1. The IHE Initiative Worldwide December 3 rd, 2008 RSNA 2008 1 Michio Kimura, MD, PhD Hamamatsu University / IHE Japan IHE Japan & Asia-Oceania Integrating the Healthcare Enterprise

2. The IHE Initiative Worldwide December 3rd, 2008 2 2008/10/27-31   40 vendor, 81 systems tested Tested profiles   Radiology SWF, PIR, CPI, KIN, MAMMO, PDI, IRWF, ARI   Cardiology CATH, ECG, ECHO, ED   Laboratory LTW, LBL, LDA, LTW-MB, LPOCT   IT Infrastructure CT, ATNA, XDS, XDS.b, XDS-I, PDQ, PAM IHE Japan Connectathon 2008

3. The IHE Initiative Worldwide December 3rd, 2008 3 ………… IHE Japan Connectathon 2008

4. The IHE Initiative Worldwide December 3rd, 2008 4 Network Structure for Stroke Care in Nagoya

5. The IHE Initiative Worldwide December 3rd, 2008 5 Nagoya IHE XDS-I project  Backed by Ministries  4 Emergency hospitals, 3 Rehab facilities(now)  Profiles and standards  Integrating XDS with PIX, PDQ and ATNA  Enhancing XUA, NAV with access control based on XACML  Excerpting XDS metadata from CDA header part  Based on ebXML ebRIM3.0/ebRS3.0 (supporting XDS storedQuery), while XDS.a was specified on ebXML2.1. (Being ahead of XDS.b.)

6. The IHE Initiative Worldwide December 3rd, 2008 6 EUA & PSA Working at NIRS NIRS users appreciate EUA

7. The IHE Initiative Worldwide December 3rd, 2008 7 Demo at JAMI Conference Japan Assoc. for Medical Informatics  Participants: 2500 Ministries-Vendors-Academia  Stroke patient’s ECG(Fukuda) on ambulance sent to ER and viewed by Nihon Koden viewer (MFER, waveform standard)  Lab exam at ER, LSWF(now LTW), LDA(Lab automation), LBL(Barcode labeling)  Referral documents CD to clinic (SS-MIX, CD based PDI with lab, Px, and referral document of CDA)

8. The IHE Initiative Worldwide December 3rd, 2008 8

9. The IHE Initiative Worldwide December 3rd, 2008 9 Now paper-based report filled by busy doctors   But, most items are in CPOE Post Market Adverse Event Report in RFD

10. The IHE Initiative Worldwide December 3rd, 2008 10 ………… …

11. The IHE Initiative Worldwide December 3rd, 2008 11

12. The IHE Initiative Worldwide December 3rd, 2008 12

13. The IHE Initiative Worldwide December 3rd, 2008 13 Images exchanged by CD started, but making some annoyance   Not conforming PDI, DICOM   Too many slices, too many studies   Multiple patients in one CD   etc. By academic assoc.(JAMI, JRS, JSRT), vendor assoc. (JIRA, JAHIS), and IHE-J   1 patient, 1 CD   Conform PDI   Conform DICOM   Reasonable amount of slices (no 1000+ MDCT), and studies   If include report, must be in "other files" position and note it PDI Agreement

14. The IHE Initiative Worldwide December 3rd, 2008 14 IHE-J HP http://www.ihe-j.org/en/

15. The IHE Initiative Worldwide December 3rd, 2008 15 15 International Growth of IHE France   Local Deployment   National Extensions   Promotional & Live Demonstration Events   Funding USAGermanyItalyJapanUKCanadaKoreaTaiwanNorway Netherlands Spain ChinaAustria 1999 2000 2001200220032004 200520062007 2008 Pragmatic global standards harmonization + best practices sharing Australia

16. The IHE Initiative Worldwide December 3rd, 2008 16 IHE, Global Standards-Based Profiles Adopted in National & Regional Projects Quebec, Toronto, Alberta, British Columbia Canada Infoway THINC- New York NCHICA – N. Carolina Italy (Conto Corrente Salute) Boston Medical Center - MA Philadelphia HIE CHINA-MoH Lab results sharing KeyHIE Pennsylvania CHINA-Shanghai Imaging Info Sharing JAPAN-Nagoya Imaging Info Sharing, Nationwide PDI guideline South Africa Malaysia VITL-Vermont CareSpark – TN & VA NETHERLANDS Friesland Lower Austria France DMP UK CfH (Radiology WF) Suisse St Gallen

17. The IHE Initiative Worldwide December 3rd, 2008 17 Our neighbors Korea  High rate of e-claim and PACS  Mainly radiology based connections since 2005 Taiwan  Connect-a-thon around HIS-RIS since 2005  Citizen’s health IC card since 2003, now upgrading to have templated documents Malaysia  400 government officials attended HIMSS AsiaPAC in Kuala Lumpur, Feb 2009  7 national hospitals has paperless EMR Australia  XDS lab demo at MEDINFO 2007 Brisbane.

18. The IHE Initiative Worldwide December 3rd, 2008 18 Questions ?