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«Integrating the Healthcare Enterprise IHE Eye Care (EYECARE) Technical Framework Volume 1 IHE EYECARE TF-1 Profiles Revision 4.0 - Final Text June ...»

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Integrating the Healthcare Enterprise

IHE Eye Care (EYECARE)

Technical Framework

Volume 1

IHE EYECARE TF-1

Profiles

Revision 4.0 - Final Text

June 14, 2016

25 Please verify you have the most recent version of this document, which is published here.

IHE Eye Care Technical Framework, Volume 1 (EYECARE TF-1): Profiles

______________________________________________________________________________

CONTENTS

1 Introduction

30 1.1 Introduction to IHE

1.2 Introduction to IHE Eye Care (EYECARE)

1.3 Intended Audience

1.4 Pre-requisites and Reference Material

1.4.1 Actor Descriptions

35 1.4.2 Transaction Descriptions

1.4.3 Content Modules

1.4.4 IHE Integration Statements

1.5 Overview of Technical Framework Volume 1

1.6 Comment Process

40 1.7 Copyright Licenses

1.7.1 Copyright of Base Standards

1.8 Trademark

1.9 Disclaimer Regarding Patent Rights

1.10 History of Document Changes

45 2 Eye Care Integration Profiles

2.1 Required Actor Groupings and Bindings

2.2 Security Implications

2.3 Integration Profiles Overview

2.4 Product Implementations

50 2.5 Actor Descriptions

2.6 Transaction Descriptions

2.7 Product Implementations

3 Advanced Eye Care Workflow (A-EYECARE)

4 Eye Care Charge Posting (EC-CHG)

55 4.1 Actor/Transactions

4.2 Eye Care Charge Posting Integration Profile Options

4.3 Eye Care Charge Posting Process Flow

4.3.1 Use Cases

4.3.2 Eye Care Uses Cases for Technical Billing (Procedure Billing)

60 4.3.2.1 New Patient Appointment

4.3.2.2 Existing Patient

4.4 Data Model for Eye Care Charge Posting

4.4.1 Model of the Real World

5 Eye Care Evidence Documents (ECED)

65 5.1 Actors/Transactions

5.2 Evidence Documents Profile – Eye Care Options

5.3 Eye Care Evidence Document Process Flow

5.4 Eye Care Evidence Documents Use Cases

5.4.1 Eye Care Evidence Documents Being Created by Acquisition Modality................. 27 70 5.4.2 Eye Care Evidence Documents Being Created by Workstations

______________________________________________________________________________

Rev. 4.0 – Final Text 2016-06-14 1 Copyright © 2016: IHE International, Inc.

IHE Eye Care Technical Framework, Volume 1 (EYECARE TF-1): Profiles ______________________________________________________________________________

6 Eye Care Displayable Report (ECDR)

6.1 Actors/Transactions

6.2 Eye Care Displayable Report Integration Profile Options

6.3 Eye Care Displayable Report Use Case

75 6.3.1 Typical Displayable Report Example

7 Basic Eye Care Workflow (B- EYECARE)

8 Core Eye Care Workflow (C-EYECARE)

9 Unified Eye Care Workflow (U-EYECARE)

9.1 U-EYECARE Actors and Transactions

80 9.1.1 Patient Registration and Appointment Scheduling

9.1.2 Real World Model I - EHR Supports DICOM Modality Worklist and Integrates with a PACS

9.1.3 Real World Model II - EHR Supports DICOM Modality Worklist, Image Storage and Display (With no PACS)

85 9.1.4 Real World Model III - EHR Implements HL7 Only (no DICOM support) and Integrates with a PACS

