3 IHE Profiles

User Success Story
Montefiore Medical Center
Albert Einstein College of Medicine
Live in NY: 3 IHE Profiles (SWF, PIR, ARI)
Bronx, NY, USA
Contacts
Nogah Haramati, M.D. Chief of Radiology
Mony Weschler, Associate Director Ancillary Systems
Learning Objectives
Understand why Montefiore Medical Center decided that IHE integration was essential
Understand how Montefiore Medical Center integrated 107 modalities in an IHE environment, and how they
plan to incorporate other modalities, dydtems and domains.
Understand how and why Montefiore Medical Center and the collaborating vendors built a parallel IHE Test
Environment.
Objective
Montefiore Medical Center is composed of three inpatient facilities including the Moses Division, Jack D. Weiler
Division and the Children?s Hospital at Montefiore along with numerous outpatient facilities. We perform
450,000 radiology examinations annually and service a large geographic territory including areas of the Bronx,
Westchester County and Southern Connecticut. Our clinical information system (CIS, HIS) is IDX LastWord and
Radiology is serviced by IDX Imagecast RIS 10.3.8 and GE Centricity PACS 2.1. Specialized image manipulation
and distribution functions are handled by IntegradWeb 3.3.3.2019. We have numerous imaging modalities from
various vendors that are mostly GE and Philips devices. We undertook this IHE integration project as part of an
enterprise approach to centralized multimedia archival and distribution. Radiology is serving as the spearhead
of this effort. We are leveraging IHE Radiology Integration Profiles to streamline our radiology department?s
operation. Moving forward, we are looking to IHE to assist our EMR in functioning as the user portal for multimedia data.
Method
We worked closely with our existing RIS and modality vendors to encourage and facilitate their adoption of IHE.
We quickly saw that as we move the IHE through radiology and onward to other clinical domains and to the core
enterprise areas, that Parallel Test & Production Environments were a critical element required for the long-term
success of this effort. We built a separate IHE test environment, which is separate from the test environments
that each vendor supplies with every clinical system. The purpose of the test environment is to create an
onsite connectathon type environment to allow us and our vendors to validate and troubleshoot intervendor IHE
transactions and functionality before new systems, updates and upgrades are introduced into regular clinical
use. In areas where legacy, non-IHE modalities and devices exist, our IHE vendors have taken the initiative of
assuming IHE actor roles and fulfilling the IHE transaction requirements in cases where the actual modality cannot. This has allowed us to create an IHE department even though all of our equipment is not IHE conformant.
This approach can only be truly implemented and tested in a setting where an IHE test environment exists. In
order to complete the loops of our test environments, we allocate modalities that are idle during off hours to
our test environment and simply have them pointed to the appropriate test servers.
As IHE profiles are not static and new profiles, some of which have significant potential for benefiting radiology,
are being added annually, we have adopted an approach to this problem. We have a small committee composed
of the Montefiore Medical Center IHE leadership along with equal representation of our major vendors in this
effort. This committee, which meets twice annually, has the power to add IHE integration profiles to our current
environment.
Results
We have found that our IHE test environment has been embraced by our vendors and by our systems integration staff. The value and utility of this approach has more than justified the cost and effort required to create
and maintain this environment. Indeed, since we embarked on this project, additional vendors have stepped
forward and asked to join our IHE effort. Their results are also part of our success. The real benefits that we
have achieved thus far goes way beyond the expected but critical benefits of patient safety improvements such
as using basic SWF elements such as MWL to markedly reduce patient identification errors. The IHE transactions and the value added that the IHE integration profiles have brought to Montefiore are evident in every facet
of our operation. Because of the success of the IHE in our institution, we anticipate adding more integration
profiles to our current environment and even extending our IHE environment to include other clinical departments and domains before all of our radiology modalities are upgraded or replaced with IHE conformant
devices.
Conclusion
We have found that our IHE test environment is a critical element necessary for large-scale IHE implementations. We plan on implementing CPI, SINR, and PGP within the next 12 months. We look forward to having our
CIS, HIS vendor join our IHE team and enabling us to reap the IHE benefits throughout our enterprise. Beyond
radiology, we are already carefully following the IHE developments in cardiology, laboratory and in the enterprise ITI areas.
IHE Integration Profiles and Actors Implemented
Integration Profile
Vendor/Product Name(s)
Actors Implemented
Scheduled Workflow
GE Healthcare
Centricity 2.1
Signa Ovation 1.5T
Lightspeed QX/i
Revolution QX/i
Revolution XR/d
Centricity CR
Acq. Modality
Image Archive
Image Creator
Image Display
Image Manager
PPS Manager
IDX Corporation
Imagecast version 10.3.8
DSS/OF
Order Placer
PPS Manager
Philips Medical Systems
Intera 1.5T
Brilliance CT
Digital Diagnost
Acq. Modality
Image Creator
Dynamic Imaging
IntegradWeb 3.3.3.2019
Image Creator
Image Display
Image Archive
Image Manager
Integration Profile
Vendor/Product Name(s)
Actors Implemented
Patient Information Reconciliation
GE Healthcare
Centricity 2.1
Centricity CR
Image Archive
Image Manager
PPS Manager
IDX Corporation
Imagecast version 10.3.8
DSS/OF
Order Placer
PPS Manager
Integration Profile
Vendor/Product Name(s)
Actors Implemented
Access to Radiology Information
GE Healthcare
Centricity 2.1
Ext. Rep. Access
Image Archive
Image Display
Image Manager
Report Reader
Report Repository
IDX Corporation
Imagecast version 10.3.8
Ext. Rep. Access
Report Reader
Report Repository
Dynamic Imaging
IntegradWeb 3.3.3.2019
Image Display
Report Reader
Image Archive
Image Manager