IHE for Product Planners Ellie Avraham — Carestream

IHE for Product Planners Ellie Avraham - Carestream Health Co-Chair IHE Radiology, Technical Committee 3/16/2018 1

Learning Objectives Clinical and Economic benefits of Integration for your customers – IHE Radiology Users Handbook Improve Product Functionality by using the IHE Technical Framework Improve Integrated System Solutions Workflows by using IHE Integration Profiles IHE Success stories and other information to refine the Products “Business case” evaluation IHE Process to Synchronize it with the Product Planning & Development 2

Discussion Areas IHE Deployment Process IHE Integration Profiles The Value Proposition from Planning Products and Integrated Solutions using IHE 3

Challenges of Integration Solutions Available Today from Several Medical Systems Vendors – BUT. . . Modern Healthcare Enterprises Are Still Confronted with Problems: (In Spite of IT Standards and Advanced Technology) § Lack of Access to Complete Medical Information § Inconsistent or Redundant Medical Information § § § Across Departments and Institutions Inadequate Communicating of Medical Data Across Multiple Systems from Different Vendors Risky Investments in Proprietary Solutions Clinical Workflows are not Optimized 4

IHE drives healthcare standards based-integration 5

IHE Process - Annual Cycle Product IHE Integration Statement IHE Connectathon Results IHE Technical Framework Standards IHE Integration Profiles B Profile A Product With IHE Connectathon IHE Demonstration IHE Technical Framework – Define Standard Integration Solutions Easy to Integrate Products User Site RFP IHE Connectathon Results – Most implemented and tested IHE Solutions IHE Integration Statements – Most Comertialized IHE Solutions IHE Success Story – Most Successful Used IHE Solutions IHE Users Handbook – IHE Solutions, Economical and Clinical benefits 6

IHE Calendar Annual Events for Synchronization with Product Planning Feb. 2007 – IHE Supplements Profiles for Public Comment May – IHE Supplements Profiles for Trial Implementation Aug. – IHE Participation Workshop Sept. – IHE Participation Registration: Connectathon & Demos Oct. - IHE Vendor Workshop for the Connectathon Oct. – Dec. IHE MESA Testing Validations for Connectathon Nov. - RSNA – IHE Radiology Demo Jan. 2008 – IHE Connectathon Feb. 2008 – HIMSS IHE ITI Demo 7

Using IHE for Product Planning IHE Aid for Global / International Product Planning § IHE Technical Framework (TF) > Vol 1: Defines Global Integration Profiles > Vol 2, 3: Defines the TF Transactions details for Development > Vol 4: Defines the Local National specialization details § IHE Connectathon Results – Learn what IHE solutions are developed § IHE User Success Stories & IHE Users Handbook – Learn the Clinical and Economic benefits of using products with IHE capabilities § IHE Integration Statements – The Commercialized products with IHE capabilities § RFP’s from customers 8

IHE Connectathon Results http: //www. ihe. net/Events/connectathon_results. cfm Consolidated Earlier Progress & Push for Market Adoption More Robust Connectathon § Results Recorded and Published Increased Industry Participation § 31 companies § 70 systems § 21 Additional Companies in IHE Europe 9

IHE User Success Story http: //www. ihe. net/resources/user_success_stories. cfm • Cleveland Clinic Foundation • Detroit Medical Center • Grossman Imaging Centers • Hôpitaux Universitaires de Genèv • IHE Mc. Kay-Dee Hospital • Johannes Gutenberg University Hospital • Magic Valley Regional Medical Center • Mayo Clinic Jacksonville • Our Lady Of The Lake Regional Medical Center (OLOL) • VA Puget Sound Health Care System • St. Vincent Hospital and Health Services • Steinberg Diagnostic Medical Imaging • University of Pisa • University of Wisconsin 10

