Integrating the Healthcare Enterprise

1
Integrating the Healthcare Enterprise

• The IHE Initiative Worldwide

• Nikolaus Wirsz, PhD Siemens Medical Solutions
  IHE Radiology Planning Committee
• Geert Claeys Agfa-Gevaert NV IHE Europe
  Committee Industry Co-Chairman
• Hee-Joung Kim, PhD Yonsei University Medical
  Center IHE Korea Committee Chairman
• David Koff, MD Sunnybrook and Women's College,
  Toronto IHE Canada Committee
• Hidenori Shinoda Toshiba Medical Systems
  Corporation IHE Japan Committee Co-Chairman
• Prof. Jenn-Lung Su, PhD Chung Yuan Christian
  University IHE Taiwan Committee President
  Medical Image Standards Association of Taiwan

2
Challenges of Integration

• Integration Solutions Available Today
  fromMedical Systems Vendors BUT ...
• Modern Healthcare Enterprises in All Countries
  Are Still Confronted with Problems(In Spite of
  IT Standards and Advanced Technology)
• Lack of Access to Complete Medical Information
• Inconsistent Medical InformationAcross
  Departments and Institutions
• Inadequate Communicating of Medical DataAcross
  Multiple Systems from Different Vendors
• Risky Investments in Proprietary Solutions

3
The IHE Initiative

• An Incremental Multi-Year ProjectLaunched in
  1998 by RSNA HIMSS
• Enhance the Access to Clinical Information
• Ensure Continuity and Integrity of Patient
  Information
• Speed Up the Integration in Healthcare
  Environments
• Foster Communication Between Vendors ofMedical
  Information Technology
• Prove that Integration is Attainable Based on
  Standards
• Participants
• Representatives of Healthcare Providers
• Information Systems Vendors
• Imaging Systems Vendors
• Standardization Groups

4
HIMSS / RSNA IHE Kick-Off Workshop October 13-14,
1998
5
IHE Progress Years 1 6 (1999 2004)

• Year 1 Proof of Concept in 1999
• Defined General Integration Model IHE Actors
  IHE Transactions
• Basic Scheduled Workflow Admission ? Ordering ?
  Scheduling ? Acquisition ? Storage
• Successful Demonstration
• 24 Companies
• 35 Systems
• Year 2 Integration Profiles Introduced in
  2000 (Solutions to Real-World Problems)
• Patient Information Reconciliation (Patient Data
  Updates, Patient Merge)
• Access to Radiology Information (Access to
  Images, Reports)
• Consistent Presentation of Images (Uniform
  Presentation on Hard/Soft Copies)
• Presentation of Grouped Procedure (Manage Subsets
  of a Single Acquisition)
• Simple Image Numeric Reports (Exchange of
  Report Data)
• Key Image Notes (Flag Relevant Images)
• Increased Industry Participation
• 30 Companies
• 58 Systems

6
IHE Progress Years 1 6 (1999 2004)

• Year 3 Consolidation in 2001
• Catching Up with Product Implementations
• Growing Industry Participation
• 31 Companies
• 70 Systems
• 21 Companies in Europe
• Expansion to France
• Year 4 New Integration Profiles in 2002
• Post-Processing Workflow (Image Processing,
  Reconstruction, CAD)
• Charge Posting (Billing Transactions)
• Basic Security (Audit Trails Node
  Authentication)
• Increased Industry Participation
• 35 Companies
• 73 Systems
• 43 Companies in Europe
• Driving Market Adoption IHE User Success Stories
• Expansion to Germany, Italy and Japan
• Expansion Beyond Radiology

7
IHE Progress Years 1 6 (1999 2004)

• Year 5 New Integration Profiles in 2003
• Extended Archiving (Multiple PACS / Archives)
• Evidence Documents (Measurements / Procedure Logs
  / CAD Results)
• Reporting Workflow (Interpretation /
  Transcription Worklists)
• Connectathons Demonstrations in North America,
  Europe and Japan
• 60 Participating Vendors
• 100 Systems
• Expansion to UK
• Launching IHE in Cardiology
• Year 6 New Integration Profiles in 2004
• Nuclear Medicine Integration (Addressing NM
  Specific Needs)
• Portable Data for Imaging PDI (Exchangeability
  of Data on CD Media)
• Distributed Demonstration in Vendor Booths
• Sample CD Available On Site for RSNA 2004
  Attendees
• Interactive Hands-On Demonstration Exhibit in
  infoRAD (RSNA 2004)
• Expansion to Scandinavia (Norway, Denmark,
  Sweden) Canada Korea Taiwan

