IHE – Radiation Oncology
What is IHE?
• Standards-based,
• Global Initiative
generating
• Real-world Implementations
in patient care
“Defining, testing, and implementing standards-based
interoperability for EHR’s”
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IHE brings reality to workflow
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IHE Organizational Structure
IHE International Board
Global Development
Regional Deployment
IHE Americas
Radiology
IT
Infrastructure
IHE Asia-Oceania
Laboratory
Canada
USA
Cardiology
Patient Care
Coordination
Eye Care
Radiation
Oncology
Patient Care
Devices
Quality
Japan
Korea
Taiwan
IHE Europe
France
Norway
Contributing &
Participating
Vendors
China
Germany
Spain
Italy
Netherlands
Sweden
UK
Professional Societies / Sponsors
ACC
ACP
HIMSS
RSNA
AAO
ASTRO
GMSIH
SFR
SFIL
COCIR
SIRM
ESC JAHIS
EAR-ECR BIR
JIRA
DRG
EuroRec
JRS
METI-MLHW
MEDIS-DC
JAMI
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IHE – Standards-Based Integration Solutions
Professional Societies Sponsorship
Healthcare Providers & Software Developers
Healthcare IT Standards
General IT Standards
HL7, DICOM, etc.
Internet, ISO, etc.
IHE
Process
Interoperable Healthcare IT
Solution Specifications
Interoperable Healthcare IT
IHE IntegrationSolution
Profile Specifications
Interoperable Healthcare IT
IHE IntegrationSolution
Profi le Specifications
Interoperable Healthcare IT
IHE IntegrationSolution
Profile Specifications
IHE Integration Profile
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What are these Standards?
• DICOM (Digital Imaging and Communications in Medicine)
– DICOM is a standard for handling, storing, printing, and transmitting
information in medical imaging.
– DICOM enables the integration of scanners, servers, workstations,
printers, and network hardware from multiple manufacturers
– http://medical.nema.org
• HL7 (Health Level 7)
– HL7 is an international community of healthcare subject matter
experts and information scientists collaborating to create standards
for the exchange, management and integration of electronic
healthcare information.
– HL7 promotes the use of such standards within and among
healthcare organizations to increase the effectiveness and efficiency
of healthcare delivery for the benefit of all.
– http://www.HL7.org
Parts from http://www.wikipedia.org
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IHE – Domain Sponsors
• Domain Sponsors shall be Member Organizations in the
User Category with no direct or indirect responsibilities in
the acquisition decision of systems implementing IHE
specified capabilities. Domain Sponsors generally come
from Healthcare Professional Organizations (clinical, IT,
administrative, public health, etc.) or Governmental
Agencies. In supporting development activities of IHE
International in the domain (or domains) relevant to their
membership and mission, they shall adhere to the
principles of IHE and promote the broad success of the
initiative worldwide.
• Domain Sponsors take responsibility for development of
IHE Technical Frameworks and associated documents in
the domain (or domains) relevant to their membership and
mission.
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IHE – Domain Secretary
• Organizing and hosting domain planning and
technical committees composed of volunteer domain
experts and IHE Member representatives.
• Coordinating with the IHE International Sponsors and
Domain Coordination Committee to publish the work
of their domain committees under IHE International
Copyright;
• Providing information for publication about their
membership, plans, process and work product (e.g.,
via the www.ihe.net Website).
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Why is IHE-RO Important?
• ASTRO’s 6-point patient protection plan
– 5) Further developing our Integrating the Healthcare Enterprise –
Radiation Oncology (IHE-RO) connectivity compliance program to
ensure that medical technologies from different manufacturers can
safely transfer information to reduce the chance of a medical error.
• Promotes discussion and correction of protocols /
standards for data communication to improve the reliability
and safety of data exchange in radiation oncology
• Provides a mechanism for inter-manufacturer testing of
radiation oncology products prior to delivery
– Domain Pre-testing
– Connectathon
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The Connectathon:
IHE’s Conformance Testing Process
Proven Standards Adoption Process
Develop
technical
specifications
Testing at
Connectathons
IHE
Demonstrations
Identify available
standards (e.g. HL7,
Products
with IHE
DICOM, IETF, OASIS)
Document Use
Case
Requirements
Timely access to
information
Easy to integrate
products
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What is a Connectathon?
