DICOM and Integrating the Healthcare Enterprise:

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DICOM andIntegrating the Healthcare Enterprise

• Five years of cooperation and mutual influence

Andrei Leontiev Chair, DICOM WG6 IDX
Charles Parisot Chair, NEMA Committee
for advancement of DICOM GE Medical Systems-IT
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IHE Mission

• IHE is an initiative promoting and supporting the
  integration of systems in the healthcare
  enterprise.

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IHE Integration Goals

• Improve the efficiency and effectiveness of
  clinical practice
• Improve Workflow
• Improve Information Accuracy
• Improve Information Availability
• Enable Cross-System Functionality

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A Proven Standards Adoption Process
IHEDemonstration
IHEConnectathon
Easy to Integrate Products
Product With IHE
IHETechnicalFramework
Standards
IHEIntegration Profiles B
IHEIntegration Profile A
User Site
RFP

• IHE Integration Profiles
• Detailled selection of standards and options each
  solving a specific integration problem
• A growing set of effective provider/vendor agreed
  solutions
• Vendors can implement with ROI
• Providers can deploy with stability

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IHE Integration profiles
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IHE IT Infrastructure5 Integration Profiles
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IHE Growth

• Radiology
• 5 years Extensive integration with IT
• IT Infrastructure
• 1 Year Strong start with critical
  infrastructure issues addressed authentication,
  linking patient ids, CCOW, retrieve info for
  display. HIMSS Feb 2004 HL7-IHE Joint Demo.
• Laboratory
• 1 year Lab Scheduled Workflow goes to public
  comment Oct 15th for demos mid 2004.
• Cardiology
• ACC and ESC have solid plans launch imminent.

Strong influence from the DICOM Efficiency Culture
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IHE DICOM / HL7

• Standards are vital (HL7, DICOM, ICD, )
• They provide tools technologies
• But Standards alone are insufficient
• They are open to interpretation
• There is room for optional variations
• They avoid specifying how to apply them to
  particular real world scenarios

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IHE Stimulated adoption of DICOM features

• By 1998, DICOM Storage and Query Retrieve SOP
  Classes have been implemented and actively used
  by dozens of vendors
• However, some features were interpreted
  differently (scout lines, query keys)
• IHE established common interpretation

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Use of DICOM in Workflow Management

• DICOM MWL and MPPS were defined but not well
  implemented because their use without correlation
  with overall information flow in Radiology
  Department was limited
• IHE defined use cases and established mechanisms
  to use these DICOM SOP Classes via Scheduled
  Workflow Integration Profiles

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IHE researched DICOM data model
Patient
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IHE Integration Profiles based on DICOM

• Most IHE Radiology Integration Profiles are based
  on one or more DICOM SOP Classes
• IHE spearheaded implementations of several
  recently defined DICOM capabilities spending time
  and effort to build practical implementation
  framework for them

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IHE Profiles vs. DICOM SOPs

• Consistent Presentation of Images
• Simple Image and Numeric Report
• Key Image Note

• Grayscale Presentation State
• Structured Reporting
• Key Object Selection Document

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IHE Profiles vs. DICOM SOPs

• Post-Processing Workflow and Reporting Workflow
• Evidence Documents

• General Purpose Worklist and PPS
• Mammo CAD, Chest CAD, etc.

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IHE initiated development of DICOM features

• IHE actively influenced development of DICOM
• Correction proposals for better consistency of
  MWL/MPPS
• Development of Key Object Selection Documents
• Development of common audit messaging

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Operational influences

• DICOM influenced development process of IHE
  Technical Framework
• Supplements, Correction Proposals
• DICOM adopted IHE approach to definitions of use
  cases
• Actors, transactions

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Summary

• The development of DICOM has influenced the
  development of IHE Technical Framework, and in
  turn, was influenced by user needs that are
  advocated for by the framework developers.
• Cooperative effort of two bodies have proved very
  effective and will continue in the future,
  allowing for further advancement of DICOM and its
  acceptance in user and vendor communities.

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Where Is More Information Available?

• IHE
• http//www.himss.org/IHE
• http//www.rsna.org/IHE
• DICOM
• http//dicom.nema.org