Use standards-based approach for integration
Blending with custom interfaces can yield effi ciencies and shorten the time required to deliver diagnostic information to care providers.
By Toni Skok ovic
etting accurate information about imaging procedures to clinicians at various points of care can enable a healthcare organization to optimize the value of radiology studies,
many of which incur signifi cant costs. In the context of patient-centered care, participants across the care continuum should be able to effectively access, use and share information derived from radiology studies. Integrating various patient information-management systems into a continuous fl ow enables not only cost-ef- fective infrastructure, but also minimizes delays in wait- ing for information. A delay in the delivery of diagnostic
The Integrated Healthcare Enterprise (IHE) initiative has created a comprehensive set of integration framework documents that outline the end-to-end care work fl ow in terms of key integration points and information-exchange transactions.
results can create bottlenecks in waiting rooms or force reordering of imaging procedures already done, leading to increased costs for duplicate medical procedures and unnecessary radiation exposure for the patient. A successful integration between an enterprise elec- tronic health record (EHR) or a network of ambulatory electronic medical record (EMR), and radiology infor- mation systems and picture archive and communication systems (RIS/PACS) can shorten the time required to deliver diagnostic information to care providers. With diagnostic results available as radiology studies are com- pleted, care planning and delivery can be accelerated to the point of virtually eliminating patient wait time. All participants in the care cycle, from the family physician to treatment specialists, can be empowered
20 April 2010
to make informed decisions based on a complete set of diagnostic results. Those decisions, in turn, allow clini- cians to deliver care in a timely and accurate fashion. Medical professionals can increase time spent with pa- tients, leading to a higher patient throughput in any type of practice. A fully integrated work fl ow also minimizes operating costs and provides an optimized reimburse- ment cost structure.
When choosing to integrate RIS/PACS work fl ow with a patient record system, organizations often choose to develop custom interfaces between the RIS and/or PACS and the EMR/EHR systems. While this approach can offer performance and customization capabilities, it also creates a costly infrastructure that can be diffi cult to maintain or extend.
The problems with proprietary software
Proprietary interfaces often require dedicated IT professionals and demand a signifi cant amount of effort when changes are required. Routine software upgrades to related systems, EHRs or RIS/PACS, can cause long proj- ects focused on revalidation of the customized interface. Since custom interfaces are always vendor-to-vendor and often site specifi c, this work is not reusable. An individual hospital or clinic bears the total cost of the effort. Standards-based integration is an alternative to the customized-integration approach. The Integrated Health- care Enterprise (IHE) initiative, sponsored by RSNA, HIMSS and other leading associations, has created a comprehensive set of integration framework documents that outline the end-to-end care work fl ow in terms of key integration points and information-exchange trans- actions. Relying on well-established HL7 and DICOM communication standards, the IHE uses industry-wide experience in the most-common, best-practices informa- tion work fl ow.
IHE integration frameworks provide a foundation for solving many types of systems integration problems. Attempting a delivery of IHE-based integration in a plug-and-play manner in an actual site, however, pres-
HEALTH MANAGEMENT TECHNOLOGY