Planning CommitteePlanning CommitteeFocus GroupFocus Group

8:00 - 17:00, Friday, September 24, 20108:00 - 17:00, Friday, September 24, 2010

8:00 - 10:00, Saturday, September 25, 2010 8:00 - 10:00, Saturday, September 25, 2010

ASTRO HQ, Fairfax, VAASTRO HQ, Fairfax, VA

1) Welcome and Introductions1) Welcome and IntroductionsPC Radiation Oncologists

PC Medical Physicists

PC Vendors TC Representatives

Kevin Albuquerque Charles Able Adam Earwicker (Varian)

Walter Bosch (ATC)

Tony Quang Sha Chang Nick Linton (Elekta)

Bruce Curran (TC Co-chair)

Akkamma Ravi Colin Field (PC Co-chair)

Martin Pellinat (Vision Tree)

Rishabh Kapoor (U of Florida)

Prabhakar Tripuraneni (Co-chair)

Todd McNutt Jacob Philip (Elekta)

Stuart Swerdloff(TC Co-chair, Elekta)

ASTRO Representatives

Jatinder Palta (Co-chair)

Norman Trapp (Siemens)

 

Sidrah Abdul Harold Beunk (Nucletron)

 

Barbara Muth Kevin Riddell    

Regrets: May Wahab (PC Co-chair), Mika Miettinen (PC co-chair, Varian), Ramesh Rengen, Christopher Rose

2) Meeting Goals2) Meeting Goals

Quick overview of IHE and IHE-ROQuick overview of IHE and IHE-RO

Establish directions & goals for IHE-RO PCEstablish directions & goals for IHE-RO PC

Have brief joint TC and PC meetingHave brief joint TC and PC meeting

Changes to Changes to Agenda ? ?

3a) Overview of IHE3a) Overview of IHE Integrating the Healthcare Enterprise, formed in 1998Integrating the Healthcare Enterprise, formed in 1998 Global initiative to facilitate sharing of health informationGlobal initiative to facilitate sharing of health information

from application to applicationfrom application to application system to systemsystem to system across multiple healthcare enterprisesacross multiple healthcare enterprises

Brings together health information technology Brings together health information technology stakeholders to implement standards for communicating stakeholders to implement standards for communicating patient information efficiently throughout and among patient information efficiently throughout and among healthcare enterprises by developing a framework of healthcare enterprises by developing a framework of interoperabilityinteroperability

Because of its proven process of collaboration, Because of its proven process of collaboration, demonstration and real world implementation of demonstration and real world implementation of interoperable solutions, IHE is in a unique position to interoperable solutions, IHE is in a unique position to significantly accelerate the process for defining, testing, significantly accelerate the process for defining, testing, and implementing standards-based interoperability and implementing standards-based interoperability among electronic health record systemsamong electronic health record systems

(from http://www.ihe.net/News/ihe_intl_expands_incorporates_2009-12-31.cfm )

IHE Organizational StructureIHE Organizational Structure

ASTRO AAPM ACR AROI CARO CSRO ESTRO JASTRO

Pharmacy Quality, Research & Public Health

Anatomic Pathology

About IHE-ROAbout IHE-RO2004: Prabhakar Tripuraneni and Jatinder 2004: Prabhakar Tripuraneni and Jatinder

Palta formed IHE-RO at RSNAPalta formed IHE-RO at RSNA2004: Bruce Curran and Stuart Swerdloff 2004: Bruce Curran and Stuart Swerdloff

spear-headed the TC spear-headed the TC 2006: First IHE-RO Domain Pre-testing2006: First IHE-RO Domain Pre-testing2007: First Connectathon (Aug)2007: First Connectathon (Aug)2007: PC became more active2007: PC became more active2007: First Public demonstration (Oct)2007: First Public demonstration (Oct)

How Does This All Happen ?How Does This All Happen ?

