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IHE Takes PACS to the Next Level

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  • 30 MINUTE PRESENTATION Attendees will get a basic overview of: - What IHE is and who is doing it - What IHE does for you (Integration Profiles) - How IHE relates to HL7 and DICOM - How to get IHE functions from your Vendors

IHE Takes PACS to the Next Level IHE Takes PACS to the Next Level Presentation Transcript

  • Integrating the Healthcare Enterprise IHE takes PACS to the next level Paul Nagy, PhD Assistant Professor of Radiology Medical College of Wisconsin
  • IHE takes PACS to the next level
    • Six reasons to use IHE today
  • Diffusion of innovation model
    • 1943 model of Iowa farmers adoption of hybrid seeds
    • Five personality and socioeconomic categories
    Time Innovators Early Adopters Early Majority Late Majority Traditionalists B. Reiner, E. Siegel “Psychological factors affecting the adoption of PACS” Applied Radiology Volume: 31 Number: 4 April 2002
  • There is PACS and then there is PACS
    • The difference is integration
    • With the RIS
    • With the Modalities
    • With the Dictation system
    • With the Hospital Network
    • IHE covers some of the more pressing integration problems
  • Reason #1: Life expectancy of your PACS
    • If you …
    • Want
    • Hope
    • Expect
    • Need
    • Pray
    • .. your PACS will last more than 3-4 years, you should be trying to use IHE where possible.
  • Technology Lifetime Standards (DICOM, HL7, IHE, SNIA…) 25- 50 years Infrastructure (IP, SAN,…) 10- 20 years Programming Languages (PL/1, Pascal, C, C++, Java, …) 5-10 years Software (data formats, compatibility, …) 2-5 years Hardware (Network cards, video cards, processors, …) 1-2 years Shapiro, IBM
  • Reason #2: PACS alone doesn’t magically fix errors
    • What happens when you get rid of all the film room personnel (and your human safety net)?
    • Will the electronic systems protect you from making mistakes?
  • Malpractice
    • Smith J, Berlin L, “Malpractice Issues in Radiology: Picture Archiving and Communication Systems (PACS) and the Loss of Patient Examination Records”, AJR: 176, June (2001), pp1381-4
    Failures of second generation systems without robust interfaces and integrity checking
  • Reason #3: PACS alone doesn’t increase productivity
    • Errors causes rework
    • Redesigning your work
    • Automating steps through interfaces
    • IHE provides a framework for robust interfaces
  • Sending safely from modality to PACS Basic PACS W/ IHE SWF
    • Scanner sends CT data to PACS
    • Tech logs into PACS and confirms all the images made across by the image count on the modality.
    • Tech manually selects, deletes, and confirms the deletion on the modality.
    • Scanner sends CT data to PACS
    • Scanner requests commitment of storage
    • PACS returns a commit for every image sent
    • Modality registers commit and sets study as archived and available for deletion off of the modality.
    What if the tech forgets to delete the study? What if the tech makes a mistake and deletes a study that hasn’t been archived. What if the tech misses the count? Which way is more efficient and more effective? Deming rule “Cease dependence upon inspection”
  • Reason #4: Getting vendors to work together
  • If getting one vendor to do what you want is hard.
  • How do you get two to work together?
  • IHE is for the relief of pains that PACS can cause
  • Reason #5: IHE is easier than DICOM
    • And more reliable
    • IHE sits atop DICOM and HL7
    • Is more stringent in mandatory fields to enable workflow
  • Reason #6: People will think you are really smart at work
    • IHE is not a standard
    • It is really a blueprint trying to solve tricky workflow problems.
    • There is enormous intellectual property in IHE and extremely thorough solutions to problems.
    • Tap into the experience and knowledge.
    • In many ways IHE is the lessons learned from all those who have tried to go soft-copy in the past decade and ran into stumbling blocks.
  • Product Evaluation Worksheet
  • Vendor Integration Statements
  • Contract Negotiation
    • “…90% payment contingent upon successful implementation and operation of … profile.”
    • Integration with other information systems is becoming more and more a differentiator between medical devices.
  • So What Now?
    • Users drive the market, you have the power.
    • Consider including IHE in your integration planning strategies
    • Take a look at the IHE Technical Framework and supporting information
    • Use IHE Integration Profiles when writing RFPs and purchasing specifications
  • Information Resources
    • Brochures and Reprints
      • IHE Integration Profiles
      • IHE At-a-Glance
      • Reprints of IHE technical papers
      • IHE Product Evaluation Worksheets
      • IHE Technical Framework
      • The IHE FAQ; IHE Video
      • IHE Fundamentals, Purchasing Strategies, IHE Primer
      • IHE Integration Checklist, Connectathon Results
      • HIMSS Monograph
    www. rsna .org/ ihe Thank you!