130 July 2009 What IHE Delivers
Connecting Health Connecting Health Information Technology Information Technology
to the Point of Care:to the Point of Care:The IHE MethodThe IHE Method
Audrey Dickerson, RN, MS Audrey Dickerson, RN, MS
Marcia Veenstra, RN, MSNMarcia Veenstra, RN, MSN
NI 2009NI 2009
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Your PresentersYour Presenters
Audrey DickersonAudrey Dickerson
Critical Care Nurse Critical Care Nurse
School of Nursing facultySchool of Nursing faculty
International Health Informatics Technical Committee International Health Informatics Technical Committee SecretarySecretary
Marcia VeenstraMarcia Veenstra
Critical Care NurseCritical Care Nurse
Primary Care Case ManagementPrimary Care Case Management
Healthcare practice and informatics consultantHealthcare practice and informatics consultant
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Presentation OutlinePresentation Outline
Objectives and definitions of terms used Objectives and definitions of terms used in this presentationin this presentation
Problem discussionProblem discussion
What and who is IHEWhat and who is IHE
IHE Nursing Sub-CommitteeIHE Nursing Sub-Committee IHE Nursing ProfilesIHE Nursing Profiles
Connections within the world of Nursing Connections within the world of Nursing InformaticsInformatics
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Objectives for WorkshopObjectives for Workshop
Discuss interoperability related to IHE process Discuss interoperability related to IHE process and implementation profile developmentand implementation profile development
Advance nursing practice no matter where the Advance nursing practice no matter where the patient/nurse interaction occurs.patient/nurse interaction occurs.
Endorse methods of nursing data collection Endorse methods of nursing data collection across care settings and timeacross care settings and time
Encourage participation in the active nursing Encourage participation in the active nursing work of profile development work of profile development
Connect with nursing globally to advance Connect with nursing globally to advance continuity of care through interoperabilitycontinuity of care through interoperability
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Terms and DefinitionsTerms and Definitions
EHREHR:: Electronic Health RecordElectronic Health Record
HIEHIE:: Health Information ExchangeHealth Information Exchange
InteroperabilityInteroperability: : The ability of two or more systems The ability of two or more systems or elements to exchange information and to use the or elements to exchange information and to use the information that has been exchanged. information that has been exchanged. IEEE, 1990IEEE, 1990
Content ProfileContent Profile: A coordinated set of standards-: A coordinated set of standards-based information/data, exchanged between the based information/data, exchanged between the functional components of communicating functional components of communicating healthcare IT systems and devices. healthcare IT systems and devices. IHE, 2004IHE, 2004
OutcomeOutcome: Define the end results of nursing : Define the end results of nursing interventions and are indicators of problem interventions and are indicators of problem resolution or progress toward problem or symptom resolution or progress toward problem or symptom resolution. resolution. ICN, 2009ICN, 2009
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Presentation OutlinePresentation Outline
Definitions of the terms used in this Definitions of the terms used in this presentationpresentation
Problem discussionProblem discussion
What and who is IHEWhat and who is IHE
IHE Nursing Sub-CommitteeIHE Nursing Sub-Committee IHE Nursing ProfilesIHE Nursing Profiles
Connections within the world of Nursing Connections within the world of Nursing InformaticsInformatics
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The ProblemThe Problem
Nursing documentation may stay within Nursing documentation may stay within one system, hospital or ambulatory one system, hospital or ambulatory systemsystem
Too many EHR’s, but not enough EHR’s Too many EHR’s, but not enough EHR’s with interoperable nursing datawith interoperable nursing data
How do we collect nursing data across How do we collect nursing data across care settings and timecare settings and time
How (for example) do we develop best How (for example) do we develop best practices for all 74 year old females with practices for all 74 year old females with heart disease?heart disease?
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Using the Nursing Process tool Using the Nursing Process tool in the Problem Spacein the Problem Space
Gathering/collecting the detailsGathering/collecting the details Data to collect:Data to collect:
• Elements, sequence, frequency, location of care delivery, Elements, sequence, frequency, location of care delivery, • Data setsData sets
Nursing documentationNursing documentation• Thorny question of which terminology to useThorny question of which terminology to use• Format?? Menus?? Flowsheet records?? Narrative??Format?? Menus?? Flowsheet records?? Narrative??
