Funded, in part, by the National Institutes of Health (NIH), iHistory was developed, deployed, and is managed by Hx Technologies Inc (HxTI), a Philadelphia-based clinical information technology company founded to solve longstanding problems related to the scatter of patient data among unaffiliated medical institutions.

The first commercially available clinical information network of its kind, iHistory enables on-demand, patient-authorized access by physicians to digital medical records located beyond their own enterprise when needed to provide care.

Most current efforts to achieve similar goals aim to create new centralized patient data archives. By contrast, iHistory links existing and diverse in-house information systems into a distributed virtual archive. Using next-generation middleware and application logic, iHistory creates on-the- fly cross-enterprise, patient-centric longitudinal medical records comprised of data otherwise scattered and out of the physician’s reach.

By leaving existing medical records with the healthcare providers and institutions who are already their trusted custodians, iHistory’s architecture resolves key issues surrounding patient data ownership, control, privacy and security as well as bandwidth utilization, scalability, and replicability. These issues continue to frustrate other efforts to establish regional or nationwide networks for on-demand physician access to patient data at the point of care. Moreover, without additional extensive capitalization, iHistory leverages existing investments in clinical IT at participating institutions to accomplish this goal.

Although applicable to all digital forms of clinical information, iHistory is particularly focused on diagnostic imaging data. It links commercial picture archiving and communication systems (PACS) and radiology information systems (RIS) in a vendor-neutral fashion to present physicians with a single interface for full-fidelity diagnostic quality data.

UPHS and CHOP have long collaborated on the care of individual patients, but such cooperation has typically required physicians to travel between institutions to consult with one another. For imaging data in particular, collaborations have typically required the physical exchange of physical film without any of the benefits that digital data could bring. iHistory now provides a secure digital portal to the shared patient’s images and reports, managing the secure flow of information between institutional firewalls. iHistory is able to create a unified view even when the data is physically located on a multitude of individual systems of different ages and from different vendors including GE, Siemens, and IDX.

"iHistory represents what we believe to be the next stage in the evolution of clinical IT, specifically cross-enterprise connectivity and on-demand access to relevant patient data when it’s needed, where it’s needed," says Alberto Goldszal, PhD, Director of Medical Informatics for UPHS Radiology. "While an important application of this technology has been sharing UPHS imaging data with our clinical colleagues at CHOP, it’s clear that the implications of iHistory are much broader. We’re looking forward to seeing our peer institutions in the region and the nation join us on the network, particularly as each new participant increases the value and power of the network geometrically, further enhancing patient safety and the quality of care among all participants."

iHistory’s successful launch in Philadelphia will be followed by regional and national expansion to other leading health systems. Within radiology, the continued rollout of iHistory will enable an important standard of care: the use of a patient’s relevant historical images ("priors") for side-by-side comparison with current imaging studies. Boosting diagnostic accuracy, physician confidence and quality of care, this practice remains frustrated today by the boundaries of medical institutions and high patient mobility among multiple caregivers, leading to diagnostic uncertainty and unnecessary procedures.

During the past two years, prior entering clinical use in Philadelphia, iHistory underwent intensive NIH-sponsored beta-testing and evaluation across the core hospitals of UPHS. The results of this collaboration among researchers from UPHS, Hx Technologies, the Johns Hopkins Information Security Institute, and RealTimeImage, Inc. will be presented at the 21st Meeting of the Society for Computing Applications in Radiology (SCAR) to be held at the Vancouver Convention and Exhibition Center (www.scarnet.org) from May 20 - 23, 2004.

Specifically, Elliot Menschik, MD PhD, the chief architect of iHistory and HxTI’s chief executive, will present "Peer-to-Peer Exchange of Distributed Imaging Data Between Institutions for Patient Care" and "Cross-Institutional Linkage of Patient Imaging Data in the Absence of a Common Identification System" at the Image Distribution scientific session (Saturday, May 22nd, 1:30-2:45pm).

Hx Technologies will demonstrate iHistory during the meeting at the Vancouver Convention and Exhibition Center (Booth #1226) starting May 20th at 4:30pm, with a third presentation in the vendor theater slated for Saturday, May 22nd at 3:40pm.

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