1. IHE Radiology –2007What IHE Delivers 1 Ellie Avraham IHE Technical Committee May 23, 2007 Cross Domain Review Laboratory

2. IHE Cross-Domain Review 2 Other IHE Domains used in Laboratory Radiology (RAD) IT Infrastructure (ITI) Patient Care Coordination (PCC)

3. IHE Cross-Domain Review 3 IHE Laboratory Scheduled Workflow (LSWF) Integration Profile LSWF  Based on the foundation of the radiology SWF actors, the LSWF defines the continuity and integrity of clinical laboratory testing and observation data throughout the healthcare enterprise. It maintain the consistency of ordering and patient information, to control the conformity of specimens, and to deliver the results at various steps of validation.  It enables automation of pre-analytical, analytical and post-analytical processes within the laboratory.

4. IHE Cross-Domain Review 4 LSWF Features Most of the LSWF features are similar to Radiology, except the unique Lab management and tracking of LAB Test results.  The LSWF profile defines the interoperable process flow for managing the Lab Tests Orders, the Lab test equipments and the Lab tests results. Features extensively the same as Radiology  Patient Registration  Patient Update Features extensively similar to Radiology  Placer Order Management  Filler Order Management

5. IHE Cross-Domain Review 5 IHE Laboratory Information Reconciliation (LIR) Integration Profile Similar to the Radiology PIR profile, the LIS profiles reconcile the Patient Information on the Lab Tests Orders, Test Procedures, Lab Observations and Test results.

6. IHE Cross-Domain Review 6 LIR Features The LIR Patient reconciliation is similar to Radiology, except the unique Lab Orders, Lab Procedures tracking and managing of LAB Test results.  The LSWF profile defines the interoperable process flow for managing the Lab Tests Orders, the Lab test equipments and the Lab tests results. Features extensively the same as Radiology  Patient Registration  Patient Update Features extensively similar to Radiology  Placer Order Management  Filler Order Management

7. IHE Cross-Domain Review 7 IHE Laboratory Device Automation (LDA) Integration Profile LDA defines the automated workflow for managing the Lab work orders that get split in to a series of Work Order Steps (WOS) that are performed on the Lab Test equipments. In addition the Test results received from the Lab Test Equipment are managed.

8. IHE Cross-Domain Review 8 LDA Features The LDA profile is unique to Laboratory domain and it manage the workflow of the Lab Test Equipments. Features extensively the same as Radiology are:  None Features extensively similar to Radiology  None

9. IHE Cross-Domain Review 9 LONIC Test Codes Subset (LTCS) LTCS introduces a subset of the LONIC Lab codes, to be used in the Lab Test results reports.

10. IHE Cross-Domain Review 10 LTCS Features LTCS is a unique LAB profile that introduces the LAB Vocabularies for the test codes. This profile do not add any new actor or transaction.

11. IHE Cross-Domain Review 11 Sharing Lab Reports (XD * -LAB) XD * -LAB defines an electronic human readable Clinical Lab report that can be shared in the large Regional Health Information Organization (RHIO). The Lab report will include the various test results that have been ordered for a patient. The Lab report is defined as an HL7 CDA R2 document that is constrained and limited to Laboratory test results, structure reports.

12. IHE Cross-Domain Review 12 XD * -LAB Features The XD * -LAB profile is an XDS specialization content profile that defines the content of the Lab reports for being shared in a Cross-enterprise utilizing the XDS solution. The XD * -LAB profile is using the other IT profiles to share the Lab reports as follows:  NAV to notify after the registration the Lab Reports availability.  XDR to distribute the Lab reports through the email.  XDM to distribute the Lab reports through the CD or USB media interchange. Features extensively similar as in the PCC XDS-MS are:  Content Creator  Content Consumer Features extensively the same to ITI XDS are:  All the other XDS Actors

13. IHE Cross-Domain Review 13 IHE Laboratory Actors Actor(s) that are extensively the same as Radiology  ADT Patient Registration, Order Placer, DSS/Order Filler. Actor(s) that are extensively the same as ITI:  NAV – Notification Sender  XDR - Document Source  XDM – Portable Media Creator Actors that are unique to PCC:  Content Creator  Content Consumer Actors that are unique to Laboratory  Order Result Tracker  Automation Manager

14. IHE Cross-Domain Review 14 IHE Laboratory Transactions List of new LAB transactions:  LAB-1, LAB-2, LAB-3, LAB-4, LAB-5 (LSWF, LIR)  LAB-21, LAB-22, LAB-23, LAB-26 (LDA) Re-used transactions from ITI:  All transactions from: XDS, XDM, XDR, NAV Re-used Transactions from Radiology:  RAD-1, RAD-12

15. IHE Cross-Domain Review 15 Standards Used in Laboratory StandardStd. VersionProfile(s) Used HL7 CDA R2, CCD, Laboratory, Specimen v3 XD * -LAB HL7v2.5LDA HL7v2.5 & v2.3.1LSWF, LIR LOINC LTCS

16. IHE Cross-Domain Review 16 Summary of Laboratory ProfileIssue DescriptionHow to Handle (see Key) LSWF/LIRUsing mixed of HL7 v2.3.1 & v2.5 Transition Radiology TF to HL7 v2.5 – Mapping the HL7 v2.3.1 messages to HL7 v2.5 XD * -LAB Do we need to add the support of the Lab reports in the XDS-I ?

17. IHE Cross-Domain Review 17 Key to Domain issues 1. Issue should result in CP in Radiology 2. Consider addition in Radiology 3. Conflict between Radiology and other Domain 4. Radiology Profile should be handed-off to other Domain 5. Gap has been identified that may result in New Opportunity

18. IHE Cross-Domain Review 18