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==Summary==
==Summary==


Core Eye Care Workflow (C-EYECARE) profile addresses a scenario where organizations have a Practice Management System (PMS), Electronic Health Record System (EHR) and eye care diagnostic imaging and testing equipment (fundus cameras, slit lamps, refractive measurement devices, visual fields etc.).
The Unified Eye Care Workflow (U-EYECARE) Integration Profile establishes the continuity and integrity of basic patient and procedure data in the context of an eye clinic workflow scenario. This profile deals specifically with consistent handling of patient identifiers and demographic data. It specifies the scheduling and coordination of procedure data to a wide variety of diagnostic imaging and testing equipment and the ability to post eye care charges.


It enables the consistent handling of patient identifiers and demographic data among the above types of systems. It includes support for features such as patient registration, appointment scheduling, eye care orders and equipment modality worklist. It reduces the implementation requirements of the other eye care workflows by not integrating an Image Archive (i.e. PACS system). Therefore, users of this profile must understand that acquisition devices and users are responsible for the safe keeping of the images and/or measurements created upon their system. It is important for users to understand how this is accomplished so that patient data is protected. How this is accomplished is outside the scope of IHE.
During the maturation process of the IHE Eye Care domain, it has developed multiple workflow integration profiles, such as Advanced Workflow, Basic Workflow and Core Workflow. These workflows are based upon each other but also have their own unique set of features and advantages.
 
This Unified Eye Care Workflow Profile takes the best features of those previously defined workflows (which are now retired), combines them into one workflow profile, and provides more flexibility for three real world implementation models for systems such as EHRs and PACS.
 
Products conform to Actors and Transactions based upon one or more three Real World Models.
 
==Details==
 
 
'''Patient Registration and Appointment Scheduling:'''
 
These messages are typically sent between Practice Management Systems (PMS) and EHRs. Patient registration and updates to patient demographic data are based upon HL7 ADT messages (A04 and A08). Management of patient appointment data (i.e., new appointments, confirmed appointments, patient checked in, cancelled, deleted, etc.) is based upon HL7 SIU messages.
 
All HL7 messages in U-EYECARE utilize HL7 v2.5.1.
 
Optional features include merging patient IDs and the ability to post billing charges.
 
The patient registration and appointments workflow is the same for all real world implementation models.
 
 
'''Real World Model I - EHR Implements DICOM Modality Worklist and Integrates with a PACS:'''
 
Real World Model I addresses a scenario where organizations have a Practice Management System (PMS), Electronic Health Record System (EHR), centralized Image Archive, Image Display (PACS) and eye care diagnostic imaging and testing equipment (fundus cameras, slit lamps, refractive measurement devices, visual fields etc.).
 
This model specifies the Transactions and Actors required for the scenario where the DSS/Order Filler Actor (i.e., typically an EHR) supports DICOM Modality Worklist and is integrated with the Image Manager/Image Archive (i.e., typically a PACS).  
 
[[File:RW Model I.png]]
 
'''Real World Model II - EHR Implements DICOM Modality Worklist, Image Storage and Display (With no PACS):'''
 
Real World Model II addresses a scenario where organizations have a Practice Management System (PMS), Electronic Health Record System (EHR) and eye care diagnostic imaging and testing equipment (fundus cameras, slit lamps, refractive measurement devices, visual fields etc.). The EHR performs the storage (not archive) and display of DICOM images, measurements, etc.
 
Real World Model III addresses a scenario where organizations have a Practice Management System (PMS), Electronic Health Record System (EHR), centralized Image Archive, Image Display (PACS) and eye care diagnostic imaging and testing equipment (fundus cameras, slit lamps, refractive measurement devices, visual fields, etc.).
 
This model specifies the Transactions and Actors required for the scenario where the DSS/Order Filler Actor (i.e., typically an EHR) does not support DICOM and only implements HL7 messages. Therefore, the Image Manager/Image Archive supports DICOM Modality Worklist. All messages utilize HL7 v2.5.1.


[[File:RW Model II.png]]
[[File:RW Model II.png]]


==Details==


C-EYECARE focuses on HL7 V2 messages that are commonly used in an eye care clinic, such as HL7 SIU (appointment scheduling) messages and HL7 ADT (out-patient registration). These HL7 messages are used to coordinate patient and appointment scheduling information between systems such as a PMS and EHR. The appointment scheduling messages are not included in A-EYECARE or B-EYECARE and provide additional features.
'''Real World Model III - EHR Implements HL7 Only (no DICOM support) and Integrates with a PACS:'''
 
Real World Model III addresses a scenario where organizations have a Practice Management System (PMS), Electronic Health Record System (EHR), centralized Image Archive, Image Display (PACS) and eye care diagnostic imaging and testing equipment (fundus cameras, slit lamps, refractive measurement devices, visual fields, etc.).
 
