1June 2006 What IHE Delivers

IHE Eye CareIHE Eye CareYear 1Year 1

IHE Workshop 2006 - IHE Workshop 2006 - Changing the Way Healthcare ConnectsChanging the Way Healthcare Connects

IHE Eye Care EducationIHE Eye Care EducationMike Schmidt, Carl Zeiss Meditec Mike Schmidt, Carl Zeiss Meditec

Co-Chair IHE Eye Care Planning CommitteeCo-Chair IHE Eye Care Planning Committee

Jim Riggi, CTO Medflow, Inc.Jim Riggi, CTO Medflow, Inc.

Co-Chair IHE Eye Care Technical CommitteeCo-Chair IHE Eye Care Technical Committee

June 2006 2

Introducing IHE Eye Care

• Targeting all eye care providersTargeting all eye care providers• Ophthalmology and OptometryOphthalmology and Optometry

• Roots in DICOM WG9 (Ophthalmology)Roots in DICOM WG9 (Ophthalmology)• OP and Stereo modules approvedOP and Stereo modules approved• OTM and Refractive SR work items in progressOTM and Refractive SR work items in progress

• AAO is the sponsoring organizationAAO is the sponsoring organization• Dr. Flora Lum, AAO, coordinatorDr. Flora Lum, AAO, coordinator• Don Van Syckle, DVS ConsultingDon Van Syckle, DVS Consulting

• Planning CommitteePlanning Committee• Mike Schmidt, Carl Zeiss MeditecMike Schmidt, Carl Zeiss Meditec• Dr. Mark Horton, U.S. Indian Health ServicesDr. Mark Horton, U.S. Indian Health Services

• Technical Committee co-chairsTechnical Committee co-chairs• Jim Riggi, MedflowJim Riggi, Medflow• Peter Kuzmak, U.S. Dept. of Veteran AffairsPeter Kuzmak, U.S. Dept. of Veteran Affairs

June 2006 3

Vendor Participants in IHE Eye Care 2005Vendor Participants in IHE Eye Care 2005

June 2006 4

Introducing IHE Eye Care

• Participating commercial vendors includeParticipating commercial vendors include• Instrument vendorsInstrument vendors• PMS / EHR system vendorsPMS / EHR system vendors• Imaging system vendorsImaging system vendors

• Strong government participationStrong government participation

• Addition of EHR vendors in 2006 is keyAddition of EHR vendors in 2006 is key

June 2006 5

IHE Eye Care – Plan for 2006

• Informal Efforts 2005Informal Efforts 2005• Participation at HIMSS IHE Showcase: Participation at HIMSS IHE Showcase: February 2005February 2005• Participation at VEHU Showcase:Participation at VEHU Showcase: May 2005May 2005• AAO Showcase: AAO Showcase: October 2005October 2005

• Development ScheduleDevelopment Schedule• Planning Committee decision:Planning Committee decision: October 2005October 2005• Issue Public Comment version: Issue Public Comment version: March 2006March 2006• Public Comment Due:Public Comment Due: April 2006April 2006• Issue Trial Implementation version: Issue Trial Implementation version: May 2006May 2006• Connectathon: Connectathon: October 2006October 2006• AAO Showcase: AAO Showcase: November 2006November 2006

• Year 1 ProfilesYear 1 Profiles• Eye Care Scheduled Workflow (EYECARE)Eye Care Scheduled Workflow (EYECARE)• Charge Posting (CHG)Charge Posting (CHG)• Eye Care Evidence Documents [ECED]Eye Care Evidence Documents [ECED]

June 2006 6

Ophthalmic Workflow Use CasesOphthalmic Workflow Use Cases

• Derived from Cardiology Workflow use cases C1 – C5Derived from Cardiology Workflow use cases C1 – C5

• Year 1 use cases:Year 1 use cases:

• Will add “emergency” use cases later, similar to C3 – C5Will add “emergency” use cases later, similar to C3 – C5

Order Placement

Patient Registration

Order Placed at Order

Placer

Order Placed at

Order Filler

Patient Registered at ADT

Case E1 Case E2 

June 2006 7

IHE Eye Care Transactions

• Extensively reusing RAD and CARD transactionsExtensively reusing RAD and CARD transactions• Storage Commitment w/intermittently connected modality option Storage Commitment w/intermittently connected modality option