ASTRO Significant SupportASTRO Significant SupportSince 2006, spent well over US$ 1.0MSince 2006, spent well over US$ 1.0MTest Tools and Administrative supportTest Tools and Administrative support

RT Vendors Significant ResourcesRT Vendors Significant ResourcesDomain Pre-testingDomain Pre-testingConnectathonsConnectathonsProduct Development and DocumentationProduct Development and Documentation

End UsersEnd UsersVolunteer time and energyVolunteer time and energy

Florida grant (Jatinder and May)Florida grant (Jatinder and May)

AcknowledgementsAcknowledgements

IHE-RO Connectathon Vendors Accuray (2009/10) BrainLAB (2007/8/9/10) Candelis (2010) Elekta (2007/8/9/10) GE Healthcare (2009) MIMVista (2008/9) Nucletron (2007/8/9/10) Philips (2007/8/9/10) Siemens (2008/9/10) Third Way Software (2010) Tomotherapy (2007/8/9/10) Varian (2007/8/9/10)

Numerous VolunteersNumerous Volunteers

Other IHE-RO Members ASTRO AAPM ATC Bogardus Medical Systems Brigham & Women’s Hospital Cogent Health Solutions Inc. Cross Cancer Institute ESTRO IBA Particle Therapy Loyala University Medical Centre Radion, Inc SEFM SJS Targeted Solutions Sun Nuclear TSG Integrations University of Florida VisionRT VisionTree Software, Inc Wake Forest

Links to more infoLinks to more info

Wiki.ihe.net

www.ihe.net

http://www.astro.org/Research/http://www.astro.org/Research/ResearchHighlights/IHERO/index.aspx ResearchHighlights/IHERO/index.aspx

3b) PC Membership3b) PC Membership

Google docs RosterGoogle docs Roster

Governance documentGovernance documenthttp://www.ihe.net/governance/index.cfm http://www.ihe.net/governance/index.cfm

Join IHEJoin IHEProcess is easy, and it is free !Process is easy, and it is free ! Institutional politics may not be as easyInstitutional politics may not be as easyLink to on-line applicationLink to on-line application

4) ASTRO IHE-RO and 4) ASTRO IHE-RO and Research CommitteeResearch Committee

a) EMR and Registry

b) CCHIT and IHE-RO

c) Patient Safety

ASTRO safety initiative named to 25 Most Influential list

ASTRO has been named as one of RT Image's 25 Most Influential people, institutions or events that shaped radiology in 2010. ASTRO ranked sixth for its Target Safely initiative, a six-point patient protection plan that will improve safety and quality and reduce the chances of medical errors. To learn more about Target Safely, visit www.astro.org/targetsafely, or ASTRO Chairman Williams’s article.

5) Use Cases5) Use Cases

Process Process Review Review

old, in development, on hold, newold, in development, on hold, new http://wiki.ihe.net/index.php?http://wiki.ihe.net/index.php?

title=Radiation_Oncology#Use_Case_Selection title=Radiation_Oncology#Use_Case_Selection

Steps of IHE ProcessSteps of IHE Process Identify Inter-operability problems (Use Cases)Identify Inter-operability problems (Use Cases)

describe how end-users will accomplish a goal by performing a task or a series

of tasks using systems (or software)includes the responses of the systems (or software)

to user actions

Select Use Cases to develop (process)Select Use Cases to develop (process) Specify Integration Profiles, Develop Test ToolsSpecify Integration Profiles, Develop Test Tools Domain Pre-testingDomain Pre-testing Test Integration Profiles at ConnectathonTest Integration Profiles at Connectathon Public Demonstration ?Public Demonstration ? Publish Integration Profiles for use in RFPsPublish Integration Profiles for use in RFPs

Successfully Completed Use CasesSuccessfully Completed Use Cases

Basic RT Treatment Planning (2007)Basic RT Treatment Planning (2007)

Multimodality Registration (2008)

Advanced RT Objects (2009)

Treatment Delivery Workflow (2010?)

Use Cases in Development (2010)Use Cases in Development (2010)

Treatment Delivery WorkflowTreatment Delivery WorkflowPublic comment (07-Mar-2010)Domain pre-testing (June 2-11, 2010)2010 connectathon (Sept 20-26, 2010)

Dose CompositingDose CompositingPublic comment (26-Feb-2010)Domain pre-testing (2011 ?)2011 connectathon (2011 ?)

Enterprise Schedule IntegrationEnterprise Schedule IntegrationJapan IHE-RO

Use Cases requiring more supportUse Cases requiring more support

Prescription AutomationPrescription AutomationNeeds DICOM WG 7 extension of standards

Structure Templates: Creation, Export Structure Templates: Creation, Export and Importand Import

User Authentication and AuthorizationUser Authentication and AuthorizationIHE-ITI XUA++ (Cross-Enterprise User Assertion

– Attribute Extension)

2010 Use Case Selection2010 Use Case Selectionhttp://www.doodle.com/k62626a552iy6y6r Flesh out top 3 details for ASTRO AGMFlesh out top 3 details for ASTRO AGM

Ensure problem is well definedEnsure problem is well definedSuggest how things should workSuggest how things should workSell TC on necessity to support the Use CaseSell TC on necessity to support the Use Case

Let’s review each Use Case in ranked orderLet’s review each Use Case in ranked orderVery brief summary by ChampionVery brief summary by ChampionQuestions, comments, discussionQuestions, comments, discussion

Currently 15 others Use Cases on the listCurrently 15 others Use Cases on the list http://wiki.ihe.net/index.php?title=Radiation_Oncology#Use_Case_Wish_List

Radiation Oncology Workflow Exchange

Data dictionary neededData dictionary needed

Closed Loop Patient Safety

Categories:Categories:Handshaking check of data transferHandshaking check of data transferFeedback loop, plan, deliver, cf planFeedback loop, plan, deliver, cf plan Imaging closed loopImaging closed loop

Population of a RegistryPopulation of a RegistryEnd to end check - phantomEnd to end check - phantom

Anonymization

Anonymize specific dicom tagsAnonymize specific dicom tagsTemplate for data to sendTemplate for data to send reader to ensure all links are preserved reader to ensure all links are preserved

between related itemsbetween related items

Radiation Oncology Patient Portal

Data dictionary requiredData dictionary requiredSource: RT data; Destination: secured Source: RT data; Destination: secured

web browserweb browser Interactive record of patient dataInteractive record of patient dataUpdating of followup dataUpdating of followup data2015 requirement for meaningful use2015 requirement for meaningful use

Deformable Registration

Instance-level Query Retrieve

6) Current Issues6) Current Issues

a)a) Clinical Release of Connectathon softwareClinical Release of Connectathon software- what are IHE rules? 1 year, special rules for IHE-RO?- what are IHE rules? 1 year, special rules for IHE-RO?- PC communicate rules to TC- PC communicate rules to TC- PC/TC cross compare passed actors with released - PC/TC cross compare passed actors with released software, vendors and users check software, vendors and users check

b)b) Use of integration profiles in RFPUse of integration profiles in RFP

c)c) Wiki pagesWiki pagesa)a) Rishabh volunteered to help with updating of Rishabh volunteered to help with updating of

Wiki Wiki

d)d) Vote using Survey Monkey instead of DoodleVote using Survey Monkey instead of Doodlea)a) Consensus was that Doodle was adequateConsensus was that Doodle was adequate

7) Open Forum7) Open Foruma)a) Future of IHE-ROFuture of IHE-RO

b)b) Funding for IHE-ROFunding for IHE-ROa)a) IHE-RO initiative should become cost neutral to ASTROIHE-RO initiative should become cost neutral to ASTRO

b)b) PC members were encourage to obtain grants in support PC members were encourage to obtain grants in support of IHE-RO activitiesof IHE-RO activities

c)c) Volunteer effortVolunteer effort

d)d) Election of Co-chairs Election of Co-chairs a)a) Dr. May Wahab will be stepping down as PC Chair, and Dr. May Wahab will be stepping down as PC Chair, and

Dr. Ramesh Rengan will be assuming this roleDr. Ramesh Rengan will be assuming this role

b)b) Some thought may need to be given to transitioning Some thought may need to be given to transitioning Mika’s and Colin’s PC co-chair roles, and Bruce’s and Mika’s and Colin’s PC co-chair roles, and Bruce’s and Stuart’s TC co-chair rolesStuart’s TC co-chair roles

e)e) Other ?Other ?

Lunch (Connectathon, LL)Lunch (Connectathon, LL)

8) Technical and Planning 8) Technical and Planning committee Joint meetingcommittee Joint meeting

IHE-RO Co-ChairsIHE-RO Co-ChairsPrabhakar TripuraneniPrabhakar Tripuraneni, MD, MD

Jatinder PaltaJatinder Palta, PhD, PhD

Planning Committee Planning Committee May Abdel-WahabMay Abdel-Wahab, MD, PhD, MD, PhD Colin FieldColin Field, MSc, MSc Mika MiettinenMika Miettinen

Recruit vendors of relevant Recruit vendors of relevant information systems and users with information systems and users with clinical and operational experienceclinical and operational experience

Prioritize & coordinate domain Prioritize & coordinate domain activitiesactivities

Identify, gather, review and prioritize Identify, gather, review and prioritize integration and information inter-integration and information inter-operability problems (Use Cases)operability problems (Use Cases)

Approve proposals selected by the Approve proposals selected by the TC for Profile developmentTC for Profile development

Develop educational materials for Develop educational materials for the domain and profilesthe domain and profiles

Technical CommitteeTechnical Committee Bruce CurranBruce Curran, MS, ME , MS, ME Stuart SwerdloffStuart Swerdloff, PhD, PhD

Recruit vendors of relevant information Recruit vendors of relevant information systems and users with technical systems and users with technical experienceexperience

Assess the feasibility and estimated Assess the feasibility and estimated effort for PC selected Use Cases effort for PC selected Use Cases

Build consensus on the appropriate Build consensus on the appropriate standards-based solutionsstandards-based solutions

Develop Integration Profiles for Use Develop Integration Profiles for Use Case solutionsCase solutions

Maintain Technical Framework for Maintain Technical Framework for domain Integration Profiles, describes domain Integration Profiles, describes solutions to inter-operability problems solutions to inter-operability problems

8) Technical and Planning 8) Technical and Planning committee Joint meetingcommittee Joint meeting

Is more support from PC required at pre-testing and at Is more support from PC required at pre-testing and at connectathon ? Yes, clinicians with practical experience, connectathon ? Yes, clinicians with practical experience, Wednesday thru Friday. Wednesday thru Friday.

Is PC input needed at TC meeting after ASTRO ? No, but Is PC input needed at TC meeting after ASTRO ? No, but questioned will need to be answered soon after TC meeting. questioned will need to be answered soon after TC meeting.

Can PC help with linac configuration gold standard? NEMA Can PC help with linac configuration gold standard? NEMA MITA working on (Stuart Swerdloff). Stuart will let us know.MITA working on (Stuart Swerdloff). Stuart will let us know.

Is a public demonstration needed ? No.Is a public demonstration needed ? No. What else can PC do to help TC ? Chase small companies What else can PC do to help TC ? Chase small companies

that should be participating to get involved. that should be participating to get involved.

9) Budget Planning9) Budget Planning Make test tools free. Charge for evaluation. Make test tools free. Charge for evaluation. Make per Actor cost for evaluation the same for all Make per Actor cost for evaluation the same for all

Actors (categorized as simple or complex) Actors (categorized as simple or complex) How is re-testing charged ? After failed test, How is re-testing charged ? After failed test,

charge at 100%. For voluntary re-testing, at a charge at 100%. For voluntary re-testing, at a discounted rate of 50%.discounted rate of 50%.

Retest every year? Ask TC.Retest every year? Ask TC. With new versions of test tools, vendor can decide With new versions of test tools, vendor can decide

whether they wish to re-test and be evaluated. whether they wish to re-test and be evaluated. They can use the new version of test tools in-They can use the new version of test tools in-house for their own evaluation.house for their own evaluation.

10) 10) Publicity and Promotion

Publish success stories from IHE-ROPublish success stories from IHE-RO

11) 11) Plan of Action for the futurea)a) Develop a list of items for the participants to Develop a list of items for the participants to

mull overnightmull overnight Should this meeting occur next year ? Yes. Preferably on Should this meeting occur next year ? Yes. Preferably on

Sunday/Monday to facilitate TC attendance ?Sunday/Monday to facilitate TC attendance ? ASTRO has asked for a single presentation in ASTRO booth ASTRO has asked for a single presentation in ASTRO booth

during ASTRO AGM. Bruce nominated. Ramesh Rengen during ASTRO AGM. Bruce nominated. Ramesh Rengen tag team.tag team.

Create webinar with CME credits for IHE-RO (MD, Physics, Create webinar with CME credits for IHE-RO (MD, Physics, RTT, CMD). Tony to investigate. Interoperability and patient RTT, CMD). Tony to investigate. Interoperability and patient safety.safety.

Create annual report showing passed actors with product Create annual report showing passed actors with product releases. Verified by vendors and usersreleases. Verified by vendors and users

Standardize information on www.ihe.net and wiki.ihe.net. Standardize information on www.ihe.net and wiki.ihe.net. RishabhRishabh

Use CasesUse Cases

Prioritize new Use Cases with prior ‘tabled’ Use CasesPrioritize new Use Cases with prior ‘tabled’ Use Cases How do we close the loop from Use Case to Integration How do we close the loop from Use Case to Integration

profile to RFP to Clinical Use ? Test tool versions. Poll profile to RFP to Clinical Use ? Test tool versions. Poll users, allowing reporting of failures. Contact initial users, allowing reporting of failures. Contact initial customers. Mini complaint system ? customers. Mini complaint system ?

Take Use cases to ASTRO Corporate Advisory Board for Take Use cases to ASTRO Corporate Advisory Board for support. Jatinder. Prepared after TC has vetted. Needed support. Jatinder. Prepared after TC has vetted. Needed by <date>by <date>

TasksTasks Develop Data Dictionary. PC role? Provided data needed to support user Develop Data Dictionary. PC role? Provided data needed to support user

cases. Todd and Waltercases. Todd and Walter Develop Standard Testing facility (or resource centre) for all vendors Develop Standard Testing facility (or resource centre) for all vendors

(outside scope of IHE-RO). Jatinder to ask ASTRO Executive(outside scope of IHE-RO). Jatinder to ask ASTRO Executive Develop scope of facilityDevelop scope of facility FDA implicationsFDA implications

Create ASTRO IHE-RO Task force to provide recommendations to RO Create ASTRO IHE-RO Task force to provide recommendations to RO community. Evidence based info needed. Interoperability Errorscommunity. Evidence based info needed. Interoperability Errors

Publications subcommittee:Publications subcommittee: Publish success storiesPublish success stories

Continue to obtain funding in support of TC. EveryoneContinue to obtain funding in support of TC. Everyone Correct Nucletron representative on PC. Colin, Harold.Correct Nucletron representative on PC. Colin, Harold. Every issue of ASTRO news to have IHE-RO content. BarbaraEvery issue of ASTRO news to have IHE-RO content. Barbara Document Budget cycle for each IHE-RO vendor. SidrahDocument Budget cycle for each IHE-RO vendor. Sidrah Use PLUNC as IHE-RO test platform ?Use PLUNC as IHE-RO test platform ? Update PC and TC membership roster in consistent manner. Sidrah Update PC and TC membership roster in consistent manner. Sidrah

Planning CommitteePlanning CommitteeFocus GroupFocus Group

8:00 - 10:00am, Saturday, September 25, 2010 8:00 - 10:00am, Saturday, September 25, 2010

ASTRO HQ, Fairfax, VAASTRO HQ, Fairfax, VA

1)1) Finalize the plan of action for Finalize the plan of action for the futurethe future

a)a) Identify tasks and create timelinesIdentify tasks and create timelines

b)b) Identify outstanding unresolved IssuesIdentify outstanding unresolved Issues

c)c) Set deliverables for ASTRO meetingSet deliverables for ASTRO meeting

Closed Loop Patient SafetyClosed Loop Patient Safety Other patient safety use cases:Other patient safety use cases:

Compare what was treated with what was planned (dynalog, Compare what was treated with what was planned (dynalog, gantry, etc). MU currently checked.gantry, etc). MU currently checked.

Handshaking check of data transfer from OIS to treatment Handshaking check of data transfer from OIS to treatment workstationworkstation

3 MITA propositions3 MITA propositions Feedback loop, plan, deliver, cf planFeedback loop, plan, deliver, cf plan Imaging closed loopImaging closed loop Population of a RegistryPopulation of a Registry End to end check - phantomEnd to end check - phantom

Focus on one aspectFocus on one aspect Working group consisting of:Working group consisting of:

Kevin, May, Stephen, Nick, Akkamma, AdamKevin, May, Stephen, Nick, Akkamma, Adam When: 15-Oct fully fleshed out; poll posted on 18-Oct, voting When: 15-Oct fully fleshed out; poll posted on 18-Oct, voting

completed 28-Octcompleted 28-Oct

Prioritize new Use Cases with prior Prioritize new Use Cases with prior ‘tabled’ Use Cases‘tabled’ Use Cases