8
Outlook IHE Year 7 (2005)International
Development Plans

• Additional Global Integration Issues
• Teaching Files Tools for Medical Education and
  Clinical Investigations
• Integration with Legacy Systems Guidelines on
  Introducing IHE in Installed Bases
• Cross-Domain Cooperation Common IHE Integration
  Issues in Radiology, Cardiology, IT
  Infrastructure
• Exploring Cross-Enterprise Images Sharing
  Access to Radiology Information Across Systems,
  Departments and Institution Boundaries
• Publishing an IHE Deployment Handbook
  Guidelines for Users and Purchasers in
  Acquiring IHE-Based Products
• Input from International IHE Initiatives is
  Encouraged

9
IHE Success Integration ProfilesSolutions to
Real-World Problems in Radiology
10
IHE Success Integration ProfilesSolutions to
Real-World Problems in IT Infrastructure
11
IHE SuccessAdvancing IHE Beyond Radiology

• Clinical Domains with IHE Developments
• Radiology
• Started in 1998
• Deployment in North-America, Europe and Asia
• IT Infrastructure
• Started 2003
• Deployment in North-America and Europe
• Cardiology
• Started 2004
• Deployment in North-America and Europe
• Laboratory
• Started 2003
• Driven by IHE-Europe and IHE-Japan
• Radiotherapy
• Considers Starting in 2005

12
Integration is Needed Everywhere

• Integration, Interoperability and Workflow
  Optimization are Global Issues NOT Local Needs
• IHE has had an international vision from the
  beginning
• IHE is promoting its adoption worldwide
• IHE encourages the formation of national and
  regional initiatives to address local healthcare
  needs

13
International Scope of the IHE Initiative

• Providing a Global Integration Framework
• Identify Common Integration Requirements
• Define Generic Solutions (Integration Profiles)
  to Solve Real-World Problems
• Specify the Details for Implementing the IHE
  Solutions
• Selection of Established Standards for Specifying
  Systems Functionality and Transactions for
  Information Exchange (e.g. DICOM, HL7, )
• Providing a Generic Technical Framework to
  Address the Vast Majority of Implementation Issues

14
National Scope of the IHE Initiatives inNorth
America Europe Asia

• Address Specific Needs of National Healthcare
  Systems According to
• Local Policies and Practices
• Support for Native Languages
• National Reimbursement Procedures
• Manage Regional Cross-Vendor Tests
  (Connectathons)
• Organize Demonstrations at National Venues
• Promote IHE User Success Stories of Local Sites
• Organize Educational Events to Raise Awareness
  and Acceptance of IHE

15
The IHE Radiology Technical Framework
Addressing Global National Integration Needs

• Common Definitions Overall Integration in
  Healthcare
• High-Level Description of Integration Profiles
  Volume I
• Detailed Implementation Specification Volumes
  II and III
• National Extensions Volume IVExamples
• Character Sets for National Languages
• Extensions of Patient and Provider Information
  According toNational Policies (Privacy,
  Confidentiality, )
• Financial Information and Transactions
  forSpecific National Health Reimbursement System
• Clinical Workflow Optimization and Information
  Access toSupport National Care Practices and
  Policies

16
IHE Organizational Structure
17
Participating and Contributing Vendors (America)
Procom Philips Medical Systems RASNA Imaging
Systems Sectra Sentillion Siemens Medical
Solutions Softmedical Stentor, Inc StorCOMM,
Inc Swissray International, Inc Tiani Medgraph
AG Toshiba America Medical Systems UltraVisual
Medical Systems Vital Images, Inc. Voxar
Limited WebMD XIMIS
GE Healthcare Heartlab Hitachi Medical
Corporation Hologic, Inc IDX Systems
Corporation IMCO Technologies InSiteOne INFINITT K
onica Minolta Marotech, Inc. McKesson Information
Solutions Medcon Medical Manager Health
Systems Mediface Co., Ltd. Merge eFilm Mortara

