North American 2010 Connectathon & Interoperability Showcase Series

1. North American 2010 Connectathon & Interoperability Showcase Series Distributing Images: Cross-enterprise Document Sharing for Imaging (XDS-I.b) SESSION <enter number> Paul Seifert/ Kinson Ho Solution Architects Agfa HealthCare Radiology Technical Committee

2. <DOMAIN>Webinar Overview This webinar will cover the following topics: • 2009 Webinar Series Schedule - brief overview • 2009-2010 North American Connectathon & Interoperability Showcase Cycle - Brief Overview<Domain> overview • History, scope, road map, key profiles, point to previous Webinars • <Domain> New Profile details • Q&A • Wrap

3. Webinar Overview Important note to all Domain-focused presentations: • This is the template for the 2009 Webinar series. • Also, please encourage visitors to your presentation to review the Webinar Series Kick-off presentation that was held on Thursday June 11 since that is where they will learn about registration processes, deadlines and other key facts. • To help you with this reminder, please include the next two overview slides in your presentation as these point participants to the Kick-off presentation link.

4. 2009-2010 Webinar Schedule Overview June 11 – Kick-off! Overview IHE 2010 NA Connectathon & HIMSS10 U.S. Interoperability Showcase June 25: 10:00 – 11:30amCT Radiology Thur July 23: Time: TBD Patient Care Coordination (PCC) Patient Care Coordination: Nursing Sub-committee Other sessions to follow July – September 2009 (Time & Date TBD) includes: Repeat of June 11 Kick-Off Webinar will be repeated in July, August & September Anatomic Pathology Cardiology Eye Care IT Infrastructure (ITI) Laboratory Patient Care Devices (PCD) Radiation Oncology Quality, Research and Public Health (QRPH) Use of IHE in the enterprise – Intra-enterprise solutions IHE and U.S. initiatives including ARRA, Meaningful Use and more IHE 2009 North American Connectathon - Connectathon Registration How-To Miss a live session? All sessions recorded & available atwww.ihe.net/Events/webinars2009.cfm 4 June - September 2009

5. 2009 Webinar Schedule Overview Miss a live session? All sessions recorded & available atwww.ihe.net/Events/webinars2009.cfm • June 11 – Kick-off! • Overview IHE 2010 NA Connectathon & HIMSS10 U.S. Interoperability Showcase This session can be downloaded at any time – if you are new to this process – please review! • June 25: 10:00 – 11:30amCT • Radiology • Thur July 23: Time: TBD • Patient Care Coordination (PCC) • Patient Care Coordination: Nursing Sub-committee Other sessions to follow July – September 2009 (Time & Date TBD) includes: • Repeat of the June 11 Kick-Off Webinar will be repeated in July, August & September • Anatomic Pathology • Cardiology • Eye Care • IT Infrastructure (ITI) • Laboratory • Patient Care Devices (PCD) • Radiation Oncology • Quality, Research and Public Health (QRPH) • Use of IHE in the enterprise – Intra-enterprise solutions • IHE and U.S. initiatives including ARRA, Meaningful Use and more • IHE 2009 North American Connectathon - Connectathon Registration How-To 5 June - September 2009

6. IHE from 30,000 feet • International initiative to implement HIT standards to improve interoperability, enable EHRs • Committee use consensus process to develop implementable specs called Profiles published in Technical Frameworks • Get Involved! Committee participation open to all members • Membership is free! Go to http://www.ihe.net/governance/ • More background and details in Kickoff Session overview presentation at http://www.ihe.net/events/webinars2009.cfm

7. IHE from 30,000 feet • Implementation testing process ensures compliance and interoperability • Culminates in annual Connectathon • Public demonstrations at HIMSS Interoperability Showcases and other medical meetings (e.g., RSNA, ASTRO, AAO) • Registration for 2010 North American Connectathon and the HIMSS10 Interoperability Showcase opens August 28 and closes September 30, 2009 • Registration link: http://www.ihe.net/north_america/

8. Placeholder: Instructions to Presenters • Placeholder – Domains, start your Domain-specific slides here • Please focus on new information for your Domains. We don’t want to repeat information available in last year’s Webinars. Each session should last roughly 1 – 1.5 hours. Point them to the 2008 Webinars for details on existing profiles. If you feel you need a separate, extended technical session, please let Chris or Lisa know and contact us if there are any questions. • Thank you for taking the time to present your domain’s information!

9. Learning Objectives • <<Outline of presentation topics>> • <<Definition of terms/examples>> • <<Takeaway messages>>

10. <Domain Name> • <Brief standard domain description from wiki> • Example: The IT Infrastructure Domain supplies infrastructure for sharing healthcare information. An infrastructure interoperability component represents a common IT function that is used as a building block for a variety of use cases... a necessary ingredient, but rarely visible to the end user!! • These components may be embedded in an application, but are often deployed as a shared resource within a RHIO or Health Information Exchange. This domain began in 2003, is sponsored by Health Information Management Systems Society (HIMSS). The ITI domain Profiles detailed in the IT Infrastructure Technical Framework. Learn more: http://wiki.ihe.net/index.php?title=IT_Infrastructure

11. Domain Overview • Mission/scope • Block diagram domain/profile overview • Key profiles (on sentence each) • Relationship to other domains

12. North American 2010 Connectathon & Interoperability Showcase Series Paul Seifert/ Kinson Ho Solution Architects Agfa HealthCare Radiology Technical Committee Members Distributing Images: Cross-enterprise Document Sharing for Imaging (XDS-I.b) SESSION <enter number>

13. Cross-enterprise Document Sharing for Imaging (XDS-I.b) • Use case and profile abstract • Value proposition • Actors and transactions • Relation/dependency on other profiles • Implementation resources (e.g., Schema, WSDL) • Implementation considerations (security, testing, etc.)