Access the patient dataAccess the patient data• Security Security • Privacy issuesPrivacy issues• ConsumerConsumer• ProviderProvider
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Nursing Process / Problem SpaceNursing Process / Problem Space
Goals/OutcomesGoals/Outcomes Setting the goal for interoperabilitySetting the goal for interoperability
PlanningPlanning StandardsStandards Terminology, NOT specificTerminology, NOT specific
Implementation of a nursing IHE profileImplementation of a nursing IHE profile DevelopingDeveloping TestingTesting DemonstratingDemonstrating
Evaluation of the implementationEvaluation of the implementation Did the profile pass the testingDid the profile pass the testing Does the profile meet expectationsDoes the profile meet expectations
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Presentation OutlinePresentation Outline
Definitions of the terms used in this Definitions of the terms used in this presentationpresentation
Problem discussionProblem discussion
What and who is IHEWhat and who is IHE
IHE Nursing Sub-CommitteeIHE Nursing Sub-Committee IHE Nursing ProfilesIHE Nursing Profiles
Connections within the world of Nursing Connections within the world of Nursing InformaticsInformatics
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An 11-year public-private initiative An 11-year public-private initiative
Driven by end-users, IHE improves patient care Driven by end-users, IHE improves patient care by harmonizing electronic health information by harmonizing electronic health information exchange exchange
Enables approved standards to seamlessly pass Enables approved standards to seamlessly pass health information amongst care providers on a health information amongst care providers on a local, regional and national levellocal, regional and national level
IHE products are freely available to allIHE products are freely available to all
What is What is “Integrating the Healthcare Enterprise”??“Integrating the Healthcare Enterprise”??
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IHE: IHE: Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise
Provides a rigorous process for developing Provides a rigorous process for developing integration profiles that address specific real-integration profiles that address specific real-world interoperability challengesworld interoperability challenges
Technically robust specifications, facilitating Technically robust specifications, facilitating ease of implementation into vendor applicationsease of implementation into vendor applications
Conformance testing, integration statements, Conformance testing, integration statements, demonstrationsdemonstrations
IHE is a key component of the national healthcare
IT standards initiative in the US, and around the world
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Standards: Standards: Necessary… not SufficientNecessary… not Sufficient
Standards areStandards are Foundational - interoperable and provide Foundational - interoperable and provide
communicationscommunications Broad - varying interpretations and implementationsBroad - varying interpretations and implementations Narrow - may not consider relationships between Narrow - may not consider relationships between
domainsdomains Plentiful - often redundant or disjointedPlentiful - often redundant or disjointed Focused - standards implementation guides typically Focused - standards implementation guides typically
focus on a single standardfocus on a single standard
Interoperability can only be enabled through a standard process for implementing multiple standards
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Connecting Standards to CareConnecting Standards to Care
It is important to ensure that the implementation of It is important to ensure that the implementation of standards meets clinical and administrative needsstandards meets clinical and administrative needs Clinicians and HIT professionals identify the key Clinicians and HIT professionals identify the key
interoperability problems they faceinteroperability problems they face Providers and industry work together to develop and Providers and industry work together to develop and
make available standards-based solutionsmake available standards-based solutions Implementers are able to follow common guidelines in Implementers are able to follow common guidelines in
purchasing and integrating effective systemspurchasing and integrating effective systems
Interoperability is of high value when there is a shared vision on how to implement standards and processes
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Proven Standards Adoption ProcessProven Standards Adoption Process
Document Use Document Use Case Case RequirementsRequirements
Document Use Document Use Case Case RequirementsRequirements
Identify available Identify available standards (standards (e.g. HL7, e.g. HL7, DICOM, IETF, OASIS)DICOM, IETF, OASIS)
Identify available Identify available standards (standards (e.g. HL7, e.g. HL7, DICOM, IETF, OASIS)DICOM, IETF, OASIS)
Develop Develop technical technical
specificationsspecifications
Develop Develop technical technical
specificationsspecifications
Testing at Testing at ConnectathonsConnectathonsTesting at Testing at ConnectathonsConnectathons
IHE IHE DemonstrationsDemonstrationsIHE IHE DemonstrationsDemonstrations
Products Products with IHEwith IHEProducts Products with IHEwith IHE
