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August 31, 2004 Year 1 of IHE Cardiology @ ESC
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August 31, 2004 Year 1 of IHE Cardiology @ ESC



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  • Specifies transactions that function to maintain the integrity of patient, image, and order information across systems Integrates modalities with information and imaging systems Biggest Value of IHE Smooth flow of patient, image and order information across systems Status updates of orders Integrates modalities with information and imaging systems


  • 1. Integrating the Healthcare Enterprise Achievements and Lessons Learned from Six Years of IHE Radiology Cor Loef Philips Medical Systems Co-chair IHE-Radiology Technical Committee
  • 2. Content
    • Expectations of stakeholders
    • Essence of the IHE process
    • Achievements in Radiology
    • Lessons learned
  • 3. IHE Stakeholders
    • Societies Representing Healthcare Segments
      • ( RSNA, HIMSS, ACC, ESC, Other Professional Societies… )
    • Users
      • ( Clinicians, Medical Staff, Administrators, CIOs, … )
    • Information Systems Vendors
    • Imaging Systems Vendors
    • Consultants
    • Standards Development Organizations (SDOs)
      • DICOM
      • HL7, others …
  • 4. Stakeholders’ expectations of IHE
    • Improve the efficiency and effectiveness of clinical practice by providing the needed information at the work spot for the best decisions
    • Speed up the rate and quality of integration in healthcare environments by products with demonstrated validity
    • Prove that integration is attainable based on standards in a multi-vendor environment, with growth-blueprint
    • Open-up markets by lowering integration barriers
    • Foster communication and voluntary collaboration among vendors
  • 5. Benefits to IHE Stakeholders
    • Clinicians
      • Improved workflow
      • Information when and where needed
      • Fewer opportunities for errors
      • Fewer tedious tasks/repeated work
    • Administrators
      • Improved efficiency
      • Best of breed opportunities
      • Decreased cost and complexity of interface deployment and management
  • 6. Benefits to IHE Stakeholders
    • Vendors
      • Decreased cost and complexity of interface installation and management
      • Validation of integration at Connectathon
      • Lower the threshold and establish an infrastructure for new markets
      • Focus competition on functionality/service space, not information transport space
    • SDOs
      • Rapid feedback to adjust standards to real-world
      • Establishment of critical mass and widespread adoption
  • 7. Essence of IHE process: IHE drives healthcare standards based-integration
  • 8. Putting standards together…. for effective information exchange Bridging the gap ? How to drive effective standards Implementations
    • IHE:
    • Integration Profiles Spec.
    • Testing Process
    • Compliance
    • Practical Deployment
    Purchasing, operational, legal policies are required to deploy and use properly the integrated systems and shared patient information Providers, Payers & Policy Makers define constraints for health-system, regional structures, business objectives, legal reqmts. Policies e.g. HIPAA, RFP, Product Acquisition Contracts, Patient EHR Portability Policies Standards designed to span a broad range of use cases for the present and the future Healthcare domains require highly structured and specialized clinical standards well beyond generic IT standards Info. Exchg. Standards e.g. HL7, DICOM, SNOMED, X12, ASTM, LOINC, AAMI, CCR, NCCLS, NCPDP, CDA, Arden, IEEE, NDP + All IT Stds: Kerberos, IETF-RFCs, W3C, LDAP, ISO, IEEE, ebXML, etc.
