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Retrieve ECG for Display Profile

This profile aims to make ECGs accessible everywhere by enabling easy retrieval and display of high-quality ECG documents in a platform/vendor neutral way. It includes requirements for vector images, apps for side-by-side synchronized display, and interoperability with existing display applications.

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Retrieve ECG for Display Profile

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  1. Retrieve ECG for Display Profile John Donnelly IHE-Cardiology Planning Committee

  2. ECG Needs • ECGs Accessible Everywhere! • Need broad distribution of ECGs using ubiquitous technology (Web). • Allow medical applications to easily retrieve and display ECGs in a platform/vendor neutral way. • High-quality ECG documents. Avoid artifacts on zoomed ECGs and arbitrary display geometries. • Vector images required (not rasterized) • Facilitate apps for serial comparison (side-by-side synchronized display). Interoperability Strategy Workshop

  3. ECG Profile Abstract / Scope • Provide ECGs and related documents to enterprise • Reuse IHE-ITI RID • Retrieve list of documents; retrieve single document • ECGs served in ready-to-display format (PDF, SVG) • Limited extension for ECG-specific needs • Add requirements on display format and quality • Include XML-based ECG report list Interoperability Strategy Workshop

  4. Out of Scope • ECG acquisition and reading workflow. • ECG raw data interchange. • Export of reports to external repository. • Central management and configuration of ECG devices. Interoperability Strategy Workshop

  5. ECG ProfileValue Proposition • Use ubiquitous HTTP Get mechanism as defined in IHE-ITI RID • Standardized URLs • Use PDF for easy integration with existing display applications • PDF vector graphics supports scalable waveforms • XML list of ECGs for serial comparison apps Interoperability Strategy Workshop

  6. Example ECG in PDF Format Interoperability Strategy Workshop

  7. Example ECG in SVG Format Interoperability Strategy Workshop

  8. ECG ProfileTransaction Diagram Retrieve Specific Info for Display [ITI-11] Retrieve ECG List [CARD-5] Information Display Retrieve ECG Document for Display [CARD-6] Source Interoperability Strategy Workshop

  9. ECG Profile Actors • Display – A system that can request and display preformatted (“presentation-ready”) data using Web technologies. • Information Source– A system that responds to requests for patient-related ECG data by encoding it in a presentation-ready format using Web technologies. • Same actors as RID Profile Interoperability Strategy Workshop

  10. ECG ProfileStandards Used • HTTP – Query/response • XHTML – Response list format • XML – Alternate response list format (processable) • PDF – ECG content format • SVG – Alternate ECG content format • A W3C Standard (XML meets graphics) • Allows scripting for embedded client side controls Interoperability Strategy Workshop

  11. ECG ProfileTransactions • Retrieve Specific Info for Display [ITI-11] • Uses HTTP Get query parameters “SUMMARY” or “SUMMARY-CARDIOLOGY” • Response list of documents (including ECGs) in ready-to-display format (XHTML) • Retrieve ECG List [CARD-5] • Uses HTTP Get query parameter “SUMMARY-CARDIOLOGY-ECG” • Response list of ECGs in processable format (HL7 RIM-derived XML) • Retrieve ECG Document for Display [CARD-6] • Response ECG served in PDF • SVG allowed if Display actor asks for it and Information Source supports it Interoperability Strategy Workshop

  12. ECG XML List based on HL7 V3 R-MIM Interoperability Strategy Workshop

  13. ECG XML List Schema Interoperability Strategy Workshop

  14. ECG PDF Content Requirements • Waveform as vector graphics • Gives high quality line drawings at any screen resolution and zoom factor • Rasterized (e.g. scanned, bitmapped) ECG “images” not allowed • Minimum context • Patient Name and ID • Date/time of recording • Confirmation status of interpretation • Waveform technical content • Standard calibration “pulse” 1 mv x 200 ms • Nominal 1 mm grid • Lead labels • Frequency response Interoperability Strategy Workshop

  15. Use Case D1: Simple Display • Display actor requests list of ECG documents for a specific patient ID. • RID profile SUMMARY-CARDIOLOGY request returns list as HTML. • ECG profile SUMMARY-CARDIOLOGY-ECG request returns list as XML with stylesheet. • Display actor requests a specific ECG document using a unique document ID. • The ID of the requested document may not have been obtained from the previously retrieved list. Interoperability Strategy Workshop

  16. Example List as HTML Interoperability Strategy Workshop

  17. Use Case D2: Advanced Display • Display actor requests list of ECG documents for a specific patient ID using ECG profile request type. • List of ECGs returned as structured XML. • Display actor parses structured document list to select related ECGs for serial comparison, for example. • Display actor requests the specific ECG documents using the unique document IDs obtained in structured list above. • Display actor displays the ECGs in a meaningful way. Interoperability Strategy Workshop

  18. ECG XML List Example Interoperability Strategy Workshop

  19. ECG List XML Example Formatted with Stylesheet Interoperability Strategy Workshop

  20. ECG List XML ExampleSimple Serial Comparison App. Interoperability Strategy Workshop

  21. Serial Comparison Example 23-April-200413:45:02 23-April-200413:47:45 Interoperability Strategy Workshop

  22. More information…. • IHE Web site: www.ihe.net • Technical Frameworks, Supplements • Cardiology Technical Framework • IT Infrastructure Technical Framework • ECG XML List Schema and examples • Non-Technical Brochures : • Calls for Participation • IHE Fact Sheet and FAQ • IHE Integration Profiles: Guidelines for Buyers • IHE Connect-a-thon Results • Vendor Products Integration Statements Interoperability Strategy Workshop

  23. Providers and Vendors Working Together to Deliver Interoperable Health Information Systems In the Enterprise and Across Care Settings W W W . I H E . N E T Interoperability Strategy Workshop

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