• Agfa HealthCare
• Algotec Systems, Ltd.
• Berdy
• Camtronics
• Canon Medical Systems
• Carefx
• Cedara Software Corp.
• Cerner Corp.
• CSIST
• Dictaphone
• DR Systems
• Dynamic Imaging
• Eastern Informatics
• Eastman Kodak Company
• Emageon
• Eclipsys
• Fujifilm Medical Systems

In yellow, companies with IHE Committees Chairs
(Summer 2004)
18
Participating and Contributing Vendors (Europe)
AGFA Healthcare AISoftw_at_re Medical
Solutions Algotec ARES SA aycan Digitalsysteme
ConVis DEDALUS Dianoema Eastman Kodak Company
Ebit Sanita EDL ELFIN s.r.l. Engineering
Sanità Enti Locali ESAOTE ETIAM Ferrania
Fujifilm GE Healthcare GMD GIE
Convergence-Profils
GWI Research IASI Srl IdeoPass Image
Device-Cerner Company INFINITT INOVIT McKesson
MED2RAD MEDASYS SA Medavis Medigration GmbH
MEDIMON Ltd. MEDOS AG Merge eFilm METAFORA
Konica Minolta Europe Omnilab Philips Medical
Systems Rasna Imaging Systems RAYPAX INC.
Rogan-Delft Sago spa Sectra Imtec AB Siemens
Medical Solutions Soluzioni Informatiche srl
Stentor Inc. Swissray Medical AG Symphonie On
Line Synapsis TELEMIS S.A. TIANI MEDGRAPH AG
TOREX GAP Medical Toshiba Medical Systems TSI
groupe europMedica VEPRO AG VISUS Technology
Transfer WAID XR PARTNER
In yellow, companies with IHE Committees Chairs
(Summer 2004)
19
Participating and Contributing Vendors (Asia)
Japan AGFA Gevaert Japan EBM Japan INFINITT
Japan AT Canon Goodman Climb Medical
Systems Konica Minolta MG Shimadzu SONY Toshiba
Medical Systems Toyo Technica Nihon
Kohden Olympus NEC Pioneer (Marotech) Hitachi Hita
chi Medico Fujitsu Fuji Film Medical Yokogawa
Taiwan INFINITT Shing Shian INQ GEN TEP Tah Ya
Korea AGFA Korea GE Healthcare Korea INFINITT LG
CNS Marotech, Inc. Medical Standard Peoplenet
Communications Samsung SDS
20
International IHE Initiatives

• IHE Asia / Oceania
• IHE-J Japan
• IHE-KR Korea
• IHE-TW Taiwan
• IHE-PRC China (Considers Participation)
• IHE Europe
• IHE-F France
• IHE-D Germany
• IHE-I Italy
• IHE-N Norway
• IHE-NL Holland
• IHE-UK United Kingdom
• IHE-DK Denmark (Starting)
• IHE-S Sweden (Considers Participation)
• IHE-E Spain (Considers Participation)
• IHE North America
• IHE-USA United States

21
The IHE Initiative Worldwide
Panel DiscussionIHE The Global Integration
Solution

• Geert Claeys Agfa-Gevaert NV IHE Europe
  Committee Industry Co-Chairman
• Hee-Joung Kim, PhD Yonsei University Medical
  Center IHE Korea Committee Chairman
• David Koff, MD Sunnybrook and Women's College,
  Toronto IHE Canada Committee
• Hidenori Shinoda Toshiba Medical Systems
  Corporation IHE Japan Committee Co-Chairman
• Prof. Jenn-Lung Su, PhD Chung Yuan Christian
  University IHE Taiwan Committee
• Nikolaus Wirsz, PhD Siemens Medical
  Solutions IHE Radiology Planning Committee

• IHE North America http//www.rsna.org/IHE
• IHE Canada http//www.ihe-canada.com
• IHE Europe http//www.IHE-Europe.org
• IHE Japan http//www.jira-net.or.jp/ihe-j/en/ind
  ex.html
• IHE Korea http//www.ihekorea.org/
• IHE Taiwan http//www.dicom.org.tw