Timely access to Timely access to informationinformationTimely access to Timely access to informationinformation
Easy to integrate Easy to integrate productsproductsEasy to integrate Easy to integrate productsproducts
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11 Years of Steady Evolution 1998 – 2009
The IHE Development DomainsThe IHE Development Domains
Laying the Groundwork1998
PharmacyNEW 2009
Pathologysince 2006
Radiation Oncologysince 2004
Radiologysince 1998
Cardiologysince 2004
Patient Care Devicessince 2005
Patient Care Coordinationsince 2004
Eye Caresince 2006
QualityResearch & Public Health
since 2006
Laboratorysince 2004
(Healthcare)IT Infrastructure
since 2003
1919191919
IHE Organizational StructureIHE Organizational Structure
Contributing &Participating
Vendors
Regional Deployment
ACCACCEACEP
JAHISJIRAJRS
METI-MLHWMEDIS-DCJAMI
RSNA SFRSFIL
SIRMBIREuroRec
COCIREAR-ECRDRG
ESCMSCMDEC
Professional Societies / SponsorsACPGMSIHIMSS
Global Development
Radiology
Cardiology
ITInfrastructure
Patient CareCoordination
Patient CareDevices
Laboratory
Pathology
Eye CareRadiationOncology
Public Health, Quality and Research
IHE International Board
IHE Europe
IHE North America
France
USA
Canada
IHE Asia-Oceania
Japan
Korea
Taiwan
Netherlands
Spain Sweden UKItaly
Germany
Norway
China
Austria
Australia
Malaysia
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Italy Italy (Genoa Region) and (Genoa Region) and AustriaAustria
Since 2006: 4 Hospitals Since 2006: 4 Hospitals and 500 physician and 500 physician offices.offices.
EMRs import and export EMRs import and export documents from their documents from their local records.local records.
All vendor products All vendor products required to pass IHE-required to pass IHE-Europe connectathon in Europe connectathon in April 2005.April 2005.
Patients chose to join Patients chose to join through one of their through one of their care providercare provider
Lower Austria Region Lower Austria Region (around Vienna) (around Vienna) Deployed in 2007 - Deployed in 2007 - Operational. 1.5 Operational. 1.5 Million patients on-Million patients on-line. 11 hospitals line. 11 hospitals connected. connected.
Use a number of IHE Use a number of IHE profiles: workflow, profiles: workflow, basic framework and basic framework and privacy/security.privacy/security.
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France and NetherlandsFrance and NetherlandsEncourage vendors to Encourage vendors to
submit their products to submit their products to the IHE-Europe the IHE-Europe Connectathon.Connectathon.
Implementation plan Implementation plan under revision.under revision.
Use a number of IHE Use a number of IHE profiles: workflow, basic profiles: workflow, basic framework and framework and privacy/security.privacy/security.
National DMP ProjectNational DMP Project
Dutch “e-Radiology” Dutch “e-Radiology” projectproject NICTIZ: capability IHE NICTIZ: capability IHE
with national with national infrastructureinfrastructure
First application: focus First application: focus on Radiologyon Radiology
Friesland Cardiology Friesland Cardiology NetworkNetwork 5 hospitals (4 5 hospitals (4
Community and one Community and one Specialty Hospital)Specialty Hospital)
Cardiac Patient TransferCardiac Patient Transfer Operational for 6 monthsOperational for 6 months
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USA and CanadaUSA and CanadaHITSPHITSP Lab results distribution Lab results distribution and sharing, Registration and and sharing, Registration and Medication History for Medication History for Consumers, Biosurveillance, Consumers, Biosurveillance, Medication Mgt, etc.Medication Mgt, etc.
2 NHIN-2 Pilots using IHE 2 NHIN-2 Pilots using IHE profiles (Medical Summaries and profiles (Medical Summaries and Lab).Lab).
Several HIEs projects are Several HIEs projects are operational and using of operational and using of HITSP/IHE Profiles:HITSP/IHE Profiles:
Philadelphia and in other Philadelphia and in other parts of Pennsylvaniaparts of Pennsylvania
Vermont Vermont Providence OregonProvidence Oregon Boston Medical Center and Boston Medical Center and
affiliated clinicsaffiliated clinics
Canada Health Canada Health Infoway: Infoway:
image sharingimage sharing Radiology workflow Radiology workflow
Toronto East Network Toronto East Network - Ontario- Ontario
Montreal McGill - Montreal McGill - QuebecQuebec
AlbertaAlberta
British ColumbiaBritish Columbia
Launch Internet Explorer Browser.lnk
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Other International IHE Other International IHE WorkWork
ChinaChina MoH selected Lab profiles for lab info sharing. Two pilots planned for MoH selected Lab profiles for lab info sharing. Two pilots planned for
2009.2009. Imaging planned for ShanghaiImaging planned for Shanghai
Israel, Jordan, Palestinian AuthorityIsrael, Jordan, Palestinian Authority Public Health Info Affinity Domain Public Health Info Affinity Domain Middle east Consortium for infectious Disease SurveillanceMiddle east Consortium for infectious Disease Surveillance Operational-2008Operational-2008
JapanJapan Nagoya region network project operational late 2007. Kobe with imaging Nagoya region network project operational late 2007. Kobe with imaging
info sharinginfo sharing
South AfricaSouth Africa National project launched in 2007. Tender awarded. Operational in 2008.National project launched in 2007. Tender awarded. Operational in 2008.