This model specifies the Transactions and Actors required for the scenario where the DSS/Order Filler Actor (i.e., typically an EHR) does not support DICOM and only implements HL7 messages. Therefore, the Image Manager/Image Archive supports DICOM Modality Worklist. All messages utilize HL7 v2.5.1.
 
[[File:RW Model III.png]]
 
'''Optional Transactions:'''
 
Many of the transactions, supported by the other eye care workflow profiles are included as optional transactions in U-EYECARE, such as those based upon DICOM Modality Performed Procedure Step, DICOM Storage Commitment, are optional for actors in U-EYECARE.
 
==Patient Registration and Appointment Workflow Example==
 
These messages are typically sent between Practice Management Systems (PMS) and EHRs. Patient registration and updates to patient demographic data are based upon HL7 ADT messages (A04 and A08).  Management of patient appointment data (i.e., new appointments, confirmed appointments, patient checked in, cancelled, deleted, etc.) is based upon HL7 SIU messages.
 
'''Actors & Transactions:'''
 
[[File:Pat Appt WF.png]]
 
==Real World Model I Workflow Example==
 
'''Real World Model I - EHR Supports DICOM Modality Worklist and Integrates with a PACS'''
 
This Model addresses a scenario where organizations have a Practice Management System (PMS), Electronic Health Record System (EHR), centralized Image Archive, Image Display (PACS), and eye care diagnostic imaging and testing equipment (fundus cameras, slit lamps, refractive measurement devices, visual fields etc.).
 
 
'''Actors & Transactions:'''
 
[[File:RW Model I WF.png]]
 
==Real World Model II Workflow Example==
 
'''Real World Model II - EHR Supports DICOM Modality Worklist, Image Storage and Display (no PACS)'''


C-EYECARE specifies basic requirements for DICOM integration such as DICOM Modality Worklist and DICOM Storage. The DICOM features are a subset of the features defined in the Basic and Advanced Eye Care Workflow Integration Profiles.  
This Model addresses a scenario where organizations have a Practice Management System (PMS), Electronic Health Record System (EHR) and eye care diagnostic imaging and testing equipment (fundus cameras, slit lamps, refractive measurement devices, visual fields etc.). The EHR performs the storage (not archive) and display of DICOM images, measurements, etc.


C-EYECARE supports an optional feature to perform billing services between a Charge Processer (often part of a PMS system) and a Department Scheduling System/Order Filler (often part of an EHR system).  It utilizes a transaction based upon a HL7 DFT (Detailed Financial Transaction) message.


All HL7 messages in C-EYECARE are based upon HL7 v2.5.1
'''Actors & Transactions:'''


==Typical Workflow Example==
[[File:RW Model II WF.png]]


==Real World Model III Workflow Example==


'''Real World Model III - EHR Implements HL7 Only (No DICOM Support) and Integrates with a PACS)'''


Patients are registered and patient demographics are distributed using the HL7 ADT_A04 message.  The patient’s appointment is created/managed (i.e., PMS) and sent to consuming systems (i.e., EHR7) via HL SIU messages. This includes new appointments, updates such as confirmed, arrived, checked in, complete. It also supports cancel/delete appointments and patient no shows.
This Model addresses a scenario where organizations have a Practice Management System (PMS), Electronic Health Record System (EHR), centralized Image Archive, Image Display (PACS), and eye care diagnostic imaging and testing equipment (fundus cameras, slit lamps, refractive measurement devices, visual fields, etc.).


The DSS/OF (i.e., EHR) creates patient orders internal to its system.
The Image Manager/Image Archive supports DICOM Modality Worklist as the SCP.


DICOM Modality Worklist (MWL) is used to convey patient and demographic information to eye care acquisition devices.  The query may be broad (get a list of scheduled procedures from which one will be selected), or patient-specific (provided with sufficient query keys to get back the scheduled procedure for a single patient). Eye Care procedures may be performed on multiple Acquisition Modalities or Acquisition Modality Importers, therefore, multiple devices may perform the queries.