IHE User Success Story & Handbook Deployment of IHE Profiles – Most Used: - Scheduled Workflow (SWF) - Patient Information Reconciliation (PIR) - Consistent Presentation of Images (CPI) - Reporting Workflow (RWF) - Basic Security for HIPAA regulations (ATNA) Clinical and Economics Accomplishments - Improve the Patient Care – Improved data accuracy and Safety, Image Quality & Consistency and time saving due to optimized Workflows and integrated systems - Improve the clinical practice productivity - reduced manual data entry using the ADT registration in one place and propagate it to all the other systems (PACS, RIS Modality) and reduced errors. - Optimize the Radiological Workflow (SWF) Reduced the incorrectly or lost studies, using DICOM MWL, MPPS 11

IHE Integration Statement http: //www. ihe. net/resources/ihe_integration_statements. cfm IHE Integration Statements document the product IHE capabilities in terms of IHE: Actors and Integration Profiles. - Promote your products with the Integration Statements - Learn from other Vendors Integration Statements the IHE Profiles and Actors supported The RSNA links to IHE Integration Statements published by the companies: - Agfa Health. Care - Cerner Corporation - Eastman Kodak Company - Emageon - Fujifilm Medical Systems USA - GE Medical Systems - INFINITT Co. , Ltd. - Mc. Kesson Information Solutions - Medcon - Philips Medical Systems - Sectra - Siemens Medical Solutions - Softmedical - Stentor - Stor. COMM, Inc - Tiani Medgraph AG - Toshiba America Medical Systems - Voxar Limited 12

Date: 03/10/2006 IHE Integration Statement Vendor Product Name Version Acme Medical Systems PACS-o-Matic V 3. 9 This product implements all transactions required to support the IHE Integration Profiles, Actors and Options listed below: Integration Profiles Implemented Actors Implemented Options Implemented Scheduled Workflow Image Manager / Archive. PPS Exception Management Patient Information Reconciliation Image Manager / Archive. None Consistent Presentation of Images Image Manager / Archive Image Display None Portable Data for Imaging Media Creator Media Importer Audit Trail and Node Authentication Audit Record Repository None Internet address for vendor's IHE information : http: //www. acme-medical. com/IHE Links to Standards Conformance Statements for the implementation Dicom: http: //www. acme-medical. com/DICOM Health Level 7: http: //www. acme-medical. com/HL 7 Links to general information on IHE In North America : http: //www. ihe. net In Europe : http: //www. ihe-europe. org In Japan : 13 http: //www. jira-net. or. jp/ihe-j

http: //www. ihe. net/Technical_Framework/index. cfm IHE Foundation IHE Technical Framework Organized in sections that provide an increasing level of detail Integration Profiles: Defines a Problem and the Solution in terms of Actors and communication transactions Actors: Identify specific kinds of operational participants in the healthcare enterprise. Transactions: Describe particular interactions between actors to perform specific operations. 14

IHE Radiology Integration Profiles Charge Posting Scheduled Workflow Patient Info. Reconciliation Presentation of Grouped Procedures NM NM Image Cardiac NM Option Post. Processing Workflow Consistent Presentation Evidence of Docs Images Reporting Workflow Key Image Notes Teaching Files & Clinical Trials Export Simple Image & Numeric Reports Image Fusion XDS for Imaging Portable Data for Imaging Access to Radiology Information Audit Trail & Node Authentication - Radiology Option 15

IHE Scheduled Workflow Profile Registration report Repository Diagnostic Workstation Film Lightbox Orders Placed Image Manager & Archive Film Folder Acquisition Modality Orders Filled acquisition in-progress completed acquisition completed Modality Film images printed 16

Patient Information Reconciliation 17

Consistent Presentation of Images Reporting Radiologist Area Of Interest Presentation State Presentation LUT Referring Physician or Reviewing Radiologist Area Of Interest Grayscale Standard Annotate Achieving Consistent Presentation Zoom Flip Window Level Without Consistent Presentation Original Image 18

