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IHE Cardiology

IHE Cardiology. Presenters. Why IHE Cardiology?. Multiple locations Office, in-patient, ED Individual patient is seen in multiple locations – distributed patient record Individual clinician practices in multiple locations – across organizational boundaries Multiple devices and modalities

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IHE Cardiology

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  1. IHE Cardiology Presenters

  2. Why IHE Cardiology? • Multiple locations • Office, in-patient, ED • Individual patient is seen in multiple locations – distributed patient record • Individual clinician practices in multiple locations – across organizational boundaries • Multiple devices and modalities • Need to integrate data for comprehensive view of patient • Multiple specialists cooperating on single patient • Chronic Disease • Long term patient care – persistent and evolving patient record Lots of hard data integration problems

  3. IHE Cardiology Organization • Principal Sponsor :American College of Cardiology • European Sponsor :European Society of Cardiology • Specialty Society Sponsors : American Society of EchocardiographyAmerican Society of Nuclear CardiologyHeart Rhythm Society

  4. Year 1 - Laying the foundation • IHE Cardiology Year 1 (2004-5) focus on managing in-patient workflow with consistently identified data • Cardiac Catheterization Workflow Profile • Echocardiography Workflow Profile • Retrieve ECG for Display Profile

  5. Cath Lab Multiple re-entry of Patient ID Error prone Results fragmented across systems Results inconsistently time-tagged Custom solutions needed for data sharing Difficult to manage Uncoordinated with Hospital Information System Unidentified patients (emergency) Un-ordered cath exams Diagnostic and interventional procedures Ad hoc scheduling of cath labs Change of rooms during procedure 7 6 5 8 10 9 11 4 3 2 1

  6. Echo Workflow • The “drive-by echo” – Cardiologist to sonographer in CCU: “While you’re here, do a TTE on bed 3” • Unordered, unscheduled exam • Machine disconnected from network • Stress echo –After exam, sonographer creates new quad displays of stages and views • No intrinsic value add • Data is redundantly copied to storage

  7. Retrieve ECGs for Display • Web technology (HTTP, PDF, XML) • Integrated into client medical applications (clinical workstations – not free-standing Web browsers) • Vector PDF, XML list

  8. Year 2 - Getting results • IHE Cardiology Year 2 (2005-6) focus on reporting • Cath and Echo Evidence Documents Profile (quantitative measurements) • Displayable Reports Profile • Cross-Enterprise Document Sharing (from IT Infrastructure)

  9. Cath and Echo Evidence Documents Echocardiography Measurement Patient: Doe, John Technologist: der Payd, N Measurements: Mitral valve diameter 3.1cm - shown in image at [ ] Ventricular length, diastolic 5.97 cm - shown in image at [ ] Ventricular volume, diastolic 14.1 ml - inferred from [ ] - inferred from VLZ algorithm Pick your current kludge: • Measurements made on modality or workstation, and written onto a paper worksheet, then transcribed into a report • Measurements output to a printer port, intercepted by an application that scrapes the values • Screen capture of measurements sent to a reporting system, which uses OCR (optical character recognition) to reconstruct the original measurement names and numbers

  10. Cardiology reports typically PDF with lots of graphics Standard profile for submitting reports encapsulated in HL7 v2 messages Displayable Reports

  11. DocumentRepository Cross-Enterprise Document Sharing Documents Registry EHR-LR:Longitudinal Recordused across encounters Long Term Care Acute Care (Inpatient) Other Specialized Careor Diagnostics Services PCPs and Clinics (Ambulatory) EHR-CR: Care Record systemssupporting care delivery

  12. Year 3 - Expanding breadth • IHE Cardiology Year 3 (2006-7) focus on addressing specialties and more specific cross-institutional sharing • Orders and Observations Profile • Stress Test Profile – ECG+Imaging • Implanted Cardiac Device Observations Profile • Nuclear Medicine (with Radiology) • Portable Data for Imaging – DVD (with Radiology) • Cross-Enterprise Document Sharing • Medical Summaries (from Patient Care Coordination) • Imaging Studies (from Radiology) • Urgent Implanted Device Identification

  13. 2006-2007 Cardiology Events • February – release some Cardiology Year 3 profiles for “early” public comment • March – Year 2 demonstration at American College of Cardiology (Atlanta) • April – release remaining Year 3 profiles for public comment • June – release Year 3 profiles for Trial Implementation • September – Year 2 demonstration at European Society of Cardiology (Barcelona) • January 2007 – IHE Connectathon for Year 3

  14. IHE Web site: www.IHE .net • Frequently Asked Questions • Integration Profiles in Technical Frameworks: • Cardiology • IT Infrastructure • Laboratory • Patient Care Coordination • Radiology • Connectathon Results • Vendor Products Integration Statements • Participation in Committees & Connectathons

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