    • Solid & long-lasting
    • Flexibility & many options
    Providers and Vendors think in term of “solutions” to address specific workflows in clinical or infrastructure domains Workflow Integration Set of specific information exchange standards to be specified for product plug & play for each specific workflow
    • Specific and Common
    • Options Removed
    IHE Integration Profile IHE Product Integration Statement
  • 9. The IHE process steps
  • 10. A Proven Standards Adoption Process User Site IHE Connectathon Results
    • IHE Integration Profiles at the heart of IHE :
      • Detailed selection of standards and options each solving a specific integration problem
      • A growing set of effective provider/vendor agreed solutions
      • Vendors can implement with focus
      • Providers can deploy with stability and incremental growth
    Easy to Integrate Product s IHE Connectathon Product With IHE IHE Demonstration RFP Standards IHE Integration Profiles B IHE Integration Profile A IHE Technical Framework Product IHE Integration Statement
  • 11. Achievements in IHE Radiology 1997/98 — The Foundation of IHE, Integrating the Healthcare Enterprise 1999/2000 — First IHE demonstration at RSNA/HIMSS Scheduled Workflow: Modality Worklist, Procedure Step, Storage Commit
      • Consistent Presentation, Slice Lines
      • Grouped Procedures, Reporting, Templates
      • Security, CAD Workflow, Exception Mgt, Charge Posting, Key Image Note
      • Reporting Workflow, Evidence Documents,
      • Multiple-source option
      • 2000/1
      • 2002
      • 2003
      • 2004
      • Portable Data for Imaging, NM Image
  • 12. IHE Radiology Integration Profiles Patient Info. Recon-ciliation Basic Security - Post-Processing Workflow Scheduled Workflow Access to Radiology Information Consistent Present- ation of Images Evidence Docs Key Image Notes Simple Image & Numeric Reports Presentation of Grouped Procedures Reporting Workflow Charge Posting Portable Data for Imaging NM Image
  • 13. IHE Radiology Scheduled Workflow
  • 14. The Annual “Connectathon”
    • Unprecedented Cross-Vendor Testing
    • Connectathon for IT Infrastructure San Diego - January 26 - 30, 2004
    • Connectathon for Radiology Tokyo – February 2004
    • Connectathon for IT Infrastructure, Laboratory & Radiology - Padova (Italy) March 29 - April 2, 2004
    • Connectathon for IT Infra, Lab, Cardiology, Radiology - January 2005
  • 15. Connectathon impression
  • 16. Participating vendors in the medical imaging industry
  • 17.  
  • 18. Live Integration of 47 HIS, RIS, PACS, and Modalities from 24 vendors Participation in the demonstrations
  • 19. IHE Integration Statements published by vendors
    • Product UVW supports the
    • IHE K Actor with the
    • IHE X and Y Integration Profiles
    • IHE J Actor with the
    • IHE T Integration Profile
  • 20. IHE Integration Statement
  • 21.  
  • 22.
    • IHE User Success Stories – Submitted since RSNA 2002 (IHE Becomes Reality)
    • Provider Demonstration of their IHE Success – Planned for RSNA 2004.
    IHE – Driving Market Adoption
    • IHE measures Success on:
      • Compliant products availability
      • Provider deployed integrated systems at clinical sites
  • 23. IHE process expansion to new domains
  • 24. Radiology Planning Committee Radiology Technical Committee IHE Europe Committee IT Infrastructure Planning Committee IT Infrastructure Technical Committee IHE Japan Committee Laboratory Sub-Committee Pharmacy Sub-Committee IHE France Planning Committee IHE Germany Planning Committee IHE Italy Planning Committee IHE UK Planning Committee IHE Norway Planning Committee IHE Strategic Development Committee KOREA EUROPE Global Development JIRA COCIR EAR ECR HIMSS JRS SFR DRG SIRM RSNA … GMSIG ZVEI BIR ACC ESC ..... ... Professional Societies / Sponsors USA IHE USA Committee IHE NL IHE Spain Cardiology Planning Committee Cardiology Technical Committee IHE geographic expansion JAPAN IHE Korea Committee
  • 25. IHE Organizational Structure Multi-Domain & Multi-National Participants contribute Global Development: Radiology, IT Infrastructure, Cardiology, Lab, etc. IHE Domain-related Planning and Technical Committees Delegates IHE Europe IHE North America IHE Asia/Oceania Regional & National Deployment supervises reports IHE (International) Strategic Development Committee Sponsor Co-Chairs Global Interoperability National Extensions
  • 26. In Summary: IHE Radiology
    • Now entering Year 7 (of the initial foreseen 5 year )
    • 50+ vendors worldwide
    • 100+ systems in annual Connectathons
    • Geographic spread
      • U.S., France, Germany, Japan, Italy, U.K, Netherlands, Spain, etc.
    • Well over 100 commercial products available
    • Countless sites integrated with IHE enabled products
  • 27. Lessons Learned IHE Radiology
    • Essential role of sponsor societies and individual leaders to drive the process with a vision, ambition and energy, and facilitate the voluntary collaboration of the industry participants
    • Marketing of the IHE initiative and benefits is not easy, because the first interest of the vendors is on the unique features of their products
    • Demonstrations are needed to get initial momentum in an IHE domain, but subsequently the focus needs to shift to Success Stories to keep the process going
    • Carefully monitor the real deployment in products of the IHE Integration Profiles, otherwise danger of creating IHE Utopia
    • Domains with larger scope, more industry players, more societies, government involvement, will be more difficult to organize than “simple” Radiology