Roadmap to Shared Imaging

Slide 1: 

Dharmendra Ghai (CPHIMS, Project+) Clinical Imaging Specialist Hamad Medical Corporation Doha-Qatar dghai@hmc.org.qa Roadmap to Shared Imaging Challenges and Opportunities HIMSS Middle-East 2009 Education Session no 25 7th May 2009

Dharmendra Ghai (CPHIMS,Project+,CDIA+)Clinical IT Systems- Project Manager : 

Dharmendra Ghai (CPHIMS,Project+,CDIA+)Clinical IT Systems- Project Manager Strong Business perspective in Healthcare Delivery and Clinical Transformation. Focused and goal oriented approach to ensure alignment of technology initiatives with business objectives.Experience includes Business/IT Strategy, Strategic Planning, Benchmark, Portfolio Analysis, Change Management, Business Process Re-engineering, and Program Management in Healthcare Domain. Expertise in aspects of planning, design, development, implementation, maintenance and evaluation of Healthcare Information Systems. Works with Management and Enduser Department to Optimize Workflow, Improve Productivity and meet Strategic Goals by initiating Clinical Automation and Healthcare IT implementations. Specialties: Healthcare Informatics, Clinical Transformation, Practice Compliance (JCI MOI), EMR, PACS, DICOM, IHE, HIPAA, HL7, Change Management, IT Strategy, Procurement Planning, Project Mgmt. http://www.linkedin.com/in/dghai

Learning Objectives : 

Learning Objectives Challenges and Issues in retention and exchange of Clinical Imaging Data. Introduction to innovative methodologies for Imaging data management and Vendor Neutrality. Snapshot of future of Clinical Imaging and impact on current Imaging management systems.

Clinical Imaging : 

Clinical Imaging

Clinical Imaging……..at Point the of care : 

Cardiology Bronchoscopy Gastrointestinal Endoscopy Hematology Pathology Surgery Nuclear Medicine Dental Radiology Dermatology Ophthalmology Podiatry Vascular Urology Nursing Electrocardiography Scanned Documents Medical Photography Clinical Imaging……..at Point the of care

Clinical Imaging…for Information Managers : 

Clinical Imaging…for Information Managers Source :- https://www-304.ibm.com/jct03004c/tools/cpeportal/fileserve/download0/158685/MedicalImagingRoundTable.pdf?contentid=158685

Clinical Imaging…for Information Managers : 

Source :- https://www-304.ibm.com/jct03004c/tools/cpeportal/fileserve/download0/158685/MedicalImagingRoundTable.pdf?contentid=158685 Clinical Imaging…for Information Managers

Clinical Imaging…for Information Managers : 

Clinical Imaging…for Information Managers Compliance and Regulatory requirements Distribution, Access and Performance requirements “…Archive everything policy” Data Explosion due to multiframes and molecular imaging. Competing technologies Shortage of domain specialists Who owns imaging in your facility? Adoption of Standards Multiple DBS for patients, workflows, procedure, clinical, Image and Non-Image data.

Clinical Imaging and EHR : 

Clinical Imaging and EHR Source :- Canada Infoway

Clinical Imaging and EHR : 

Clinical Imaging and EHR Standardized Platforms for Interoperability Proactive Domain (IHE Profiles) Capitalizing IT advancements (communication bus, web technology, storage speed) Delivers Credibility to EHR Way-in for Clinical Transformation and Adoption. Enabling new era of Molecular medicine.

Clinical Imaging………..Opportunities : 

Clinical Imaging………..Opportunities

http://jnm.snmjournals.org/cgi/content-nw/full/48/12/1916/FIG4kinase; w = week. (Reprinted with permission from (24).) Nanotechnology at the University of Michigan, : 

http://jnm.snmjournals.org/cgi/content-nw/full/48/12/1916/FIG4kinase; w = week. (Reprinted with permission from (24).) Nanotechnology at the University of Michigan,

Shared Imaging………….. Opportunities : 

Shared Imaging………….. Opportunities Proven HIS/RIS/PACS workflow Enhancing patient experience and deliver timely care Longitudinal Imaging Record Regional/Geographical Imaging Repositories Eliminating rescan, but reusing clinical work products! Integration of computer-assisted detection and diagnosis (CAD) in daily clinical practice; Convergence of Bioinformatics and Imaging Informatics 3D medical informatics for surgical planning and intervention, providing clarity for critical decisions. Translational Research Emerging role of Imaging in pharma research, academia and regulatory environments In vivo image-guided diagnosis and real-time surgical treatments, Gene Therapy

