1. Shands–Jacksonville Successfully Uses IHE to Achieve its Goals IHE at RSNA 2002

2. Shands PACS challenges Large 650 bed community teaching hospital with a three- building campus Challenging budget 28 legacy modalities from 10 vendors, connected to all DICOM and HBOC 10 BaseT network Unpredictable routing environment Large 650 bed community teaching hospital with a three- building campus Challenging budget 28 legacy modalities from 10 vendors, connected to all DICOM and HBOC 10 BaseT network Unpredictable routing environment

3. Shands PACS Goals Communication w/ Siemens Specials PACS, ADAC nuclear and AGFA CR Cost effective communication to 260 eFilm viewing PCs Accuracy through MWL and MPPS Teaching conference image availability Communication w/ Siemens Specials PACS, ADAC nuclear and AGFA CR Cost effective communication to 260 eFilm viewing PCs Accuracy through MWL and MPPS Teaching conference image availability

4. Shands–Jacksonville Goals Implement an IHE-based open-architecture PACS that would: Improve report turnaround for referring MDs Eliminate the incompatibility of multiple image transmission systems Make relevant prior images readily available Improve productivity and stakeholder satisfaction Maximize Shands prior investments in modalities and information systems Implement an IHE-based open-architecture PACS that would: Improve report turnaround for referring MDs Eliminate the incompatibility of multiple image transmission systems Make relevant prior images readily available Improve productivity and stakeholder satisfaction Maximize Shands prior investments in modalities and information systems

5. Shands–Jacksonvilles IHE-based Solution Partnering with Merge eFilm to implement an IHE- based integrated solution that includes multiple IHE actors: Department System Scheduler/Order Filler HBOC RIS - integrated by Merge eFilm Acquisition Modality Over 2 dozen imaging modalities - integrated by Merge eFilm Provided by Merge eFilm Image Archive Image Manager Image Display Partnering with Merge eFilm to implement an IHE- based integrated solution that includes multiple IHE actors: Department System Scheduler/Order Filler HBOC RIS - integrated by Merge eFilm Acquisition Modality Over 2 dozen imaging modalities - integrated by Merge eFilm Provided by Merge eFilm Image Archive Image Manager Image Display

6. Shands–Jacksonvilles IHE-based Solution Integration Profiles implemented include: Scheduled Workflow Patient Information Reconciliation Access to Radiology Information Solution operational since Q1 2002 Integration Profiles implemented include: Scheduled Workflow Patient Information Reconciliation Access to Radiology Information Solution operational since Q1 2002

7. Shands Jacksonville Medical Center Phase A: Integration of HL7 Data From HIS/RIS with Images, Short-Term Archiving, Rapid Image Distribution Across The Enterprise For Softcopy Viewing m APS HIS/RIS m Merge eFilm EW-V m m m m m m EW+ m MVP+ Bundle m MVP+ Bundle m EW+ m m m m EW-V m m m m APS m EW+ EW-V m m m EW+ m m m APS m EW+ m MVP+ Bundle m EW-V m m APS Merge eFilm Workstations Merge eFilm mm Desktop PCs With Merge eFilm Access via VPN Merge eFilm Workstations Merge eFilm Workstation PavillionTowers Clinical Center Acuson U/S Sonosite U/S Acuson U/S Acuson U/S Acuson U/S Sonosite U/S Philips CT Philips CT Siemens CT Philips MRI Adac NM Adac NM GE NM OEC C-ARM OEC C-ARM OEC C-ARM DryView Laser Camera DryView Laser Camera AGFA CR ATL U/S Acuson U/S GE CT Adac NM GE NM DryView Laser Camera DryView Laser Camera GE MRI Siemens CT GE CT Agfa Laser Camera

8. Shands Jacksonville Medical Center Phase B: Establish Scalable, Long Term Archive DryView Laser Camera m APS HIS/RIS m MergePort EW-V m Acuson U/S EW-V m Sonosite U/S EW-V m Acuson U/S EW-V m Acuson U/S EW-V m Acuson U/S EW-V m Sonosite U/S EW+ m Philips CT MVP+ Bundle m Philips CT MVP+ Bundle m Siemens CT EW+ m Philips MRI EW+ m Adac NM EW+ m Adac NM EW+ m GE NM DryView Laser Camera m APS AGFA CR m EW+ EW-V m ATL U/S EW-V m Acuson U/S EW-V m GE CT EW+ m Adac NM EW+ m GE NM DryView Laser Camera m APS DryView Laser Camera m APS EW+ m GE MRI MVP+ Bundle m Siemens CT EW-V m GE CT Agfa Laser Camera m APS 2View Workstations 2View m m 2Store m Desktop PCs With 2View Access via VPN 2View Workstations 2View Workstation PavillionTowers Clinical Center EW-V m OEC C-ARM EW-V m OEC C-ARM EW-V m OEC C-ARM

9. Shands Jacksonville Medical Center Future: Scaling up capacity and functional capabilities DryView Laser Camera m APS HIS/RIS m MergePort EW-V m Acuson U/S EW-V m Sonosite U/S EW-V m Acuson U/S EW-V m Acuson U/S EW-V m Acuson U/S EW-V m Sonosite U/S EW+ m Philips CT MVP+ Bundle m Philips CT MVP+ Bundle m Siemens CT EW+ m Philips MRI EW+ m Adac NM EW+ m Adac NM EW+ m GE NM DryView Laser Camera m APS AGFA CR m EW+ EW-V m ATL U/S EW-V m Acuson U/S EW-V m GE CT EW+ m Adac NM EW+ m GE NM DryView Laser Camera m APS DryView Laser Camera m APS EW+ m GE MRI MVP+ Bundle m Siemens CT EW-V m GE CT Agfa Laser Camera m APS 2Report with 2View Workstations 2View m m 2Store m Desktop PCs With 2View Access via VPN or Remote Access To Integrated Reports and Images via The Web 2Report with 2View Workstations 2Report with 2View Workstation PavillionTowers Clinical Center 2Web m EW-V m OEC C-ARM EW-V m OEC C-ARM EW-V m OEC C-ARM

10. Large Teaching Hospital

11. Results Filmless workflow throughout the enterprise Report turnaround time reduced from 3 days to 1 day Accurate storage and locatable images Fast viewing and image distribution across 260 PC-based workstations Transition toward less paper-based environment Access to better patient care via improved image availability for effective consulting Images readily available for teaching conferences Implementation on IHE Platform for future growth and functionality Filmless workflow throughout the enterprise Report turnaround time reduced from 3 days to 1 day Accurate storage and locatable images Fast viewing and image distribution across 260 PC-based workstations Transition toward less paper-based environment Access to better patient care via improved image availability for effective consulting Images readily available for teaching conferences Implementation on IHE Platform for future growth and functionality