Most of IHE’s (Integrating the Healthcare Enterprise) efforts involve making it easier for healthcare informatics professionals to “choreograph” the operations of their health IT systems to ease workflow and prevent problems, according to a presentation by David S. Channin, MD, associate professor, chief of imaging informatics, Department of Radiology, Northwestern University Medical School, presenting at SIIM 2007 in Providence, R.I., last week.

IHE popped on the scene back in 1997 and began trying to resolve interoperability challenges between health IT components, starting with radiology. The goal was to use common and established standards such as HL7 and DICOM to make this choreography easier. The organization makes good use of industry experts and care providers to identify problems that could be addressed by existing standards. After a lot of work, technical frameworks are released within certain domains (i.e. radiology) which lay out profiles that describe how standards can be implemented to address specific challenges. IHE then facilitates a testing process so that organizations that implement the standards can test them against other organizations that are doing the same.

The radiology domain, for example, currently includes 18 integration profiles, generally covering workflow, particular problems in radiology, non-image object content profiles, sharing information outside radiology, and auditing, said Channin. Generally, “this is a way to get consistency throughout your processes” with a goal of developing a sort of “independent, parallel operation.”

As further examples of the benefits of the organization’s vast work, Channin noted four options for improving workflow in a department via interoperability: exception management options (i.e. error management); assisted acquisition protocol setting option, to decrease variance in performance of procedures; instant availability notification, a push mechanism that allows other systems to know that certain information is available; and department-wide appointment notification.

At your facility, he suggested that you demand IHE compliance in all your purchase documents for new health IT systems, including modalities, to achieve some of the workflow enhancements and ideals that are possible with health IT.

Each year IHE sets itself a complex and ambitious to-do list. Following are some of the organization’s recently completed or current projects:

• Reporting 2.0 –IHE is now doing a reporting 2.0 investigation, a multi-year integration profile that will seek to redefine reporting workflow;
  
  
• Import reconciliation workflow – “Everyone these days is making CDs,” said Channin, including not only radiology departments, but patients arriving at your doors with them. The catch is that you can’t just pop the information contained on the disc into your PACS because lots of information has to be reconciled. This profile helps to standardize the information reconciliation process;
  
  
• The mammography image profile addresses how acquisition modalities transfer FFDM (full-field digital mammography) images; how CAD (computer-aided detection) acts as an evidence creator; and how image displays should retrieve and make use of images and CAD results;
  
  
• Image fusion, which is big in PET/CT, for example, said Channin, has been addressed through the use of two new DICOM objects to clearly define what tasks each modality in fusion imaging performs to standardize it from facility to facility, and vendor to vendor; and
  
  
• Audit trail and node authentication radiology option addresses how to secure nodes on a network and send audit messages to a central repository.