September, 2005What IHE Delivers 1 Contributing Authors: John Donnelly, Tim Becker, Harry Solomon Edited by Bryan Jennings, Medical Micrographics Retrieve ECG for Display Profile

2 ECG Needs ECGs Accessible Everywhere! Need broad distribution of ECGs using ubiquitous technology (Web).  Allow medical applications to easily retrieve and display ECGs in a platform/vendor neutral way. High-quality ECG documents. Avoid artifacts on zoomed ECGs and arbitrary display geometries.  Vector images required (not rasterized) Facilitate apps for serial comparison (side- by-side synchronized display).

3 Original Goal for Profile High ROI — value added problem solutions Standards in place (HTTP, PDF, SVG) No “political” challenges – just technical Restricted scope for a “quick win” Leverage IHE IT Infrastructure

4 RED Profile Scope Reused IHE-ITI RID as it existed:  Retrieve list of cardiology documents, including ECGs in ready-to-display format (HTML)  Retrieve single document, including an ECG  ECGs served in ready-to-display formats (PDF, SVG)  Compatibility with existing RID clients

5 RED Scope (cont.) Make ECG-specific extensions to RID  Place requirements on ECG source to ensure high-quality ECG documents.  Add ECG-specific request for list of ECGs to be returned as XML allowing more client flexibility.  Add SVG (vector graphics) as allowed ECG document format.

6 PDF ECG Source required to support PDF so it is compatible with existing RID clients. PDF is a common document type and most computers already have a viewer. ECG Source required to use vector graphics for waveforms in PDF.  Gives high quality line drawings at any screen resolution and zoom factor.  Rasterized (e.g. scanned, bitmapped) ECG “images” not allowed.

7 Example ECG in PDF Format

8 SVG Scalable Vector Graphics – “XML Graphics for the Web” – a W3C standard. Well suited for line drawings (e.g. waveforms) in a XML/Web environment. Currently supported through web browser plug-ins. Allows scripting to enable advanced user- side display control.

9 Example ECG in SVG Format

10 Serial Comparison Example

11 ECG Profile Actors Display – A system that can request and display preformatted (“presentation-ready”) data using Web technologies. Information Source – A system that responds to requests for patient-related ECG data by encoding it in a presentation-ready format using Web technologies. Same actors as RID Profile

12 ECG Profile Transaction Diagram Display Information Source Retrieve Specific Info for Display [ITI-11] Retrieve ECG List [CARD-5] Retrieve ECG Document for Display [CARD-6]

13 Use Case D1: Simple Display Display actor requests list of ECG documents for a specific patient ID.  RID profile SUMMARY-CARDIOLOGY request returns list as HTML.  ECG profile SUMMARY-CARDIOLOGY-ECG request returns list as XML with stylesheet. Display actor requests a specific ECG document using a unique document ID.  The ID of the requested document may not have been obtained from the previously retrieved list.

14 Example List as HTML

15 ECG List XML Example (1/3)

16 ECG List XML Example (2/3)

17 ECG List XML Example (3/3)

18 ECG List XML Example Formatted with Style sheet

19 More information…. IHE Web site: Technical Frameworks, Supplements Cardiology Technical Framework Cardiology Technical Framework IT Infrastructure Technical Framework IT Infrastructure Technical Framework ECG XML List Schema and examples ECG XML List Schema and examples Non-Technical Brochures : Calls for Participation Calls for Participation IHE Fact Sheet and FAQ IHE Fact Sheet and FAQ IHE Integration Profiles: Guidelines for Buyers IHE Integration Profiles: Guidelines for Buyers IHE Connect-a-thon Results IHE Connect-a-thon Results Vendor Products Integration Statements Vendor Products Integration Statements

20 Providers and Vendors Working Together to Deliver Interoperable Health Information Systems In the Enterprise and Across Care Settings W W W. I H E. N E T