The Future of IHE Linking Domains Across the Enterprise Dr. Nikolaus Wirsz – IHE Planning Committee Siemens Medical Solutions

HIMSS/RSNAHIMSS 2003 Introduction The Vision IHE Over Time IHE Success IHE Future Plans IHE Vision for Growth Shaping the Future of IHE IHE Benefits The Future of IHE

HIMSS/RSNAHIMSS 2003 Integration solutions available today - BUT: Proprietary departmental solutions leave many problems unresolved: Communicating Medical Data Across Multiple Systems from Different Vendors Access to the Complete Information Consistency of Information Across Departments and Institutions No Long-term Guarantee of Viability or Evolutionary Path Introduction

HIMSS/RSNAHIMSS 2003 Nov HIMSS & RSNA Launch a New Initiative: Integrating the Healthcare Enterprise (IHE) An Incremental Multi-Year Project The Vision

HIMSS/RSNAHIMSS 2003 The Vision Speed up the integration in healthcare environments Foster communication between vendors Prove that integration is attainable based on standards

HIMSS/RSNAHIMSS 2003 The Vision Participants: Representatives of Healthcare Providers: HIMSS, RSNA, … Users: Radiologists, Medical Staff, Administrators, CIOs, … Information Systems Vendors: RIS & HIS Vendors Imaging Systems Vendors: Modality & PACS Vendors Standards Committee Members: HL7, DICOM

HIMSS/RSNAHIMSS 2003 Year 1 Initial Functional System Architecture Integrate Radiology with HIS Patient Registration & ADT Order Entry & Scheduling Image Communication: -Image Acquisition -Image Storage -Image Retrieval IHE Over Time

HIMSS/RSNAHIMSS 2003 Year 2 Expand Radiology Transactions Interdepartmental Information Sharing Image Availability Information ( Location ) to Enable Subsequent Process Steps ( Reporting ) Access to Radiology Information ( Reports and Images) within Radiology and within Other Departments Patient Information Reconciliation (“John Doe” / Trauma) IHE Over Time

HIMSS/RSNAHIMSS 2003 Year 2 Expand Radiology Transactions Interdepartmental Information Sharing Consistent Presentation of Images Report Management Enable Access to Non-Radiology Information (e.g. Lab data) IHE Over Time

HIMSS/RSNAHIMSS 2003 Year 3 Consolidation Year for Radiology Drive IHE into Market and into Real World Improvements Based on Year 1 and 2 Experience: -Order Tracking ( Order Status Updates ) -Clinical Data and Alerts Available to Medical Staff -Templates for Structured Reports -Rules to Link Reports to Studies / Images Include Other Clinical Specialties Advance Integration with Enterprise Information Systems Encourage IHE Initiative Worldwide IHE Over Time

HIMSS/RSNAHIMSS 2003 Year 4 Radiology Resumes Vertical Growth Post-Processing Workflow: Using DICOM General Purpose Worklist Initial Security Features: Audit & Authentication Controls Charge Posting: Billing / Financial Transactions Error Management: Fixing operator errors and other exception cases using DICOM Modality Worklist IHE Over Time

HIMSS/RSNAHIMSS 2003 Year 4 The Vision is REAL IHE is no longer just a demonstration IHE expands its presence on the exhibit floor 13 poster presentations and user success stories are featured IHE Over Time

HIMSS/RSNAHIMSS 2003 acquisition in progress / completed IHE Success – Closing Loop acquisition in progress / completed

HIMSS/RSNAHIMSS 2003 Access to Radiology Information Retrieve & view images and reports Consistent Presentation of Images Hardcopy and softcopy grayscale presentation state Key Image Notes Flag & search for significant images Simple Image and Numeric Reports Simple reports with image links and measurements Basic Security Audit Trail Consolidation & Node Authentication Presentation of Grouped Procedures Manage subsets of 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 & store images with notification of completed steps Patient Information Reconciliation Unknown patients and unscheduled orders IHE Success – Integration Profiles

HIMSS/RSNAHIMSS 2003 IHE Future Plans Year 5 Boost Evolution and Acceptance of IHE Expansion to other Clinical Specialties Support for Interpretation / Reporting Workflow: -Radiologist’s Worklist: Using DICOM General Purpose Worklist -Evidence Documents: Measurements, Waveforms, Procedure Documentation,

