2. RSNA/HIMSS Integrating the Healthcare Enterprise IHE in an International Context Ellie Avraham Eastman Kodak – IHE Planning & Technical Committees Member Dr. Nikolaus Wirsz Siemens Medical Solutions – IHE Planning Committee Member Prof.Berthold Wein, MD University Clinic Aachen, Germany – IHE Europe Committee User Co-Chair Geert Claeys Agfa-Gevaert NV – IHE Europe Committee Industry Co-Chair Dr. Takeo Ishigaki, MD Nagoya University Graduate School of Medicine – IHE Japan Committee Co-Chair

3. IHE Classroom Sessions – RSNA 2003 Introduction Integrating the Healthcare (IHE) is an initiative to stimulate the integration of Healthcare Information and Imaging Systems – Provides Interoperability and Workfolws Optimization. IHE was initiated in the USA (1998) by the RSNA & HIMSS societies. The foundation of IHE is the Technical Framework that contains the Global framework and the national specializations framework (DICOM & HL7) IHE has an international vision encouraging the IHE nationals initiatives to address the National specific Healthcare policies and practices

4. IHE Classroom Sessions – RSNA 2003 Scope of the International IHE Initiatives International – Global Technical Framework – Define Integration Solutions and Optimize Workflow Profiles – Define the Actors and Transactions to implement the Integration Profiles

5. IHE Classroom Sessions – RSNA 2003 Scope of National IHE Initiatives North America – Europe – Asia National Healthcare Specializations – Define specific information for the National Healthcare System: Policies, Practices and Information in Native Languages based on DICOM (Latin1, ISO-2022) and HL7 national Patient management, using additional segments: ZFU, ZBE,… Developing Testing and Simulation Tools: MESA – Peer-to-Peer Testing based on Global & National Framework Connectathon – Multi Vendor Testing: – Testing Integration Solution based on the Global & National Framework Demonstrations, Education and Success Stories in each country

6. IHE Classroom Sessions – RSNA 2003 RIS HIS PACS acquisition in progress / completed acquisition in progress / completed IHE Success – Closing the Loop

7. IHE Classroom Sessions – RSNA 2003 IHE Success – Integration Profiles Patient Information Reconciliation Reconcile Worklists, Status and Data Objects For Unknown Patients and Demographics Changes Access to Radiology Information Consistent access to images and reports Consistent Presentation of Images Create, store, manage, retrieve & use objects for hardcopy and softcopy grayscale presentation states Key Image Notes Create, store, manage, retrieve & use objects to flag significant images Simple Image and Numericc Reports Create, store, manage, retrieve & use simple diagnostic reports with optional image links & Scheduled Workflow Presentation of Grouped Procedures Manage individual procedure image subsets from a multi-procedure acquisition for viewing & reporting Basic Security Charge Posting Collect and post timely billable procedure details Audit Trail Consolidation & Node Authentication Reporting Workflow Manage worklists, track status, perform & notify diagnostic reporting steps Evidence Documents Create, store, manage, retrieve & use objects to record study evidence Manage worklists, track status, perform & notify image processing & CAD steps Post - Processing Workflow Create, Store, Manage, Retrieve & Use Images Admission, Order Management, Scheduling, Store, Retrieve Manage Worklists, Track Status, Perform & Notify Acquisition Related Steps

8. IHE Classroom Sessions – RSNA 2003 Profiles Implementation: Actors & Transactions Examples of Actors:Examples of Actors: -ADT / Patient Registration -Scheduler (Order Filler) -Acquisition Modality -Image Display -Report Reader Examples of Transactions:Examples of Transactions: -Register Patient -Update Procedure -Procedure Scheduled -Images Stored -Query / Retrieve Images -Query / Retrieve Reports

9. IHE Classroom Sessions – RSNA 2003 International IHE Initiatives IHE North America IHE Europe – IHE-FFrance – IHE-DGermany – IHE-IItaly – IHE-UKUnited Kingdom – IHE-NNorway(Starting) – IHE-DKDenmark(Starting) – IHE-SSweden(Considers Participation) – IHE-NLHolland(Considers Participation) IHE Asia / Oceania – IHE-JJapan – IHE-PRCChina – IHE-KRKorea

10. IHE Classroom Sessions – RSNA 2003 IHE Organizational Structure Multi-Domain & Multi-National IHE Europe IHE North America IHE Asia / Oceania Participants supervises reports contribute Delegates IHE (International) Strategic Development Committee Global Development: Radiology, IT Infrastructure, Cardiology, Lab, etc. Regional & National Deployment IHE Domain-related Planning and Technical Committees Sponsor Co-Chairs Global Interoperability

