1September, 2005 What IHE Delivers

Lloyd Hildebrand, M.D., American Lloyd Hildebrand, M.D., American Academy of Ophthalmology, Medical Academy of Ophthalmology, Medical Information Technology Committee ChairInformation Technology Committee Chair

IHE Eye Care WebinarIHE Eye Care WebinarWhy IHE Eye Care?Why IHE Eye Care?

From a Business Point of View From a Business Point of ViewJune 6, 2006June 6, 2006

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AAO SupportAAO Support

Collaboration WG9

• Bringing users and vendors together

Standards DICOM

• Ophthalmic Photography• Ophthalmic Tomography

SNOMED• Convergent Ophthalmic Terminology Project

Interoperability Integrating the Healthcare Enterprise

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Integrating the Healthcare Enterprise (IHE) Eye Care Stimulates the integration of eye care information

resources Uses standards to communicate images and

patient data, i.e., DICOM Is part of a larger initiative across medicine,

Integrating the Healthcare Enterprise (IHE)

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Premise of IHE Eye CarePremise of IHE Eye Care

Standards Pre-requisite for multi-vendor interoperability Basis for fully electronic offices

Interoperability Seamless and secure exchange of patient information

electronically Fueled by federal government programs and funding

Market demand Requirements for interoperability because purchasers want

efficiency and quality

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Electronic Health RecordsElectronic Health Records

Electronic health records (EHR) vs. paper records Scheduled workflow Automatic demographics Automatic billing

Emphasis on electronic workflow between different office functions

Front office functions Patient registration / patient scheduling / order placing

Clinical functions Procedure scheduling Acquisition / Analysis Professional reporting

Back office functions Charge processing

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Modality WorkflowModality Workflow

Digital instrument records vs. film or paper

Emphasis on electronic workflow for storage and review of modality data

Clinical function of acquisition & analysis

Classic example: digital photography vs. film

Includes future multi-modality clinical management systems

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Vision of Office of the FutureVision of Office of the Future

Networking will use industry standards (IHE / DICOM / HL7)

Will look like offices of the present in other medical specialties

Radiology Cardiology Patient Care (adopting IHE now)

Customers will expect plug-and-play

If it doesn’t work, will want to return it

The future is here

Concept demonstrated at AAO 2005 IHE Eye Care Showcase Full electronic workflow at AAO 2006 IHE Eye Care Showcase

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Electronic WorkflowElectronic Workflow

The vision is full electronic workflow, eliminating the need for paper, film, or removable media to transfer information, and having patient care data anytime, anywhere.

This is made possible through implementation of industry-wide standards.

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President BushPresident Bush

Executive Order April 27, 2004 Incentives for use of health information

technology and establishing position of the National Health Information Technology Coordinator

Overall goal is the widespread adoption of interoperable electronic health records within 10 years

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Vision of National Interoperable HITVision of National Interoperable HIT

Information available at the time and place of care

Improves quality, reduces errors, and advances evidence-based medical care

Reduces costs resulting from inefficiency, errors, incomplete information

Improves coordination of care and information among providers

Ensures that patients' individually identifiable health information is secure

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US Government PolicyUS Government Policy

Goal to increase efficiency of healthcare administration

Policy to encourage development of nationwide electronic healthcare records

Funding for government healthcare facilities to implement EHR

Strong participation by government agencies in industry standards efforts

Government healthcare facilities require networking solutions

VistA Office project funded by US government

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US Government FundingUS Government Funding

$3,300,000 awarded to American National Standards Institute (ANSI) to convene the Health Information Technology Standards Panel (HITSP).

HITSP will develop, prototype, and evaluate a harmonization process for achieving a widely accepted and useful set of health IT standards that will support interoperability among health care software applications

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StandardsStandards

Standards are fundamental to success of widespread interoperability

Many standards for health information exchange exist, but variations and gaps hinder interoperability and the widespread adoption of health IT

IHE provides a common framework for passing health information seamlessly through developing solutions for integration problems

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imagesstored

imagesretrieved

report

Scheduled Workflow ProfileScheduled Workflow Profile

Orders Filled

report

Workstation

Modality

acquisitionacquisitionin-progressin-progressacquisitioncompleted

acquisitioncompleted

EMR

PMS

procedurescheduled

Image Manager& Archive

StorageServer

Orders Placed

ReportRepository

Registration

AcquisitionModality

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Benefits to IHE ParticipantsBenefits to IHE Participants

Manufacturers/Vendors Align product interoperability with industry

consensus Decreased cost and complexity of interface

installation and management Focus competition on functionality/service space,

not information transport space, thus reducing costs in the long run

Produce devices that meet customers’ demands for interoperability and connectivity

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Benefits to IHE ParticipantsBenefits to IHE Participants

Clinicians Improved workflow Information when and where needed Fewer opportunities for errors Fewer tedious tasks/repeated work Improved report turn around time Increased efficiency overall Increased quality of care

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**HIMSS web-based survey in data collection in November 2004 – 163 participants

6%

14%

18%

28%

35%

Fewer Point-to-PointInterfaces

Improved Use of Data

Enhanced PatientSafety

Improved Access toData

Improved ClincalWorkflow

2005 IHE Survey Results2005 IHE Survey Results

Potential benefits of IHE Improved clinical workflow + access of data = 63%

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**HIMSS web-based survey in data collection in November 2004 – 163 participants

22%

30%

52%

56%

Other

Increased Sales

Technical Framework ProvidesInformation to Marketing Staff

Reduced Deployment Costs

2005 IHE Survey Results2005 IHE Survey Results

Benefits of IHE in products Reduce deployment costs

= 56%

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Success depends on interoperabilitySuccess depends on interoperability

Clinicians and providers need confidence that the EHR will consistently support clinical information

Patients need confidence that the most current information is available and reusable

Vendors need confidence that providers will be satisfied

Healthcare policy and payers need confidence that quality and efficiency will improve

IHE is a foundational component of the Healthcare Information Technology Standards Panel (HITSP) standards harmonization activities

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Effective bridge between information exchange standards

and their practical usein eye care

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SummarySummary

Standards are a pre-requisite for multi-vendor interoperability

Standards will fuel the transition to fully electronic offices within the next 5 years

IHE Eye Care is the vehicle to implement standards and enable interoperability in the ophthalmic marketplace Derive savings to the manufacturers Produces desired results for the purchasers Propels eye care into the electronic age