HIMSS/RSNAHIMSS 2003 IHE Future Plans Year 5 Boost Evolution and Acceptance of IHE Expansion to other Clinical Specialties Support IHE Efforts Evolving in Other Domains: -Cardiology -Overall Healthcare IT Infrastructure: MPI, Desktop Integration, … Concepts for Extended Archiving: -Centralized / Decentralized Archiving Solutions in Multi-Institution Environments

HIMSS/RSNAHIMSS 2003 IHE Future Plans Integration Beyond Radiology Boundaries Encourage Other Clinical Fields to Attain Internal Vertical Integration: -Cardiology -Laboratory / Pathology -Pharmacy / Medication Management Expand Enterprise IT Infrastructure in Healthcare Goals: -Integration of Multiple Clinical Specialties -Incorporate IT Infrastructure Features

HIMSS/RSNAHIMSS 2003 A Multidimensional Expansion of Integration IHE Vision for Growth Dept Sched. ADT Order Mgt Image Mgr Modality 1 st Dimension: Vertical Integration for Radiology IHE Years 1, 2, 3, 4,...

HIMSS/RSNAHIMSS nd Dimension: Growing the Horizontal Healthcare Enterprise Integration Master Patient Index Clinical Patient Record Ordering Process... Dept Sched. ADT Order Mgt Image Mgr Modality Patient Registration A Multidimensional Expansion of Integration IHE Vision for Growth

HIMSS/RSNAHIMSS rd Dimension: Increasing the Number of Vertically Integrated Departments Master Patient Index Clinical Patient Record Ordering Process... Patient Registration R a d i o l o g y C a r d i o l o g y Laboratory / PathologyAdd’l Clinical Fields Pharmacy / Med. Adm. A Multidimensional Expansion of Integration IHE Vision for Growth

HIMSS/RSNAHIMSS 2003 IHE Vision for Growth ADT/ Reg. Lab/Path. Radiology Cardiology Int. Med. Endoscopy Ophthalm Dental ER

HIMSS/RSNAHIMSS 2003 IHE Strategic Development Committee Est. August 2001 Expansion of IHE process to meet integration needs of entire enterprise Engage leading medical professionals and associations from other key domains to help move IHE beyond Radiology Shaping the Future of IHE

HIMSS/RSNAHIMSS 2003 Objectives: Identify and recommend clinical and operational domains Identify steps in the typical patient care workflow Identify integration needs and barriers within and across domains Populate domain specific planning and technical committees Shaping the Future of IHE

HIMSS/RSNAHIMSS 2003 IT Infrastructure Issues Enterprise Master Patient Index ( EMPI ) Advanced Security & Access Privileges Single Sign-On & Desktop Applications Synchronization Liaison & Coordination with the HL7 Organization Shaping the Future of IHE

HIMSS/RSNAHIMSS 2003 Strategic Development Committee Radiology Planning Committee Radiology Technical Committee IHE Europe Planning Committee IT Infrastructure Planning Committee IT Infrastructure Technical Committee IHE Japan Planning Committee …… Sub-Committee Pharmacy Sub-Committee Laboratory Cardiology Committee IHE France Planning Committee IHE Germany Planning Committee IHE Italy Planning Committee IHE UK Planning Committee IHE … Planning Committee IHE Steering Committee JAPANEUROPENorth America JIRACOCIREARECRHIMSS JRSSFRDRGSIRMRSNA …GMSIGZVEIBIR … … Professional Societies / Sponsors IHE Organizational Structure

HIMSS/RSNAHIMSS 2003 IHE Expands Scope Recruiting Participants in New Committees Enterprise Master Patient Index Advanced Security Query/Display/Synchronized Patient View Special Panel Session in IHE Theatre Overview of new IHE enterprise initiatives Learn how to participate – Tuesday, February 11, 9:15 – 10:00 a.m. – Wednesday, February 12, 12:15 – 1:00 p.m

HIMSS/RSNAHIMSS 2003 Special IHE Panel Session IHE - IT Infrastructure: The Value Proposition – Find out how you can benefit from participating in IHE committees and Connectathons – Learn how IHE fills the interoperability gap – Hear the status of new enterprise initiatives Software vendors, developers and interested parties invited to attend special panel session

HIMSS/RSNAHIMSS 2003 Continuity and Integrity of Patient Information Clinical Workflow Optimization Fostering Communication Among Diverse Information Systems Avoid Repeating Tasks Eliminating Gaps and Redundancies in Data Access Driving the Use and Evolution of Healthcare Communication Standards Benefits of IHE Improving the Patient Care Process

HIMSS/RSNAHIMSS 2003 Questions? Information Available On the Web at: Home Page of IHE Europe: Home Page of IHE Japan: