Image Enable Office

1. Proposed Profile: Image Enabled Office

Proposal Editor: Micha Coleman micha.coleman@siemens.com
Profile Editor: Harry Solomon harry.solomon@ge.com
Date: N/A (Wiki keeps history)
Version: N/A (Wiki keeps history)
Domain: Cardiology

2. The Problem

An increasing number of clinicians have imaging equipment and electronic medical records in their offices. This equipment needs to be integrated into the office workflow, and the imaging results need to be seamlessly integrated into the EMR.

The workflow and result integration efforts of IHE have to this point been directed towards the in-patient environment. However, there is a critical need for simplified integration in the ambulatory environment.

3. Key Use Case

A patient is referred to a cardiologist for consultation regarding heart murmur. The cardiologist orders an echo study, which the patient elects to have performed in the cardiologist’s office. The sonographer in the office performs the echo study, and makes preliminary measurements on the ultrasound machine. The images and measurements are sent to a local image server. The cardiologist through his EMR system over-reads (reviews) the images and measurements, and creates a report with findings, selected measurements, and representative images. The report is stored in the EMR, and is also sent to the referring primary care physician.

4. Standards & Systems

IHE scheduled workflow profiles for the in-patient environment (SWF, CATH, ECHO, STRESS)

IHE XDS, XDS-I, XDR profiles for cross-enterprise medical record.

5. Discussion

The scope of the Image Enabled Office profile is to have everything that is necessary for integrating the ambulatory specialty office. Therefore that includes the funtionality of SWF, PIR, ED, and XDS-I profiles.

The proposed approach is:

1. simplify the "top half" of the Scheduled Workflow actor-transaction diagram, consolidating the ADT, Order Entry, and Order Filler actors into a Practice Manager actor

2. add actors and transactions as necessary to bring imaging evidence documents into an EMR

3. ensure the necessary end-to-end workflow and triggers for publishing XDS-I content to the affinity domain

The development of this profile will occur within the Cardiology Technical Committee. The ITI Technical Committee is invited to participate to ensure the perspectives of the EMR vendor community are considered.

This profile may facilitate compliance with functional certification of EMR’s for the specialty office under the auspices of CCHIT