IHE Integrating the Healthcare Enterprise

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IHEIntegrating the Healthcare Enterprise

• General Overview (again once)
• Scheduled Workflow
• Patient Information Reconciliation
• Consistent Presentation of Images
• Key Image Notes
• How to deal with IHE-items
• Prof. Berthold B. Wein
• User co-chair IHE-Europe

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IHE short overview and scheduled workflow and
patient information reconciliation

• Prof. Berthold B. Wein, MD
• User co-chair IHE-Europe
• Praxisgemeinschaft Kapuzinerkarree
• University Hospital Aachen Germany

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Healthcare IT Main Obstacles

• Lack of financial funding
• IT 2.3 of hospital budget (in other industries
  2.8) Gartner
• Lack of national/regional guidelines incentives
• Lack of access to IT infrastructure
• Lack of solutions that meet clinical needs
• Lack of adequate healthcare IT standards and
  interoperability
• Integration cost 20 of hospital IT budget

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IHE Mission
IHE Integrating the Healthcare Enterprise

• Improve the quality and cost of healthcare by
  removing the interoperability barriers
• Continuity Integrity of Patient Information
• Clinical Workflow Optimization
• Provide an open interoperability framework, based
  on existing standards
• Enable cross-vendor environment
• Make life more easy for the users and vendors

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Benefits of IHE

• seamless information flow
• from system to system
• within and across departments
• within and across hospital borders
• access to all vital clinical data
• at the right time and at the right place
• workflow optimisation
• elimination of redundancies in data entry
• foster openess of products
• less problems in interoperability and
  understanding

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IHE is based on

• Technical framework
• The bible for interoperability, the hope for
  us/vndrs
• Connect-a-thon
• The real-life test of systems, the hell for
  products
• Demonstration
• The show to others, how it works
• Integration statements
• The advertising to users, enabling understanding
• Sucess
• The teaching by others

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IHE Members

• Users
• Clinicians, Medical Staff, Administrators, CIOs,
  
• Vendors
• Information Systems Imaging Equipment (80
  vendors)
• Societies Representing Healthcare Segments
• EAR, ECR, ESC, Other Professional Societies
• Governmental agencies
• e.g. GMSIH
• Active liaison with Standards Development
  Organizations (SDOs)
• HL7, DICOM, ASTM, others

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IHE TF Development Process
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IHE - Connect-a-thon
European
Application rather than protocol testing real life
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IHE - Demonstrations
First experiences with IHE-compliant
systems during hands-on trials on user congresses
F D I UK EUR
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IHE Integration Statement
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IHE Europa
National initiatives Well established F, D, I,
NL, GB In organisation DK, N, E beginning S
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Technical Framework

• Integration Profiles
• Practical solutions for daily-work integration
  problems
• Precise definitions of actors and transactions
• Exact requirements for open standards
• Conversion tables
• Defining correspondant fields
• Describing characteristics of the fields
• Use cases
• Depicting daily scenarios for easy understanding

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TF and IHE Domains

• Radiology
• Laboratory Medicine
• Information Technology Infrastructure
• Cardiology
• General practicioners
• Pathology
• Dermatology

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Integration Profiles

• Solving daily life problems by standards
• Exactly defining solutions and parts for
  succeeding in interoperability
• Reduce the problem to
• actors
• transactions
• therefore making it independent from real world
  limitations and offering a global strategy for
  solution

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Laboratory Medicine 2004-2005
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IHE IT Infrastructure 2004-2005
Personnel White Page
Access to workforcecontact information
Patient Demographics Query
Patient Synchronized Applications
Synchronize multiple applications on a desktop to
the same patient
Patient Identifier Cross-referencing for MPI
Patient Identifier Cross-referencing for MPI
Enterprise User Authentication
Provide users a single nameand centralized
authentication processacross all systems
Map patient identifiers across independent
identification domains
Map patient identifiers across independent
identification domains
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Radiology 2000-2005
Scheduled Workflow
Charge Posting
Presentation of Grouped Procedures
Reporting Workflow
Post- Processing Workflow
Patient Information Reconciliation
Consistent Presentation of Images
Simple Image and Numeric Report
Key Image Notes
Evidence Document
Access to Radiology Information
Basic Security
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Radiology 2000-2005
Charge Posting
Presentation of Grouped Procedures
Reporting Workflow
Post- Processing Workflow
Patient Information Reconciliation
Consistent Presentation of Images
Simple Image and Numeric Report
Key Image Notes
Evidence Document
Access to Radiology Information
Basic Security
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Radiology 2000-2005
Charge Posting
Presentation of Grouped Procedures
Reporting Workflow
Post- Processing Workflow
Patient Information Reconciliation
Consistent Presentation of Images
Simple Image and Numeric Report
Key Image Notes
Evidence Document
Access to Radiology Information
Basic Security
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Problems

• It is very hard to get the ball teed-up for the
  technologist on the modality.
• Paper based workflow with data re-entry
• Risk of error
• Inefficient
• Stale information
• Changes between time of print and time of data
  entry
• Cancel orders
• Generic Order / Order Changes
• After the tech wacks the ball, how do I let all
  systems know where it went.
• When are things ready to be read (PACS)
• When can things be deleted (Modality)
• How do I know what to bill (RIS)
• When do I wake up the referring physician

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Key IHE Concepts

• Generalized Systems gt Actors
• Interactions between Actors gt Transactions
• Problem/Solution Scenarios gt Integration
  Profiles

• For each Integration Profile
• the context is described (which real-world
  problem)
• the actors are defined (what systems are
  involved)
• the transactions are defined (what must they do)

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The Product World..
HIS
ADT
Poduct XYZfrom Vendor T
MPI
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The IHE World.
Actor
Actor
IHETransaction
IHETransaction
IHE Actor
Actor
IHE Actor
IHETransaction
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Mapping IHE to Products
Actor
HIS
Actor
ADT
Poduct XYZfrom Vendor T
IHETransaction
IHETransaction
IHE Actor
Actor
MPI
IHE Actor
IHETransaction
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Integration Profiles

• Easy to understand practical solutions for IT
  integration problems in daily life.
• Fostering the under-standing between users and
  vendors

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Integration Profiles
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Workflow involves several IHE Actors
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Scheduled Workflow
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IHE Scheduled WorkflowThe Connection side
RIS
PACS Archive
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Problems

• John Doe Trauma Clean-Up
• Recovering after Systems are Down
• Error in Manual Entry at Modality
• VIP and Getting Married

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Scheduled Workflow
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Thank you for your attention !