Integration Profiles - Overview Integrating the Healthcare Enterprise G. Claeys Agfa Healthcare R&D, Technology Manager Vendor co-chair IHE Europe Courtesy

Integration Profiles - Overview

Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise

G. ClaeysAgfa Healthcare R&D, Technology Manager

Vendor co-chair

IHE Europe

Courtesy of IHE Committees

7 February 2005 IHE Europe Educational Event2

Integration Profiles - ObjectiveIntegration Profiles - Objective

Address real-world interoperability problems (bottom-up approach)

Leverage same integration solutions over multiple domains (top-down) Generalized solutions Example : Scheduling exams, display `exam results

Integration Profiles are orthogonal IPs are independent of each other Applications may combine multiple Integration Profiles

• E.g. Information access + security


Integration Profile - structureIntegration Profile - structure

Referenced standard (HL7) Detailed

messaging info --------------------------Roles

Integration Profile

Actor Actor Actor…

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Solves an Integration Problem: A collection of real world information exchange capabilities supported by a set of specific Actors using Standards-based Transactions


IHE RoadmapIHE Roadmap

CardiologyCardiologyLabora-Labora-ttoryory

Pharmacy,…..Pharmacy,…..RadiologRadiologyy

Patient Identifier Linkage, Registries, SecurityPatient Identifier Linkage, Registries, Security

Access to clinical information; Electronic Health RecordAccess to clinical information; Electronic Health Record

Other (e.g. Acces Control, eHealthWorkflows)Other (e.g. Acces Control, eHealthWorkflows)

Patient ManagementPatient Management

Order ManagementOrder Management


IHE

EHR- Longitudinal Record

IHE Cardiology

IHE Laboratory

IHE Radiology

IHE

Future Domain

IHE

Future Domain

IHE

IT Infrastructure Intra-Enterprise

Cross-Enterprise

1 Integration Profile

3 New Integration Profiles

5 Existing / 4 New

Integration Profiles

12 Existing / 2+2 New

Integration Profiles

IHE ScopeIHE Scope


IHE Radiology – Focus PointsIHE Radiology – Focus Points

Streamline the workflow sub-processes Upstream : Patient ADT – Ordering – Data creation & processing Downstream : Reporting – Treatment – Billing Exception management : e.g. update unknown patient IDs

Quality control Consistent presentation of images on displays & printers

Improve communication with referring physicians Access to information, generated in radiology (images, reports) Image notes (post-its)

Improve machine-machine communication (automatic processing) Structured reports Measurements and coded data

Security : Adhere to (parts of) existing Security&Privacy regulation authentication, auditing

Off-line medium distribution (new)


PatientInformation

Reconciliation

ReconcileWorklists,

Statusand

Data Objects For

UnknownPatients

andDemographics

Changes

Access to Radiology Information

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

ChargePosting

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 &

UseImages

Admission, Order Management, Scheduling, Store, Retrieve

ManageWorklists,

Track Status,Perform &

NotifyAcquisition

Related Steps

Radiology – Integration ProfilesRadiology – Integration Profiles

New

NMImage

Portable Data for ImagingNew


IHE IT Infrastructure – Focus PointsIHE IT Infrastructure – Focus Points

Enterprise interoperability issues, common to multiple departments

Improve information consistency among applications & departments : Cross referencing patient IDs among hospitals (MPI) Patient synchronisation of multiple desktop applications

Simple access to patient’s clinical information from workstations and browsers Reports, images,

Simple access to administrative information of patient and staff Patient’s demographic information, personnel directory

Security : Single sign-on (shared user context) Centralized user management Audit trails on enterprise level

Sharing of clinical information among healthcare providers (e.g. regional health networks)


IT Infrastructure – Integration ProfilesIT Infrastructure – Integration Profiles

Enterprise User AuthenticationEnterprise User Authentication

Provide users a single nameand centralized authentication

processacross all systems

Retrieve Information for Display

Access a patient’s clinical information and documents in a

format ready to be presentedto the requesting user

Retrieve Information for Display

Access a patient’s clinical information and documents in

a format ready to be presented

to the requesting user

Patient Identifier Cross-referencing

for MPIMap patient identifiers

across independent identification domains

Patient Identifier Cross-referencing for

MPI

Map patient identifiers across independent

identification domains

Synchronize multiple applications on a desktop to the

same patient

Patient Synchronized Applications

Consistent TimeCoordinate time across

networked systems

Audit Trail & Node Authentication

Centralized privacy audit trail and node to node authentication

to create a secured domain.

New

Patient Demographics Query New

Personnel White PageAccess to workforcecontact information

New

Cross-Enterprise Document Sharing

Registration, distribution and access across health enterprises of clinical

documents forming a patient electronic health record

New


IHE Laboratory – Focus PointsIHE Laboratory – Focus Points

Leverage schedule workflow of radiology

Ordering, scheduling and performing clinical laboratory tests

Support specimen testing on the point of care or on the patient’s bedside

Delivering the observation results to the medical staff, at various steps of validation.

Manage the sequence of operations of automated lab equipment E.g. analyzers, robotic decappers, centrifuges, conveyors

All specialties working on specimen, not on the patient itself.


Laboratory IHE Integration ProfilesLaboratory IHE Integration Profiles

Laboratory Device Automation (LDA)

In Process –TI Nov 2004In Process –TI Nov 2004

Pre-analytic process, analysis and post-analytical treatment

Laboratory Scheduled Workflow (LSWF)Completed in 2003Completed in 2003

Tests performed by a laboratory for an identified

inpatient or outpatient

Laboratory Patient Information Reconciliation (LPIR) In ProcessIn Process

Tests performed on an unidentified or misidentified patient

Laboratory Code Set Distribution (LCSD) In ProcessIn Process

Sharing the batteries and tests code sets throughout the enterprise

Laboratory Point Of Care Testing (LPOCT) In Process –TI Nov 2004In Process –TI Nov 2004

Tests performed on point of care or patient’s bedside


IHE Cardiology – Focus PointsIHE Cardiology – Focus Points

Leverage “schedule workflow” (radiology) for cath lab and echocardiography

Leverage “retrieve for display” for ECG’s

Differences with radiology :

Echo cardio modalities are not always on-line Ad-hoc scheduling is the rule, not the exception Time synchronization among multiple modalities


IHE Cardiology – Integration ProfilesIHE Cardiology – Integration Profiles

Cardiac Catheterization Workflow

NewEchocardiography

Workflow

NewRetrieve ECG for Display Integration Profile (RED)

Provide ECGs and related documents to

enterprise

New


Example ECG in SVG FormatExample ECG in SVG Format


ConclusionConclusion

Leverage existing IHE Integration Profiles in different domains

Multi-year roadmap of IHE Integration Profiles per domain

IT Infrastructure address enterprise level integration issues


More information….More information….

IHE Web sites: • www.ihe.net• http://ihe-europe.org• http://www.rsna.org/IHE• http://www.acc.org/quality/ihe.htm• http://ihe-nl.org

Technical Frameworks:• ITI V1.0, RAD V5.5, LAB V1.0, CARDIO V1.0

Non-Technical Brochures :• IHE Europe Business Case• IHE Fact Sheet and FAQ• IHE Integration Profiles: Guidelines for Buyers• IHE Connectathon Results• Vendor Products Integration Statements