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IHE / RSNA Image Sharing Project - IHE Colombia Workshop (12/2014) Module 5a
1. RSNA 2014
IHE Profiles for
Radiology Applications
Written by: David S. Mendelson, M.D.
Professor of Radiology
The Icahn School of Medicine at Mount
Sinai
Senior Associate - Clinical Informatics
The Mount Sinai Medical Center
Co-chair IHE International Board
Adapted and presented for the
IHE Colombia IHEWorkshop by:
Elliot B. Sloane, PhD, CCE,
FHIMSS
Co-chair IHE International Board
President, Center for Healthcare
Information Research and Policy
(CHIRP)
4. What is IHE?
IHE is International
Provides for local variation
IHE includes
participation from
Professional organizations
Vendors
End users
1997: Founded in Radiology (RSNA)
and IT (HIMSS)
Many professional societies
(stakeholder representation)
American Academy of Ophthalmology
(AAO)
American College of Cardiology (ACC)
American College of Physicians (ACP)
American College of Clinical Engineering
(ACCE)
American College of Emergency
Physicians (ACEP)
American Society forTherapeutic
Radiation Oncology (ASTRO)
GMSIH (IT France), JAHIS (IT Japan), SFIL
(laboratory)
Healthcare Information Management
Systems Society (HIMSS)
Radiological Society of North America
(RSNA)
And many more….
5. 5
IHE: A Framework for Interoperability
A common framework for harmonizing and implementing
multiple standards
Application-to-application
System-to-system
Setting-to-setting
Enables seamless health information movement within and
between enterprises, regions, nations
Promotes unbiased selection and coordinated use of
established healthcare and IT standards to address specific
clinical needs
6. 6
Stakeholder Benefits
Healthcare providers and health authorities
Improved workflows
Information whenever and wherever needed
Reduced implementation costs
Vendors
Align product interoperability with industry consensus
Decreased cost and complexity of interface installation and management
Focus competition on functionality/service not information transport
SDOs- Standards Development Organizations
Rapid feedback to adjust standards to real-world
Establishment of critical mass and widespread adoption
7. 7
Standards: Necessary…Not Sufficient
Foundational - to interoperability and communications
Broad - varying interpretations and implementations
Narrow - may not consider relationships between standards
domains
Plentiful - often redundant or disjointed
Focused - standards implementation guides focus only on a
single standard
IHE provides a process to implement an
integrated solution based upon multiple
standards
10. Coordination of Deployment Activities
3-Tier Model
Global Deployment Coordination Committee (GDC)
Continental Mirror Committees
IHE Americas IHE Europe IHE Asia
Representatives from each
Continental Mirror Committee
Meet regularly by Tcon
Others …
IHE World Summit
rotating country/continent, e.g. aligned with another global event like ISO
All Deployment Committees are
invited to an annual World Summit
Organizes
US CDN FRA TUR JPN CN
11. IHE – the process
Identify Interoperability issues
Develop Integration Profiles
Actors andTransactions
Workflow
Gather relevant standards
ConnectathonTesting
Publish Integration Statements
Vendors list tested profiles
12
12. IHE terminology
Integration Profiles
Describe workflow use cases, standards and the overall
relationships to achieve transparent interoperability
Integration Statements
Tell customers the IHE Profiles supported by a specific
release of a specific product.
Technical Frameworks
The documents for each “domain” that specify the
Integration Profiles and the associated systems (actors) and
transactions.
