June 2006What IHE Delivers 1 IHE Eye Care Year 1 IHE Workshop Changing the Way Healthcare Connects IHE Eye Care Education Mike Schmidt, Carl Zeiss Meditec Co-Chair IHE Eye Care Planning Committee Jim Riggi, CTO Medflow, Inc. Co-Chair IHE Eye Care Technical Committee

June Introducing IHE Eye Care Targeting all eye care providersTargeting all eye care providers Ophthalmology and OptometryOphthalmology and Optometry Roots in DICOM WG9 (Ophthalmology)Roots in DICOM WG9 (Ophthalmology) OP and Stereo modules approvedOP and Stereo modules approved OTM and Refractive SR work items in progressOTM and Refractive SR work items in progress AAO is the sponsoring organizationAAO is the sponsoring organization Dr. Flora Lum, AAO, coordinatorDr. Flora Lum, AAO, coordinator Don Van Syckle, DVS ConsultingDon Van Syckle, DVS Consulting Planning CommitteePlanning Committee Mike Schmidt, Carl Zeiss MeditecMike Schmidt, Carl Zeiss Meditec Dr. Mark Horton, U.S. Indian Health ServicesDr. Mark Horton, U.S. Indian Health Services Technical Committee co-chairsTechnical Committee co-chairs Jim Riggi, MedflowJim Riggi, Medflow Peter Kuzmak, U.S. Dept. of Veteran AffairsPeter Kuzmak, U.S. Dept. of Veteran Affairs

June Vendor Participants in IHE Eye Care 2005

June Introducing IHE Eye Care Participating commercial vendors includeParticipating commercial vendors include Instrument vendorsInstrument vendors PMS / EHR system vendorsPMS / EHR system vendors Imaging system vendorsImaging system vendors Strong government participationStrong government participation Addition of EHR vendors in 2006 is keyAddition of EHR vendors in 2006 is key

June IHE Eye Care – Plan for 2006 Informal Efforts 2005Informal Efforts 2005 Participation at HIMSS IHE Showcase: February 2005Participation at HIMSS IHE Showcase: February 2005 Participation at VEHU Showcase:May 2005Participation at VEHU Showcase:May 2005 AAO Showcase: October 2005AAO Showcase: October 2005 Development ScheduleDevelopment Schedule Planning Committee decision:October 2005Planning Committee decision:October 2005 Issue Public Comment version: March 2006Issue Public Comment version: March 2006 Public Comment Due:April 2006Public Comment Due:April 2006 Issue Trial Implementation version: May 2006Issue Trial Implementation version: May 2006 Connectathon: October 2006Connectathon: October 2006 AAO Showcase: November 2006AAO Showcase: November 2006 Year 1 ProfilesYear 1 Profiles Eye Care Scheduled Workflow (EYECARE)Eye Care Scheduled Workflow (EYECARE) Charge Posting (CHG)Charge Posting (CHG) Eye Care Evidence Documents [ECED]Eye Care Evidence Documents [ECED]

June Ophthalmic Workflow Use Cases Derived from Cardiology Workflow use cases C1 – C5 Derived from Cardiology Workflow use cases C1 – C5 Year 1 use cases: Year 1 use cases: Will add emergency use cases later, similar to C3 – C5 Will add emergency use cases later, similar to C3 – C5 Order Placement Patient Registration Order Placed at Order Placer Order Placed at Order Filler Patient Registered at ADT Case E1Case E2

June IHE Eye Care Transactions Extensively reusing RAD and CARD transactionsExtensively reusing RAD and CARD transactions Storage Commitment w/intermittently connected modality option [CARD-3]Storage Commitment w/intermittently connected modality option [CARD-3] Adding EYECARE transactionsAdding EYECARE transactions Query Modality Worklist [EYECARE-1]Query Modality Worklist [EYECARE-1] Modality Images/Evidence Stored [EYECARE-2]Modality Images/Evidence Stored [EYECARE-2] Retrieve Images [EYECARE-3]Retrieve Images [EYECARE-3] Query Evidence Documents [EYECARE-4]Query Evidence Documents [EYECARE-4] Example Issue: Query Modality WorklistExample Issue: Query Modality Worklist Glaucoma progression analysis requires longitudinal dataGlaucoma progression analysis requires longitudinal data Instruments consequently provide persistent storageInstruments consequently provide persistent storage EYECARE-1 ensures that Issuer of ID is mandatory in worklistEYECARE-1 ensures that Issuer of ID is mandatory in worklist Will be used to determine identity of patient recordWill be used to determine identity of patient record Will allow updates / corrections of patient demographicsWill allow updates / corrections of patient demographics

June EYECARE-1 Query Modality Worklist Both Query Modes must be supported Both Query Modes must be supported Patient QueryPatient Query Broad QueryBroad Query Mandatory Issuer of ID Glaucoma progression analysis requires longitudinal dataGlaucoma progression analysis requires longitudinal data Instruments consequently provide persistent storageInstruments consequently provide persistent storage Will be used to identify patient recordsWill be used to identify patient records Will allow updates / corrections of patient demographicsWill allow updates / corrections of patient demographics

June EYECARE-2 Modality Images/Evidence StoredModality Images/Evidence Stored Eyecare Image OptionsEyecare Image Options Encapsulated PDFEncapsulated PDF

June EYECARE-3 Retrieve ImagesRetrieve Images Eye Care SOP classesEye Care SOP classes OP (Ophthalmic Photography)OP (Ophthalmic Photography) US for ophthalmic ultrasound devicesUS for ophthalmic ultrasound devices Enc PDF for post-processed evidence documentsEnc PDF for post-processed evidence documents Represent post-processed evidence documentsRepresent post-processed evidence documents Like cardiology, also created by Acquisition ModalityLike cardiology, also created by Acquisition Modality Significant clinical utilitySignificant clinical utility Extensive modality support is key to IHE Eye Care acceptanceExtensive modality support is key to IHE Eye Care acceptance CompressionCompression

June IHE Eye Care Modality Coding Issue Only OP and US modality codes are definedOnly OP and US modality codes are defined DICOM correction proposal to add other modality codesDICOM correction proposal to add other modality codes Based on prior work within DICOM WG9Based on prior work within DICOM WG9 Draft proposal already distributed to WG9Draft proposal already distributed to WG9 Fast-track March review in WG9 and submit to WG6Fast-track March review in WG9 and submit to WG6

June Query Evidence Documents DICOM Encapsulated PDF EYECARE-4

June IHE Eye Care Planning 1.Support new DICOM IODs a.Ophthalmic Tomography b.Refractive SRs 2.Additional DICOM IODs needed – work for DICOM WG9 a.Ophthalmic visual testing / perimetry b.Ophthalmic mapping / topography 3.Non-scheduled use cases C3-C5 (See IHE Cardiology) 4.Context sharing a.Enterprise User Authentication (EUA) b.Patient Synchronized Applications (PSA) 5.Post-processing a.Scheduled post-processing workflow (PWF)

June