The patient is selected and the eye care device performs the acquisition.  Each Modality (eye care device) may produce a variety of images and other evidence (visual fields, refractive and biometry information, etc.). The key DICOM SOP instances are stored to the Image Storage/Display which resides on the EHR. The Image Storage/Display is highly recommended to support all the object types as specified by the Eye Care Image Option, the Eye Care Measurement Option and the Encapsulated PDF Option.
'''Actors & Transactions:'''


The Image Storage/Display Actor stores the DICOM SOP Instances and is able to display them to the user of the system.
[[File:RW Model III WF.png]]


The DSS/Order Filler provides charging information to the Charge Processor and the Charge Processor post the charges.
==All Actors and Transactions==


[[File:Core WF.png]]


==Systems Affected==
'''All possible Actors and Transactions for U-EYECARE'''
*Practice Management System or Enterprise-wide information systems that manage patient registration and services ordering (i.e., admit-discharge-transfer (ADT)/registration system and hospital information system (HIS))
 
*Electronic Medical Record System or Departmental information systems that manage department scheduling
This figures shows all the Actors and Transactions possible for U-EYECARE. They are not specific to any Real World Model and may be implemented for various workflow scenarios.
*Acquisition modalities (e.g., fundus cameras, ultrasound machines, ophthalmic tomography devices, slit-lamp biomicroscopes)




'''Actors & Transactions:'''
'''Actors & Transactions:'''


[[File:Core Act Trans.png]]
[[File:U EC All Act and Trans.png]]


==Specification==
==Specification==
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'''Documents:''' [http://www.ihe.net/Technical_Framework/index.cfm#eye| Eye Care Technical Frameworks]
'''Documents:''' [http://www.ihe.net/Technical_Framework/index.cfm#eye| Eye Care Technical Frameworks]


:* [ftp://ftp.ihe.net/DocumentPublication/Archive/EyeCare/2014/Published/IHE_EyeCare_Suppl_C-EYECARE.pdf Core_TF]
:* [http://www.ihe.net/uploadedFiles/Documents/Eye_Care/IHE_EyeCare_Suppl_Unified_EC_Workflow.pdf U-EYECARE]
:* [http://www.ihe.net/Technical_Framework/upload/ihe_eyecare_tf_rev3-7_vol1_Final_Text_2010-02-15.pdf Vol. 1]
:* [http://www.ihe.net/Technical_Framework/upload/ihe_eyecare_tf_rev3-7_vol1_Final_Text_2010-02-15.pdf Vol. 1]
:* [http://www.ihe.net/Technical_Framework/upload/ihe_eyecare_tf_rev3-7_vol2_Final_Text_2010-02-15.pdf Vol. 2]
:* [http://www.ihe.net/Technical_Framework/upload/ihe_eyecare_tf_rev3-7_vol2_Final_Text_2010-02-15.pdf Vol. 2]
Line 63: Line 127:


http://one.aao.org/CE/PracticeGuidelines/Information_Technology.aspx
http://one.aao.org/CE/PracticeGuidelines/Information_Technology.aspx
[[Category:Profiles]]
[[Category:Eye Profile]]
[[Category:HL7v2]]
[[Category:DICOM]]

Latest revision as of 14:07, 4 November 2019

Summary

The Unified Eye Care Workflow (U-EYECARE) Integration Profile establishes the continuity and integrity of basic patient and procedure data in the context of an eye clinic workflow scenario. This profile deals specifically with consistent handling of patient identifiers and demographic data. It specifies the scheduling and coordination of procedure data to a wide variety of diagnostic imaging and testing equipment and the ability to post eye care charges.

During the maturation process of the IHE Eye Care domain, it has developed multiple workflow integration profiles, such as Advanced Workflow, Basic Workflow and Core Workflow. These workflows are based upon each other but also have their own unique set of features and advantages.

This Unified Eye Care Workflow Profile takes the best features of those previously defined workflows (which are now retired), combines them into one workflow profile, and provides more flexibility for three real world implementation models for systems such as EHRs and PACS.

Products conform to Actors and Transactions based upon one or more three Real World Models.

Details

Patient Registration and Appointment Scheduling:

These messages are typically sent between Practice Management Systems (PMS) and EHRs. Patient registration and updates to patient demographic data are based upon HL7 ADT messages (A04 and A08). Management of patient appointment data (i.e., new appointments, confirmed appointments, patient checked in, cancelled, deleted, etc.) is based upon HL7 SIU messages.

All HL7 messages in U-EYECARE utilize HL7 v2.5.1.

Optional features include merging patient IDs and the ability to post billing charges.

The patient registration and appointments workflow is the same for all real world implementation models.