11. IHE Classroom Sessions – RSNA 2003 IHE Radiology Profiles Patient Information Reconciliation Reconcile Worklists, Status and Data Objects For Unknown Patients and Demographics Changes Access to Radiology Information Consistent access to images and reports Consistent Presentation of Images Create, store, manage, retrieve & use objects for hardcopy and softcopy grayscale presentation states Key Image Notes Create, store, manage, retrieve & use objects to flag significant images Simple Image and Numericc Reports Create, store, manage, retrieve & use simple diagnostic reports with optional image links & Scheduled Workflow Presentation of Grouped Procedures Manage individual procedure image subsets from a multi-procedure acquisition for viewing & reporting Basic Security Charge Posting Collect and post timely billable procedure details Audit Trail Consolidation & Node Authentication Reporting Workflow Manage worklists, track status, perform & notify diagnostic reporting steps Evidence Documents Create, store, manage, retrieve & use objects to record study evidence Manage worklists, track status, perform & notify image processing & CAD steps Post - Processing Workflow Create, Store, Manage, Retrieve & Use Images Admission, Order Management, Scheduling, Store, Retrieve Manage Worklists, Track Status, Perform & Notify Acquisition Related Steps

12. IHE Classroom Sessions – RSNA 2003 Global IHE Radiology Technical Framework – Volumes I, II, III IHE Radiology Technical Framework Volumes I, II, III Contain Definitions for the Overall Integration of Healthcare Systems: – HIS – RIS – PACS – Workstations – Acquisition Modalities – Printers

13. IHE Classroom Sessions – RSNA 2003 National IHE Extensions Technical Framework – Volume IV Process for Developing National Extensions Scope of National Extensions in IHE Radiology: – Character Set for National Languages – Translations of IHE Concepts and Data Fields into National Languages – Extension of Patient and Provider Information According to National Policies (Privacy, Confidentiality, …) – Financial Information and Transactions for the Specific National Health Reimbursement System – Clinical Workflow Optimization and Information Access to Support the National Care Practices and Policies

14. IHE Classroom Sessions – RSNA 2003 IHE North America Connectathon – October 2003 – 37 vendors – 15 countries IHE Europe Connectathon – March 2003 – 44 vendors – 9 countries IHE Japan Connectathon for Asia & Oceania – February 2004 Testing & Verification by National IHE Initiatives

15. IHE Classroom Sessions – RSNA 2003 IHE Japan – Main events Connectathon in February/March 2004 Demonstration at JRC April 8-10 2004 in Yokohama Showing the IHE Radiology Integration Profiles: – Scheduled Workflow (SWF) – Patient Information Reconciliation (PIR) – Consistent Presentation of Images (CPI) – Simple Image & Numeric Reports (SINR) New IHE Domain to Develop the Technical Framework for Endoscopic and Physiological Examination Analyze the Cardiology Workflow for Japan Analyze the Nuclear Medicine Workflow for Japan Develop IHE LAB National Extensions for Japan

16. IHE Classroom Sessions – RSNA 2003 IHE Europe – Main events Implemented the 1 st IHE LAB Integration Profile – Additional IHE Lab Integration Profiles Planned Implementing the IHE IT Infrastructure Integration Profiles: – Retrieve Information Display (RID) – Enterprise User Authentication (EUA) – Patient Identifier Cross-Reference (PIX) for MPI – Consistent Time (CT) IHE Europe Connectathon in Padova (Italy) in March 2004 Testing IHE RAD, ITI and LAB Profiles IHE Demonstrations in Europe in 2004: – IHE-FHôpital Expo – IHE-FJFR – IHE-DDRK – IHE-DMEDICA – IHE-ISIRM – IHE-UKUKRC – IHE-UKHCC

17. IHE Classroom Sessions – RSNA 2003 Benefits of Multi-National IHE Developments Availability of Products Tailored to Address Specific National Needs:  National Character Sets  National Privacy and Confidentiality Policies Facilitate Integration and Workflow Optimization to Accommodate Specific National Policies:  Regional Care Practices  National Health Reimbursement System User Benefits

18. IHE Classroom Sessions – RSNA 2003 Benefits of Multi-National IHE Developments Rationalizing Product Design to Address Global and Regional Requirements Better Product Positioning on the International Market Avoiding Localization Problems in Installations Vendor Benefits

19. IHE Classroom Sessions – RSNA 2003 IHE in an International Context Panel Discussion IHE – The Global Integration Solution  IHENorth America: http://www.rsna.org/IHEor http://www.himss.org/IHE  IHEEurope: http://www.IHE-Europe.org  IHEFrance: http://www.gmsih.fr/fr/som_comm.htm  IHEGermany: http://www.IHE-D.org  IHEItaly: http://www.rad.unipd.it/IHE  IHEUK: http://www.IHE-UK-org  IHEJapan: http://www.jira-net.or.jp/ihe-j/en/index.html Dr. Okazaki IHE Japan Ellie Avraham Eastman Kodak Dr. Nikolaus Wirsz Siemens Medical Solutions Geert Claeys Agfa-Gevaert NV