1. August 31, 2004Year 1 of IHE Cardiology @ ESC 1 Integrating the Healthcare Enterprise Achievements and Lessons Learned from Six Years of IHE Radiology Cor Loef Philips Medical Systems Co-chair IHE-Radiology Technical Committee

2. August 31, 2004Year 1 of IHE Cardiology @ ESC 2 Content Expectations of stakeholders Essence of the IHE process Achievements in Radiology Lessons learned

3. August 31, 2004Year 1 of IHE Cardiology @ ESC 3 IHE Stakeholders Societies Representing Healthcare Segments  ( RSNA, HIMSS, ACC, ESC, Other Professional Societies… ) Users  ( Clinicians, Medical Staff, Administrators, CIOs, … ) Information Systems Vendors Imaging Systems Vendors Consultants Standards Development Organizations (SDOs)  DICOM  HL7, others …

4. August 31, 2004Year 1 of IHE Cardiology @ ESC 4 Stakeholders’ expectations of IHE Improve the efficiency and effectiveness of clinical practice by providing the needed information at the work spot for the best decisions Speed up the rate and quality of integration in healthcare environments by products with demonstrated validity Prove that integration is attainable based on standards in a multi-vendor environment, with growth-blueprint Open-up markets by lowering integration barriers Foster communication and voluntary collaboration among vendors

5. August 31, 2004Year 1 of IHE Cardiology @ ESC 5 Benefits to IHE Stakeholders Clinicians  Improved workflow  Information when and where needed  Fewer opportunities for errors  Fewer tedious tasks/repeated work Administrators  Improved efficiency  Best of breed opportunities  Decreased cost and complexity of interface deployment and management

6. August 31, 2004Year 1 of IHE Cardiology @ ESC 6 Benefits to IHE Stakeholders Vendors  Decreased cost and complexity of interface installation and management  Validation of integration at Connectathon  Lower the threshold and establish an infrastructure for new markets  Focus competition on functionality/service space, not information transport space SDOs  Rapid feedback to adjust standards to real-world  Establishment of critical mass and widespread adoption

7. August 31, 2004Year 1 of IHE Cardiology @ ESC 7 Essence of IHE process: IHE drives healthcare standards based-integration

8. August 31, 2004Year 1 of IHE Cardiology @ ESC 8 Putting standards together…. for effective information exchange Purchasing, operational, legal policies are required to deploy and use properly the integrated systems and shared patient information Providers, Payers & Policy Makers define constraints for health- system, regional structures, business objectives, legal reqmts. Policies e.g. HIPAA, RFP, Product Acquisition Contracts, Patient EHR Portability Policies Standards designed to span a broad range of use cases for the present and the future Healthcare domains require highly structured and specialized clinical standards well beyond generic IT standards Info. Exchg. Standards e.g. HL7, DICOM, SNOMED, X12, ASTM, LOINC, AAMI, CCR, NCCLS, NCPDP, CDA, Arden, IEEE, NDP + All IT Stds: Kerberos, IETF- RFCs, W3C, LDAP, ISO, IEEE, ebXML, etc.  Solid & long-lasting  Flexibility & many options Bridging the gap ? How to drive effective standards Implementations Providers and Vendors think in term of “solutions” to address specific workflows in clinical or infrastructure domains Workflow Integration Set of specific information exchange standards to be specified for product plug & play for each specific workflow  Specific and Common  Options Removed IHE: 1. Integration Profiles Spec. 2. Testing Process 3.Compliance 4. Practical Deployment IHE Integration Profile IHE Product Integration Statement

9. August 31, 2004Year 1 of IHE Cardiology @ ESC 9 The IHE process steps

10. August 31, 2004Year 1 of IHE Cardiology @ ESC 10 A Proven Standards Adoption Process Easy to Integrate Products IHE Connectathon Product With IHE IHE Demonstration User Site RFP Standards IHE Integration Profiles B IHE Integration Profile A IHE Technical Framework Product IHE Integration Statement IHE Connectathon Results IHE Integration Profiles at the heart of IHE :  Detailed selection of standards and options each solving a specific integration problem  A growing set of effective provider/vendor agreed solutions  Vendors can implement with focus  Providers can deploy with stability and incremental growth

11. August 31, 2004Year 1 of IHE Cardiology @ ESC 11 Achievements in IHE Radiology 1997/98 — The Foundation of IHE, Integrating the Healthcare Enterprise 1999/2000 — First IHE demonstration at RSNA/HIMSS Scheduled Workflow: Modality Worklist, Procedure Step, Storage Commit Scheduled Workflow: Modality Worklist, Procedure Step, Storage Commit 1999/2000 — First IHE demonstration at RSNA/HIMSS Scheduled Workflow: Modality Worklist, Procedure Step, Storage Commit Scheduled Workflow: Modality Worklist, Procedure Step, Storage Commit Consistent Presentation, Slice Lines Grouped Procedures, Reporting, Templates Consistent Presentation, Slice Lines Grouped Procedures, Reporting, Templates Security, CAD Workflow, Exception Mgt, Charge Posting, Key Image Note Reporting Workflow, Evidence Documents, Multiple-source option Reporting Workflow, Evidence Documents, Multiple-source option 2000/12000/1 200220022003200320042004 Portable Data for Imaging, NM Image

