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1、Chapter 7Integrating the Health Enterprise醫療系統整合的應用與發展,IHE的整合發展與應用,IHE技術發展背景 IHE第五年技術架構簡介 醫療資訊相關標準之應用 醫療資訊整合 IHE發展的新趨勢,IHE技術發展背景,美國RSNA及HIMSS主導IHE五年計畫(19992003)目的:應用及整合HL7、DICOM及XML等現有醫療資訊及醫療影像傳輸標準，以減少醫療資源之浪費協會、產業界、學者專家、使用者嚴謹的發展流程 IHE第五年:(1)92年初：技術架構(Technical Framework)擬訂(2)92.02.0103.03：技術架構公開討論(3
2、)92.04.2404.25：產業界說明會(4)92.04.2505.30：產業界報名(5)92.07.09：視訊會議(研習會)(分組討論)(6)92.08/09：MESA測試及回報(7)92.10.0610.10：Connect-A-Thon整合測試(8)92.11.3012.05：RSNA2003年會IHE(動態展示-研討會),IHE技術發展背景,技術架構公開討論(Submit and review comments)技術架構文件:討論區:公開討論截止日期:92.03.032003年公開討論版本:Revision 5.5,http:/www.rsna.org/IHE/tf/ihe_tf_i
3、ndex.shtml,http:/forums.rsna.org/,IHE技術發展背景,產業界說明會(IHE Radiology Vendor Workshop 2003)說明會時間:92.04說明會內容(Documents)說明會簡報資料,Introduction To IHE,Review of Mature IHE Integration Profiles,New IHE Integration Profiles,Planning and Participation for IHE Radiology 2003,http:/www.rsna.org/IHE/presentations/i
4、he_pres_index.shtml,IHE技術發展背景,圖片摘錄自RSNA IHE網頁,IHE技術發展背景,產業界報名(續)(Participation)1999/2000/2001/2002年參與廠家數:24/32/31/352002年參與廠家:,IHE技術發展背景,分組討論(Participant Workshop)視訊會議(Participant Web Conference，2003.07),RSNA 2001/HIMSS 2002 IHE 展示分組A,Scheduled Workflow/Patient Information Reconciliation:Group A,IHE
5、技術發展背景,MESA測試系統發展及MESA測試結果回報Medical Enterprise Simulators and AnalyzersO.S.:Component:Developed by the Electronic Radiology Laboratory at the Mallinckrodt Institute of Radiology,Washington University of St.Louis(由Steve Moore教授所帶領的技術團隊)MESA下載網址:,Linux/Solaris/Windows NT/2000/Other Unix,Facilities/Sim
6、ulators/Utility_Programs/Documentation,http:/www.erl.wustl.edu/mesa/index.html,IHE技術發展背景,Connect-A-Thon整合測試整合測試時間:2003.10整合測試地點:美國芝加哥RSNA總部,圖片摘錄自RSNA IHE網頁,IHE技術發展背景,RSNA/HIMSS年會展示,IHE第五年技術架構簡介,IHE Integration Profiles(T.F.Rev.5.5)第一冊:Integration Profiles第二冊:Transactions 1-31第三冊:Transactions 32-46第四
7、冊:National Extensions法國德國美國義大利英國,圖片摘錄自 IHE Technical Framework,IHE第五年技術架構簡介,IHE Radiology Integration Profiles(T.F.Rev.5.5 Vol.I),圖片摘錄自 IHE Technical Framework,IHE第五年技術架構簡介,圖片摘錄自RSNA IHE網頁,IHE第五年技術架構簡介,AcquisitionModality,Order Placer,DSS/Order Filler,ADT,ImageArchive,Image Manager,Scheduled Workflo
8、w Integration Profile,PPS Manager,Evidence Creator,Image Display,Pt.Registration 1Patient Update 12,Placer Order Management 2Filler Order Management 3,Procedure Scheduled 4Image Availability Query 11Procedure Updated 13Performed Work Status Update 42Performed Work Status Update 42,Query Images 14Ret
9、rieve Images 16,StorageCommitment 10,StorageCommitment 10,Creator ImagesStored 18,Modality Image Stored 8,Modality PS in Progress 6Modality PS Completed 7Creator PS in Progress 20Creator PS Completed 21,Creator PS in Progress 20Creator PS Completed 21,Modality PS in Progress 6Modality PS Completed 7
10、Creator PS in Progress 20Creator PS Completed 21,Modality PS in Progress 6Modality PS Completed 7,Modality Worklist Provided 5,Pt.Registration 1Patient Update 12,ADT,DSS/Order Filler,Order Placer,Image Display,Evidence Creator,Image Manager,PPS Manager,AcquisitionModality,continue,IHE第五年技術架構簡介,Sched
11、uled Workflow Integration Profile,圖片摘錄自 IHE Technical Framework,IHE第五年技術架構簡介,Scheduled Workflow Integration Profile,圖片摘錄自 IHE Technical Framework,IHE第五年技術架構簡介,圖片摘錄自 IHE Technical Framework,共23個Actors,IHE第五年技術架構簡介,圖片摘錄自 IHE Technical Framework,醫療資訊相關標準之應用,協定1:Patient Registration，病患掛號資料，HL7 協定2:Place
