1. September, 2005What IHE Delivers 1 Chris Lindop GE Healthcare Co-chair, IHE Radiology Planning Committee Chris Lindop, GE Healthcare Co-chair, IHE Radiology Planning Committee Radiology 2008 Update

2. 2 An Incremental Multi-Year Project Launched in 1998 Goal: Enhance the Access to Clinical Information Enhance the Access to Clinical Information Ensure Continuity and Integrity of Patient Information Ensure Continuity and Integrity of Patient Information Speed Up the Integration in Healthcare Environments Speed Up the Integration in Healthcare Environments Fosters Communication Between Vendors of Medical Information Technology Fosters Communication Between Vendors of Medical Information Technology Prove that Integration is Attainable Based on Standards Participants: Representatives of Healthcare Providers Representatives of Healthcare Providers Information Systems Vendors Information Systems Vendors Imaging Systems Vendors Imaging Systems Vendors Standardization Groups Standardization Groups The IHE Initiative

3. 3 IHE Radiology Scope: Radiology including Nuclear Medicine, Mammography Radiology including Nuclear Medicine, MammographyVendors Acquisition Modalities, RIS, PACS, Workstations, Displays, Printers Acquisition Modalities, RIS, PACS, Workstations, Displays, Printers Established 1998 (first IHE domain) Sponsor: RSNA Supporters: COCIR, DRG, EAR, ECR, EuroPACS, GMSIH, JIRA, JAHIS, JRS, JSRT, METI, MEDIS-DC, SFR, SIRM

4. 4 IHE Radiology - Achievements Now entering 10th year Robust Vendor Participation at Connectathons Robust Vendor Participation at Connectathons Over 200 IHE Integration Statements published Over 200 IHE Integration Statements published Over 1000 Actors in Radiology implemented Over 1000 Actors in Radiology implemented IHE Profiles appearing in User Purchasing Processes IHE Profiles appearing in User Purchasing Processes Have addressed basic radiology workflows Acquisition, Post-Processing, Reporting, Teaching Files/Clinical Trials Acquisition, Post-Processing, Reporting, Teaching Files/Clinical Trials Have addressed imaging content handling Measurements, CAD Results, NM, Mammo, Presentation States, Reports, Key Image Notes Measurements, CAD Results, NM, Mammo, Presentation States, Reports, Key Image Notes Have addressed distribution of imaging information on CDs, to enterprise, to EHRs, keeping Audit Trails on CDs, to enterprise, to EHRs, keeping Audit Trails

5. 5 IHE Radiology – Recent Development Activities Expand focus to integration and workflow spanning departments/enterprises/regions Teaching Files and Clinical Export*** Teaching Files and Clinical Export*** Scheduled Workflow II**** Scheduled Workflow II**** PDI-large image set option**** PDI-large image set option**** Expand focus to Quality Initiatives in Radiology Radiation Emission Monitoring (REM) * Radiation Emission Monitoring (REM) * Focused support for specialties Modality Acquisition Workflow * Modality Acquisition Workflow * NM Image Cardiology Option ** NM Image Cardiology Option ** Image Fusion ** Image Fusion ** * Approved for Trial Implementation 2008/09 ** Carried over for Trial Implementation in 2008/09 *** Approved for release in Technical Framework V9.0 **** Strategic - to be carried over in next Development cycle

6. 6 Connectathon Status North American Jan 28 – Feb 1, Chicago, IL Jan 28 – Feb 1, Chicago, IL 70 Vendors, 136 products 70 Vendors, 136 productsJapan February, Tokyo, Japan February, Tokyo, Japan 36 Vendors, 60 systems 36 Vendors, 60 systemsEurope 20-26 April, Oxford, England 20-26 April, Oxford, England 72 Vendors, 120 products 72 Vendors, 120 productsChina May, Beijing May, BeijingAustralia July, Sydney July, Sydney

