Trend Tracker | IHE in Cardiology Makes Progress

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You probably know by now that the Integrating the Healthcare Enterprise initiative is moving into the cardiology realm. But if this is news to you, there are some marketplace changes underway that you may want to understand - quickly!

Every vendor that offers systems used in ECG, echocardiography or the cardiac cath lab needs to be on board with IHE Cardiology within the next few months. While a good number of software and hardware device companies already participate in the Planning or Technical Committees, a significant group of vendors are still missing, including both large and small companies.

For OEMs skilled at reading between the lines, the IHE Cardiology opportunity is spelled UPGRADE. Newly minted IHE-capable products and systems are likely to be purchased sooner than the normal replacement lifecycle for products that are routinely connected to networks in a clinical care setting. The benefits from these systems are primarily workflow and departmental productivity.

While IHE specifications are not yet in use in the cardiology world, the upcoming demonstrations at ACC and HIMSS in early 2005 are expected to enlighten many thought leaders. IHE Cardiology has garnered substantial official sponsorship, including the ACC, European Society of Cardiology, American Society of Echocardiography and Society of Cardiac Angiography and Interventions.

IHE Cardiology upcoming events and milestones include a final release of the Technical Framework and Call for Vendor Participation, a vendor workshop meeting, a participants technical meeting for ACC and HIMSS demonstrations, MESA (Medical Enterprise Simulators and Analyzers) testing tools, a Connect-a-thon testing in a multivendor environment, and HIMSS and ACC demo areas.

The sidebar below is a brief summary of key points contained in the IHE Cardiology Technical Framework that is now available for review and comment. To view the complete documents, go to www.cardiosource.org.

The Cardiac Catheterization Procedure in Perspective

It is important to understand the cardiac catheterization procedure that is being addressed in Year 1 of the Cardiology Technical Framework, and to put that into perspective with regard to a broader picture. The cath procedure itself occurs inside of a clinical context wherein a patient has a clinical presentation, diagnostic and/or interventional procedures are performed, and events of interest are monitored after the procedure itself has concluded.

Clinicians may use the terms such as "case," "encounter," or "admission" to refer to this broader scope. To help avoid confusion with other standards documents and nomenclature, this appendix introduces the term "Episode of Care."

The clinical activities associated with cardiac catheterization are shown schematically above. The evidence-gathering activities may actually start hours, days or weeks ahead of time as the patient is evaluated before the procedure. The cath procedure itself refers to the events that occur in the cath lab suite itself. Evidence will continue to be gathered after the actual procedure has finished, which would typically include the recording of complications (if any), and subsequent patient outcome.

At some point in time, there is an event (that may be site-specific) that indicates that the Episode of Care has concluded. In its simplest form, this might be represented by the patient's discharge from the facility. Any evidence that is gathered relating to events after that point in time is no longer added directly to the Set of Results associated with cardiac cath.

In Year 1 of the IHE for Cardiology Technical Framework, activities have been identified that occur between the patient's arrival in and departure from the cath lab suite. In subsequent years, the Technical Framework will be extended to include the entire Episode of Care.

IHE in Cardiology: The Framework

Key Excerpts from the Technical Framework, Vols I and II

The current IHE Cardiology Year 1 Technical Framework addresses the following primary features:

  • The Cath Workflow Integration Profile describes mechanisms to manage and distribute the workflow within the cardiology department catheterization labs across the several types of equipment in a synchronized manner.
  • The Echo Workflow Integration Profile describes mechanisms to manage and distribute the workflow within the cardiology department echocardiography function, including stress echo.
  • The Retrieve ECG for Display Integration Profile describes interoperable ways