TC provides status on ‘tabled’ Use Cases Information distributed to PC Rank vote on 3 new and 3 ‘tabled’ Use Cases Results for ASTRO AGM When: When:

10-Oct info received from TC10-Oct info received from TC 15-Oct info distributed to PC15-Oct info distributed to PC 18-Oct poll posted18-Oct poll posted 28-Oct voting completed28-Oct voting completed

Create annual report showing passed Create annual report showing passed actors with product releasesactors with product releases

Verified by vendors and usersVerified by vendors and users ask users for confirmationask users for confirmation Survey tool for testSurvey tool for test Who: Who:

Colin to ask Bruce for passed actors and software Colin to ask Bruce for passed actors and software versions from previous connectathonsversions from previous connectathons

Colin, Jacob to create table Colin, Jacob to create table

When: draft table to be shown at ASTRO AGMWhen: draft table to be shown at ASTRO AGM

How do we close the loop from Use Case to How do we close the loop from Use Case to Integration profile to RFP to Clinical Use ? Integration profile to RFP to Clinical Use ?

Add Test tool version number Add Test tool version number Poll users, allowing reporting of failures. Poll users, allowing reporting of failures. Contact initial customers to validate clinical Contact initial customers to validate clinical

release. release. Establish Mini complaint system for tracking Establish Mini complaint system for tracking

issues? issues? Aside: End to end ‘scripting’ test to verify RT Aside: End to end ‘scripting’ test to verify RT

processprocess Who?Who? When? Table to AGM after matrix is availableWhen? Table to AGM after matrix is available

Publicity and Promotions Publicity and Promotions Success StoriesSuccess Stories

Wait for use case / software version Wait for use case / software version matrix, talk to vendors to get users to matrix, talk to vendors to get users to approachapproach

Set timelines for ASTROnews publications Set timelines for ASTROnews publications and AAPM newsletter, PROand AAPM newsletter, PRO

Create webinar with CME credits for Create webinar with CME credits for IHE-RO (MD, Physics, RTT, CMDIHE-RO (MD, Physics, RTT, CMD

Interoperability and patient safetyInteroperability and patient safety Who: Who:

Tony to investigate/create (Lynn Brown ASTRO)Tony to investigate/create (Lynn Brown ASTRO) With assistance from Publications and Promotions ? With assistance from Publications and Promotions ? Everyone to bombard Tony with facts. Dick FraassEveryone to bombard Tony with facts. Dick Fraass 1 hour presentation ?1 hour presentation ?

When: update at ASTRO AGMWhen: update at ASTRO AGM

Create a ASTRO IHE-RO Task force to Create a ASTRO IHE-RO Task force to provide recommendations to RO provide recommendations to RO

communitycommunity

Evidence based info neededEvidence based info needed Errors resulting from interoperabilityErrors resulting from interoperability Cost of not having interoperabilityCost of not having interoperability Who ? Akkamma, Kevin, Jacob, CharlesWho ? Akkamma, Kevin, Jacob, Charles When ? Table (tie to webinar)When ? Table (tie to webinar)

Develop Standard Testing facility (or Develop Standard Testing facility (or resource centre) for all vendorsresource centre) for all vendors

Develop scope of facilityDevelop scope of facility FDA implicationsFDA implications Jatinder to ask ASTRO ExecutiveJatinder to ask ASTRO Executive Who? Jatinder, Adam, Nick, Tony, Todd, Sha, Who? Jatinder, Adam, Nick, Tony, Todd, Sha,

Martin Martin When? Create a separate working group outside When? Create a separate working group outside

of IHE-RO.of IHE-RO.

2) ASTRO PC & TC Meetings

PCPC7:00-10:00am, Tues, 02-Nov-20107:00-10:00am, Tues, 02-Nov-2010Where: TBDWhere: TBD

TCTCPotentially noon-1:00pm, Tues, 02-Nov-2010Potentially noon-1:00pm, Tues, 02-Nov-2010

in room used for NEMA meeting 7:30am-noonin room used for NEMA meeting 7:30am-noonWhere: TBDWhere: TBD

3) Meeting Wrap Up

Comments, QuestionsComments, Questions