Cardiology Workflow Cardiology IHE ACC-03 Paradigm differences

Cardiology Workflow Cardiology IHE ACC-03

Paradigm differences – Radiology v. Cardiology • Cardiologists … – Are frequently physically separated from Hospital and Office (mobility) – Diagnose and treat patients directly (ownership and self referral) – In general generate more complex reports then Radiologists – Are autonomous – “Getting Cardiologists to agree is like herding cats” Cardiology - IHE Andrew M. Keller, MD 2

Workflow • Ideal workflow for a Cardiology test – With integrated patient view • Each step may be a topic for an IHE • technical framework Goal : Balance existing Radiology technical frameworks with critical Cardiology workflow needs Cardiology - IHE Andrew M. Keller, MD 3

Workflow Events • Order entry, processing, and receipt • Pre-authorization (advanced beneficiary notice) – Professional / Global – Technical • Patient scheduling • Staff / room scheduling • Transportation if inpatient Cardiology - IHE Andrew M. Keller, MD 4

Workflow Events • Patient Registration – – with HIS/LCR Demographic reconciliation • Coordination and scheduling with mobile • physicians performing the examination Generate workflow documents “the folder” • • Cardiology - IHE Hardcopy of order Billing information Previous reports Previous media Andrew M. Keller, MD 5

Workflow Events • DICOM Worklist to carts (DMWL) • Study acquisition • Notification of study status changes to CPOE/HIS – MPPS • (DICOM Modality Performed Procedure Step) • ordered, pending, in acquisition, preliminary, final, signed • Study storage and final archiving • Study retrieval using an intelligent rapid search Cardiology - IHE Andrew M. Keller, MD 6

Workflow Events • Materials management • Study dissemination – Intranet • Diagnostic format for review • Bedside review – low resolution – Extranet – low resolution review and interface – CD or other hard copy for dissemination Cardiology - IHE Andrew M. Keller, MD 7

Workflow Events • Reporting – – Review workstation Physician entry paradigm for report Preliminary report dissemination Final report • Electronic signature • Dissemination – hard copy, email, fax, HIS/LCR – Revision and reconciliation • Quality assurance Cardiology - IHE Andrew M. Keller, MD 8

Workflow Events • Data mining • Billing and auditing – Professional and Technical • Electronic • Link to BAR – Automatic Audit tracking and reporting • Disaster Recovery Cardiology - IHE Andrew M. Keller, MD 9

Milestones • Existing IHE integration profiles – Access to Information – Q/R images – Key Image Notes – Consistent Presentation – Simple Image / Numeric Reports – Basic Security – Schedule workflow – Patient Info / Reconciliation – Charge Posting – Post Processing Workflow Cardiology - IHE • Possible top workflow events to prioritize – Bidirectional order processing, status, reconciliation, and DMWL – Scheduling staff/equipment and physicians – Posting to BAR with ABN – Secure Web based viewers – Consistent Presentation of Waveforms Andrew M. Keller, MD 10

Mission • In order to reduce medical errors, improve quality, and efficiency IHE shall develop intercommunication standards to manage order entry, acquisition, and billing, and provide a consistent display of images, waveforms, measurements, and reports leveraging existing IHE technical frameworks. Cardiology - IHE Andrew M. Keller, MD 11