June-September 2009www.ihe.net North American 2010 Connectathon & Interoperability Showcase Series Paul Seifert/ Kinson Ho Solution Architects Agfa HealthCare Radiology Technical Committee Distributing Images: Cross-enterprise Document Sharing for Imaging (XDS-I.b) SESSION

June - September Webinar Overview This webinar will cover the following topics: 2009 Webinar Series Schedule - brief overview North American Connectathon & Interoperability Showcase Cycle - Brief Overview overview  History, scope, road map, key profiles, point to previous Webinars New Profile details Q&A Wrap

June - September Webinar Overview Important note to all Domain-focused presentations: This is the template for the 2009 Webinar series. Also, please encourage visitors to your presentation to review the Webinar Series Kick-off presentation that was held on Thursday June 11 since that is where they will learn about registration processes, deadlines and other key facts. To help you with this reminder, please include the next two overview slides in your presentation as these point participants to the Kick-off presentation link.

- September Webinar Schedule Overview June 11 – Kick-off!  Overview IHE 2010 NA Connectathon & HIMSS10 U.S. Interoperability Showcase June 25: 10:00 – 11:30amCT  Radiology Thur July 23: Time: TBD  Patient Care Coordination (PCC)  Patient Care Coordination: Nursing Sub-committee Other sessions to follow July – September 2009 (Time & Date TBD) includes: Repeat of June 11 Kick-Off Webinar will be repeated in July, August & September Anatomic Pathology Cardiology Eye Care IT Infrastructure (ITI) Laboratory Patient Care Devices (PCD) Radiation Oncology Quality, Research and Public Health (QRPH) Use of IHE in the enterprise – Intra-enterprise solutions IHE and U.S. initiatives including ARRA, Meaningful Use and more IHE 2009 North American Connectathon - Connectathon Registration How-To Miss a live session? All sessions recorded & available at

Webinar Schedule Overview June - September June 11 – Kick-off!   Overview IHE 2010 NA Connectathon & HIMSS10 U.S. Interoperability Showcase This session can be downloaded at any time – if you are new to this process – please review! June 25: 10:00 – 11:30amCT   Radiology Thur July 23: Time: TBD   Patient Care Coordination (PCC)   Patient Care Coordination: Nursing Sub-committee Other sessions to follow July – September 2009 (Time & Date TBD) includes: Repeat of the June 11 Kick-Off Webinar will be repeated in July, August & September Anatomic Pathology Cardiology Eye Care IT Infrastructure (ITI) Laboratory Patient Care Devices (PCD) Radiation Oncology Quality, Research and Public Health (QRPH) Use of IHE in the enterprise – Intra-enterprise solutions IHE and U.S. initiatives including ARRA, Meaningful Use and more IHE 2009 North American Connectathon - Connectathon Registration How-To Miss a live session? All sessions recorded & available at

IHE from 30,000 feet International initiative to implement HIT standards to improve interoperability, enable EHRs Committee use consensus process to develop implementable specs called Profiles published in Technical Frameworks Get Involved! Committee participation open to all members Membership is free! Go to More background and details in Kickoff Session overview presentation at June - September

IHE from 30,000 feet Implementation testing process ensures compliance and interoperability Culminates in annual Connectathon Public demonstrations at HIMSS Interoperability Showcases and other medical meetings (e.g., RSNA, ASTRO, AAO) Registration for 2010 North American Connectathon and the HIMSS10 Interoperability Showcase opens August 28 and closes September 30, 2009 Registration link: June - September

Placeholder: Instructions to Presenters Placeholder – Domains, start your Domain-specific slides here Please focus on new information for your Domains. We don’t want to repeat information available in last year’s Webinars. Each session should last roughly 1 – 1.5 hours. Point them to the 2008 Webinars for details on existing profiles. If you feel you need a separate, extended technical session, please let Chris or Lisa know and contact us if there are any questions. Thank you for taking the time to present your domain’s information!

Learning Objectives >

Example: The IT Infrastructure Domain supplies infrastructure for sharing healthcare information. An infrastructure interoperability component represents a common IT function that is used as a building block for a variety of use cases... a necessary ingredient, but rarely visible to the end user!! These components may be embedded in an application, but are often deployed as a shared resource within a RHIO or Health Information Exchange. This domain began in 2003, is sponsored by Health Information Management Systems Society (HIMSS). The ITI domain Profiles detailed in the IT Infrastructure Technical Framework.Health Information Management Systems Society (HIMSS) ProfilesIT Infrastructure Technical Framework Learn more:

Domain Overview Mission/scope Block diagram domain/profile overview Key profiles (on sentence each) Relationship to other domains

North American 2010 Connectathon & Interoperability Showcase Series Paul Seifert/ Kinson Ho Solution Architects Agfa HealthCare Radiology Technical Committee Members Distributing Images: Cross-enterprise Document Sharing for Imaging (XDS-I.b) SESSION

Cross-enterprise Document Sharing for Imaging (XDS-I.b) Use case and profile abstract Value proposition Actors and transactions Relation/dependency on other profiles Implementation resources (e.g., Schema, WSDL) Implementation considerations (security, testing, etc.)