12. August 31, 2004Year 1 of IHE Cardiology @ ESC 12 IHE Radiology Integration Profiles Patient Info. Recon- ciliation Access to Radiology Information Consistent Present- ation of Images Basic Security - Evidence Docs Key Image Notes Simple Image & Numeric Reports Presentation of Grouped Procedures Post- Processing Workflow Reporting Workflow Charge Posting Scheduled Workflow Portable Data for Imaging NM Image

13. August 31, 2004Year 1 of IHE Cardiology @ ESC 13 IHE Radiology Scheduled Workflow

14. August 31, 2004Year 1 of IHE Cardiology @ ESC 14 The Annual “Connectathon”  Unprecedented Cross-Vendor Testing  Connectathon for IT Infrastructure San Diego - January 26 - 30, 2004  Connectathon for Radiology Tokyo – February 2004  Connectathon for IT Infrastructure, Laboratory & Radiology - Padova (Italy) March 29 - April 2, 2004  Connectathon for IT Infra, Lab, Cardiology, Radiology - January 2005

15. August 31, 2004Year 1 of IHE Cardiology @ ESC 15 Connectathon impression

16. August 31, 2004Year 1 of IHE Cardiology @ ESC 16 Participating vendors in the medical imaging industry

17. August 31, 2004Year 1 of IHE Cardiology @ ESC 17

18. August 31, 2004Year 1 of IHE Cardiology @ ESC 18 Live Integration of 47 HIS, RIS, PACS, and Modalities from 24 vendors Participation in the demonstrations

19. August 31, 2004Year 1 of IHE Cardiology @ ESC 19 IHE Integration Statements published by vendors Product UVW supports the IHE K Actor with the IHE X and Y Integration Profiles IHE J Actor with the IHE T Integration Profile

20. August 31, 2004Year 1 of IHE Cardiology @ ESC 20 IHE Integration Statement

21. August 31, 2004Year 1 of IHE Cardiology @ ESC 21

22. August 31, 2004Year 1 of IHE Cardiology @ ESC 22 IHE – Driving Market Adoption IHE User Success Stories – Submitted since RSNA 2002 (IHE Becomes Reality) Provider Demonstration of their IHE Success – Planned for RSNA 2004. IHE measures Success on:  Compliant products availability  Provider deployed integrated systems at clinical sites

23. August 31, 2004Year 1 of IHE Cardiology @ ESC 23 IHE process expansion to new domains

24. August 31, 2004Year 1 of IHE Cardiology @ ESC 24 Radiology Planning Committee Radiology Technical Committee IHE Europe Committee IT Infrastructure Planning Committee IT Infrastructure Technical Committee IHE Japan Committee Laboratory Sub-Committee Pharmacy Sub-Committee IHE France Planning Committee IHE Germany Planning Committee IHE Italy Planning Committee IHE UK Planning Committee IHE Norway Planning Committee IHE Strategic Development Committee KOREAEUROPE Global Development JIRACOCIREARECRHIMSS JRSSFRDRGSIRMRSNA …GMSIGZVEIBIR ACC ESC........ Professional Societies / Sponsors USA IHE USA Committee IHE NL IHE Spain Cardiology Planning Committee Cardiology Technical Committee IHE geographic expansion JAPAN IHE Korea Committee

25. August 31, 2004Year 1 of IHE Cardiology @ ESC 25 IHE Organizational Structure Multi-Domain & Multi-National Participants contribute Global Development: Radiology, IT Infrastructure, Cardiology, Lab, etc. Delegates IHE Europe IHE North America IHE Asia/Oceania Regional & National Deployment supervises reports IHE (International) Strategic Development Committee Sponsor Co-Chairs Global Interoperability IHE Domain-related Planning and Technical Committees National Extensions

26. August 31, 2004Year 1 of IHE Cardiology @ ESC 26 In Summary: IHE Radiology Now entering Year 7 (of the initial foreseen 5 year ) 50+ vendors worldwide 100+ systems in annual Connectathons Geographic spread  U.S., France, Germany, Japan, Italy, U.K, Netherlands, Spain, etc. Well over 100 commercial products available Countless sites integrated with IHE enabled products

27. August 31, 2004Year 1 of IHE Cardiology @ ESC 27 Lessons Learned IHE Radiology Essential role of sponsor societies and individual leaders to drive the process with a vision, ambition and energy, and facilitate the voluntary collaboration of the industry participants Marketing of the IHE initiative and benefits is not easy, because the first interest of the vendors is on the unique features of their products Demonstrations are needed to get initial momentum in an IHE domain, but subsequently the focus needs to shift to Success Stories to keep the process going Carefully monitor the real deployment in products of the IHE Integration Profiles, otherwise danger of creating IHE Utopia Domains with larger scope, more industry players, more societies, government involvement, will be more difficult to organize than “simple” Radiology