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Presented at World of Health IT 2010 Barcelona, Spain March 15, 2010  ,[object Object],[object Object],[object Object]
Presentation Overview ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Presenter:  Pierre Yves Nectoux
A Fundamental Move In Hospitals Volume of  data Clinical Expertise  dispersion Level of  IT Expertise  required ,[object Object],[object Object],[object Object],[object Object],Resources sharing  IT complexity Expertise  sharing Collaboration Patient mobility How to face these challenges ?
Real Life: Multiple Requirements, Multiple Needs  ,[object Object],[object Object],[object Object],Expertise sharing Clinicians  looking at patient records from  other health institutions Resource sharing Hospitals looking at  consolidating and sharing  their IT infrastructure Collaboration Hospitals wanting to organize  reading  between different sites, to deal with  patient mobility Multiple solutions ?
A New Approach: Cloud-based Services… Cloud Archiving Collaboration Reading Site A Site B Site ... N Sharing
What Is Cloud-based Service? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],A Business model  +  An architecture  Pay as you go Flexible & Distributed   ,[object Object],[object Object],[object Object],[object Object],[object Object]
The eHealth Cloud: A cloud For Healthcare The eHealth cloud Workflow elements General purpose cloud  Google, Amazon, … The eHealth cloud Security Confidentiality Signature Access  tracking Long term mgt
The eHealth Cloud: Implementation Example Hospital Site  Data Center  Online communities ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
The eHealth Cloud: The Ultimate Peace Of Mind  No System Change Vendor Neutral Infrastructure Customer responsibility Cloud supplier responsibility Service boundary
A Service Oriented Architecture Service Access Point #1 Tele radiology Service Access Point #2 Service Access Point #3 Service Access Point #4 Tele radiology Tele radiology Archive Information  Exchange PIX Data Management Bus Service Interface Local site Service Logic Workflows Service Infrastructure Data management One infrastructure, supporting multiple needs Data & Metadata
One Architecture, Two Examples Maasstad  Hospital Imadis Service Access Point #1 Tele radiology Service Access Point #2 Service Access Point #3 Service Access Point #4 Tele radiology Tele radiology Archive Information  Exchange PIX Data Management Bus Data & Metadata Service Interface Local site Service Logic Workflows Service Infrastructure Data management
Application To Use Cases Use Case 1: Long Term Archiving
User Profile ,[object Object],[object Object],[object Object],[object Object],[object Object],Maasstad Hospital, Rotterdam, The Netherlands
Requirements ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Maasstad Hospital, Rotterdam, The Netherlands
Workflow - Archive DICOM Encrypted data Copies
Workflow - Retrieve DICOM Encrypted requests Priors? Encrypted data Only if data not already in the DAP
Workflow - Prefetching HL7 Encrypted requests Priors? Encrypted data Only if data are  not already in the DAP Rules DICOM
Workflow – File System NFS/CIFS
Workflow – Scanned Records XDS
Workflow – Migration Automatic Take over Migration strategy
Maasstad Hospital Benefits ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Application To Examples Case Study 2: Emergency Teleradiology
User Profile ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Imadis, France Lack of  radiologists Duties spread  on less radiologists ,[object Object],[object Object]
Requirements ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Their Workflow ,[object Object],2 Formalization 3 Protocol 4 Images 4 Images 5 Report 1 Telephone Emergency department Radiographer Reading Center  IMADIS Data Center Carestream
Reading Center Reading Station: CARESTREAM PACS Virtual Reading
Examination Request
Real Time Follow Up Of The Request
Reports
Workflow: Image Transfer DICOM Encrypted data DICOM Encrypted data 1- Studies sent from local PACS 2- Transfer to data center 3- Studies forwarded to reading center  Hospital Reading Center Datacenter
Workflow: Redundancy And Alternate Route Hospital Reading Center Datacenter Alternate route always available to ensure redundancy
Imadis Benefits ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusion
One Infrastructure, Several Needs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
http://ems.carestreamhealth.com http://blog.carestreamhealth.com

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Cloud eHealth in Medical Imaging & Radiology

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  • 5. A New Approach: Cloud-based Services… Cloud Archiving Collaboration Reading Site A Site B Site ... N Sharing
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  • 7. The eHealth Cloud: A cloud For Healthcare The eHealth cloud Workflow elements General purpose cloud Google, Amazon, … The eHealth cloud Security Confidentiality Signature Access tracking Long term mgt
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  • 12. The eHealth Cloud: The Ultimate Peace Of Mind No System Change Vendor Neutral Infrastructure Customer responsibility Cloud supplier responsibility Service boundary
  • 13. A Service Oriented Architecture Service Access Point #1 Tele radiology Service Access Point #2 Service Access Point #3 Service Access Point #4 Tele radiology Tele radiology Archive Information Exchange PIX Data Management Bus Service Interface Local site Service Logic Workflows Service Infrastructure Data management One infrastructure, supporting multiple needs Data & Metadata
  • 14. One Architecture, Two Examples Maasstad Hospital Imadis Service Access Point #1 Tele radiology Service Access Point #2 Service Access Point #3 Service Access Point #4 Tele radiology Tele radiology Archive Information Exchange PIX Data Management Bus Data & Metadata Service Interface Local site Service Logic Workflows Service Infrastructure Data management
  • 15. Application To Use Cases Use Case 1: Long Term Archiving
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  • 18. Workflow - Archive DICOM Encrypted data Copies
  • 19. Workflow - Retrieve DICOM Encrypted requests Priors? Encrypted data Only if data not already in the DAP
  • 20. Workflow - Prefetching HL7 Encrypted requests Priors? Encrypted data Only if data are not already in the DAP Rules DICOM
  • 21. Workflow – File System NFS/CIFS
  • 22. Workflow – Scanned Records XDS
  • 23. Workflow – Migration Automatic Take over Migration strategy
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  • 25. Application To Examples Case Study 2: Emergency Teleradiology
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  • 29. Reading Center Reading Station: CARESTREAM PACS Virtual Reading
  • 31. Real Time Follow Up Of The Request
  • 33. Workflow: Image Transfer DICOM Encrypted data DICOM Encrypted data 1- Studies sent from local PACS 2- Transfer to data center 3- Studies forwarded to reading center Hospital Reading Center Datacenter
  • 34. Workflow: Redundancy And Alternate Route Hospital Reading Center Datacenter Alternate route always available to ensure redundancy
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Editor's Notes

  1. Connexion de l’urgentiste : Portail Web = favoris Login et mot de passe Sommaire = options disponibles Création du bon d’examen : Formulaire minimum Prescripteur et son mot de passe Patient Type d’examen Niveau d’urgence Formulaire secondaire Confirmation de la demande dans la liste Arrivée du bon Liste de travail Provenance Type d’examen Priorité Formulaire de téléradiologie Consultation de la demande Saisie du protocole Impression de la fiche suiveuse Examen accepté Connexion du manipulateur Portail Web = favoris Login et mot de passe Sommaire = options disponibles Production des images Modalité DICOM du site DICOM Storage vers le DAP Transfert vers le centre Carestream Routage vers le centre IMADIS Arrivée des images Liste de travail Affichage de l’heure d’arrivée des images Rédaction du compte-rendu Intégration contextuelle Zone de frappe Accès aux modèles Saisie d’une conclusion/ d’un résumé Validation pour publication Suivi par l’urgentiste Liste de travail Suivi de l’état de l’examen Consultation du compte-rendu préliminaire Signature du compte-rendu Zone de rédaction du compte-rendu Contrôle de la conclusion/du résumé Icône de signature Liste de travail Affichage de signature du compte-rendu