September, 2005What IHE Delivers 1 Mike Schmidt, Carl Zeiss Meditec IHE Eye Care Year 1

2 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

3 Vendor Participants in IHE Eye Care 2005

4 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

5 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 Ophthalmic Workflow (OPHTHALMIC)Ophthalmic Workflow (OPHTHALMIC) Charge Posting (CHG)Charge Posting (CHG) Evidence Documents [ED]Evidence Documents [ED]

6 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

7 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 Procedure Step Completed [EYECARE-2]Modality Procedure Step Completed [EYECARE-2] Modality Image/Evidence Stored [EYECARE-3]Modality Image/Evidence Stored [EYECARE-3] Retrieve Image [EYECARE-4]Retrieve Image [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

8 EYECARE-1Query Modality Worklist Require patient queryRequire patient query Mandated by some eye care providersMandated by some eye care providers Mandatory Issuer of IDMandatory 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

9 EYECARE-2MPPS Completed Require billing & material managementRequire billing & material management Support charge processingSupport charge processing

10 EYECARE-3Images/Evidence Stored EYECARE-4Retrieve Image 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

11 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

12 IHE Eye Care Planning 1.Support new DICOM IOD’s a.Ophthalmic Tomography b.Refractive SR’s 2.Additional DICOM IOD’s 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)

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