Workflow captures spotlight at infoRAD/IHE demonstration

January 9, 2002

IT's role continues to expand with PDAs, CADThis year's Integrating the Healthcare Enterprise demonstration, as seen at the RSNA's infoRAD, focused on advances in workflow, emphasizing the efficiencies that have been created in

IT's role continues to expand with PDAs, CAD

This year's Integrating the Healthcare Enterprise demonstration, as seen at the RSNA's infoRAD, focused on advances in workflow, emphasizing the efficiencies that have been created in data entry. Especially evident were functionalities that integrate information and imaging systems to boost productivity. Rather than focusing on what might be, IHE developers highlighted what is and distributed an integration checklist. The checklist included a matrix of systems categories versus IHE integration profiles. The matrix was designed to give prospective buyers the information they need to find out from vendors whether systems being considered for purchase will interconnect as they should.

Simplification is the core of IHE, a point underscored by a simulation of the processes involved from the time a patient is registered to the time the final report is dictated and distributed to the referring physician. Because systems are not usually linked, technologists and administrative personnel must enter data several times, increasing the likelihood of mistakes. Procedures are not always updated. And system management is complex and expensive: an information system may attempt to cancel a procedure that has already been performed, or information systems can become temporarily unavailable, requiring manual reconciliation.

The IHE demonstration showed how information entered once, at the time of the patient's initial registration and exam scheduling, can flow through the HIS, RIS, modality console, PACS, and reporting system with all systems continuously updated on the status of exams and treatments.

The IHE project seeks to guide practitioners and industry to improve the way computer systems share information. IHE promotes the coordinated use of established communications standards such as DICOM and HL7 to facilitate functionality between systems. The initiative has grown from just a handful of vendors three years ago to more than 30 companies that participated in the 2001 demonstration.

"This high level of integration is real and available in products today," said Chris Carr, RSNA director of informatics. "Our goal is to educate the radiology customer in the functionality of these integration profiles. We think that customers should expect these new levels of functionality from their vendors with the purchase of new equipment, and they should not be considered an option for future purchase."

Several other IHE themes resonated at infoRAD. One involved the presentation of images. Demonstrators showed how sets of images could be linked and standardized using presentation criteria established and passed on between display stations and printers. Standardized templates for image and numeric reports simplify the management of reports. The ability to attach comments to images resulting from certain key procedures supports the development of teaching files.

Another theme was improving the effectiveness of procedures. This included the development of techniques for grouping so that technologists can link procedures whose results must be considered together for optimal diagnostic effectiveness. Methods of patient information reconciliation allow practitioners to perform procedures on patients for whom demographics have not yet been entered-and then link those demographics with test results later.

The advanced applications showcased by infoRAD demonstrated the challenges and opportunities that lie ahead for IHE. The infoRad PDA (personal data assistant) area illustrated the impact these devices could have on the delivery of healthcare. Nine vendors demonstrated wireless networking. Applications such as the Medical Manager showed how a PDA can provide access to patient data and images.

Other exhibits included computer-assisted diagnosis (CAD) for 3D breast sonography, image-guided surgery, and Web-based image distribution. Flat-panel displays were compared according to brightness, resolution, and distortion. InfoRAD classrooms included the use of PACS workstations, and instructors taught basic to advanced computer skills for current and future configurations of the Internet.