1September, 2005 What IHE Delivers

Contributing Authors: John Donnelly, Tim Contributing Authors: John Donnelly, Tim Becker, Harry SolomonBecker, Harry Solomon

Edited by Bryan Jennings, Medical MicrographicsEdited by Bryan Jennings, Medical Micrographics

Retrieve ECG for Display Profile

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ECG NeedsECG Needs

ECGs Accessible Everywhere!ECGs Accessible Everywhere!

Need broad distribution of ECGs using Need broad distribution of ECGs using ubiquitous technology (Web).ubiquitous technology (Web). Allow medical applications to easily retrieve and Allow medical applications to easily retrieve and

display ECGs in a platform/vendor neutral way.display ECGs in a platform/vendor neutral way.

High-quality ECG documents. Avoid High-quality ECG documents. Avoid artifacts on zoomed ECGs and arbitrary artifacts on zoomed ECGs and arbitrary display geometries.display geometries. Vector images required (not rasterized)Vector images required (not rasterized)

Facilitate apps for serial comparison (side-Facilitate apps for serial comparison (side-by-side synchronized display).by-side synchronized display).

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Original Goal for ProfileOriginal Goal for Profile

High ROI — value added problem High ROI — value added problem solutionssolutions

Standards in place (HTTP, PDF, SVG)Standards in place (HTTP, PDF, SVG)

No “political” challenges – just technicalNo “political” challenges – just technical

Restricted scope for a “quick win”Restricted scope for a “quick win”

Leverage IHE IT InfrastructureLeverage IHE IT Infrastructure

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RED Profile ScopeRED Profile Scope

Reused IHE-ITI RID as it existed:Reused IHE-ITI RID as it existed:Retrieve list of cardiology documents, Retrieve list of cardiology documents,

including ECGs in ready-to-display format including ECGs in ready-to-display format (HTML)(HTML)

Retrieve single document, including an Retrieve single document, including an ECGECG

ECGs served in ready-to-display formats ECGs served in ready-to-display formats (PDF, SVG)(PDF, SVG)

Compatibility with existing RID clientsCompatibility with existing RID clients

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RED Scope (cont.)RED Scope (cont.)

Make ECG-specific extensions to RIDMake ECG-specific extensions to RIDPlace requirements on ECG source to Place requirements on ECG source to

ensure high-quality ECG documents.ensure high-quality ECG documents.Add ECG-specific request for list of ECGs Add ECG-specific request for list of ECGs

to be returned as XML allowing more client to be returned as XML allowing more client flexibility.flexibility.

Add SVG (vector graphics) as allowed Add SVG (vector graphics) as allowed ECG document format.ECG document format.

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PDFPDF

ECG Source required to support PDF so it ECG Source required to support PDF so it is compatible with existing RID clients.is compatible with existing RID clients.

PDF is a common document type and PDF is a common document type and most computers already have a viewer.most computers already have a viewer.

ECG Source required to use vector ECG Source required to use vector graphics for waveforms in PDF.graphics for waveforms in PDF. Gives high quality line drawings at any screen Gives high quality line drawings at any screen

resolution and zoom factor.resolution and zoom factor. Rasterized (e.g. scanned, bitmapped) ECG Rasterized (e.g. scanned, bitmapped) ECG

“images” not allowed.“images” not allowed.

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Example ECG in PDF FormatExample ECG in PDF Format

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SVGSVG

Scalable Vector Graphics – “XML Scalable Vector Graphics – “XML Graphics for the Web” – a W3C standard.Graphics for the Web” – a W3C standard.

Well suited for line drawings (e.g. Well suited for line drawings (e.g. waveforms) in a XML/Web environment.waveforms) in a XML/Web environment.

Currently supported through web browser Currently supported through web browser plug-ins.plug-ins.

Allows scripting to enable advanced user-Allows scripting to enable advanced user-side display control.side display control.

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Example ECG in SVG FormatExample ECG in SVG Format

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Serial Comparison ExampleSerial Comparison Example

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ECG Profile ECG Profile ActorsActors

DisplayDisplay – A system that can request and – A system that can request and display preformatted (“presentation-ready”) display preformatted (“presentation-ready”) data using Web technologies.data using Web technologies.

Information SourceInformation Source – A system that responds – A system that responds to requests for patient-related ECG data by to requests for patient-related ECG data by encoding it in a presentation-ready format encoding it in a presentation-ready format using Web technologies.using Web technologies.

Same actors as RID ProfileSame actors as RID Profile

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ECG ProfileECG ProfileTransaction DiagramTransaction Diagram

DisplayInformation

Source

Retrieve Specific Info for Display [ITI-11]Retrieve ECG List [CARD-5]

Retrieve ECG Document for Display [CARD-6]

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Use Case D1: Simple DisplayUse Case D1: Simple Display

Display actor requests list of ECG Display actor requests list of ECG documents for a specific patient ID.documents for a specific patient ID. RID profile SUMMARY-CARDIOLOGY request RID profile SUMMARY-CARDIOLOGY request

returns list as HTML.returns list as HTML. ECG profile SUMMARY-CARDIOLOGY-ECG ECG profile SUMMARY-CARDIOLOGY-ECG

request returns list as XML with stylesheet.request returns list as XML with stylesheet.

Display actor requests a specific ECG Display actor requests a specific ECG document using a unique document ID.document using a unique document ID. The ID of the requested document may not have The ID of the requested document may not have

been obtained from the previously retrieved list.been obtained from the previously retrieved list.

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Example List as HTMLExample List as HTML

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ECG List XML Example (1/3)ECG List XML Example (1/3)

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ECG List XML Example (2/3)ECG List XML Example (2/3)

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ECG List XML Example (3/3)ECG List XML Example (3/3)

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ECG List XML ExampleECG List XML Example

Formatted with Style sheetFormatted with Style sheet

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More information….More information….

IHE Web site: IHE Web site: www.ihe.netwww.ihe.net

Technical Frameworks, SupplementsTechnical Frameworks, Supplements• Cardiology Technical Framework Cardiology Technical Framework • IT Infrastructure Technical Framework IT Infrastructure Technical Framework • ECG XML List Schema and examplesECG XML List Schema and examples

Non-Technical Brochures :Non-Technical Brochures :• Calls for ParticipationCalls for Participation• IHE Fact Sheet and FAQIHE Fact Sheet and FAQ• IHE Integration Profiles: Guidelines for BuyersIHE Integration Profiles: Guidelines for Buyers• IHE Connect-a-thon ResultsIHE Connect-a-thon Results• Vendor Products Integration StatementsVendor Products Integration Statements

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Providers and VendorsProviders and Vendors

Working Together to DeliverWorking Together to Deliver

Interoperable Health Information SystemsInteroperable Health Information Systems

In the EnterpriseIn the Enterprise

and Across Care Settingsand Across Care Settings

W W W . I H E . N E TW W W . I H E . N E T