[CARD-3][CARD-3]

• Adding EYECARE transactionsAdding EYECARE transactions• Query Modality Worklist [EYECARE-1]Query Modality Worklist [EYECARE-1]• Modality Images/Evidence Stored [EYECARE-2]Modality Images/Evidence Stored [EYECARE-2]• Retrieve Images [EYECARE-3] Retrieve Images [EYECARE-3] • Query Evidence Documents [EYECARE-4]Query Evidence Documents [EYECARE-4]

• Example Issue: Query Modality WorklistExample Issue: Query Modality Worklist• Glaucoma progression analysis requires longitudinal dataGlaucoma progression analysis requires longitudinal data• Instruments consequently provide persistent storageInstruments consequently provide persistent storage• EYECARE-1 ensures that Issuer of ID is mandatory in worklistEYECARE-1 ensures that Issuer of ID is mandatory in worklist• Will be used to determine identity of patient recordWill be used to determine identity of patient record• Will allow updates / corrections of patient demographicsWill allow updates / corrections of patient demographics

June 2006 8

EYECARE-1

• Query Modality Worklist• Both Query Modes must be supportedBoth Query Modes must be supported

• Patient QueryPatient Query

• Broad QueryBroad Query

Mandatory Issuer of IDMandatory Issuer of ID• Glaucoma progression analysis requires longitudinal dataGlaucoma progression analysis requires longitudinal data• Instruments consequently provide persistent storageInstruments consequently provide persistent storage• Will be used to identify patient recordsWill be used to identify patient records• Will allow updates / corrections of patient demographicsWill allow updates / corrections of patient demographics

June 2006 9

EYECARE-2

• Modality Images/Evidence StoredModality Images/Evidence Stored

• Eyecare Image Options Eyecare Image Options • Encapsulated PDFEncapsulated PDF

June 2006 10

EYECARE-3

• Retrieve ImagesRetrieve Images• Eye Care SOP classesEye Care SOP classes

• OP (Ophthalmic Photography)OP (Ophthalmic Photography)

• US for ophthalmic ultrasound devicesUS for ophthalmic ultrasound devices

• Enc PDF for post-processed evidence documentsEnc PDF for post-processed evidence documents• Represent post-processed evidence documentsRepresent post-processed evidence documents• Like cardiology, also created by Acquisition ModalityLike cardiology, also created by Acquisition Modality• Significant clinical utilitySignificant clinical utility• Extensive modality support is key to IHE Eye Care Extensive modality support is key to IHE Eye Care

acceptanceacceptance

• CompressionCompression

June 2006 11

IHE Eye Care Modality Coding Issue

• Only OP and US modality codes are definedOnly OP and US modality codes are defined

• DICOM correction proposal to add other modality DICOM correction proposal to add other modality codescodes• Based on prior work within DICOM WG9Based on prior work within DICOM WG9• Draft proposal already distributed to WG9Draft proposal already distributed to WG9• Fast-track March review in WG9 and submit to WG6Fast-track March review in WG9 and submit to WG6

June 2006 12

Query Evidence DocumentsQuery Evidence DocumentsDICOM Encapsulated PDFDICOM Encapsulated PDF

EYECARE-4

June 2006 13

IHE Eye Care Planning

1.1. Support new DICOM IOD’sSupport new DICOM IOD’sa.a. Ophthalmic TomographyOphthalmic Tomographyb.b. Refractive SR’sRefractive SR’s

2.2. Additional DICOM IOD’s needed – work for DICOM WG9Additional DICOM IOD’s needed – work for DICOM WG9a.a. Ophthalmic visual testing / perimetryOphthalmic visual testing / perimetryb.b. Ophthalmic mapping / topographyOphthalmic mapping / topography

3.3. Non-scheduled use cases C3-C5 (See IHE Cardiology)Non-scheduled use cases C3-C5 (See IHE Cardiology)4.4. Context sharingContext sharing

a.a. Enterprise User Authentication (EUA)Enterprise User Authentication (EUA)b.b. Patient Synchronized Applications (PSA)Patient Synchronized Applications (PSA)

5.5. Post-processingPost-processinga.a. Scheduled post-processing workflow (PWF)Scheduled post-processing workflow (PWF)

June 2006 14