well-planned Integration Strategy IHE Integration Delivers Value When It Is Managed To Deliver Value And ROI IHE Benefits Users, Providers And Vendors