Radiology Option for Audit Trail and Node Authentication (ATNA) • TLS authentication of remote node (digital certificates) • with/without encryption • Audit PHI trail with: • Real-time access • Time synchronization Secured System Secure network System B System A Central Audit Trail Repository 19

Presentation of Grouped Procedures Profile Chest View Requested Procedure: CHEST Report: CHEST RIS / PACS Requested Procedure: Ab/Pelvis View AB/PELVIS MODALITY Performs a single exam Operator groups 2 procedures Report: AB/PELVIS Chest View Ab/Pelvis View 20

Portable Data for Imaging (PDI) Distribute Imaging Information on Media Image/ Report Display CD Creator John Doe CD Printer Media Importer 21

Cross-enterprise Document Sharing for Imaging (XDS- I) Patient Identity Source Patient Identity Feed Document Registry Query Documents Document Consumer Register Document Set Document Source Image Manager Image Archive Provide & Register Document Set Document Repository Retrieve Document Retrieve Images Retrieve Presentation States Retrieve Key Image Note Retrieve Evidence Documents WADO Retrieve 22

Key Image Notes Profile Radiologist Flags Images: Note 1 Referring Physician Sees Key Images First: Note 1 for refering physician This image shows the renal rupture. For referring physician: This image shows the renal rupture. Note 2 For referring physician: This image has the hematoma. Note 1 for refering physician This image shows the renal rupture. Study & Key Image Notes Note 2 for refering physician This image has the hematoma. 23

Charge Posting Profile ADT Terminal Post Charges Account Management *Billing System Charge Poster Study Performed / Materials Used Report Generated / Signed 3 -D Performed CAD Performed Acquisition Modality 3 -D *Workstation CAD *Workstation … Report Repository 24

IHE Reporting Workflow Work Item Claimed RIS Reporting Worklist Report Manager Store Reports Report Reader/Creator Measurements CAD Reports ………………… Retrieve Images & Evidence Documents PACS & Archive Reporting Procedure Step STARTED Image Manager/ Archive Reporting Procedure Step STARTED Reporting Procedure Step COMPLETED 25

IHE Value Proposition • Product Planning • IHE Solutions are Driven by Strategic Healthcare Lead Users that collaborate with Healthcare Vendors • IHE Solutions are Generic, Reusable and Interoperable based on Healthcare Standards: DICOM, HL 7, RFC • IHE Solutions Optimize the Clinical Workflows • IHE Deployment process – Connectathon, Integration Statements and Users Success Stories information helps to refine the product “Business Case” • IHE Technical Framework specification describes the Global IHE solutions at a High Level for Planning & Marketing and in details for products Architects and Engineering development 26

IHE Benefits • Clinical Users • Greater access to consistent information • Fewer errors, fewer tedious tasks • Buyers • Specify/purchase RFP’s integration capabilities easily and Freedom to acquire “Best of Breed” systems • IT Professionals • Faster, more predictable integration projects • Facilitate cooperation of competing vendors • Administrators • Increased throughput - Better scheduling • Reduce Cost 27

Picking IHE Profiles Considerations Customer RFP’s Product positioning in the market with a Good Business Case – Selecting IHE Profiles IHE Technical Framework Volume 1, Users Handbook Healthcare Institution Needs: > Optimized Clinical Workflow : SWF, PIR, RWF > Improve the Patient Health Care: SWF, PIR, CPI, PGP, KIN > Economy - Reduce Healthcare cost: SWF, CHG > Protect the Patient Health Information: SEC 28

IHE for Product Planers Questions? IHE North America: RSNA - http: // www. ihe. net HIMSS - http: //www. himss. org/IHE ACC - http: //www. acc. org/quality/ihe. htm IHE Europe: http: //www. IHE-Europe. org IHE France: http: //www. gmsih. fr/fr/som_comm. htm IHE Germany: http: //www. IHE-D. org IHE Italy: http: //www. rad. unipd. it/IHE UK: http: //www. IHE-UK-org IHE Japan: http: //www. jira-net. or. jp/ihe-j/en/index. html 29

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