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Private Tags Key notes, measurements, Presentation state HealthcareILM When , HOW, WHAT Compliance HIPAA, ISO TC215, CEN TC 251 Information Governance On-going procurements (Adding 320 slice CT) Distributed Workflow (sharing PET-CT) “…ologies” Thin slice / Thick slice archive Viewer Capabilities IHE DICOM HL7 Learning Curve & Adoption IT Infrastructure BW, SOA,EAI, ETL Shared Imaging……………….. ………………………….Real world

Not only Radiology…………. : 

Not only Radiology…………. Source :- http://campar.in.tum.de/Chair/TeachingWs08MISeminar

Shared Imaging…………..Challenges : 

Shared Imaging…………..Challenges Poor or No Implementation of Standards Non-Image clinical work products in proprietary Information Systems Inefficient Dicom Header Info to deliver clinical value Explosion of Data Generation (genomics, proteomics, imaging), Vendors capabilities and pace to deliver true interoperable solutions Other …..ologies & Applications Enterprise policies and procedures for compliance (PHI) Buy-In from all the stakeholders in affinity domain Change management & Learning curve. Isolated/Unique workflows…Thin slices archives

Shared Imaging…………..Challenges : 

Shared Imaging…………..Challenges

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Shared Imaging……………….. ………………………….Real world IHE DICOM HL7 Awareness - Knowing there are images that might be of use. Selection - Choosing images to make use of. Access - "Getting" the images. Update - Knowing about updates to images you have copies of. Transport - Conveying the images http://wiki.ihe.net/

Roadmap Shared Imaging………….Concepts : 

Roadmap Shared Imaging………….Concepts Dr Harvey, Source :- http://www.e-health-insider.com/Features/item.cfm?docId=197

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IHE DICOM HL7 Shared Imaging……………….. ……………………. …….Real world Vendor Neutral Dicom Archive

Roadmap Shared Imaging………….Concept : 

Source :- Agfa Healthcare Roadmap Shared Imaging………….Concept

Shared Imaging……………….. Innovate : 

Shared Imaging……………….. Innovate Lessons Learned…….NHS, Canada Infoway, Image Exchange Networks in the Mid-Atlantic Region, caBIG In -vivo Imaging Workspace IHE XDS, XDS-I, IT Infrastructure Technical profiles. Multi-Format Vendor – Neutral Archive Private Tags Morphing Technologies Capable & Secure Web Viewer Accessing indexed report key words, image annotations or markups for easy search and retrieval. Tele-Imaging Workflow- Functional Interoperability Teaching Workflow

Shared Imaging……………….. Innovate : 

Shared Imaging……………….. Innovate Business aligned ILM policies for management of Imaging data Strategic approach for XDS Affinity Domains PACS Procurement (GCC XDS Affinity Domain!!!!) Inadequacy of IT Infrastructure must not govern Clinical Workflow and Information exchange Complement IHE with innovative thought process to meet local/regional workflow and compliance needs

Slide 24: 

Devil is in…………………………..Details

Slide 25: 

Thank You! “……..the challenge is to ensure that clinical benefits are not lost in translation” -dharmendra ghai Dharmendra Ghai (CPHIMS, Project+) Clinical Imaging Specialist Hamad Medical Corporation Doha-Qatar dghai@hmc.org.qa

References : 

References Utilization of medical imaging informatics and biometrics technologies in healthcare delivery, H. K. Huang Received: 11 January 2008 / Accepted: 29 April 2008 / Published online: 22 May 2008. Chapter 11 Public access to anatomical images George R. Thoma. Reference Canada Infoway and NHS http://www.ihe.net/IT_infra/committees/index.cfm http://www-03.ibm.com/industries/global/files/Advancing_the_utility_of_imaging_biomarkers_White_Paper.pdf?re=healthcare&sa_message=title=advancing_the_utility_of_imaging_biomarkers https://chidb.com/register/bioit/Genologics_Briefing_on/Genologics-TransResearch_final.pdf http://www-03.ibm.com/industries/global/files/Pharma_2010_Info-Based_medicine.pdf?re=healthcare&sa_message=title=personalized_healthcare_2010:_are_you_ready_for_information-based_medicine? http://www.ihe.net/IT_infra/committees/index.cfm IHE Canada: www.ihe-canada.com IHE Canada WIKI: http://wiki.ihe.net/index.php?title=Canada Infoway, Presentation by Trevor Hodge Senior Vice President, Canada Health Infoway | May 4, 2007 Healthcare and Lifesciences –Changing the World …Everyday, Dr. Caroline A. Kovac General Manager IBM Healthcare and Life Sciences Image Exchange: IHE and the Evolution of Image Sharing, David S. Mendelson, MD • Peter R. G. Bak, PhD • Elliot Menschik, MD, PhD • Eliot Siegel, MD http://en.wikipedia.org/wiki/Translational_medicine Author/s: Koutelakis, George V (GV); Lymberopoulos, Dimitrios K (DK);