Proposal of the Cooperation Method Between EMR/CPOE-RIS-TMS by Using the IHE (integrating the Healthcare Enterprise) - Implementation and Challenge

Abstract

Our institution is a hospital which specialized in radiation therapy. It started charged particle therapy since in 1994 and treated over 6,500 cases up to March 2012. We have managed and operated multiple systems such as the Electronic Medical Record system/ Computerized Physician Order Entry system (EMR/CPOE), the radiology information system(RIS), clinical database system, the Picture Archiving and Communication System (PACS) and the charged particle therapy management system (TMS). The purpose to improve the interoperability, communicate function between the EMR/CPOE system, the radiology information system and the radiation oncology department system was implemented. To implement the cooperation between the EMR/CPOE system and the charged particle therapy management system , we have adopted the ESI(Enterprise Schedule workflow) integration profile which is proposed by Radiation Oncology Domain of the IHE. We have deployed Order Placer(OP) Actor of ESI to the EMR/CPOE system and Treatment Management System(TMS) Actor to the charged particle therapy management system. As a method of communication between systems, we adopted the nine transactions necessary for the workflow of our hospital. Since the treatment planning CT device and creating fixture operation are under the control of the radiology department information system, those order informations published by TMS would be in process of notification and the radiology department information system notify the performed information to TMS was necessary. We are referring to the SWF (Scheduled Workflow) integration profile which is proposed by the Radiation Domain of the IHE, and we have implemented its functions. We have selected the route via the EMR/CPOE system to work the CT order information from radiology department information system (RIS)/TMS to TMS/ radiology department information system (RIS) .We used HL7 message for communication between these systems. We are able to implement a system with the EMR/CPOE system and charged particle therapy management system by the standards. There is a merit of this method even if these systems such as the EMR/CPOE system or charged particle therapy management system or manufactures are updated, it keeps interoperability. We desire this implementation would be collected as extended function of ESI which IHE-RO has been proposed.