Image Enabled Office Profile - Work Page

Editor:

• Harry Solomon (GE)

1. Summary

An increasing number of clinicians have imaging and diagnostic equipment and electronic medical records in their offices. This equipment needs to be integrated into the office environment 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 primarily towards the in-patient environment. However, there is a critical need for simplified integration in the ambulatory environment.

Note that the systems in an office environment must in may ways be more technically sophisticated than in an in-patient environment, as they must operate with less IT-savvy human supervision, and combine features that would otherwise be distributed across multiple systems.

2. The Problem

The office IT environment

Ambulatory office Practice Management and Electronic Medical Record (PM/EMR) systems are integrated systems incorporating functions for patient management, prescription (order entry), scheduling, and charting / clinical reporting. However, PM/EMR systems do not typically handle imaging and image management functions, which are typically provided by a different set of vendors. One problem addressed by this profile is establishing standard interfaces to enable effective worklow between the PM/EMR and imaging sides of the house.

Unlike the in-patient environment where comparable functions would likely be implemented by separate ADT, CPOE, departmental, and medical records information systems with HL7 interfaces, PM/EMR systems integrate all those features. They typically have minimal implementations of HL7 standard interfaces; most often, there is some capability for receiving ORU (unsolicited observation) messages for lab results.

Regional integration

The primary professional specialties for the Image Enabled Office include cardiology, radiology, and orthopedics. In all of these cases, the use of diagnostic imaging in the office is often a prelude to, or a follow up from, a diagnostic or therapeutic procedure in an acute care setting.

Continuity of care across these different practice settings and organizations requires effictive cross-enterprise sharing of clinical documentation, including imaging.

5. Technical Approach

New actors

Possible new actors:

• Manager - generate local reports