12、r Order Management，醫令產生或取消訊息，HL7 協定3:Filler Order Management，醫令產生、取消或更改訊息，HL7 協定4:Procedure Scheduled，造影取像排程訊息，HL7 協定5:Modality Worklist Provided，造影取像排程訊息，DICOM 協定6:Modality Procedure Step In Progress，取像回報，DICOM 協定7:Modality Procedure Step Completed，取像完成回報，DICOM 協定8:Modality Images Stored，造影儀器影像儲存，D
13、ICOM 協定9:Modality Presentation State Stored，描繪參數儲存，DICOM 協定10:Storage Commitment，儲存確認，DICOM 協定11:Image Availability Query，影像查詢，DICOM 協定12:Patient Update，病患資料更新，HL7 協定13:Procedure Update，造影取像排程更新訊息，HL7 協定14:Query Images，影像查詢，DICOM 協定15:Query Presentation States，描繪參數查詢，DICOM,醫療資訊相關標準之應用,協定16:Retrieve
14、Images，影像讀取，DICOM 協定17:Retrieve Presentation States，描繪參數讀取，DICOM 協定18:Creator Images Stored，影像產生器影像儲存，DICOM 協定19:Creator Presentation State Stored，描繪參數儲存，DICOM 協定20:Creator Procedure Step In Progress，產像回報，DICOM 協定21:Creator Procedure Step Completed，產像完成回報，DICOM 協定23:Print Request with Presentation L
15、UT，影像列印，DICOM 協定24:Report Submission，報告資料儲存，DICOM 協定25:Report Issuing，報告資料儲存，DICOM 協定26:Query Reports，報告資料查詢，DICOM 協定27:Retrieve Reports，報告資料讀取，DICOM 協定28:Structured Report Export，結構化報告資料轉換，HL7 協定29:Key Image Note Stored，關鍵影像註解資料儲存，DICOM 協定30:Query Key Image Notes，關鍵影像註解資料查詢，DICOM 協定31:Retrieve Key
16、Image Notes，關鍵影像註解資料讀取，DICOM,醫療資訊相關標準之應用,協定32:Authenticate Node，DICOM、TLS(RFC 2246)、X.509 協定33:Maintain Time，NTP(RFC 1305)協定34:Record Audit Event，BSD(RFC 3164)、PS 115-99、XML1.0 協定35:Charge Posted，HL7 協定36:Account Management，HL7 協定37:Worklist Provided，DICOM 協定38:Workitem Claimed，DICOM 協定39:Workitem P
17、PS In Progress，DICOM 協定40:Workitem PPS Completed，DICOM 協定41:Workitem Completed，DICOM 協定42:Performed Work Status Update，DICOM 協定43:Evidence Document Stored，DICOM 協定44:Query Evidence Documents，DICOM 協定45:Retrieve Evidence Documents，DICOM 協定46:Reporting Worklist Provided，DICOM,醫療資訊相關標準之應用,IHE Transacti
18、on 1(Patient Registration，HL7),圖片摘錄自 IHE Technical Framework,醫療資訊相關標準之應用,IHE Transaction 5(Modality Worklist Provided，DICOM),圖片摘錄自 IHE Technical Framework,醫療資訊相關標準之應用,IHE Integration Security Process Flow,圖片摘錄自 IHE Technical Framework,醫療資訊整合,AcquisitionModality,Order Placer,DSS/Order Filler,ADT,Imag
19、eArchive,Image Manager,Scheduled Workflow Integration Profile HL7/DICOM Mapping,PPS Manager,Evidence Creator,Image Display,Pt.Registration 1Patient Update 12,Pt.Registration 1Patient Update 12,Placer Order Management 2Filler Order Management 3,Procedure Scheduled 4Image Availability Query 11Procedur
20、e Updated 13Performed Work Status Update 42Performed Work Status Update 42,Query Images 14Retrieve Images 16,StorageCommitment 10,StorageCommitment 10,Creator ImagesStored 18,Modality Image Stored 8,Modality PS in Progress 6Modality PS Completed 7Creator PS in Progress 20Creator PS Completed 21,Crea
21、tor PS in Progress 20Creator PS Completed 21,Modality PS in Progress 6Modality PS Completed 7Creator PS in Progress 20Creator PS Completed 21,Modality PS in Progress 6Modality PS Completed 7,Modality Worklist Provided 5,DSS/Order Filler,醫療資訊整合,HL7 Order Mapping to DICOM MWL,圖片摘錄自 IHE Technical Frame
22、work,醫療資訊整合,HL7 Order Mapping to DICOM MWL(續),圖片摘錄自 IHE Technical Framework,醫療資訊整合,HL7 Order Mapping to DICOM MWL(續),圖片摘錄自 IHE Technical Framework,醫療資訊整合,HL7 Order Mapping to DICOM MWL(續),圖片摘錄自 IHE Technical Framework,醫療資訊整合,HL7 Order Mapping to DICOM MWL(續),圖片摘錄自 IHE Technical Framework,醫療資訊整合,HL7
23、Order Mapping to DICOM MWL(續),圖片摘錄自 IHE Technical Framework,醫療資訊整合,AcquisitionModality,Order Placer,DSS/Order Filler,ADT,ImageArciive,Image Manager,Patient Information Reconciliation Integration Profile HL7/DICOM Mapping,PPS Manager,Image Display,Patient Update 12,Patient Update 12,Image Availabilit