9.1.5 U-EYECARE Workflow with DICOM Options

9.1.6 U-EYECARE Actor/Transaction Table

9.1.7 Actor Descriptions and Actor Profile Requirements

90 9.1.7.1 Real World Models

9.2 U-EYECARE Actor Options

9.2.1 Acquisition Modalities Storage Options

9.2.1.1 Eye Care Image Option

9.2.1.2 Encapsulated PDF Option for Evidence Documents

95 9.2.1.3 Eye Care Measurement Option

9.2.1.4 Relative Image Position Coding Option

9.2.1.5 Stereo Relationship Option

9.2.1.6 Contrast Start Time Reporting in OP Images Option

9.2.1.7 Radiological Studies of the Eye

100 9.2.2 Patient Record Merging Option

9.2.3 Imaging Procedure Instructions Option

9.2.4 Imaging Procedure Status Update (DICOM) Option

9.2.5 Imaging Procedure Status Update (HL7) Option

9.2.6 Storage Commitment Option

105 9.2.7 Charge Posting Option

9.2.8 PACS Key Images Sent Option

9.2.9 Procedure Status Tracking (DICOM MPPS) Option

9.3 U-EYECARE Actor Groupings

9.3.1 U-EYECARE Required Actor Groupings

110 9.3.1.1 Additional U-EYECARE Required Actor Groupings

9.4 Unified Eye Care Workflow Process Flow

9.4.1 Patient Registration, Appointment Scheduling, Charge Posting

9.4.2 Real World Model I - EHR Supports DICOM Modality Worklist and Integrates with a PACS

______________________________________________________________________________

Rev. 4.0 – Final Text 2016-06-14 2 Copyright © 2016: IHE International, Inc.

IHE Eye Care Technical Framework, Volume 1 (EYECARE TF-1): Profiles ______________________________________________________________________________

115 9.4.3 Real World Model II - EHR Supports DICOM Modality Worklist, Image Storage and Display (With no PACS)





9.4.4 Real World Model III - EHR Implements HL7 Only (no DICOM support) and Integrates with a PACS

9.4.5 DICOM Storage Commitment and DICOM MPPS Support

120 9.4.6 Extension to Query Modality Worklist for Eye Care [EYECARE-1]

9.4.6.1 Issuer of Patient ID

9.5 Unified Eye Care Workflow Use Cases

9.5.1 Workflow Example with Manual Procedure Order

9.5.2 Workflow for Automatic Modality Worklist

125 9.6 Workflow Concepts in Practice

9.7 Patient Record Merging Use Case

9.8 Unified Eye Care Workflow Security Considerations

9.9 Unified Eye Care Cross-Profile Considerations

Glossary

130 Appendices

Appendix A – Challenges of Workflow Management in Eye Care

A.1 Clinical Context – Patient Encounter in an Independent Practice

A.2 The Current Workflow

A.3 Workflow Example using Automatic Modality Worklist

135 A.3.1 The Use Case

A.3.2 Example of how IHE Could Be Used for this Use Case

A.3.3 Continued Use Case Example with Manual Orders

Appendix B – The Eye Care Procedure in Perspective

Appendix C – IHE Integration Statements

140 C.1 Structure and Content of an IHE Integration Statement

C.2 Format of an IHE Integration Statement

Appendix D – Security Environment Considerations

______________________________________________________________________________

Rev. 4.0 – Final Text 2016-06-14 3 Copyright © 2016: IHE International, Inc.

IHE Eye Care Technical Framework, Volume 1 (EYECARE TF-1): Profiles ______________________________________________________________________________

1 Introduction This document, Volume 1 of the IHE Eye Care (EYECARE) Technical Framework, describes the clinical use cases, actors, content module, and transaction requirements for the Eye Care 155 profiles.

1.1 Introduction to IHE Integrating the Healthcare Enterprise (IHE) is an international initiative to promote the use of standards to achieve interoperability among health information technology (HIT) systems and effective use of electronic health records (EHRs). IHE provides a forum for care providers, HIT 160 experts and other stakeholders in several clinical and operational domains to reach consensus on standards-based solutions to critical interoperability issues.

The primary output of IHE is system implementation guides, called IHE profiles. IHE publishes each profile through a well-defined process of public review and Trial Implementation and gathers profiles that have reached Final Text status into an IHE Technical Framework, of which 165 this volume is a part.

1.2 Introduction to IHE Eye Care (EYECARE) The IHE Eye Care domain was formed in 2005 and is sponsored by the American Academy of Ophthalmology (AAO). The mission of the IHE Eye Care domain is to bring together information technology stakeholders and healthcare professionals to implement standards for 170 communicating patient information efficiently throughout healthcare facilities, large and small.

1.3 Intended Audience

The intended audience of IHE Technical Frameworks Volume 1 (Profiles) is:

Those interested in integrating healthcare information systems and workflows IT departments of healthcare institutions 175 Technical staff of vendors participating in the IHE initiative

1.4 Pre-requisites and Reference Material For more general information regarding IHE, refer to www.ihe.net. It is strongly recommended that, prior to reading this volume, the reader familiarizes themselves with the concepts defined in the IHE Technical Frameworks General Introduction.

