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Jack Lam



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  • OS18 - Evolving Standards (ID 24)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Not Rated
    • Presentations: 1
    • Coordinates: 6/06/2017, 01:00 PM - 02:00 PM, Room 203CD
    • OS18.01 - Healthcare Information System Interoperability -  Leveraging Standards Case Study (ID 323)

      Jack Lam, University Health Network; Toronto/CA

      • Abstract
      • Slides

      Purpose/Objectives: The Image Capture system serves as a case study of how leveraging DICOM and HL7 as interoperability standards can provide an extremely low cost strategy to communicate and archive visible light medical images through a centralized PACS (Picture Archiving and Communication System). Leveraging this approach could allow for regional/provincial management of endoscopic, surgical, retinal, dermatologic, and other medical images for clinical care and quality management purposes.

      Methodology/Approach: Our system was originally developed in 1995 to run on commodity hardware and capture medical images generically from medical video processors. It has been in production at a large multi-site health sciences center since then with very little cost, training and support requirements. The capture system consists of a Microsoft Windows software program written to interface with a USB NTSC video capture device and a HD-SDI capture card. Still bitmap images are captured and converted to DICOM and then routes to PACS. Digital mpeg video is archived and available through a web review application. Other features include a custom developed hardware interface to the endoscopy image processors for endoscope hand switch capture control, as well as an HL7 patient work list interface to the hospital ADT information system. Upgrades have included privacy and data security controls and secure wireless network transmission for emergency cases performed on mobile procedure carts in areas such as the ICUs and emergency departments. The system is currently being adapted for newer generation HD image processors.

      Finding/Results: This system’s simplistic yet functional features have served the needs for electronic documentation of patient procedures for the past two decades with average usage statistics of 800 cases per month and 10 images per case. The usage areas include Endoscopy, Cystoscopy, Neurosurgery, Orthopedic surgery. In leveraging the existing PACS system, operating costs are negligible and clinicians access the images through their preferred review application along with traditional medical images without the need for additional applications and training.

      Conclusion/Implication/Recommendations: Medical data interoperability requires different information systems to communicate and exchange meaningful data across all medical facilities. DICOM and HL7 are two medical data standards that contribute to the eventual “plug and play” interoperable model. Ongoing work to achieve interoperability is being done by IHE (Integrating the Healthcare Enterprise), a worldwide organization that supports interoperable healthcare to improve quality, ensure patient safety and reduce cost through the adoption of standards for healthcare by publishing guides for how to use those standards. Our case study serves as an excellent example of an affordable scalable approach to medical interoperability. Within Canada, this approach to interoperability could affordably support provincial initiatives for cancer screening and endoscopy quality improvement programs.

      140 Character Summary: Health Information data interoperability: a case study leveraging DICOM and HL7 standards to improve management of medical images and clinical care quality.

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