14. XDS-I.b Abstract / Scope • Sharing of Imaging Information across affiliated health enterprises • Imaging Information includes • extensive sets of DICOM instances including images, evidence documents and presentation states • diagnostic reports provided in a "for display" form • selection of diagnostically significant images associated with the report content

15. XDS-I.b Value proposition • Imaging component of the Electronic Health Record: Shared imaging Record, in a community, region, etc. • Effective means to contribute and access imaging documents across health enterprises. • Without XDS-I.b, access to the radiology report across health enterprises is difficult • Scalable sharing of imaging documents between radiology departments, private physicians, clinics, long term care, acute care with different clinical IT systems. • Easy access: Care providers are offered means to query and retrieve imaging documents (images and reports) of interest • using the same mechanisms used to query other documents

16. Sharing Radiology Reports and Imagesin a Regional Health Information Network Regional Health Information Network Radiology Enterprise B PACS B Radiology-to-radiology Radiology-to-Physicians PACS A Physician Office Radiology Enterprise A

17. Sharing Radiology Reports and Imagesin a Regional Health Information Network Regional Health Information Network Radiology Enterprise B PACS B Patient Id= 3547F45 • Report 5/21/1998 : CT Head B • Study 5/21/1998 : CT Head B • Report 2/18/2005 : Chest Xray A • Study 2/18/2005 : Chest Xray A Cross-Enterprise Registry PACS A Physician Office Radiology Enterprise A

18. Physicians and Systems within a Regional Health Network - Routine Imaging Referral Register Imaging Information for sharing Priorimaging Reports & Studies Register Imaging Information for sharing Query for Documents Regional Health Information Network Radiology Enterprise B Cross-Enterprise Registry Patient Id= 3547F45 • Report 5/21/1998 : CT Head B • Study 5/21/1998 : CT Head B Physician Office Radiology Enterprise A

19. Physicians and Systems within a Regional Health Network - Routine Imaging Referral Register Imaging Information for sharing Register Imaging Information for sharing Notification of Doc Availability Regional Health Information Network Radiology Enterprise B Cross-Enterprise Registry Physician Office Radiology Enterprise A

20. Physicians and Systems within a Regional Health Network for a Routine Imaging Referral Prior Imaging Report & Study Query for documents Imaging Report & Study Regional Health Information Network Radiology Enterprise B Patient Id= 3547F45 • Report 5/21/1998 : CT Head B • Study 5/21/1998 : CT Head B • Report 2/18/2005 : Chest Xray A • Study 2/18/2005 : Chest Xray A Cross-Enterprise Registry Physician Office Radiology Enterprise A

21. XDS-I.b Actors and Transactions

22. What’s New in XDS-I.b • New Provide and Register Imaging Document Set Transaction • Updated to use MTOM/XOP Transport mechanisms • Fully compatible with existing XDS.b Repositories and Registries • More heavily leverages XDS-SD for CDA-wrapped text reports • New Retrieve Imaging Document Set Transaction • Web services based retrieval of DICOM images • Based on XDS Retrieve Document Set Transaction • Key Actor Requirements • Imaging Document Source is required to support all retrieval types; Imaging Document Consumer can choose • “Old” version of XDS-I is simultaneously deprecated • No more “SOAP with attachments” based Provide transaction

23. XDS-I.b Dependencies • XDS-I.b depends on IT Infrastructure Cross-Enterprise Document Sharing (XDS) • Profiled XDS metadata with radiology specifics • Acquisition Modality (e.g. CT, MR) • Anatomic Region (e.g. Arm, Elbow, Hand) • Requested procedure (e.g. MRI Knee with contrast) • Reuses CDA-wrapper defined by XDS-SD for plain text reports. • XDS-I.b specific Actors • Imaging Document Source • Imaging Document Consumer (must be grouped with XDS Document Consumer) • XDS Actors reused • Document Consumer, Document Registry, Document Repository

24. Implementation Considerations • XDS-I.b security considerations • XDS-I.b actors must be grouped with ATNA Secure Node or Secure Application Actor • Document retrievals must be capable of being done across a protected (encrypted) channel. • Implementation Resources (XML schemas and WSDL) • Will soon be available via link at http://wiki.ihe.net/

25. END of XDS-I.b presentation

26. List of new profiles and major profile updates • A few slides on each new profile • A few slides on each major profile update

27. Dates/Relevant Sessions from Overall Schedule

28. Major Take-Away Points

29. Placeholder for Domain slides

30. Placeholder for Domain slides

31. Important dates • 2009 - 2010 Webinar Series, June - September 2010 • http://www.ihe.net/Events/webinars2008.cfm • Registration for NA Connectathon & HIMSS10 Interoperability Showcase • August 28 – September 30, 2009 • IHE 2010 NA Connectathon, Chicago, IL - January 11-15, 2010 • Registration August 22 – September 30, 2009 • www.ihe.net/connectathon/ • HIMSS10 Annual Conference, Atlanta, GA, March 1-4, 2010 • Registration August 28 – September 30, 2009 • www.interoperabilityshowcase.org

32. IHE & Interoperability Resources • Integrating the Healthcare Enterprise • http://www.ihe.net • www.ihe.net/north_america/connectathon2010.cfm • Interoperability Showcase • www.interoperabilityshowcase.org • Health Information Technology Standards Panel • http://www.ansi.org/standards_activities/standards_boards_panels/hisb/hitsp.aspx?menuid=3