24、y Query 11Patient Updated 12Procedure Updated 13,Query Images 14Retrieve Images 16,Modality PS in Progress 6Modality PS Completed 7,Modality PS in Progress 6Modality PS Completed 7,Modality PS in Progress 6Modality PS Completed 7,Modality Worklist Provided 5,ReportManager,Report Creator/Report Reade
25、r,Reporting Worklist Provided 46Query Reports 26Retrieve Reports 27,Patient Updated 12Procedure Updated 13,ReportManager,Image Manager,Image Availability Query 11Patient Updated 12Procedure Updated 13,醫療資訊整合,AcquisitionModality,Charge Processor,DSS/Order Filler,ADT,Charge Posting Integration Profile
26、 DICOM/HL7 Mapping,PPS Manager,Account Management 36,Patient Registration 1 Account Management 36,Modality PS Completed 7 Creator PS Completed 21,Modality PS Completed 7,Report Manager,Evidence Creator,Performed Work Status Update42,Charge Posted 35,Creator PS Completed 21,DSS/Order Filler,醫療資訊整合,Re
27、port Creator,Simple Image and Numeric Report Integration Profile DICOM/HL7 Mapping,Report Submission 24,External Report Repository Access,Report Manager,Report Repository,Report Reader,Enterprise Report Repository,Report Issuing 25,Structured Report Export 28,Query Reports 26Retrieve Reports 27,Quer
28、y Reports 26Retrieve Reports 27,Report Manager,IHE發展的新趨勢,IHE 國際化,歐洲IHE(IHE Europe)The second European IHE connect-a-thon,hosted by the Department of Diagnostic Radiology,University Hospital Aachen,Germany,in the week from 24th to 28th March 2003,was a big success.46 vendors tested 79 systems within
29、a period of 4.5 days from Monday to Friday in the worldwide biggest connect-a-thon.(會員國包括英國、法國、德國及義大利),IHE發展的新趨勢,IHE 國際化,亞太IHE(IHE-Asia&Oceania，IHE-AO)IHE Japan2002年6月26日至29日CARS(Computer Assisted Radiology and Surgery)會議，台灣、日本及韓國提議組織亞洲IHE(IHE ASIA)之可行性2002年12月RSNA年會中舉行第一次IHE-Asia&Oceania(IHE-AO)會議，
30、台灣、日本、韓國、中國及新加坡IHE Taiwan(92.08.21-22，HL7研討會IHE demo)2003年12月芝加哥RSNA年會,IHE發展的新趨勢,IHE 技術架構延伸,IHE Radiology-RSNAIHE IT Infrastructure-HIMSSIHE IT Infrastructure Integration Profiles,Retrieve Informationfor DisplayAccess a patients clinicalinformation and documentsin a format ready to bepresentedto the
31、 requesting user,Patient IdentifierCross-referencingfor MPIMap patient identifiersacross independentidentification domains,ConsistentTimeCoordinate timeacross networkedSystems,Patient SynchronizedApplicationsSynchronize multiple applicationson a desktop to the same patient,EnterpriseUserAuthenticati
32、onProvide users asingle nameandcentralizedauthenticationprocessacross allSystems,IHE發展的新趨勢,IHE IT Infrastructure Timeline,February 5-7 2003 First face to face meeting-Oakbrook,ILFebruary 27IT Planning t-con Select 2003/Year 5 IT profilesApril 22-25 Face to face meeting to close all tech issuesJune 2
33、-6 Face to face meeting to produce Public Comment TFJuly 14 Comments due on IT Profiles for Public CommentJuly 28-August 1 Face to face comments consolidation meeting,August 10IHE IT Integration Profiles(approved-final),September 10-11 Vendor workshop-Memphis,Reg.due October 1st.,January 12-16 2004
34、IHE IT Connectathon-San Diego,CA,February 22-26 2004HIMSS HL7-IHE Demo Orlando,FL,IHE發展的新趨勢,臺灣IHE 發展近況,(1)92-06-18 92-07-11：參展廠商參與IHE連線展示意願調查(2)92-07-15：IHE連線展示架構討論(北醫生物資訊中心)(3)92-07-16 92-08-11：各系統建置及自測(含Internet連測)(4)92-08-12：IHE連線測試(在中科院)(5)92-08-21 92-08-22：IHE連線展示(HL7研討會展示區)(6)參與廠商：新愷、先見、鉅仁、達亞、英飛特,