Cross-vendor, live, supervised, structured tests
• All participating vendors’ products tested together in the
same place/time
• Experts from each vendor available for immediate problem
resolution… fixes are done in minutes, not months!!
• Each vendor tests with multiple trading partners (actual
product to product)
• Testing of real-world clinical scenarios with IHE Integration
Profiles
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Connectathon Testing is based on specifications
laid out in the Technical Framework
Technical Framework
Part 1: Integration Profiles
model the business process
problem (use case) and its
solution.
Part 2: Transactions
define in how current
standards are used to solve
the business problem
defined in the Integration
Profiles.
Connectathon: Vendors
register to test their product
as an actor(s) within an
Integration Profile
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What happens after the Connectathon?
• Successful results (specific by IHE profile/actor) are
published by the sponsors (www.ihe.net/connectahons)
• Vendors self-certify, by publishing IHE Integration
Statements: Precise and explicit public interoperability
commitment fro a specific commercial product.
• Only vendors who are successful are entitled to participate in
Interoperability Showcase demonstrations:
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–
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–
HIMSS Annual Conference (February 26th – March 1st, New Orleans)
ACC Annual Conference (March 24th – 27th, New Orleans)
Canada e-Health 2007 Conference (May 27th – 30th, Quebec City)
RSNA Annual Conference (November 25th – 30th, Chicago)
others…
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IHE Integration Statement
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RFPs & Integration Statements
• Be Brief ?
– “The system must support HL7”
• Be Effective ?
– “The system must support the following HL7 V2 messages
according to the following 100 pages of specifications”
• Be Both:
– “The system must support IHE Patient Id Cross-reference
as a Patient Identifier Source actor”
• Integration Statement
– Version 2.1 of the Enterprise HIS supports IHE Patient Id
Cross-referencing as Patient Identifier Source actor
Requiring vendors to publish their products IHE Integration
Statements provide a very effective pressure point
for market-driven interoperability
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RFP Language (actual example)
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How Does IHE-RO Function?
• Planning Committee
• Technical Committee
– Identifies information
systems or components of
information systems that
produce, manage, or act
on information associated
with clinical and
operational activities that
require integration.
– Identifies and implements
standards for interactions
between actors that
communicate the required
information through
standards-based
messages.
The PC and TC work together to
Prioritize Efforts, Propose Solutions,
and Eventually Demonstrate Connectivity
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IHE-RO Progress
• Profiles
– 2007
• Basic Interoperability
– 2008
• Multi-Modality Image Registration
– 2009
• Basic Worklist / Workflow Integration
• Advanced Interoperability
– 2010
• Dose Compositing
• Treatment Delivery Workflow
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Domain Pre-Testing 2006
•25+ participants, 9 Vendors, 10+ systems
•95+ monitored test cases
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IHE-RO 2007 Formal
Connect-a-thon
ASTRO HQ
Elekta
Impac
CMS
Brainlab
Nucletron
Tomotherapy
Philips
Varian
Courtesy of ASTRO HQ
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IHE-RO 2007 (Basic Interoperability)
Contouring
System
Imaging Study
Simulation
System
Rad Onc
IMS
Treatment
Verification
Planning
Workstation
Treatment
Delivery
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IHE-RO 2008 (Image Registration)
Contouring
System
Imaging Studies
Simulation
System
Rad Onc
IMS
Treatment
Verification
Planning
Workstation
Treatment
Delivery
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IHE-RO 2009 (Modality Worklist)
Contouring
System
Imaging Study
Simulation
System
Rad Onc
IMS
Treatment
Verification
Planning
Workstation
Treatment
Delivery
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Where can you learn more?
http://wiki.ihe.net
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Where can you learn more?
http://www.ihe.net
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