180 Additional reference material available includes:

1. Radiology Technical Framework Volume 1, Integration Profiles

2. Radiology Technical Framework Volume 2, Transactions

3. Cardiology Technical Framework Volume 2, Transactions

4. IT Infrastructure Technical Framework Volume 1 185 5. IT Infrastructure Technical Framework Volume 2 ______________________________________________________________________________

Rev. 4.0 – Final Text 2016-06-14 4 Copyright © 2016: IHE International, Inc.

IHE Eye Care Technical Framework, Volume 1 (EYECARE TF-1): Profiles ______________________________________________________________________________

6. IT Infrastructure Technical Framework Volume 3

7. IHE Patient Care Coordination Technical Framework Volume 1

8. IHE Patient Care Coordination Technical Framework Volume 2

9. HL7®1 Implementation Guide for CDA®2 Release 2: IHE Health Story Consolidation, 190 DSTU Release 1.1 (US Realm) Draft Standard for Trial Use July 2012

10. HL7 and DICOM®3 standards documents referenced in Volume 1 and Volume 2 1.4.1 Actor Descriptions Actors are information systems or components of information systems that produce, manage, or act on information associated with operational activities in the enterprise.

195 A list of actors defined for all domains and their brief descriptions can be found as an appendix to the IHE Technical Frameworks General Introduction.

1.4.2 Transaction Descriptions Transactions are interactions between actors that transfer the required information through standards-based messages.

200 A list of transactions defined for all domains, their transactions numbers, and a brief description can be found as an appendix to the IHE Technical Frameworks General Introduction.

1.4.3 Content Modules Content modules are data and data definitions shared between actors.

A list of content modules defined for all domains, their reference numbers, and a brief 205 description can be found as an appendix to the IHE Technical Frameworks General Introduction.

1.4.4 IHE Integration Statements IHE Integration Statements provide a consistent way to document high level IHE implementation status in products between vendors and users.

The instructions and template for IHE Integration Statements can be found as an appendix to the IHE Technical Frameworks General Introduction.

IHE also provides the IHE Product Registry (http://www.ihe.net/IHE_Product_Registry) as a resource for vendors and purchasers of HIT systems to communicate about the IHE compliance of such systems. Vendors can use the Product Registry to generate and register Integration Statements.

1 HL7 is the registered trademark of Health Level Seven International.

2 CDA is the registered trademark of Health Level Seven International.

3DICOM is the registered trademark of the National Electrical Manufacturers Association for its standards publications relating to digital communications of medical information.

______________________________________________________________________________

Rev. 4.0 – Final Text 2016-06-14 5 Copyright © 2016: IHE International, Inc.

IHE Eye Care Technical Framework, Volume 1 (EYECARE TF-1): Profiles ______________________________________________________________________________

1.5 Overview of Technical Framework Volume 1

Volume 1 is comprised of several distinct sections:

• Section 1 provides background and reference material.

• Section 2 presents the conventions used in this volume to define the profiles.

• Sections 3 and beyond define Eye Care profiles, actors, and requirements in detail.

220 The appendices in Volume 1 provide clarification of uses cases or other details. A glossary of terms and acronyms used in the IHE Technical Framework is provided in the IHE Technical Frameworks General Introduction.

1.6 Comment Process IHE International welcomes comments on this document and the IHE initiative. They can be 225 submitted by sending an email to the co-chairs and secretary of the Eye Care domain committees at eyecare@ihe.net.

1.7 Copyright Licenses IHE International hereby grants to each Member Organization, and to any other user of these documents, an irrevocable, worldwide, perpetual, royalty-free, nontransferable, nonexclusive, 230 non-sublicensable license under its copyrights in any IHE profiles and Technical Framework documents, as well as any additional copyrighted materials that will be owned by IHE International and will be made available for use by Member Organizations, to reproduce and distribute (in any and all print, electronic or other means of reproduction, storage or transmission) such IHE Technical Documents.

235 The licenses covered by this Copyright License are only to those copyrights owned or controlled by IHE International itself. If parts of the Technical Framework are included in products that also include materials owned or controlled by other parties, licenses to use those products are beyond the scope of this IHE document and would have to be obtained from that other party.

1.7.1 Copyright of Base Standards 240 IHE technical documents refer to and make use of a number of standards developed and published by several standards development organizations. All rights for their respective base standards are reserved by these organizations. This agreement does not supersede any copyright provisions applicable to such base standards.



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