Wednesday, November 6, 2013

RSNA 2013 Preview

We are presenting a number of posters and orals from our group at the RSNA 2013 in Chicago later this year. Some of the topics made it to Auntminnie.

Check out the coverage at the AuntMinnie website:

Caution should be used with DICOM data deidentification


Before migrating your PACS, do a test run

Friday, November 1, 2013

HIMSS Europe 2013 Amsterdam - Closing Keynote: Assessing and AdvancingEHR System Usability

Zariukian stated usability to be an underexposed topic in HealthIT. Form, fit and function are important in usability. Form is the shape, size, mass, the 'look' of a product. Fit is ability physically interface, connect, integrate. Function is the action the product is designed to perform. Usability affects how we think, feel and act. By examples and backgrounds, Zaroukian clearly showed the importance of usability to get HealthIT accepted and used both by patients and professionals. With good usability It is easier to do the thing right and it is easier to do the right thing. The meaningfull use projects in he US has shown a struggle of physicians to use EHRs requiring extensive training. Specific problems were system wait times for busy clinicians and new abilities that seemed to be "bolted on" and not integrated properly. 

HIMSS published a document on usabilty of the EMR in 2009, accessible at

Below you can find the official information and abstract from the program

Closing Keynote: Assessing and Advancing EHR System Usability

Michael H. Zaroukian, MD, PhD, FACP, FHIMSS Vice President and CMIO, Sparrow Health System

Physicians, nurses and other clinicians are responsible for gathering, recording, analyzing and acting on health information in electronic health record (EHR) systems. Assessing and advancing EHR usability is important to clinician productivity, satisfaction and best use of clinical information systems to improve healthcare quality, safety, efficiency and value. In the closing keynote, a HIMSS Board member and practicing physician informaticist, will give his perspective on EHR usability challenges and opportunities, as well as strategies and tools for evaluating and improving the usability of EHR systems.

HIMSS Europe 2013 Amsterdam - SA7: Update and New Developments on IHE

Parisot presented in the update and new developments of IHE. One of the main messages from his presentation was that interoperability will never be turnkey magic, but always involve hard work. IHE is growing into new domains, new paradigms, adoption at national and regional level, enhancing deployment support, benefits for profile based interoperablity better understood. The challenge in getting IHE working is not in the writing of the profiles and produce the corresponding documents but in the deployment and use of the profiles. To support this open source test tooling (Gazelle) is available from IHE to test for IHE profiles and setup quality management for test plans. The tools are available for eHealth projects and vendors through IHE services.

Parisot also stated that the mobile world poses a large problem that every app is a silo on itself resulting in thousands of apps that can be used by the patient that are not connected and do not allow data sharing. Therefore, patients will have to use tens of apps to get all their required information. IHE is developing IHE profiles for mHealth to have app compatibility such that the user can choose te app and connect to required hospitals and other healthcare providers (IHE-MHD profile). Mhealth = IHE + HL7 + DICOM. A major challenge here is still authentication and determination of the identity of the user. 

 below you can find the official information and abstract from the programme

SA7: Update and New Developments on IHE

New Developments in IHE: Mobile Health, Device Connectivity and eHealth Projects Services

Charles Parisot, Manager Architecture and Standards, IHE Europe Stearing Committee, France

Integrating the Healthcare Enterprise has established a solid reputation in providing standards-based interoperability specification, IHE profiles that are proven, tested at Connectathon and widely adopted by the market and eHealth projects around the world. This presentation will provide an overall update of IHE profiles adoption world-wide, focusing on the recent profiles targeting specifically mobile Health, and home and hospital medical devices interoperability. It will conclude with the increased attention by IHE to offer its open interoperability test tools along with supporting services that greatly facilitate hospital and regional eHealth project deployment.

HIMSS Europe 2013 Amsterdam - SA6: Success Story from IHE Netherlands

Cross enterprise document sharing (XDS) in the Neterlands is discussed. Some exmples of possible pitfalls and problems based on experience in both regional and national (screening) infrastructures are:

Problem: lost documents because of discrepency in descriptions and lack of uniformity
Solution: standarization in coding (SNOMED, ICD-10) resulting in a Dutch standard metadataset. Role codes are also standardized.

Problem: security and privacy
Solution: ATNA secure node actor or secure application actor. Timestamp consistency

Problem: how to deal with patient consent?
Solution: no definite solution yet, ongoing discussion

Below the official information and abstracts are provided below

SA6: Success Story from IHE Netherlands

XDS in the Netherlands: Possibilities and Experiences of Implementing Cross-Institutional Collaboration

Piet-Hein Zwaal, Partner, Medical PHIT, The Netherlands

IHE Cross-Enterprise Document Sharing (XDS) allows authorized health care providers to electronically collect, store, manage, distribute and view patient documents, reports and images entirely in digital format. XDS networks are the building blocks that facilitate sharing and make the information an integral part of longitudinal patient records regardless of where the images or reports are acquired or created.

Several diagnostic imaging & document XDS deployments has been carried out in the Netherlands. These networks are separated into two different groups. The first group is the regional sharing of documents and images for patients between hospitals. The second group is the XDS infrastructures, which support the Dutch screening operations. Experiences of setting up 4 networks will be discussed.

All the Dutch projects involved the integration of different EHR, Picture Archiving and Communication Systems.

In implementing the different XDS networks, obstacles were found along the way. Some of them were technological in nature, and could be addressed directly. However, it was found that many obstacles are a mix of organisational and technical reasons.

This talk will explain the implementation outcomes and successful steps in realising XDS networks. One of those steps can be lowering the technical barriers and organisational barriers to starting with a focused use-case. Another could be starting with less interoperability from the beginning only to facilitate the organisational cooperation. Also new re-use and possibilities of combining XDS networks will be discussed.

HIMSS Europe 2013 Amsterdam - SA5: Success Story IHE France

The presentation showed that getting to a national personal health record is a long term project that took years of preparation and experimenting (started in 2002). The health records is nationwide and products can obtain a compatibility certificate when they are proven to connect to the central system properly. The architecture of the personal health record is based on IHE profiles. 
The compatibilty certification has three levels: create, read and write. 123 IT products are already compatible with the system (including EMR, IHE interface, ambulatory physician softwares, lab information systems).

Both patients and healthcare providers have a smartcard allowing access to the sytem for identification and authentication. Patients have an internet account with a single use password deliverd to their mobile phone to access their own data.

In France, the DMP account is optional for the patient. It will be created together with a healthcare provider. The patient grants permission for access by physicians, departments or institutions. All information is available to the patient but it is possible to lock certain information until after a certain event. For example, if bad news is included in a report, the report can be blocked until after a personal consult with the patient.

By now about 380,000 patients have a record which is still modest but shows a steady growth. This modest usage is partly explained by the fact that no public marketing campain was undertaken yet.

Below, the official information and abstract from the program are provided

SA5: Success Story IHE France

The French PHR: The Creation, Usage and Lessons Learnt With a National e-Health Record

Francois Macary, Responsible for Semantic Interoperability, ASIP Santé, France

This presentation summarizes the different steps in the national Personal Health Record project (DMP in French stands for PHR): regulation and legal adaptations, standardization activities, design of the framework, build of the solution, promotion and support towards healthcare providers and health IT vendors, certification of the interoperability of Health IT solutions. The presentation shows the interactions that this project has had back and forth with IHE all along the way, and draws some lessons and perspectives for the future.