7. 7 Radiology Profiles Access to Radiology Information - Consistent Presentation of Images Evidence Document Key Image Notes Simple Image & Numeric Reports Presentation of Grouped Procedures Post- Processing Workflow Reporting Workflow Charge Posting Patient Info. Reconciliation Scheduled Workflow Portable Data for Imaging Mammo- graphy Image Audit Trail & Node Authentication – Radiology Option Image Fusion Teaching Files & Clinical Export Import Reconcil- iation Workflow Cross-Enterprise Document Sharing for Imaging NM Image Card Option Radiation Emission Monitoring Mammo- graphy Acquisition Workflow

8. 8 IHE Radiology – Integration Profiles Workflow Scheduled Workflow Patient Information Reconciliation Post-Processing Workflow Reporting Workflow Import Reconciliation Workflow Mammography Acquisition Workflow** Infrastructure Access to Radiology Information Portable Data for Imaging Cross-Enterprise Data Sharing for Images Security: Audit Trails & Node Authentication Charge Posting Teaching Files & Clinical Trials Export Presentation & Content Consistent Presentation of Images Key Image Notes Image Fusion ** Presentation of Grouped Procedure Evidence Documents Simple Image & Numeric Reports NM Image* Mammography Image Radiation Emission Monitoring** * Cardiology Option – in Trial Implementation ** in Trial Implementation Publications Radiology Users Guide Mammography Users Guide

9. 9 2008 Trial Implementation Profiles Radiation Emmission Monitoring Mammography Acquisition Workflow

10. 10 Dose Reporting Facilitates the collection and distribution of reports detailing patient radiation exposure resulting from imaging procedures. Retrieve Dose Information Query Dose Information Perform Study Submit Dose Information Prepare Monthly Submission Store Dose Information (CT) Store Dose Information (XR) Retrieve Dose Information Query Dose Information Generate Weekly Reports... Acquisition Modality 1 (XR) Image Archive Dose Information Monitor Dose Registry Acquisition Modality 2 (CT)... Initiate Weekly Report Task

11. 11 Mammography Acquisition Workflow (MAWF) MAWF addresses specific Digital XR Mammo Workflow issues: MAWF addresses specific Digital XR Mammo Workflow issues: High Throughput High Throughput Screening vs. diagnostic acquisition context Screening vs. diagnostic acquisition context Procedure conversion done at acquisition Procedure conversion done at acquisition –screening -> diagnostic, self referral MAWF leverages existing profiles and options of IHE (SWF, KIN) MAWF leverages existing profiles and options of IHE (SWF, KIN)

12. 12 MAWF – Use cases overview 3 main uses: Procedure error or modification Procedure error or modification Finish an exam with supplemental views Finish an exam with supplemental views Correct / Remove images at modality or workstation Correct / Remove images at modality or workstation Each use case drives new requirements for each actor of the radiology department: Each use case drives new requirements for each actor of the radiology department: Acquisition modalities, Acquisition modalities, DSS/OFs (RIS) DSS/OFs (RIS) Image managers/archives (PACS) Image managers/archives (PACS) Image displays (Workstations) Image displays (Workstations)

13. 13 Use of coded values IHE provides baseline of codes IHE provides baseline of codes MAWF uses cases rely on extensive use of codes (incl. Assisted protocol setting and exception management) MAWF uses cases rely on extensive use of codes (incl. Assisted protocol setting and exception management) Codes are configurable on a enterprise basis Codes are configurable on a enterprise basis Codes allow for a better workflow integration and exception cases (see previous uses cases) Codes allow for a better workflow integration and exception cases (see previous uses cases)

