Why
IHE?
For the Clinician — Using the
work already done by IHE means you get all the clinical information
you need when you need it, where you need it, accurately integrated
into a single system. It means security, even when you’re
accessing hospital information in your office! Encourage your
administrators and IT staff to leverage IHE to save you time, your IT staff resources, and to be able to provide a better quality of care.
For the Clinical Administrator —
Using the work already done by IHE means improved workflow
in the labs. It means minimizing patient identification errors,
and reducing billing cycles. You won’t worry about archiving
images or gathering data for clinical registries — the
work is done. Request IHE connectivity in every purchase contract or equipment upgrade.
For the IT Staff — Get out of
the infinite interface engine cycle. Using the work
already done by IHE means software upgrades will not break
interfaces. Interface specifications are already written,
and vendor-to-vendor testing is done. Ask for IHE connectivity
in every contract.
What
is IHE?
Integrating the Healthcare Enterprise is a
professional collaboration of medical societies, clinicians
and vendors. IHE was organized to find practical solutions
to the complex issues of clinical system integration.
IHE does not develop standards. IHE promotes open
standards such as DICOM, HL7 and Web technologies. IHE
refines interface specifications using these open standards,
rigorously tests vendor implementations, and promotes their
use through Scientific Session demonstrations and education.
IHE accelerates the adoption of the Electronic
Healthcare Record (EHR), which also enables sharing of clinical
data between the hospital(s), offices and clinics. This cross-location
sharing of data may be more important to cardiology than any
practice.
All of this is done at no charge to you, the
end user. Just ask for IHE from your vendors!
Where
is IHE now?
Integrating the Healthcare Enterprise (IHE)
is a multi-year, international effort sponsored by the American
College of Cardiology (ACC), the Radiological Society of North
America (RSNA) and the Healthcare Information and Management
Systems Society (HIMSS). There are now eight “domains”
in IHE, only one of which is Cardiology. In other words,
IHE is integrating all of a patient’s clinical information,
not just the patient’s cardiovascular history.
IHE has rapidly gained momentum in Cardiology, under the sponsorship
of the ACC. The IHE Year 2 Demonstrations at the ACC 55th
Annual Scientific Session in Atlanta were very successful
with over 1,000 people attending presentations and hands-on
demonstrations!
The “IHE North American Connectathon” is a gathering of vendors conducting vendor-to-vendor testing. In January, 2006, more than 400 software developers from 60 companies brought over 140 products to be tested in Chicago. The IHE-Japan Connectathon was held in March, 2006, in Nagoya, Japan. The IHE-Europe Connectathon took place in April, 2006, in Barcelona, Spain.
IHE Cardiology Year 3 (2006 – 2007) is well underway! IHE IT Infrastructure and IHE Radiology are entering their eighth annual IHE cycle!
How
do I learn more about IHE?
It is in your best interest to leverage the work already completed
by the IHE Cardiology initiative, and to help guide its future
development. Consider joining the IHE Cardiology Users’
Group (e-mail ihe@acc.org)
for educational sessions and Web seminars. Visit www.ihe.net
for additional IHE general information. Detailed White Papers
for every IHE Cardiology Profile, guidelines for writing a
Request For Proposal (RFP), and more, can be found below.
Or, request IHE Information by sending an email
to ihe@acc.org.
A Cross-Domain (radiology, cardiology, IT, ophthalmology, etc.) IHE Educational Workshop will be held mid-January, 2007, in Chicago, IL. The intended audience is clinicians, clinic administrators, IT staff, as well as vendor marketing/product managers or lead systems architects, interested in detailed IHE discussions. For more information, send an e-mail to ihe@rsna.org.
What
can IHE Cardiology do for me?
IHE Cardiology begins with Cardiologists in the IHE Planning
Committee. These doctors define the clinical systems integration
problems they need addressed. These become “IHE
Profiles.” IHE Cardiology is currently tackling the
following Profiles:
1. My patient was just admitted through
Emergency. I need a meds list and previous ECG from my office
— and I need it now!
Cross-Enterprise Document Sharing Profile:
The problem: A patient comes into the ED at night,
but their medications list, office notes and ECGs are in the
clinic, locked up. The patient comes into the office for a
follow-up visit, but the cath report is still at the hospital.
The solution: IHE provides a secure mechanism
to share information and data, including cath and echo images,
medications, problems, allergies, reports and more, through
a regional health information organization (RHIO).
This Profile is being developed in conjunction with the U.S.
Department of Health and Human Services (HHS) in response
to the Presidential Executive Order to enable electronic healthcare
records (EHRs).
Ask for: IHE Cross-Enterprise Document Sharing (XDS) Profile.
2. Why do I have to enter all this patient
information into five systems with five different user
interfaces in my cath lab?
Cardiac Catheterization Workflow Profile:
The problem: Cath lab management verges on chaotic.
Patient demographics have to be re-entered on multiple systems,
usually incurring data entry errors, and reconciliation of
emergency cases can be tedious or impossible. Procedure logs
and quantitative measurements cannot be shared between different
systems.
