IHE Eye Care Webinar Why IHE Eye Care from a Business Point of View June 6, 2006

1. IHE Eye Care WebinarWhy IHE Eye Care from a Business Point of ViewJune 6, 2006 Lloyd Hildebrand, M.D., American Academy of Ophthalmology, Medical Information Technology Committee Chair

2. AAO Support • Collaboration • WG9 • Bringing users and vendors together • Standards • DICOM • Ophthalmic Photography • Ophthalmic Tomography • SNOMED • Convergent Ophthalmic Terminology Project • Interoperability • Integrating the Healthcare Enterprise

3. Integrating the Healthcare Enterprise (IHE) Eye Care • Stimulates the integration of eye care information resources • Uses standards to communicate images and patient data, i.e., DICOM • Is part of a larger initiative across medicine, Integrating the Healthcare Enterprise (IHE)

4. Premise of IHE Eye Care • Standards • Pre-requisite for multi-vendor interoperability • Basis for fully electronic offices • Interoperability • Seamless and secure exchange of patient information electronically • Fueled by federal government programs and funding • Market demand • Requirements for interoperability because purchasers want efficiency and quality

5. Electronic Health Records • Electronic health records (EHR) vs. paper records • Scheduled workflow • Automatic demographics • Automatic billing • Emphasis on electronic workflow between different office functions • Front office functions • Patient registration / patient scheduling / order placing • Clinical functions • Procedure scheduling • Acquisition / Analysis • Professional reporting • Back office functions • Charge processing

6. Modality Workflow • Digital instrument records vs. film or paper • Emphasis on electronic workflow for storage and review of modality data • Clinical function of acquisition & analysis • Classic example: digital photography vs. film • Includes future multi-modality clinical management systems

7. Vision of Office of the Future • Networking will use industry standards (IHE / DICOM / HL7) • Will look like offices of the present in other medical specialties • Radiology • Cardiology • Patient Care (adopting IHE now) • Customers will expect plug-and-play • If it doesn’t work, will want to return it • The future is here • Concept demonstrated at AAO 2005 IHE Eye Care Showcase • Full electronic workflow at AAO 2006 IHE Eye Care Showcase

8. Electronic Workflow The vision is full electronic workflow, eliminating the need for paper, film, or removable media to transfer information, and having patient care data anytime, anywhere. This is made possible through implementation of industry-wide standards.

9. President Bush • Executive Order April 27, 2004 • Incentives for use of health information technology and establishing position of the National Health Information Technology Coordinator • Overall goal is the widespread adoption of interoperable electronic health records within 10 years

10. Vision of National Interoperable HIT • Information available at the time and place of care • Improves quality, reduces errors, and advances evidence-based medical care • Reduces costs resulting from inefficiency, errors, incomplete information • Improves coordination of care and information among providers • Ensures that patients' individually identifiable health information is secure

11. US Government Policy • Goal to increase efficiency of healthcare administration • Policy to encourage development of nationwide electronic healthcare records • Funding for government healthcare facilities to implement EHR • Strong participation by government agencies in industry standards efforts • Government healthcare facilities require networking solutions • VistA Office project funded by US government

12. US Government Funding • $3,300,000 awarded to American National Standards Institute (ANSI) to convene the Health Information Technology Standards Panel (HITSP). • HITSP will develop, prototype, and evaluate a harmonization process for achieving a widely accepted and useful set of health IT standards that will support interoperability among health care software applications

13. Standards • Standards are fundamental to success of widespread interoperability • Many standards for health information exchange exist, but variations and gaps hinder interoperability and the widespread adoption of health IT • IHE provides a common framework for passing health information seamlessly through developing solutions for integration problems

14. IHE Networking – Full Electronic Workflow

15. Benefits to IHE Participants • Manufacturers/Vendors • Align product interoperability with industry consensus • Decreased cost and complexity of interface installation and management • Focus competition on functionality/service space, not information transport space, thus reducing costs in the long run • Produce devices that meet customers’ demands for interoperability and connectivity

16. Benefits to IHE Participants • Clinicians • Improved workflow • Information when and where needed • Fewer opportunities for errors • Fewer tedious tasks/repeated work • Improved report turn around time • Increased efficiency overall • Increased quality of care

17. 2005 IHE Survey Results • Potential benefits of IHE  Improved clinical workflow + access of data = 63% **HIMSS web-based survey in data collection in November 2004 – 163 participants

18. 2005 IHE Survey Results • Benefits of IHE in products  Reduce deployment costs = 56% **HIMSS web-based survey in data collection in November 2004 – 163 participants

19. Success depends on interoperability • Clinicians and providers need confidence that the EHR will consistently support clinical information • Patients need confidence that the most current information is available and reusable • Vendors need confidence that providers will be satisfied • Healthcare policy and payers need confidence that quality and efficiency will improve • IHE is a foundational component of the Healthcare Information Technology Standards Panel (HITSP) standards harmonization activities

20. Effective bridge between information exchange standards and their practical usein eye care

21. Summary • Standards are a pre-requisite for multi-vendor interoperability • Standards will fuel the transition to fully electronic offices within the next 5 years • IHE Eye Care is the vehicle to implement standards and enable interoperability in the ophthalmic marketplace • Derive savings to the manufacturers • Produces desired results for the purchasers • Propels eye care into the electronic age