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«Integrating the Healthcare Enterprise IHE Eye Care Technical Framework Supplement Basic Eye Care Workflow (B-EYECARE) Trial Implementation Date: ...»

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Integrating the Healthcare Enterprise

IHE Eye Care

Technical Framework Supplement

Basic Eye Care Workflow

(B-EYECARE)

Trial Implementation

Date: March 31, 2011

Author: IHE Eye Care Domain

Email: eyecare@ihe.net

Copyright © 2011: IHE International, Inc.

IHE Eye Care Technical Framework Supplement – Basic Eye Care Workflow (B-EYECARE)

______________________________________________________________________________

Foreword

This is a supplement to the IHE Eye Care Technical Framework V3.7. Each supplement undergoes a process of public comment and trial implementation before being incorporated into the volumes of the Technical Frameworks.

This supplement is submitted for Trial Implementation as of March 31, 2011 and will be available for testing at subsequent IHE Connectathons. The supplement may be amended based on the results of testing. Following successful testing it will be incorporated into the Eye Care Technical Framework. Comments are invited and may be submitted on the IHE forums at http://forums.rsna.org/forumdisplay.php?f=11 or by email to eyecare@ihe.net.

This supplement describes changes to the existing technical framework documents and where indicated amends text by addition (bold underline) or removal (bold strikethrough), as well as addition of large new sections introduced by editor’s instructions to “add new text” or similar, which for readability are not bolded or underlined.

“Boxed” instructions like the sample below indicate to the Volume Editor how to integrate the

relevant section(s) into the relevant Technical Framework volume:

Replace Section X.X by the following:

General information about IHE can be found at: www.ihe.net Information about the IHE Eye Care can be found at: http://www.ihe.net/Domains/index.cfm

Information about the structure of IHE Technical Frameworks and Supplements can be found at:

http://www.ihe.net/About/process.cfm and http://www.ihe.net/profiles/index.cfm

The current version of the IHE Technical Framework can be found at:

http://www.ihe.net/Technical_Framework/index.cfm ______________________________________________________________________________

Rev. 1.1 – 2011-03-31 Copyright © 2011: IHE International, Inc.

IHE Eye Care Technical Framework Supplement – Basic Eye Care Workflow (B-EYECARE) ______________________________________________________________________________

CONTENTS Introduction

Profile

Abstract

Open Issues and Questions

Closed Issues

Volume 1 – Integration Profiles

1.7 History of Annual Changes

1.n Copyright Permission

2.1 Dependencies among Integration Profiles

2.2.5 Basic Eye Care Workflow Integration Profile

2.3 Actors Descriptions

2.4 Transaction Descriptions

2.5 Product Implementations

7 Basic EYE CARE Workflow (B-EYECARE)

7.1 Actors/Transactions

7.2 Basic Eye Care Workflow Integration Profile Options

7.2.1 Implementation of Transactions Defined in Advanced Eye Care Integration Profile

7.2.2 Acquisition Modalities Storage Options

7.2.3 Acquisition Modality Importer Storage

7.3 Basic Eye Care Workflow Process Flow

7.3.1 Extension to Query Modality Worklist for Eye Care [EYECARE-1].................. 16

7.4 Basic Eye Care Workflow Use Cases

7.4.1 Workflow Example with Manual Procedure Order

7.4.2 Workflow Where the Procedure Ordered is an Automatic Eye Care Order......... 18

7.5 Workflow Concepts in Practice

7.6 Patient Reconciliation Use Case

7.7 Workflow Use Cases

X.4 Profile Name Security Considerations

Glossary

Volume 2 - Transactions

______________________________________________________________________________

Rev. 1.1 – 2011-03-31 Copyright © 2011: IHE International, Inc.

IHE Eye Care Technical Framework Supplement – Basic Eye Care Workflow (B-EYECARE) ______________________________________________________________________________

Introduction Introduce a new Eye Care integration profile Basic Eye Care Workflow (B-EYECARE). Updates to Volume 1 section 2 to include new integration profile B-EYECARE and added new section 7.

