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Enhancing Radiology Efficiency Through IHE Integration at Mainz University Hospital

This success story from the Department of Radiology at Johannes Gutenberg University Mainz highlights the impact of integrating IHE (Integrating the Healthcare Enterprise) profiles on clinical workflows and data management. With a capacity of 1,500 beds and extensive outpatient services, the department manages over 25,000 images and 500 studies daily. Implementing IHE has improved documentation quality, data consistency, and clinical workflow efficiency. The lessons learned advocate for flexible, vendor-independent approaches to enhance interoperability in healthcare operations.

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Enhancing Radiology Efficiency Through IHE Integration at Mainz University Hospital

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  1. User Success Story Johannes Gutenberg-University Department of Radiology, Mainz, Germany prepared by Peter Mildenberger, MD

  2. Topics • Infrastructure (Hospital / Radiology) • IT - responsibilities • IHE Integration Profiles used • Further developments • Conclusions

  3. University Hospital Mainz and Department of Radiology • 1500 beds, ~100 wards • 53.000 inpatients/year, 190.000 outpatients • >30 examination rooms • ~ 500 exams / d • ~ 15 clinical conferences / d • RIS since 1988 • PACS since 1996(Rad, Neurorad, NUK, Endo, Dent..) • >30 modalities (e.g. 5 CTs, 5 MRs, 5 CRs, 3 DRs..) • 15 - 20 GB / d as new data • ~ 25 TB online (>40 million images)

  4. Internal 210 Orthopedics503 Surgery 505 Internal701 Radiotherapy Ward 401-2b Departmental Structure Dept. of Radiology Angiogr. Skeletal R Angiogr. CT Radiotherapy Ward CT CT DL DL DL DL MRT MRT Neuroradiology MRT Thorax Mammography Thorax Angiogr. Skelett Thorax Skeletal R CT ICU Skelett ICU DL Ward US Chest US Skeletal R Archive/ Workstation

  5. HIS (Administration) IT Depart in Administration SAP/R3 and IS-H* productive General IT Concept • PACS • Radiology • all DICOM - Objects • central server , RAID + long term storage • DICOM-Viewer • separated workgroup-servers with on demand access • productive HL7 Digital Archive for paperbased files Medical Informatics Microfiche plus Web-Access not available yet! EPR IT Department in Administration SAP based (IS-H*MED) first pilots (2 of 30 dept)

  6. The IHE Radiology Workflow X Modified according to N. Wisrz, PhD, Siemens

  7. Modality Worklist / Performed Procedure Step Name, Date of Birth Accession number UIDs et al. MWL: RIS (gap it!, iSoft) Acq. modality (Integris, PMS) Exposure Time Total dose Exposure dose Fluoro dose Number frames Fluoro time Number series MPPS with auto- matic transfer of:

  8. Pitfalls in conventional documentation • Exposure data *10-100 • incomplete document • Diff. in Fluorotime >20%

  9. Consistency and Completeness of Image Archiving RESULT: • ~ 25000 images / d • ~ 500 studies / d • manual control takes 5 - 15 min / modality • ~ 3h/d for the complete department

  10. Storage Commitment – Push Model Please take responsibility for safekeeping of data O.k., commitment for archiving images permanently PACS (ImageDevices) P A C S DVD Acq modality

  11. Ophthalmology Gastroenterology Urology Cardiology Onkology Dermatology Dental Imaging ... Total (outside Radiology) 300 GB / year 300 GB / year 250 GB / year 900 GB / year 400 GB / year 750 GB / year 700 GB / year ... 5 TB / year Survey in different Departments (est.)

  12. Conclusions • flexible implementation, less independant from a vendor • MWL, MPPS, StComm improve clinical workflow, data consistency, quality of documentation,... • IHE is a pragmatic model for the clinical scenarios • IHE profiles should become regular part of RFPs • IHE Process fit also outside Radiology (e.g. Lab., Card.) • IHE is NOT a standard, it is beyond !!! • IHE solves daily-life problems by Integration Profiles

  13. Using IHE there will be less work for „Consultants“ like this one....

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