Spain: CataloniaSpain: Catalonia Close to one million patient records on-line using IHE profilesClose to one million patient records on-line using IHE profiles
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Sharing and Accessing Electronic Health Sharing and Accessing Electronic Health RecordsRecords
IHE offers interoperability for local, regional, specific, or IHE offers interoperability for local, regional, specific, or national health information exchangenational health information exchange
Goal is to enable exchange between providers’ clinical Goal is to enable exchange between providers’ clinical and administrative systems and ancillary IT systemsand administrative systems and ancillary IT systems
Objective is to empower the consumersObjective is to empower the consumers in having in having “shared EHR information” between all of its potential “shared EHR information” between all of its potential healthcare providers (if authorized) and self.healthcare providers (if authorized) and self.
Objective is to empower the providersObjective is to empower the providers in choosing when in choosing when and what information to share, and to trust the and what information to share, and to trust the information they may use in the care of their patients.information they may use in the care of their patients.
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Community
Clinical Encounter
Clinical IT System
Aggregate Patient Info
4-Patient data 4-Patient data presented to presented to
PhysicianPhysician
HIEHIE
Clinic Record Specialist Record
Hospital Record
2-Reference2-Referenceto Records to Records for Inquiryfor Inquiry
Access to Shared Records : IHE-XDSAccess to Shared Records : IHE-XDS
3-Records3-RecordsReturnedReturned
Repository ofRepository ofDocumentsDocuments
Repository ofRepository ofDocumentsDocuments
Index of Index of patients recordspatients records
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A content profile is….A content profile is….
A sharable information component that A sharable information component that can be exchanged..can be exchanged.. Within an HIE using the IHE document sharing Within an HIE using the IHE document sharing
profileprofile Via HIS system using IHE profile standardsVia HIS system using IHE profile standards
Human and/or machine readableHuman and/or machine readable Standards exchange complete structured Standards exchange complete structured
documents documents
A library of reusable profilesA library of reusable profiles
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PCC ProfilesPCC Profiles
Medical Summaries
Emergency Department
Referral
ExchangingPHR
Content
AntepartumCare
Summary
EmergencyDepartmentEncounter Summary
FunctionalStatus
Assessments
2005-062005-062006-072006-072007-082007-082008-09 2008-09 2009-102009-10 I
nte
gra
tio
nC
on
ten
t
Query for Existing Data
AntepartumRecord
ClinicalResearch
ImmunizationRegistryContent
Care Management
Query for Clinical
Guidance
Labor and
Delivery Record
Patient Plan of Care
Pre-Hospital
Care Report
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Presentation OutlinePresentation Outline
Problem discussion Problem discussion
Definitions of the terms used in this Definitions of the terms used in this presentationpresentation
What and who is IHEWhat and who is IHE
IHE Nursing Sub-CommitteeIHE Nursing Sub-Committee IHE Nursing ProfilesIHE Nursing Profiles
Connections within the world of Nursing Connections within the world of Nursing InformaticsInformatics
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History of IHE and NursingHistory of IHE and Nursing
Early IHE work mostly technical and physician basedEarly IHE work mostly technical and physician based
2006 Nursing Special Interest Group formed and submitted 2006 Nursing Special Interest Group formed and submitted a profile of Functional Status Assessments (FSA)a profile of Functional Status Assessments (FSA)