Updates to Volume 2, text in various sections of 4.2 related to PDF/A requirements.

Profile Abstract Implementation experience has shown the eye care community that integration of patient and procedure data between EHR’s (typically Order Fillers) and Instruments (Acquisition Modalities) is the main and most important transaction between the two actors. This is accomplished by DICOM Modality Worklist Transactions based on DICOM Modality Performed Procedure Step and Storage Commitment are useful in a completely integrated system, but are not easily understood by users and not typically requested. Therefore, IHE Eye Care decided to create the Basic Eye Care Workflow Integration Profile.

Basic Eye Care Workflow Integration Profile establishes the continuity and integrity of basic patient and procedure data in the context of an eye clinic and/or an integrated hospital workflow scenario. This profile is a subset of the features defined in the Advanced Eye Care Workflow Integration profile.





Additionally, non-DICOM install base acquisition modality implementations have often been providing PDF solutions. Migration to the PDF/A standard is a difficult and costly upgrade for the installed base therefore we modified the requirement to a recommendation.

Note: Implementations that support the Basic Eye Care Workflow profile may also support transactions defined in the Advanced Eye Care Workflow but not the complete list of required features. For example, an Acquisition Modality may choose to support DICOM Storage Commitment but not Modality Performed Procedure Step. Or they could choose to implement the Stereo Relationship Option.

The Basic Eye Care Workflow Integration Profile has been integrated with the Patient Administration Management (PAM) profile created by IHE ITI.

Open Issues and Questions No open questions at this time.

Closed Issues No issues at this time.

______________________________________________________________________________

Rev. 1.1 – 2011-03-31 Copyright © 2011: IHE International, Inc.

IHE Eye Care Technical Framework Supplement – Basic Eye Care Workflow (B-EYECARE) ______________________________________________________________________________

Volume 1 – Integration Profiles

1.7 History of Annual Changes Add the following bullet to the end of the bullet list in section 1.7 Added the Basic Eye Care Workflow Integration Profile. B-EYECARE establishes the continuity and integrity of basic patient and procedure data in the context of an eye clinic and/or an integrated hospital workflow scenario. This profile is a subset of the features defined in the Advanced Eye Care Workflow Integration profile.

The Basic Eye Care Workflow Integration Profile is synchronized with the IHE ITI Patient Administration Management Profile (PAM) which includes actors Patient Demographics Supplier and Patient Demographics Consumer.

1.n Copyright Permission No changes.

Add the following to sections 1.n:

2.1 Dependencies among Integration Profiles Add the following to Figure 2-1 ______________________________________________________________________________

Rev. 1.1 – 2011-03-31 Copyright © 2011: IHE International, Inc.

IHE Eye Care Technical Framework Supplement – Basic Eye Care Workflow (B-EYECARE) ______________________________________________________________________________

–  –  –

Add the following section to section 2.2 2.2.5 Basic Eye Care Workflow Integration Profile B-EYECARE addresses three workflow scenarios, standalone eye care clinics; large eye care groups and hospital-based eye care departments.

Note: We understand that others scenarios exist, i.e., eye care referrals, telemedicine, etc. However, they are not being formally addressed and will be considered in future versions.

______________________________________________________________________________

Rev. 1.1 – 2011-03-31 Copyright © 2011: IHE International, Inc.

IHE Eye Care Technical Framework Supplement – Basic Eye Care Workflow (B-EYECARE) ______________________________________________________________________________

In eye care settings, patients present with a variety of symptoms and complaints, which may or may not result in the need for diagnostic imaging and testing. Some types of imaging and testing may be performed routinely, before patients are seen by a healthcare provider. Other types of imaging and testing may be performed only after a healthcare provider has determined the need for them while examining the patient. Thus orders may be placed either manually, or automatically. This requirement of flexibility is paramount.

