1. September, 2005What IHE Delivers 1 IHE Changing the Way Healthcare Connects in HOSPITALS HIMSS Interoperability Showcase February 2006 Glen Marshall (Siemens), Elie Avraham (Kodak), John Donnelly (IntePro) Chris Carr (RSNA), Chris Lindop (GE)

2. 2 IHE - Connecting standards to care Care providers and IT professionals work with vendors to coordinate the implementation of standards to meet their needs  Care providers identify the key interoperability problems they face  Drive industry to develop and make available standards-based solutions  Implementers follow common guidelines in purchasing and integrating systems that deliver these solutions

3. 3 Growth in IHE Domains Radiology (18) IT Infrastructure for Healthcare (17) Cardiology (7) Laboratory (6) Radiation Oncology (1) Patient Care Coordination (5) Patient Care Devices (1) Quality Eye Care (3) Veterinary Endoscopy Pathology Pharmacy Year 1 (1999) Year 2 (2000) Year 3 (2001) Year 4 (2002) Year 5 (2003) Year 6 (2004) Year 7 (2005) Year 8 (2006) Year 9 (2007) Over 100 vendors involved world-wide Over 100 vendors involved world-wide 8 Technical Frameworks 8 Technical Frameworks 48 Integration Profiles 48 Integration Profiles Testing at “Connectathons” world-wideTesting at “Connectathons” world-wide Demonstrations at major conferences world-wide Demonstrations at major conferences world-wide

4. 4 IHE Model Actors in precisely defined roles  Abstracts a specific function of information system …Executing precisely defined transactions  Using existing standards ……To solve real world interoperability problems  Specifying Integration Profiles

5. 5 IHE Technical Frameworks Implementation Guide for each Integration Profile An Integration Profile :  A Set of Actors  Exchanging Transactions Use cases Process Flows For each transaction:  Std referenced  Options specified  Mapping required ActorsTransactions

6. 6 IHE – The Business Case for Hospitals Re-engineering System Integration : Leverage standards-based, robust and innovative solutions  refocus customization to value-add Reduce RFP costs with common guidelines in purchasing and integrating systems that deliver these solutions It works, IHE did it with your vendors ! Lets look at specific solutions….

7. 7 IHE Solutions within the Enterprise eMPI User Auth Enterprise IT Infrastructure Enterprise IT Infrastructure Laboratory LIS Auto Mgr Analyzer EMR - HIS Cardiology CIS CathECG Radiology RIS PACS Img Acq -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye Care

8. 8 Cath Lab Workflow 1 2 3 4 5 6 7 8 9 10 11 note: IHE Cath Profile includes Electrophysiology lab Multiple re-entry of Patient ID Error prone data entry Results fragmented across systems Results inconsistently time-tagged Custom solutions needed for data sharing Difficult to manage Uncoordinated with Hospital Information System Unidentified patients (emergency) Un-ordered cath exams Diagnostic and interventional procedures Ad hoc scheduling of cath labs Change of rooms during procedure The Cure for:

9. 9 Echo Workflow Need to solve the “drive-by echo” ? Cardiologist to sonographer in CCU: “While you’re here, do a TTE on bed 3”  Unordered, unscheduled exam  Machine disconnected from network Stress echo, need more automation ? After exam, sonographer creates new quad displays of stages and views  No intrinsic value add  Data is redundantly copied to storage

10. 10 Stress Workflow ~85% of stress tests are multi- modality (ECG + imaging) ~0% of current architectures manage ECG and imaging workflow and results in an integrated manner Poor adherence to ACC/ASNC nuclear image display requirements IHE Stress Testing Profile and IHE Nuclear Medicine Image Profile Trial Implementation

11. 11 IHE Solutions within the Enterprise Cardiology Radiology CardiologyLaboratory Enterprise IT Infrastructure Enterprise IT Infrastructure EMR - HIS RIS PACS Img Acq CIS CathECG LIS Auto Mgr Analyzer -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology Cardiology Integration Profiles Cardiac Catheterization Lab Workflow Echocardiography Lab Workflow Retrieve ECG for Display Displayable Reports Cath and Echo Evidence Documents Implanted Device ObservationseMPI User Auth

