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ents some practical challenges. An integrator and/or IT department leader would need to ensure that all vendor systems maintain the same level of HL7 and DICOM compliance, and that they have all successfully com- pleted relevant integration- framework tests at a recent IHE Connectathon.

Toni Skokovic is vice president of product management for Merge Healthcare’s OEM division. For more information on Merge Healthcare solutions:

This assumption may not be practical since most

information systems at a hospital, clinic or an imaging fa- cility move on separate lifecycle phases. Instances where a healthcare institution can upgrade all of its systems to

DICOM and HL7, along with support from the IHE’s in- tegration frameworks, deliver a key set of building blocks for connectivity. To successfully use these connectivity building blocks, an integrator, vendor or an internal IT department should have a technical architecture that is conducive to customization.

Modern integration architectures, such as the Web- services paradigm often referred to as service-based architecture allow for this type of fl exible implementa- tion. Rapid-development tools for the Web and robust network infrastructure in both hospitals and regional-care networks provide the fi nal element in delivering this bal- anced technology foundation.

Standards-based connectivity and open W`eb architecture form a robust foundation for work fl ow-optimizing solutions and diagnostic results sharing.

the latest release or install the entire IT infrastructure in a single project are rare – if non-existent. Such compre- hensive IT implementations require signifi cant work-fl ow change, which disrupts care delivery. Effi ciencies are lost and costs associated with the disruption often invalidate the fi nancial benefi ts of the information system. Integrators should not, however, give up on standards- based integration, but consider an approach that provides an optimal use of existing levels of HL7 and DICOM compliance, while using IHE integration frameworks as a referencable, best-practices foundation.

Consider DICOM, HL7 compliance

An integration should address the organization’s need to maintain an existing-care work fl ow, minimize changes to proven care-delivery fl ow, use existing standards-based compliance, and optimize the value of systems already installed at the facility. Current levels of compliance with

Connectivity building blocks allow for the reuse of diagnostic informa- tion that is already in place, captured by systems already installed. Web services-based architecture enables the delivery of this information, in a secure and safe way, to any participant in the continuum of care, either through a customized portal application or through information delivery direct to the “home” system. Finally, the availability of high-band- width network access eliminates the need to duplicate and/or migrate data by allowing on-demand access in the context of an immediate care episode or request. Clinicians have new capabili- ties to make informed decisions when they are given full access to diagnostic information, including data-heavy radi- ology, cardiology and pathology results. For radiology, this information includes not only baseline diagnostic images, but

also image annotations and report text.

A fully connected model allows providers to use existing systems and work fl ow, gives CIOs optimal op- erational infrastructure, ensures timely and accurate care for the patient, and assures payers that care is provided in a cost-effective manner. Standards-based connectivity, open architecture and rapid development capability offer a quick way to integrate existing systems without necessitating any duplication of information, changes in established work fl ow or costly upgrades to any individual system. In this scenario, all the benefi ts of a standards-based interop- erability model are combined with site- and diagnosis- specifi c work-fl ow requirements. The result: streamlined information fl ow without imposing costly changes on existing systems and work processes – an approach that yields cost-effective information exchange and increased relevance for existing systems.



April 2010 21
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