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Image Sharing- the NIBIB/RSNA image sharing project employing IHE solutions. Fourth China-U.S. Roundtable Meeting on Scientific Data Cooperation:. IHE-Providing the Foundation for Interoperability. David S. Mendelson, M.D. Professor of Radiology Chief of Clinical Informatics

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image sharing the nibib rsna image sharing project employing ihe solutions

Image Sharing- the NIBIB/RSNA image sharing project employing IHE solutions

Fourth China-U.S. Roundtable Meeting on Scientific Data Cooperation:

IHE-Providing the Foundation for Interoperability

David S. Mendelson, M.D.

Professor of Radiology

Chief of Clinical Informatics

The Mount Sinai Medical Center

Co-chair IHE International Board

presentation objectives
Presentation Objectives
  • Integrating the Healthcare Enterprise (IHE)
    • Overview- How is IHE organized?
  • Healthcare Interoperability in the United States
    • Challenges
    • ARRA (American Recovery and Reinvestment Act)
  • Image Sharing
    • Via HIE
    • Image Sharing Project- Personal Health Records (PHRs)
integrating the healthcare enterprise the state of ihe 2010

Integrating the Healthcare EnterpriseThe state of IHE - 2010

David S. Mendelson, M.D.

Chief of Clinical Informatics

The Mount Sinai Medical Center

Co-chair IHE Board

international adoption of ihe
Germany

Holland

Norway

Canada

Austria

Taiwan

France

Japan

Korea

China

Spain

USA

Italy

UK

Year 7 (2005)

Year 8 (2006)

Year 1 (1999)

Year 2 (2000)

Year 3 (2001)

Year 4 (2002)

Year 5 (2003)

Year 6 (2004)

International Adoption of IHE
  • Local Deployment
  • National Extensions (Local Adaptions)
  • Promotional & Live Demonstration Events
  • Funding

Pragmatic global standards harmonization + best practices sharing

national and regional projects using ihe profiles
Lower

Austria

Austria

National and Regional Projects Using IHE Profiles

Netherland

Amsterdam

Italy (Conto Corrente Salute)

UK CfH

(Radiology WF)

Denmark (Funen)

Italy (Veneto)

Spain (Aragon)

FranceDMP

Quebec, Toronto,Alberta, British ColumbiaCanada Infoway

VITL-Vermont

Boston Medical Center - MA

Philadelphia HIE

CPHIC – Pennsylvania

CareSpark – TN & VA

South Africa

THINC- New York

NCHICA – N. Carolina

Malaysia

CHINA-MoH

Lab results sharing

JAPAN-Nagoya

Imaging Info Sharing

CHINA-Shanghai

Imaging Info Sharing

slide6
IHE International Board

Global Development

IHE North America

IHE Asia-Oceania

China

Japan

Radiology

IT

Infrastructure

Laboratory

Canada

USA

Korea

Taiwan

Cardiology

Patient Care

Coordination

Pathology

IHE Europe

Radiation

Oncology

Patient Care

Devices

Eye Care

Austria

France

Germany

Netherlands

Italy

Norway

Spain

UK

Sweden

Professional Societies / Sponsors

ACC

ACCE

ACEP

ACP

GMSIHIMSS

Contributing &

ParticipatingVendors

COCIR

EAR-ECR

DRG

SIRM

BIR

EuroRec

RSNA SFRSFIL

ESC

JAHISJIRAJRS

METI-MLHW

MEDIS-DCJAMI

IHE Organizational Structure

Regional Deployment

ihe china http www ihe c org
IHE China: http://www.ihe-c.org

Thank You for Your Attention

Prof. Jianping Dai, MD

slide8
Events: Promotion

Education and Promotion by Journals

Education and Promotion by Workshop

slide9
Events: Connectathon

Dr. Zhu, Chairman of IHE China, past vice Minister of Healthcare attended

There are 7 companies attended

The IHE-C Connectathon was held at April 26, 2008 in Beijing Tiantan Hospital

slide10
Events: Connectathon

The IHE-C Connectathon was held at April 26, 2008 in Beijing Tiantan Hospital

ihe the process
IHE – the process
  • Identify Interoperability issues
  • Develop Integration Profiles
    • Actors and Transactions
    • Workflow
    • Gather relevant standards
  • Connectathon Testing
  • Publish Integration Statements
    • Vendors list tested profiles
interoperability in the us challenges
Interoperability in the US-Challenges
  • Privacy rights
  • HIPAA
  • No Single identifier
office of the national coordinator for healthcare it onc
Office of the National Coordinator for Healthcare IT (ONC)
  • Health Information Technology Standards Panel (HITSP)
  • Certification Commission for HIT (CCHIT)
  • American Recovery and Reinvestment Act (ARRA)
    • Includes financial incentives for adoption of the Electronic Health Record throughout the US
      • Interoperability is a cornerstone
    • Funding for related research- NIH
      • Quality -Comparative Effectiveness
      • EHR
xds cross enterprise document sharing
XDS (Cross-Enterprise Document Sharing)
  • XDS.a
  • XDS- I.a
  • XDS.b
    • ?? XDS-I.b
  • a vs. b
    • Related to web standards and transactions
nibib contract summary
NIBIB contract summary
  • Consumer Control
  • Employ IHE solutions whenever possible
    • IHE generally has not focused on consumer driven solutions but rather on institutional and enterprise workflow
  • 5 Academic Institutions
    • Mayo Clinic
    • Mount Sinai Medical Center
    • University of California San Francisco
    • University of Chicago
    • University of Maryland
  • Establish a clearinghouse
  • Engage PHRs
  • 300,000 patients over 2 years
elements of solution
Elements of Solution
  • Edge Server
    • Register a patient
    • Listens to a Radiology Information System (RIS)- looking for a complete exam
    • Retrieves Image set from PACS and Report from RIS
    • Send both to clearinghouse
  • Clearinghouse – functions as a secure router
    • Transiently hold encrypted patient data
  • PHR
    • Consumer controls upload and future access
    • Develop web based viewers
    • Download full DICOM data set
xds cross enterprise document sharing1
XDS (Cross-Enterprise Document Sharing)
  • XDS.a
  • XDS- I.a
  • XDS.b
    • ?? XDS-I.b
future directions
Future Directions
  • Refine Workflow
    • Initial workflow is to replace a CD
    • Exam updates
    • Download DICOM data and archive in a local PACS
  • Edge server as a platform
    • Radiation Monitoring
    • Peer Review
    • Quality Metrics
radiation exposure monitoring profile rem
Radiation Exposure Monitoring Profile -REM
  • Supplement to Technical Framework for Trail Implementation
  • Acquisition modalities inlcudes information regarding dose exposure
    • Estimates
  • Permits communication of that information to other systems
  • Useful for Individual lifetime estimates as well as Population analysis
radiation exposure monitoring rem
Radiation Exposure Monitoring (REM)
  • Includes
    • CT
    • Plain X-Ray
    • Mammography
  • Current Exclusions
    • Nuclear Medicine
    • RT
    • Brachytherapy
slide32
DICOM Dose SR objects
    • DICOM 2008 PS 3.3: A.35.8 X-Ray Radiation Dose SR IOD
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