2007 FSA demonstrated at HIMSS Showcase2007 FSA demonstrated at HIMSS Showcase
2008 Nursing Subcommittee proposed and initiated2008 Nursing Subcommittee proposed and initiated
2009 Patient Plan of Care Profile in development2009 Patient Plan of Care Profile in development
2010 Planned demonstration at HIMSS 2010 in Atlanta. 2010 Planned demonstration at HIMSS 2010 in Atlanta.
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Desired OutcomesDesired OutcomesAvailability of patient and clinical information Availability of patient and clinical information prior to admission/transferprior to admission/transfer
Minimized complications due to early Minimized complications due to early intervention intervention
Safe, effective and evidence based care as a Safe, effective and evidence based care as a result of accurate point of care information result of accurate point of care information
Improved patient/family education Improved patient/family education
Continuity of individualized care plan Continuity of individualized care plan
Use of interoperable nursing data Use of interoperable nursing data communicates health informationcommunicates health information
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Value in IHE NursingValue in IHE NursingThe value of interoperable electronic health records The value of interoperable electronic health records
nursing data includesnursing data includes:: Plan for early interventions with appropriate resources Plan for early interventions with appropriate resources
based on patient acuity including nurse staffing (resource based on patient acuity including nurse staffing (resource maximization)maximization)
Early intervention minimizes complicationsEarly intervention minimizes complications Complete clinical information promotes safety and Complete clinical information promotes safety and
improved outcomesimproved outcomes Continuity of care delivery using a plan of care Continuity of care delivery using a plan of care Promotes safer transfers of care and evidence for Promotes safer transfers of care and evidence for
outcomes improvements outcomes improvements
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IHE Nursing SC PlanningIHE Nursing SC Planning
Development of a process framework to Development of a process framework to house the nursing IHE profileshouse the nursing IHE profiles
Expand the framework for the nursing Expand the framework for the nursing process to be interoperableprocess to be interoperable
Framework will communicate consistency Framework will communicate consistency of care needs in an individualized planof care needs in an individualized plan
Consensus driven, evidence based processConsensus driven, evidence based process
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The IHE Nursing PlanThe IHE Nursing Plan
GoalGoal: Move nursing data between care : Move nursing data between care settings across timesettings across time
Year 1Year 1: Move data from non-hospital : Move data from non-hospital settings into acute care and back settings into acute care and back electronically without regard for vendor electronically without regard for vendor application.application.
Year 2Year 2: Use of the Nursing process, a : Use of the Nursing process, a problem solving method, to provide a problem solving method, to provide a framework for further profile work.framework for further profile work.
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Functional Status Assessment – Functional Status Assessment – Year 1Year 1
ConsiderationsConsiderations
Need to demonstrate value and feasibilityNeed to demonstrate value and feasibility
Scales chosen are evidence-based with strong reliability and validity.Scales chosen are evidence-based with strong reliability and validity.
Widely accepted cross-enterprise or required/recommended by Widely accepted cross-enterprise or required/recommended by accrediting agenciesaccrediting agencies
Content ScalesContent Scales
Numeric Rating Scale (NRS-11) for Pain Numeric Rating Scale (NRS-11) for Pain
Braden Scale for Predicting Pressure Sore RiskBraden Scale for Predicting Pressure Sore Risk©©
Geriatric Depression Scale (GDS)Geriatric Depression Scale (GDS)
Minimum Data Set – Section GMinimum Data Set – Section G
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Use Case Example – FSA Use Case Example – FSA
76 year old resident of Residential Facility76 year old resident of Residential Facility
Increased weakness and lethargyIncreased weakness and lethargy
Complains of chills and refuses to get out of bedComplains of chills and refuses to get out of bed
Assessment findings:Assessment findings: pulse increased, respirations shallowpulse increased, respirations shallow low grade temperature low grade temperature reddened area on coccyx, skin moistreddened area on coccyx, skin moist fasting blood glucose is out of controlfasting blood glucose is out of control
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Combined Workflow/Dataflow DiagramCombined Workflow/Dataflow Diagram
Identifies change in functional assessment,
braden scale and glucose level.
Discusses findings from assessment
and labs
Nurse comparesCurrent assessmentto LTC EHR data and
initiates POC
RHIODocumentExchange
Server
Unit RN updates daily assessments
In the EHR
Attending reviews progress notes
and assessments
Nurse assessesresident
Nurse initiatesphone collaboration
with PCP
PCP reviewspatient status
Transfer Patient?
Yes
Reviews EHR data
Patient transferredto acute care
facility
Hospital admissionnurse reviews
transmitted EHRdata
Pt acuity &staffing
levels rvw
Unit placementdecision based oncurrent pt acuity,& staffing levels
Unit RN assessespatient on
admission to unit
Care providersaddress patient’s
medical issues
Unit RN updates daily assessments
In the EHR
Patient regainsstrength,
progressing well
Unit RN updates daily assessments
In the EHR
Attending reviewspatient status
DischargePatient to LTC?
