After a year aimed largely at consolidating its early gains, the Integrating the Healthcare Enterprise initiative is rapidly expanding in its fourth year. New this year for IHE -- a joint project between the RSNA and the Healthcare Information and Management Systems Society (HIMSS) -- are three new integration profiles, enhancements to IHE’s scheduled workflow profile, and more international activities.
New integration profiles debuting this year are:
- Postprocessing workflow
- Charge posting
- Basic security
The postprocessing workflow profile describes mechanisms to automate distributed postprocessing of images and computer-aided detection (CAD), said John Paganini, a member of both the IHE technical and planning committees and manager for the Cleveland Clinic account at IDX Systems of Burlington, VT. Picking up where the scheduled workflow integration profile leaves off, postprocessing workflow specifies several transactions that provide for scheduling and tracking items such as CAD, image processing, and quality control, Paganini said.
The initiative's first foray into the financial domain -- charge posting -- offers a way to handle transactions regarding account management (such as sharing patient account numbers and procedural billing information), he said. In this profile, accounting messages are sent from the admission, discharge, and transfer (ADT) system to the billing system. These accounting messages are matched up later on with the actual procedure information sent to the billing system from the order filler, typically the radiology information system.
Basic security enables institutions to consolidate audit trails on user activity across several interconnected systems (such as between PACS and RIS or RIS and HIS) in a secure manner, Paganini said.
"With this profile, we're saying that authorized persons must have access to medical data of patients, and information must not be disclosed otherwise," he said.
In addition to the new integration profiles, the committees have added an exception management option to its existing scheduled workflow profile. This new option describes how the imaging modality and other systems handle errors -- such as an incorrect worklist entry -- that originate at the modality, he said.
Another addition to scheduled workflow -- assisted acquisition protocol setting -- allows the order filler (RIS), image manager, and modalities to manage acquisition protocols used in the imaging department, and to enable automated posting of billing charges, Paganini said.
The new integration profiles will formally be presented at an IHE vendor workshop April 8 in Chicago. At the same meeting, IHE will hold an education session for consultants.
IHE is also ramping up its international operations. National IHE extensions to the IHE technical framework for Germany, France, and Japan are scheduled for release within the next few months.
Looking beyond Year 4, the IHE committees are targeting other clinical specialties, Paganini said.
"We feel that we've understood the essential requirements of radiology integration, and are now going to be moving on to meet the entire enterprise's integration requirements," he said. "So we anticipate engaging leading medical professionals and associations from other key healthcare domains to help us move IHE beyond radiology."
Cardiology is likely the next target, followed by laboratory and pharmacy, Paganini said. The IHE committees also continue to emphasize marketing of the initiative to end users and vendors, in hopes of increasing utilization of IHE in commercial PACS installations.
"We need to get the message out to healthcare organizations, consultants, and IT departments to include IHE guidelines in their RFPs, and in their thinking when they are purchasing vendor solutions," he said. "The IHE committees will probably never be happy with the market awareness of the initiative until IHE is as commonly used as DICOM and HL7."
As part of its plan to increase market awareness of IHE, the committees will change the demonstrations at the RSNA and HIMSS meetings to help PACS, RIS, and other IS purchasers get a clearer understanding of how the initiative can benefit their practice, he said. The exact form of the exhibitions is still being determined.By Erik L. Ridley
AuntMinnie.com staff writer
April 3, 2002
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