IHE looks for more participation by HIS vendors, other specialties

NEW ORLEANS - Now in its second year of demonstrations, the Integrating the Healthcare Enterprise initiative has already sparked improvements in radiology systems integration and workflow. But as the joint project of the RSNA and the Healthcare Information and Management Systems Society enters year three, it hopes to include more HIS vendors, and even other medical specialties.

Bringing IHE's advantages to other disciplines is at the top of the agenda, according to Paul Vegoda, the HIMSS representative to IHE.

"Our goal for the future is to do what we’ve done in radiology and replicate it in all of the different subspecialties that use imaging and that use various modes of integrated information," he said.

Yesterday at the HIMSS conference in New Orleans, Vegoda and representatives from the IHE planning and technical committees outlined the organization's accomplishments, and glimpsed its future goals.

In year one the IHE focused on integrating PACS and radiology information systems. In the second year, the IHE technical framework grew to support expanded radiology transactions. Some functions, such as report generation, were included for the first time.

Specifically, the year-two enhancements included patient registration and patient update functions, HIS-RIS integration, and automatic updates of patient demographics and visit information, Vegoda said.

The second year also brought new procedure information and status-update features that enable the scheduling of new procedures and the cancellation of existing ones. IS-PACS integration was introduced as well, Vegoda said.

More vendors participated in the IHE demonstrations at the RSNA and HIMSS meetings in year two. In all, 32 vendors with 66 systems participated, compared with 23 vendors and 47 information systems in the first year, Vegoda said. Once again the vendors showcased their integration capabilities in an IHE booth in the HIMSS exhibit hall.

While the overall increase in vendors has been positive, the initiative needs more participation by HIS vendors, Vegoda said.

"The radiology vendors -- PACS, RIS, and modality vendors -- have been wonderful," Vegoda said. "We’ve had a few problems with the HIS vendors, because their attitude is, ‘Well, what’s in it for me?’ What we need is for [HIS purchasers] to make sure that when you put out an RFI or RFP, that it states you want the products to be IHE-compliant. That’s the only way we can push the vendor community to do something that’s good for them, that’s good for you, and that’s good for your patients."

To help prospective purchasers implement IHE-compatible systems, the IHE committees have released IHE integration profiles, which provide guidelines for buyers on specific integration tasks. There are now seven integration profiles available:

  • Scheduled workflow: establishes continuity and integrity of basic radiological data.
  • Patient information reconciliation: extends the scheduled workflow integration profile by offering a means to match images acquired for an unidentified patient with the patient’s admission and order history.
  • Consistent presentation of images: specifies transactions that maintain consistency of presentation for grayscale images and their presentation state information. It also defines a grayscale standard display function.
  • Access to radiology information: specifies query transactions providing access to radiology information, including images and related reports, in a DICOM format as they were acquired or created.
  • Key image note: specifies a transaction that allows a user to flag one or more images in a study as significant.
  • Simple image and numeric report: exchanges simple reports with image links, and, optionally, measurements.
  • Presentation of grouped procedures: provides a mechanism for facilitating workflow when viewing reporting on individual imaging procedures (such as CT chest, abdomen, and pelvis) that an operator has grouped together.

The integration profiles, as well as the 263-page technical framework, can be downloaded from the RSNA's Web site at http://www.rsna.org/IHE.

In year three, the IHE planning and technical committees will consolidate their work on radiological transactions, allowing companies to catch up on implementing IHE functionality, Vegoda said.

"We’ve decided to pull back a little bit on creating new functional requirements, giving vendors the opportunity to start implementing the IHE technical framework into their products," he said. "A lot of vendors already have IHE functionality, but they’re having (to add) more and more functions that allow them to interoperate with other systems."

As for incorporating other disciplines, IHE representatives have already met with organizations representing ophthalmology, laboratory, and cardiology to discuss their potential participation, Vegoda said.

And while the first two years have focused on the DICOM and HL-7 standards, the IHE committees have begun to explore the use of other standards, such as CORBAMed.

Finally, the IHE hopes to improve integration with the "horizontal" systems that can tie all of the specialties and departments together, such as master patient indexes and electronic medical records, Vegoda said.

"My goal has always been that a [physician], with proper clearance, can walk up to any workstation anywhere in the healthcare facility, sign on, and get any piece of clinical information from any subspecialty that they’re cleared to get for the treatment of their patient," he said.

By Erik L. Ridley
AuntMinnie.com staff writer
February 6, 2001

Related Reading

RSNA, HIMSS release IHE test tools, announce Year 2 plans, June 16, 2000

RSNA and HIMSS renew IHE project for improving healthcare data exchange, April 10, 2000

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