Yes
RHIODocumentExchange
Server
Key: Process DecisionNurseEHR
PhysicianEHR
Patient transferredto long-term care
facility End of Process
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Patient Plan of Care (PPOC) Patient Plan of Care (PPOC)
Use Case: PneumoniaUse Case: Pneumonia
A A 70 year old male is admitted to a hospital unit after 70 year old male is admitted to a hospital unit after presenting to the Emergency Department (ED) with;presenting to the Emergency Department (ED) with; Productive cough and acute rib pain Productive cough and acute rib pain Coughing, increased work of breathing Coughing, increased work of breathing Increased temperature, heart rate and blood pressureIncreased temperature, heart rate and blood pressure Chest x-ray showed bilateral infiltratesChest x-ray showed bilateral infiltrates Lab hematologies showed high White blood cell countLab hematologies showed high White blood cell count
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Patient Plan of Care Patient Plan of Care
Nursing DiagnosisNursing Diagnosis (medical diagnosis Pneumonia)(medical diagnosis Pneumonia)
Respiratory alteration due to ineffective gas exchangeRespiratory alteration due to ineffective gas exchange Acute Pain upon coughing Acute Pain upon coughing
Outcome IdentificationOutcome Identification Stabilize respiratory alterationStabilize respiratory alteration Acute pain within patient acceptable limitsAcute pain within patient acceptable limits
Planning and ImplementationPlanning and Implementation Pulmonary CarePulmonary Care Pain ControlPain Control
EvaluationEvaluation Re-assessment of patient outcomesRe-assessment of patient outcomes
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Using the IHE Process for NursingUsing the IHE Process for Nursing
Discussion Questions:Discussion Questions:
Current nursing issues where you practiceCurrent nursing issues where you practice
Define/describe data elements for nursing care Define/describe data elements for nursing care summaries/transfers/handoverssummaries/transfers/handovers
Implementing nursing interventions and Implementing nursing interventions and accountability for your nursing practiceaccountability for your nursing practice
Interoperability in nursing practice, wInteroperability in nursing practice, what issue in hat issue in your nursing practice could interoperability help your nursing practice could interoperability help solve?solve?
How could you make the IHE nursing profiles be How could you make the IHE nursing profiles be reflected your nursing practice?reflected your nursing practice?
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Key Points Key Points
Use of nursing critical thinking processes Use of nursing critical thinking processes and documentation requirements fit well and documentation requirements fit well into the IHE method.into the IHE method.
IHE provides a proven process for IHE provides a proven process for interoperability between disparate systemsinteroperability between disparate systems
Collection of nursing data across time and Collection of nursing data across time and care settings will allow research to care settings will allow research to determine evidence based practice determine evidence based practice guidelines for the futureguidelines for the future
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Presentation OutlinePresentation Outline
Problem discussion Problem discussion
Definitions of the terms used in this Definitions of the terms used in this presentationpresentation
What and who is IHEWhat and who is IHE
IHE Nursing Sub-CommitteeIHE Nursing Sub-Committee IHE Nursing ProfilesIHE Nursing Profiles
Connections within the world of Nursing Connections within the world of Nursing InformaticsInformatics
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Advancing the Agenda for Patient CareAdvancing the Agenda for Patient Care
Understand and embrace this initiativeUnderstand and embrace this initiative
Get involved with Profile developmentGet involved with Profile development
Respond to public comment opportunitiesRespond to public comment opportunities
Attend educational workshopsAttend educational workshops
Attend a HIMSS Interoperability ShowcaseAttend a HIMSS Interoperability Showcase
Include IHE Integration Profiles in your RFP’sInclude IHE Integration Profiles in your RFP’s
Participate in IHE CommitteesParticipate in IHE Committees
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Questions and ContactsQuestions and Contacts
Audrey Dickerson RN, MSAudrey Dickerson RN, MS
HIMSS Liaison to IHE Nursing SubcommitteeHIMSS Liaison to IHE Nursing Subcommittee
[email protected]@himss.org
Marcia Veenstra RN, MSNMarcia Veenstra RN, MSN
Co-Chair of Nursing SubcommitteeCo-Chair of Nursing Subcommittee
[email protected]@gmail.com