XDS-I.b Abstract / Scope Sharing of Imaging Information across affiliated health enterprises Imaging Information includes  extensive sets of DICOM instances including images, evidence documents and presentation states  diagnostic reports provided in a "for display" form  selection of diagnostically significant images associated with the report content

XDS-I.b Value proposition Imaging component of the Electronic Health Record: Shared imaging Record, in a community, region, etc. Effective means to contribute and access imaging documents across health enterprises.  Without XDS-I.b, access to the radiology report across health enterprises is difficult Scalable sharing of imaging documents between radiology departments, private physicians, clinics, long term care, acute care with different clinical IT systems. Easy access: Care providers are offered means to query and retrieve imaging documents (images and reports) of interest  using the same mechanisms used to query other documents

Radiology Enterprise A Radiology Enterprise B Physician Office Regional Health Information Network PACS B PACS A Radiology-to-radiology Radiology-to- Physicians Sharing Radiology Reports and Images in a Regional Health Information Network

Radiology Enterprise A Radiology Enterprise B Physician Office Regional Health Information Network Cross- Enterprise Registry Patient Id= 3547F45 Report 5/21/1998 : CT Head  B Study 5/21/1998 : CT Head  B Report 2/18/2005 : Chest Xray  A Study 2/18/2005 : Chest Xray  A PACS B PACS A Sharing Radiology Reports and Images in a Regional Health Information Network

Radiology Enterprise A Radiology Enterprise B Physician Office Regional Health Information Network Query for Documents Register Imaging Information for sharing Prior imaging Reports & Studies Cross- Enterprise Registry Register Imaging Information for sharing Patient Id= 3547F45 Report 5/21/1998 : CT Head  B Study 5/21/1998 : CT Head  B Physicians and Systems within a Regional Health Network - Routine Imaging Referral

Radiology Enterprise A Radiology Enterprise B Physician Office Regional Health Information Network Register Imaging Information for sharing Cross- Enterprise Registry Notification of Doc Availability Register Imaging Information for sharing Physicians and Systems within a Regional Health Network - Routine Imaging Referral

Radiology Enterprise A Radiology Enterprise B Physician Office Prior Imaging Report & Study Regional Health Information Network Query for documents Imaging Report & Study Cross- Enterprise Registry Patient Id= 3547F45 Report 5/21/1998 : CT Head  B Study 5/21/1998 : CT Head  B Report 2/18/2005 : Chest Xray  A Study 2/18/2005 : Chest Xray  A Physicians and Systems within a Regional Health Network for a Routine Imaging Referral

XDS-I.b Actors and Transactions

What’s New in XDS-I.b New Provide and Register Imaging Document Set Transaction  Updated to use MTOM/XOP Transport mechanisms  Fully compatible with existing XDS.b Repositories and Registries  More heavily leverages XDS-SD for CDA-wrapped text reports New Retrieve Imaging Document Set Transaction  Web services based retrieval of DICOM images  Based on XDS Retrieve Document Set Transaction Key Actor Requirements  Imaging Document Source is required to support all retrieval types; Imaging Document Consumer can choose “Old” version of XDS-I is simultaneously deprecated  No more “SOAP with attachments” based Provide transaction

XDS-I.b Dependencies XDS-I.b depends on IT Infrastructure Cross-Enterprise Document Sharing (XDS) Profiled XDS metadata with radiology specifics  Acquisition Modality (e.g. CT, MR)  Anatomic Region (e.g. Arm, Elbow, Hand)  Requested procedure (e.g. MRI Knee with contrast) Reuses CDA-wrapper defined by XDS-SD for plain text reports. XDS-I.b specific Actors  Imaging Document Source  Imaging Document Consumer (must be grouped with XDS Document Consumer) XDS Actors reused  Document Consumer, Document Registry, Document Repository

Implementation Considerations XDS-I.b security considerations  XDS-I.b actors must be grouped with ATNA Secure Node or Secure Application Actor  Document retrievals must be capable of being done across a protected (encrypted) channel. Implementation Resources (XML schemas and WSDL)  Will soon be available via link at

END of XDS-I.b presentation

List of new profiles and major profile updates A few slides on each new profile A few slides on each major profile update

Dates/Relevant Sessions from Overall Schedule

Major Take-Away Points

Placeholder for Domain slides

Placeholder for Domain slides

June - September Important dates Webinar Series, June - September 2010  Registration for NA Connectathon & HIMSS10 Interoperability Showcase  August 28 – September 30, 2009 IHE 2010 NA Connectathon, Chicago, IL - January 11-15, 2010  Registration August 22 – September 30, 2009  HIMSS10 Annual Conference, Atlanta, GA, March 1-4, 2010  Registration August 28 – September 30, 2009 

June - September IHE & Interoperability Resources Integrating the Healthcare Enterprise   Interoperability Showcase  Health Information Technology Standards Panel  panels/hisb/hitsp.aspx?menuid=3 panels/hisb/hitsp.aspx?menuid=3

June - September