The solution: IHE provides accurate patient demographics
to all cath systems, automates after-the-fact patient reconciliation,
and enables electronic log and measurement exchange.
Accurate demographics are critical to enable data gathering
and outcomes analysis later, including data registry submissions.
Ask for: IHE Cardiac Catheterization Workflow Profile and IHE Evidence Document Profile with the Cath Option.
3. I have to compare this patient’s
previous echo measurements. How do I reconcile patient information
once the Echo system goes mobile?
Echocardiography Workflow and Evidence Documents
Profiles:
The problem: Echo carts are often mobile and
echo procedures often go un-ordered and unbilled. Echo
measurements have to be manually transcribed, if you can locate
them. Today, it is very difficult, if not impossible,
to send echo measurements from one vendor’s echo cart
to a different, or even the same, vendor’s workstation.
The solution: IHE provides accurate patient demographics,
automates order reconciliation, and enables electronic measurement
exchange. Accurate demographics are critical to enable
data gathering and outcomes analysis later, including data
registry submissions.
4. I am at my workstation and I need to
see a patient’s ECG.
Retrieve ECG for Display Profile:
The problem: Often you need to see an ECG tracing,
but are not at an ECG management system workstation. Often
a patient has had many ECGs. You have to obtain a list
of all of the known ECGs and select the patient’s first
ECG and his most recent ECG for display.
The solution: IHE enables high resolution ECGs
to be displayed from any clinical workstation. The ECG
Management system acts as a “server” allowing
a workstation to access the ECG information over the Web once
a patient has been selected.
IHE
IHE Cardiology Year 3 New Profiles available forTrial Implementation!
IHE Cardiology has entered its Year 3 effort with the publication of new Integration Profiles. In accordance with the IHE process, these new profiles were circulated for a period of one month for Public Comment in April, 2006.. Based on the Public Comment input, the IHE Cardiology Technical Committee published the profiles for Trial Implementation in June 2006. “Trial Implementation” is literally a request for vendors to try to implement the Profile and then begin interoperability testing. These new profiles will form the basis for the IHE demonstrations at the ACC Scientific Session, the ESC Congress, and other venues in 2007.
There are three new proposed profiles for Year 3 (2006-2007):
Implantable
Device Cardiac Observation Profile (IDCO)defines a mechanism for the creation, transmission, and processing of discrete data elements and report attachments associated with implantable cardiac device interrogations (observations). It supports the use cases for in-clinic and remote implanted cardiac device follow-ups. Simply put, this Profile allows for programmed information from defibrillators, pacemakers, and other implanted devices to be stored in a consistent manner in a central location such as an Electronic Healthcare Record system to that is easily accessible by different people in different locations in the future. This profile is a product of the IHE Electrophysiology Subcommittee sponsored by the Heart Rhythm Society.
Stress Testing Workflow Integration Profile (STRESS) describes the workflow for managing cardiac stress test procedures. This profile specifies the scheduling and coordination of procedure data across a variety of imaging (both echo and nuclear medicine), ECG acquisition, measurement, and analysis systems, and its reliable storage in an archive from where it is available to support subsequent workflow steps, such as reporting. This profile also provides for consistent descriptions of procedures, protocols, and stages.
Nuclear Medical Imaging (NM) developed in conjunction with IHE Radiology, describes acquisition and display requirements for NM images. The Cardiac Option addresses cardiac stress/rest studies based on the ASNC/ACC/AHA NM Cardiac Display Guidelines. It includes the ability to view stress/rest cine loops simultaneously as well as the standard "stress over rest" perfusion display, change single loop display characteristics, apply and change color maps, realign images within displays, and to send results (measurements or reconstruction) screens from third party software products.
In addition to the three new profiles, the
IHE Cardiology Technical Committee invites comment on Change
Proposal 2006-1: EP Lab, which adds a use case for the
Electrophysiology Ablation/Implantation Lab to the existing
Cath Workflow Profile (i.e., the initial demonstration of
EP lab workflow will simply use the actors and transactions
of the Cath Workflow Profile; further refinements to this
workflow are expected in Year 4). Again, this Change Proposal
is a product of the IHE Electrophysiology Subcommittee.
In addition, the following profiles in other
IHE domains have direct applicability to Cardiology Use Cases:
- Cross-Enterprise Document Sharing (XDS)
(IHE IT Infrastructure) defines a method of securely sharing
documents across institutional boundaries through a Regional
Health Information Organization (RHIO)
- XDS Medical Summary (XDS-MS) (IHE Patient
Care Coordination) describes the use of the XDS Profile
for the sharing of standard medical summary documents, such
as encounter or discharge summaries.
- XDS for Imaging (XDS-I) (IHE Radiology)
describes the use of the XDS Profile for the sharing of
images.
- Retrieve Forms for Data Entry (currently
in development in IHE IT Infrastructure) will specify a
means of facilitating the collection of data for clinical
trials, outcomes research, performance measures, bio-surveillance,
pharmaco-surveillance, and similar use cases.
Learn more about these profiles at http://www.ihe.net/Technical_Framework/index.cfm.
These Profiles may also be included in the 2007 IHE demonstrations.
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