12. 12 IHE Solutions within the Enterprise eMPI User Auth Enterprise IT Infrastructure Enterprise IT Infrastructure Laboratory LIS Auto Mgr Analyzer EMR - HIS Cardiology CIS CathECG Radiology RIS PACS Img Acq -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye Care

13. 13 Laboratory Scheduled Workflow - Value Proposition A comprehensive workflow approach  Address specimen linkage  most lab specialties: Blood gases, Chemistry, Hematology, Immunology, Laboratory, Microbiology, Mycrobacteriology, Mycology, Serology, Toxicology, Virology. Provides workflow improvement  Increases continuity and integrity of clinical data  Decreases user need for manual tasks. Spans ordering, conformity of specimens, lab automation, results delivery.  Externally placed order with identified specimens  Externally placed order with specimens unidentified or to be collected by the laboratory  Internally placed order with specimens identified by third party or collected by the laboratory

14. 14 IHE Solutions within the Enterprise Laboratory Radiology CardiologyLaboratory Enterprise IT Infrastructure Enterprise IT Infrastructure EMR - HIS RIS PACS Img Acq CIS CathECG LIS Auto Mgr Analyzer -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye Care Laboratory Integration Profiles Laboratory Scheduled Workflow Laboratory Information Reconciliation Laboratory Point Of Care Testing Laboratory Device Automation Laboratory Code Set DistributioneMPI User Auth

15. 15 IHE Solutions within the Enterprise eMPI User Auth Enterprise IT Infrastructure Enterprise IT Infrastructure Laboratory LIS Auto Mgr Analyzer EMR - HIS Cardiology CIS CathECG Radiology RIS PACS Img Acq -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye Care

16. 16 Scheduled Workflow & patient Info reconciliation Backbone of IHE Radiology Integrates Registration, Scheduling, Acquisition Workflow and Image Content Bridges HL7 and DICOM Spaces Preserve Order Continuity Improve Demographic Integrity Improve Workflow Efficiency – synchronized Worklists Reliable Storage Improve Order Tracking Reduce Integration Effort at Site

17. 17 IHE Solutions within the Enterprise Radiology Radiology CardiologyLaboratory Enterprise IT Infrastructure Enterprise IT Infrastructure EMR - HIS RIS PACS Img Acq CIS CathECG LIS Auto Mgr Analyzer -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye CareeMPI User Auth Radiology Integration Profiles Radiology Scheduled Workflow Patient Information Reconciliation Access to Radiology Information Portable Data for Imaging Consistent Presentation of Images Key Image Note Presentation of Grouped Procedures Evidence Documents Audit trail and Node Authentication (Rad option) Teaching Files and Clinical Trials Export Post-processing Workflow Reporting Workflow Charge Posting Simple Image and Numeric Reports Media Import Reconciliation Workflow How to use IHE ?  IHE Radiology Handbook

18. 18 IHE Solutions within the Enterprise eMPI User Auth Enterprise IT Infrastructure Enterprise IT Infrastructure Laboratory LIS Auto Mgr Analyzer EMR - HIS Cardiology CIS CathECG Radiology RIS PACS Img Acq -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye Care

19. 19 Patient Administration Mgt (PAM) Coordinates exchange of patient registrations, updates, and movements for all clinical areas Information may be received and processed by consuming applications in any clinical domain Optionally allows unambiguous updating of historic patient movement events Demographic and encounter tracking works in both inpatient and ambulatory care settings Standardizes on HL7 V2.5 and its conformance structures

20. 20 Patient Administration Management Actor & Transaction: flexibility and compatibility Flexible Actor grouping

21. 21 Patient Demographics Query – HL7 V2.5 Adopted b y HITSP Patient Demographics Supplier Patient Demographics Consumer Patient Demographics Query Patient Demographics and Visit Query Registration system or departmental system that is connected on demand to it. Diverse systems including bedside monitors, physician office systems, lab applications, mobile blood bank registries; might be any system at the point of care.

