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

3. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA2 IntroductionIntroduction IHE Over TimeIHE Over Time IHE Vision for GrowthIHE Vision for Growth IHE Future PlansIHE Future Plans IHE ParticipationIHE Participation IHE InternationalIHE International ConclusionsConclusions Future of IHE

4. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA3 Integration solutions available today - BUT:Integration solutions available today - BUT: Proprietary departmental solutions leave many problems unresolved:Proprietary departmental solutions leave many problems unresolved: –Communicating Medical Data Across Multiple Systems from Different Vendors –Access to the Complete Medical Information –Consistency of Medical Information Across Departments and Institutions –No Long-term Guarantee of Viability or Evolutionary Path Introduction

5. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA4 Nov. 1998 HIMSS & RSNA Launch a New Initiative: “Integrating the Healthcare Enterprise (IHE)” An Incremental Multi-Year Project Speed Up the Integration in Healthcare EnvironmentsSpeed Up the Integration in Healthcare Environments Foster Communication Between Vendors of Medical ITFoster Communication Between Vendors of Medical IT Prove that Integration is Attainable Based on StandardsProve that Integration is Attainable Based on Standards Participants:Participants: –Representatives of Healthcare Providers –Information Systems Vendors –Imaging Systems Vendors –Standardization Groups Introduction

6. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA5 Who Is IHE ? Societies / Associations:Societies / Associations: –Healthcare IT:........................HIMSS –Radiology:.............................RSNA –Other Clinical Specialties:...The Appropriate Societies Vendors:Vendors: –Healthcare IT:........................IS Vendors –Radiology:.............................RIS Vendors, Imaging: Modalities, PACS,... –Other Clinical Specialties:...Suppliers of Departmental Systems/Products Users:Users: –Healthcare IT:........................CIOs, Administrators –Radiology:.............................Radiologists –Other Clinical Specialties:...Clinicians, Medical Staff IHE Participation

7. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA6 Year 1 Initial Functional System Architecture Integrate Radiology with HIS Patient Registration & ADTPatient Registration & ADT Order Entry & SchedulingOrder Entry & Scheduling Image Communication:Image Communication: –Image Acquisition –Image Storage –Image Retrieval IHE Over Time

8. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA7 Year 2 Expand Radiology Transactions Initial Interdepartmental Information Sharing Image Availability Information ( Location ) to Enable Subsequent Process Steps ( Reporting )Image Availability Information ( Location ) to Enable Subsequent Process Steps ( Reporting ) Access to Radiology Information ( Reports and Images) within Radiology and within Other DepartmentsAccess to Radiology Information ( Reports and Images) within Radiology and within Other Departments Access to Non-Radiology Information ( e.g. Lab Data )Access to Non-Radiology Information ( e.g. Lab Data ) Patient Information Reconciliation ( “John Doe” / Trauma )Patient Information Reconciliation ( “John Doe” / Trauma ) Consistent Presentation of ImagesConsistent Presentation of Images Report ManagementReport Management IHE Over Time

9. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA8 Year 3 Consolidation Year for Radiology Drive IHE into Market and into Real World Improvements Based on Year 1 and 2 Experience: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 SpecialtiesInclude Other Clinical Specialties Advance Integration with Enterprise Information SystemsAdvance Integration with Enterprise Information Systems Encourage IHE Initiative WorldwideEncourage IHE Initiative Worldwide IHE Over Time

10. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA9 acquisition in progress acquisition completed IHE Success – Closing Loop

11. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA10 Presentation of Grouped Procedures Subset a single acquisition Patient Information Reconciliation Unknown patients and unscheduled orders Consistent Presentation of Images Hardcopy and softcopy grayscale and presentation state Access to Radiology Information Consistent access to images and reports Key Image Notes Exchange flagging significant images Simple Image and Numeric Reports Exchange simple reports with image links and, optionally, measurements Scheduled Workflow Admit, order, schedule, acquire images, notify of completed steps IHE Success - Integration Profiles

12. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA11 Year 4 Radiology Resumes Vertical Growth Improving the Reporting and Reviewing Workflow:Improving the Reporting and Reviewing Workflow: –General Purpose Worklist for: Interpretation / Reporting ( Radiologist’s Worklist )Interpretation / Reporting ( Radiologist’s Worklist ) Post-ProcessingPost-Processing Initial Security Features:Initial Security Features: –Audit / Authentication Controls Charge Posting ( Billing / Financial Transactions)Charge Posting ( Billing / Financial Transactions) Error Management (fixing operator errors and other exception cases using modality worklist)Error Management (fixing operator errors and other exception cases using modality worklist) IHE Future Plans

13. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA12 Long-Range Radiology and IT Infrastructure Issues Integrated Clinical Desktop Linking Radiology and Other Clinical ApplicationsIntegrated Clinical Desktop Linking Radiology and Other Clinical Applications Master File UpdatesMaster File Updates Hanging Protocols (Radiologist’s Preferences)Hanging Protocols (Radiologist’s Preferences) Enhanced Queries for Structured ReportsEnhanced Queries for Structured Reports Integration with the Master Patient Index (MPI)Integration with the Master Patient Index (MPI) Interdepartmental Information Sharing (Results, Images)Interdepartmental Information Sharing (Results, Images) Standardized Codes and TerminologyStandardized Codes and Terminology Relevant Information Management (Historical Studies)Relevant Information Management (Historical Studies) IHE Future Plans

14. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA13 Integration Beyond Boundaries Encourage Other Clinical Fields to Attain Internal Vertical IntegrationEncourage Other Clinical Fields to Attain Internal Vertical Integration Expand Enterprise IT InfrastructureExpand Enterprise IT Infrastructure IHE Year 5 Achieves Integration of:IHE Year 5 Achieves Integration of: –Multiple Clinical Specialties –Significant IT Infrastructure Features IHE Future Plans

15. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA14 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,...

16. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA15 A Multidimensional Expansion of Integration IHE Vision for Growth 2 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

17. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA16 A Multidimensional Expansion of Integration IHE Vision for Growth 3 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 Add’l Clinical Fields

18. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA17 Shaping the Future of IHE IHE Strategic Development Committee Est. July 2002 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 RadiologyEngage leading medical professionals and associations from other key domains to help move IHE beyond Radiology Identify integration needs / barriers and problems / solutions within and across domainsIdentify integration needs / barriers and problems / solutions within and across domains Identify and recommend clinical and operational domainsIdentify and recommend clinical and operational domains Populate domain specific sub-committees:Populate domain specific sub-committees: –Cardiology –Laboratory –Pharmacy / Medication Administration –Interdepartmental Information Sharing:Ad-hoc Query/Retrieve Master File Updates

19. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA18 IHE Goes International IHE International Steering Committee IHE North AmericaIHE North America IHE Europe:IHE Europe: –IHE France:Demo at JFR Oct. 20-24, 2001 –IHE Germany:Demo at DRK May 8-11, 2002 –IHE France:Demo at Hospital Expo May 21-24, 2002 Demo at JFR Oct. 19-23, 2002 –IHE Italy:Demo at SIRM May 24-28, 2002 IHE Japan: Demo at JMCP Apr. 2002IHE Japan: Demo at JMCP Apr. 2002 IHE International

20. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA19 IHE Europe To address European-based healthcare information system vendors ( RIS, HIS )To address European-based healthcare information system vendors ( RIS, HIS ) To provide information to, and get feedback from European healthcare providers.To provide information to, and get feedback from European healthcare providers. To facilitate European influence in the IHE and avoid local European solutions if global solutions are adequate.To facilitate European influence in the IHE and avoid local European solutions if global solutions are adequate. Why IHE in Europe ?

21. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA20 IHE Europe Healthcare information system vendors often address only national markets in EuropeHealthcare information system vendors often address only national markets in Europe Most imaging vendors have a global presence. However: integration with European IS vendors is needed.Most imaging vendors have a global presence. However: integration with European IS vendors is needed. Provide European vendors with a platform to develop and test world-class interoperabilityProvide European vendors with a platform to develop and test world-class interoperability European Healthcare Information Systems Market Is Different:

22. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA21 IHE Europe Sponsors:COCIR (European imaging vendors), ECR, EAR, National Societies (e.g. SFR, DRG,...)Sponsors:COCIR (European imaging vendors), ECR, EAR, National Societies (e.g. SFR, DRG,...) Formation of IHE-Europe Planning CommitteeFormation of IHE-Europe Planning Committee No IHE-Europe Technical Committee: re-use of IHE Technical FrameworkNo IHE-Europe Technical Committee: re-use of IHE Technical Framework How To Implement IHE In Europe:

23. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA22 Global Technical Framework … National Extensions National Specificities Feed the Global TF During its Definition/Review. Evolution of the Technical Framework (1) JapanUSFrance Germany

24. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA23 … Japan US France Germany … Technical Framework Year N Global Evolution of the Technical Framework (2) Global US Germany France Japan Technical Framework Year N+1 National Extensions should not contradict the Global TF Year N+1 should include general purpose local extensions of Year N

25. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA24 IHE in the USA European IHE Committee IHE in France Planning Committee IHE in Germany Planning Committee IHE in ……. Planning Committee Demonstrations Education National extensions Comprehensive Technical Framework Connect-a-thon European Coordination European-level exhibitions, marketing and education Vendor Participation IHE Europe

26. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA25 Healthcare Needs Addressed by IHE Continuity and Integrity of Patient InformationContinuity and Integrity of Patient Information Clinical Workflow OptimizationClinical Workflow Optimization Fostering Communication Among Diverse Medical Information SystemsFostering Communication Among Diverse Medical Information Systems Avoid Repeating TasksAvoid Repeating Tasks Eliminating Gaps and Redundancies in Data AccessEliminating Gaps and Redundancies in Data Access Driving the Use and Evolution of Healthcare Communication StandardsDriving the Use and Evolution of Healthcare Communication Standards Improving the Patient Care Process

27. RSNA 2002 The Future of IHE – Linking Domains Across the Enterprise HIMSS / RSNA26 Questions? Information Available On the Web at:Information Available On the Web at: www.rsna.org/IHEwww.himss.orgwww.rsna.org/IHEwww.himss.org Home Page of IHE Europe:Home Page of IHE Europe: www.IHE-Europe.orgwww.IHE-Europe.org