Connectathons
Testing events
? Certification
15. Development - IHE Domains
• Anatomic Pathology
• Cardiology
• Dental
• Eye Care
• IT Infrastructure (ITI)
• Laboratory
• Patient Care Coordination
• Patient Care Devices
• Pharmacy
• Quality, Research and Public Health
• Radiation Oncology
• Radiology
• Mammography
16. ITI Profiles
XDS,XDS- I Cross Enterprise Document Sharing
XCA, XCA-I Cross Community Access
XDR, XDR-I Cross-Enterprise Document Reliable Interchange
Document sharing in the absence of a registry and repository
XDM Cross-enterprise Document Media Interchange
XUA Cross Enterprise User Assertion Integration Profile
XDS-SD Cross-Enterprise Sharing of Scanned Documents
BPPC Basic Patient Privacy Consents
ATNA AuditTrail and Node Authentication
20. Major Radiology IT Themes-
Meaningful Use for the Radiologist
Radiation Exposure- REM
Aggregating and monitoring patient and population
exposure
ACR DIR mapping tool
RadLex Playbook- vendors are interested in making this part of
an IHE profile
Image Sharing- XDS
IHE XDS; Personal Health Records as a vehicle
Reporting
Teaching and Research- TCE
MIRC
CTP
Meaningful Use – ONC/CMS
21. New Radiology Profiles
MRRT
Management of Radiology ReportingTemplates
IID
Invoke Image Display
22. Radiation Exposure
Evaluating legacy dose information
OCR solutions
Evaluating dose today
Within the institution
Comparing multiple instruments
Patient
Site comparison
IHE- REM profile
ACR registry- Dose Index Registry (DIR)
Site to Site comparison as well as within an enterprise
Radlex terms- RadLex Playbook mapping tool
24. TCE- Teaching File and
Clinical Trial Export
How to get images directly out of PACS as a
part of your normal workflow
MIRC compatible
Image Selector
Image Exporter
Receiver
29. NIBIB/RSNA Image Sharing Project
Consumer Control-Patient
Engagement
Diminishes the need for BAAs
between enterprises
Imaging Site to Clearinghouse
Clearinghouse to PHR
Bootstrap an IHE based network
Employ IHE solutions whenever
possible
IHE generally has not focused on
consumer driven solutions but
rather on institutional and
enterprise workflow
Can be extended to other forms of
sharing
HIE
Security, Security…….
5 Academic Institutions
Develop a solution for all
Radiology Sites
Establish a clearinghouse
Engage PHRs
Primary emphasis is Consumer
Control through PHRs
Security and Confidentiality are
drivers
Replacement / Alternative to CD
A Standards Based Solution
30. Technical Framework
Planning Committees identify the work to be done
in a yearly cycle
Technical committees develop a solution
Public Comment
Refined solution is released for “Trial
Implementation”
FinalText is published as part of theTechnical
Framework
32. Document Use Case
Requirements
Identify available
standards (e.g. HL7,
DICOM, IETF, OASIS)
Develop
technical
specifications
Testing at
Connectathons IHE
Demonstrations
Products
with IHE
Timely access to
information Easy to integrate
products
IHE Deployment Process
33. Connectathons- Testing
How does the end user know
that a system is compliant?
Vendor develops a solution
following the specifications of a
profile
Vendors test their solutions with
one another at a Connectathon
“Monitors” judge success
Modules are tested
Vendors that pass testing can
then implement these modules
as part of larger systems
The first Connectathon was held
in 1999 in Chicago, IL, within the
basement of the Radiological
Society of North America's
(RSNA) parking garage.
At the first Connectathon there
were 23 vendors, 47 applications
tested, and 1 IHE Integration
Profile tested.
The IHE NA Connectathon 2012
held over 150 organizations and
has grown dramatically to
include over 450 participants,
which is held annually at the
Hyatt Regency Chicago.
35. 41
Events: Connectathon
The IHE-C Connectathon was held at April 26, 2008 in Beijing Tiantan Hospital
There are 7 companies attendedDr. Zhu, Chairman of IHE China, past vice
Minister of Healthcare attended
36. After the Connectathon
Vendor may publish an “Integration Statement”
IHE maintains a product registry
End Users can use this information when
evaluating an RFP response
42
40. Certification- IHE Profiles
Currently Connectathon testing results in a vendor being
able to state they are compliant. IHE USA has
embarked on a formal certification process. Trial
Working Group – IHE International wished to provide
more structure for all such activities and created a
working group
41. Conclusions
IHE provides workflow driven standards based
interoperability solutions
Easier to implement
Promotes transparent interoperability between
disparate systems
Diminishes costs
Promotes quality
www.ihe.net