22. 22 Patient Identifier Cross-referencing-HL7 V2.5 Adopted b y HITSP Registration system or eMPI Registration system Departmental or Outpatient system

23. 23 IHE Solutions within the Enterprise IT Infrastructure (Enterprise) Radiology CardiologyLaboratory RIS PACS Img Acq CIS CathECG LIS Auto Mgr Analyzer -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye CareeMPI User Auth EMR - HIS IT Infrastructure Integration Profiles Patient Administration Management Patient Demographics Query Patient Identifier Cross-referencing Retrieve Information for Display Enterprise User Authentication Consistent Time Patient Synchronized Applications Audit Trail and Node Authentication Personnel White Pages Enterprise IT Infrastructure Enterprise IT Infrastructure

24. 24 IHE Solutions for extending the Enterprise eMPI User Auth Enterprise IT Infrastructure Enterprise IT Infrastructure Laboratory LIS Auto Mgr Analyzer EMR - HIS Cardiology CIS CathECG Radiology RIS PACS Img Acq -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye Care Outpatient Clinic EMR Pactice Mgt Partner Clinic EMR Pactice Mgt Practice EMR Partner Clinic EMR Pactice Mgt Partner Clinic EMR Pactice Mgt Practice EMR Partner Practices EMR Pactice Mgt Index of shared patients records

25. 25 IHE Solutions for Extending the Enterprise Integrated Delivery Networks eMPI User Auth Enterprise IT Infrastructure Enterprise IT Infrastructure Laboratory LIS Auto Mgr Analyzer EMR - HIS Cardiology CIS CathECG Radiology RIS PACS Img Acq -Radiation Therapy -Patient Care Devices -Patient Care Devices -Pathology -Pathology -Eye Care -Eye Care Outpatient Clinic EMR Pactice Mgt Partner Clinic EMR Pactice Mgt Practice EMR Partner Clinic EMR Pactice Mgt Partner Clinic EMR Pactice Mgt Practice EMR Partner Practices EMR Pactice Mgt Index of shared patients records Integration Profiles for an IDN Cross-Enterprise Document Sharing Patient Id Cross-Referencing Patient Demographics Query Audit Trail and Node Authentication Consistent Time Sharing of Medical Summaries Sharing of Lab Reports Sharing of Imaging Information Sharing of Scanned Documents See presentation: IHE Changing the Way Healthcare Connects Communities

26. 26 Want to know what new integration profiles will be developed in 2007 ? Visit the IHE Web Site

27. 27 What can you do? Attend the IHE Domain specific sessions in these Theaters during HIMSS 2007 (Orange sessions) Learn about IHE, www.ihe.net www.ihe.net Insist on IHE compliance in your RFPs and contract documents:  Select Integration Profiles, and Appropriate Actor(s)  Ask vendors for their products “IHE Integration Statements”. Need more interoperability ?  Contribute to IHE Committees

28. 28

29. 29 As a Provider or Vendor Contributor Offer Clinical Use Case Input to Drive IHE Profile Development Become a member of relevant domain’s Planning or Technical Committees Become a member of relevant Regional/National Committees Help to shape IHE’s future direction As a Vendor Participant Respond to Public Comments of Domain Supplements Attend the June Educational Workshop Participate in Connect-a-thons and Demonstrations As a Provider/Consultant Participant Respond to Public Comments of Domain Supplements Attend the June Educational Workshop Attend Demonstrations and include IHE Integration Profiles in your RFPs and Integration Projects. How can I participate?

30. 30 IHE Web site: www.IHE.net Frequently Asked Questions Integration Profiles in Technical Frameworks: See Volume 1 of each TF for Use cases   Cardiology   IT Infrastructure   Laboratory   Patient Care Coordination   Radiology Connectathon Result: www.ihe.net/Events/connectathon_results.cfm Vendor Products Integration Statements Participation in Committees & Connectathons

31. September, 2005What IHE Delivers 31