14. 14 2008 Development Schedule TimeframeActivityScheduledLocation 2007 Aug.Submit Brief Profile Proposals to Planning Committee (PC)Brief Profile ProposalsPlanning Committeeby Aug 31E-mail Sept.PC Selects "Short List" of ProposalsSept 4T-Con Sept.PC Drafts Detailed Profile Proposals for "Short Listed" ProposalsDetailed Profile Proposalsby Sept 14E-mail Oct.TC Completes technical review of Detailed ProposalsT-Con Oct.PC makes Final Selection of Proposals for this yearFinal Selection of ProposalsOct 24T-Con Nov.TC Profile development kickoff meetingNov. 5-7Chicago 2008 Jan.TC Finalizes profile supplements for public commentFeb 4-7Chicago Feb.Publication of Public Comment Supplementsapprox. Feb 27www.ihe.net Mar.Deadline for submission of public comments on profile supplementsapprox. Mar 27www.ihe.net Mar.TC reconciles public commentsMar 31-Apr 2Chicago Jun.Publication of Trial Implementation Supplementswww.ihe.net Jun.Publication of Final Text Technical Frameworkwww.ihe.net 2009 Jan.First Test implementations at ConnectathonChicago

15. 15 Strategic Profile Development for 2008 PDI – Large Data Sets (DVD/USB media) Scheduled Workflow II (Volume 1 only) Profiles not yet released! Development is still in progress

16. 16 Media Creator Printer [Media Reader] Image Display [Media Reader] PACS [Media Importer] CD DVD* USB* John Doe DICOM Data Web Data (Optional) DICOM PC Browser Web Data Required to cleanup Patient ID, Acc#, etc. Portable Data for Imaging * New Option

17. 17 Scheduled Workflow II Scheduled Workflow Scope Volume 1 only Volume 1 only PAM Adoption PAM Adoption Use of Current HL-7 Version (v 2.5) Use of Current HL-7 Version (v 2.5) Options Review Options Review Incorporate, remove or maintain status Incorporate, remove or maintain status Actor Evaluation Actor Evaluation Examples Examples –MPPS Mgr – is it needed –Image Archive/Manager should they be grouped? Transactions Transactions Examples Examples –Image availability Query Profile Grouping Profile Grouping Incorporate PIR Incorporate PIR

18. 18 Strategic Profile Deployment for 2008 Global Deployment priority PDI PDI XDS-I XDS-I for North America TCE TCE

19. 19 PDI Use Case for External Acquisition Radiology Enterprise A Radiology Enterprise B Provider A Radiology Site B PACS A Portable Data Creator Patient Data 2. Radiology Site B creates portable media with patient images 1. Provider A orders External Radiology Procedure 3. Portable Media is sent to Reading Site A via CD. Patient Data is imported and read. 4. Study Results sent to Provider Radiologist PDI Disk

20. 20 Radiology Enterprise B Radiology Enterprise A PACS B Portable Data Creator Patient Data 2.Relevant Data (including film) is collected and Enterprise A creates portable media with patients radiology information. 1. Request for Patients case data to be transferred from Enterprise A to B. 3.Data is transported to Site B via CD. Patient Demographics are reconciled and data is imported into archive. 4. Patient Data is now associated with Bs electronic health record system. PDI Use Case for Patient Referral

21. 21 XDS-I Actors and Transactions

22. 22 Teaching File & Clinical Trail Export Priority Profile for IHE USA

23. 23 Participating Vendors Implement IHE Profiles in your products Implement IHE Profiles in your products Test your products at the IHE Connectathon Test your products at the IHE Connectathon Publish IHE Integration Statements Publish IHE Integration StatementsUsers Learn about the IHE Profiles Learn about the IHE Profiles Include specific IHE Profiles in your RFPs Include specific IHE Profiles in your RFPs IHE Process Review Draft Profiles during Public Comment phase Review Draft Profiles during Public Comment phase Participate on Committees Participate on Committees Radiology Planning Committee: Radiology Planning Committee: –Kevin ODonnell (Toshiba) & Chris Lindop (GE Healthcare) Radiology Technical Committee: Radiology Technical Committee: –Cindy Levy ( Cedara) Chris Carr (RSNA) – ihe@rsna.org Chris Carr (RSNA) – ihe@rsna.org

24. September, 2005What IHE Delivers 24