The Basic Eye Care Workflow Integration Profile establishes the continuity and integrity of basic patient and procedure data in the context of an eye care clinic and/or an integrated hospital workflow scenario. This profile deals specifically with consistent handling of patient identifiers and demographic data. This includes when specific procedure(s) have been manually ordered by a healthcare provider in addition to the scenario where an automatic eye care order has been placed. The automatic orders are created for procedures routinely performed on patients without a healthcare provider order and frequently prior to the patient being seen by a healthcare provider. Thus the purpose of the automatic order is not to provide legal authority for performing a procedure, but rather to provide data integrity. This profile specifies the scheduling and coordination of procedure data to a wide variety of diagnostic imaging and testing equipment.

B-EYECARE is a subset of the features defined in the Advanced Eye Care Workflow Integration profile.

2.3 Actors DescriptionsAdd column to table 2.3-1

Patient Demographics Supplier – A system responsible for adding, updating and maintaining demographics about a patient, and additional information such as related persons (primary caregiver, guarantor, next of kin, etc.). It supplies new and updated information to the Patient Demographics Consumer.

Patient Demographics Consumer – A system that uses demographic information provided by the Patient Demographics Supplier about a patient.

Add column to table 2.3-1

–  –  –

______________________________________________________________________________

Rev. 1.1 – 2011-03-31 Copyright © 2011: IHE International, Inc.

IHE Eye Care Technical Framework Supplement – Basic Eye Care Workflow (B-EYECARE) ______________________________________________________________________________

–  –  –

2.4 Transaction Descriptions Add column to table 2.4-1 Patient Identity Management – The Patient Demographics Supplier registers or updates a patient and forwards the demographic information (i.e., all information directly related to the patient, such as ID, address, next of kin, guarantor, etc.) to other systems implementing the Patient Demographics Consumer Actor.

Add column to table 2.4-1

–  –  –

______________________________________________________________________________

Rev. 1.1 – 2011-03-31 Copyright © 2011: IHE International, Inc.

IHE Eye Care Technical Framework Supplement – Basic Eye Care Workflow (B-EYECARE) ______________________________________________________________________________

–  –  –

2.5 Product Implementations Add bullets in section 2.5 to describe product actor groupings

• A Department System Scheduler/Order Filler participating in Basic Eye Care Integration Profile shall be grouped with a Patient Demographics Consumer.

• An Order Placer participating in Basic Eye Care Integration Profile shall be grouped with a Patient Demographics Consumer.

______________________________________________________________________________

Rev. 1.1 – 2011-03-31 Copyright © 2011: IHE International, Inc.

IHE Eye Care Technical Framework Supplement – Basic Eye Care Workflow (B-EYECARE) ______________________________________________________________________________

7 Basic EYE CARE Workflow (B-EYECARE) The Basic Eye Care Workflow Integration Profile establishes the continuity and integrity of basic patient and procedure data in the context of an eye clinic and/or an integrated hospital workflow scenario. This profile deals specifically with consistent handling of patient identifiers and demographic data. It also specifies the scheduling and coordination of procedure data to a wide variety of diagnostic imaging and testing equipment.

B-EYECARE is a subset of the features defined in the Advanced Eye Care Workflow Integration profile. It has much in common with the IHE Radiology Scheduled Workflow, but deals more explicitly with the eye care workflow and data requirements. See RAD TF-1: 3.4 for the integrated workflow data model adopted by the IHE Technical Framework for HL7 messages and DICOM information objects. This data model offers three major levels of control for

workflow:

• Order: A request for a Departmental Service

• Requested Procedure: Unit of work resulting in one or more reports, with associated codified, billable acts.

• Scheduled and Performed Procedure Step: the smallest unit of work in the workflow that is scheduled (work to do) or performed (work done).

A clear understanding of the workflow data model is essential to interpreting the Eye Care Workflow Integration Profile. Additional information may be found in Appendix A and B. BEYECARE workflow address the Order, Requested Procedure and Scheduled Procedure Step.

The Performed Procedure Step is not modeled in B-EYECARE but included in A-EYECARE.



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