Clinical Assistant now regional deployable
18-07-2008During the most recent European Connectathon of 7-11 April 2008 in Oxford, RVC used Clinical Assistant to demonstrate that they meet the IHE criteria, described in the XDS profile. RVC’s Clinical Assistant demonstrated during this ‘exam’ that it can also be deployed regionally!
IHE
The aim of Integrating the Healthcare Enterprise is to encourage unequivocal exchange of medical data in a safe manner. In this connection proven standards (DICOM and HL7) are used as much as possible. In this way these standards are re-used in solving communication/exchange (inter-operability) problems caused because multiple software applications are involved in a medical process. The end result of the IHE process is a pragmatic solution described in a profile.
XDS and XDS-I
These profiles describe the exchange of documents and images, the IHE-XDS and IHE-XDS-I profiles (Cross-enterprise Document Sharing and Cross-enterprise Document Sharing for Imaging). These profiles can be applied in the exchange of patient information between various departments within a hospital but also between various medical centres.
How does it work?
The process starts with the application by a general practitioner, patient or other medical specialist for an examination. This application appears in the agenda/planning system after which it ends up on a worklist (DICOM or the Clinical Assistant worklist). With regard to a non-Dicom compatible modality such as the video tower for ENT (Ear, Nose and Throat diseases), Gastroenterology & Liver Diseases, Gynaecology, Surgery etc. or for Pathology (micro- and macro-camera), the worklist can be retrieved within Clinical Assistant. This worklist shows the necessary data about the examination to be carried out clearly itemised.
After having selected the patient, the attending physician can immediately inspect any relevant examinations and those carried out previously and a new examination can be added via Clinical Assistant (IHE XDS document source). This examination may consist of image material (in the broadest sense) and/or a report of the findings.
After authorisation the document created can be sent automatically to the various recipients, in this respect for instance the ‘EPD’ (national electronic patient database), the applicant, the patient and the Clinical Assistant database (IHE XDS source repository) come to mind. From the database a limited set of data can be passed on to a regional register (IHE XDS registry). The files as well as the register can be placed within the medical centre and/or in the region (scalable). This register can be approached via Clinical Assistant or any other EPD (IHE XDS Consumer), so that via this register you can get an insight into other examinations carried out.
Obviously this whole process must meet the strict safety requirements and should it be possible to log all the steps as described in the ATNA profile (Audit Trail and Node Authentication).
Connectathon
All the IHE profiles implemented by a supplier within the existing software or as a new product, should be presented on a Connectathon. Tests are made under the supervision of medical specialists to confirm the accurate operation of the software. If an application has proved its worth, these adjustments will be published in an Integration Statement.
Connectathon
All the IHE profiles implemented by a supplier within the existing software or as a new product, should be presented on a Connectathon. Tests are made under the supervision of medical specialists to confirm the accurate operation of the software. If an application has proved its worth, these adjustments will be published in an Integration Statement.
Practice example
The IHE XDS profile is being applied in pilot projects in Amsterdam, Friesland and the Rotterdam region.
In this pilot after identification a physician can access the regional register and see in it which relevant examinations of a patient are present. When a physician wants to have a look at an examination, he can select it and the examination is retrieved from the source (the medical centre where the examination took place and its details were saved).