Real World Model I - EHR Implements DICOM Modality Worklist and Integrates with a PACS:

Real World Model I addresses a scenario where organizations have a Practice Management System (PMS), Electronic Health Record System (EHR), centralized Image Archive, Image Display (PACS) and eye care diagnostic imaging and testing equipment (fundus cameras, slit lamps, refractive measurement devices, visual fields etc.).

This model specifies the Transactions and Actors required for the scenario where the DSS/Order Filler Actor (i.e., typically an EHR) supports DICOM Modality Worklist and is integrated with the Image Manager/Image Archive (i.e., typically a PACS).

Real World Model II - EHR Implements DICOM Modality Worklist, Image Storage and Display (With no PACS):

Real World Model II addresses a scenario where organizations have a Practice Management System (PMS), Electronic Health Record System (EHR) and eye care diagnostic imaging and testing equipment (fundus cameras, slit lamps, refractive measurement devices, visual fields etc.). The EHR performs the storage (not archive) and display of DICOM images, measurements, etc.

Real World Model III addresses a scenario where organizations have a Practice Management System (PMS), Electronic Health Record System (EHR), centralized Image Archive, Image Display (PACS) and eye care diagnostic imaging and testing equipment (fundus cameras, slit lamps, refractive measurement devices, visual fields, etc.).

This model specifies the Transactions and Actors required for the scenario where the DSS/Order Filler Actor (i.e., typically an EHR) does not support DICOM and only implements HL7 messages. Therefore, the Image Manager/Image Archive supports DICOM Modality Worklist. All messages utilize HL7 v2.5.1.


Real World Model III - EHR Implements HL7 Only (no DICOM support) and Integrates with a PACS:

Real World Model III addresses a scenario where organizations have a Practice Management System (PMS), Electronic Health Record System (EHR), centralized Image Archive, Image Display (PACS) and eye care diagnostic imaging and testing equipment (fundus cameras, slit lamps, refractive measurement devices, visual fields, etc.).

This model specifies the Transactions and Actors required for the scenario where the DSS/Order Filler Actor (i.e., typically an EHR) does not support DICOM and only implements HL7 messages. Therefore, the Image Manager/Image Archive supports DICOM Modality Worklist. All messages utilize HL7 v2.5.1.

Optional Transactions:

Many of the transactions, supported by the other eye care workflow profiles are included as optional transactions in U-EYECARE, such as those based upon DICOM Modality Performed Procedure Step, DICOM Storage Commitment, are optional for actors in U-EYECARE.

Patient Registration and Appointment Workflow Example

These messages are typically sent between Practice Management Systems (PMS) and EHRs. Patient registration and updates to patient demographic data are based upon HL7 ADT messages (A04 and A08). Management of patient appointment data (i.e., new appointments, confirmed appointments, patient checked in, cancelled, deleted, etc.) is based upon HL7 SIU messages.

Actors & Transactions:

Real World Model I Workflow Example

Real World Model I - EHR Supports DICOM Modality Worklist and Integrates with a PACS

This Model addresses a scenario where organizations have a Practice Management System (PMS), Electronic Health Record System (EHR), centralized Image Archive, Image Display (PACS), and eye care diagnostic imaging and testing equipment (fundus cameras, slit lamps, refractive measurement devices, visual fields etc.).


Actors & Transactions:

Real World Model II Workflow Example

Real World Model II - EHR Supports DICOM Modality Worklist, Image Storage and Display (no PACS)

This Model addresses a scenario where organizations have a Practice Management System (PMS), Electronic Health Record System (EHR) and eye care diagnostic imaging and testing equipment (fundus cameras, slit lamps, refractive measurement devices, visual fields etc.). The EHR performs the storage (not archive) and display of DICOM images, measurements, etc.


Actors & Transactions:

Real World Model III Workflow Example

Real World Model III - EHR Implements HL7 Only (No DICOM Support) and Integrates with a PACS)

This Model addresses a scenario where organizations have a Practice Management System (PMS), Electronic Health Record System (EHR), centralized Image Archive, Image Display (PACS), and eye care diagnostic imaging and testing equipment (fundus cameras, slit lamps, refractive measurement devices, visual fields, etc.).

The Image Manager/Image Archive supports DICOM Modality Worklist as the SCP.


Actors & Transactions:

All Actors and Transactions

All possible Actors and Transactions for U-EYECARE

This figures shows all the Actors and Transactions possible for U-EYECARE. They are not specific to any Real World Model and may be implemented for various workflow scenarios.


Actors & Transactions:

Specification

Profile Status: Trial Implmentation

Documents: Eye Care Technical Frameworks


Underlying Standards:

See Also

http://one.aao.org/CE/PracticeGuidelines/Information_Technology.aspx

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