September, 2005 What IHE Delivers
Charles Parisot, Charles Parisot, GE healthcare, ITI Plan co-chairGE healthcare, ITI Plan co-chair
IHE-Europe at WHIT, October 2007IHE-Europe at WHIT, October 2007
IHE integration profiles: XDS – Cross Enterprise Sharing of
Healthcare Information
22
Presentation ObjectivesPresentation Objectives
What is cross-enterprise document sharingWhat is cross-enterprise document sharing
Support of semantic interoperabilitySupport of semantic interoperability
Adoption of IHE in Europe and world-wide in Adoption of IHE in Europe and world-wide in regional and national eHealth projectsregional and national eHealth projects
33
Health Information Exchanges:Health Information Exchanges:Linking diverse Care Delivery and Personal Health RecordsLinking diverse Care Delivery and Personal Health Records
eHealth Information Exchange
HospitalGroup
Integrated Care Delivery EMR’s
HospitalGroup
Hospital
Hospital Multi-Practitioner
Clinics
Physician Offices
Lab/pathology
Radiology
Pharmacy
Personal Health Record
Specific Registries
Building an eHealth Infrastruture is easy….Building an eHealth Infrastruture is easy….Integrating current and existing HIT systems is the challenge !Integrating current and existing HIT systems is the challenge !
44
Content
Content
Interoperability Dimensions for eHealth Info NetsInteroperability Dimensions for eHealth Info Nets
ITIT
HealthHealth
InfrastructurInfrastructuree
SecuritySecurityPrivacyPrivacy Id MgtId Mgt
HealthHealthRecordsRecordsSharingSharing
WorkflowWorkflowTransactionsTransactions
DynamicDynamicQueriesQueries
From EHR Vendor Association Interop Roadmap: www.ehrva.org
Examples:Examples:
ePrescriptionePrescription(Orders)(Orders)
Laboratory Laboratory Order/ResultsOrder/Results
Examples:Examples:
Care Record Care Record ServiceService
(includes Meds, (includes Meds, allergies, allergies,
diagnosis, labs, diagnosis, labs, etc.)etc.)
Examples:Examples:
Immunization Immunization QueriesQueries
Targeted Targeted Medication Medication
HistoryHistory
55
DocumentDocumentSourceSource
DocumentDocumentSourceSource
Document Registry/Repository Model:Document Registry/Repository Model:
DocumentDocumentRepositoryRepository Submit
Doc Meta-data+ References
SubmitDocuments
DocumentDocumentRepositoryRepository
SubmitDoc Meta-data+ References
DocumentDocumentRegistryRegistry
RetrieveDocuments
Query for DocsReferences
DocumentDocumentConsumerConsumer
RetrieveDocuments
66
IHE PIX / XDSIHE PIX / XDS
PATIENTS
PUBLIC HEALTH
Hospital Other Practices
PHARMACY
Clinics/GPsINSURANCES
Personal Health Record
Claim Data
Registries
LAB
Results
Rx History
Practice Mgmt
XDSRep
PIX mgr
XDS Reg
Save DocumentRegister Document
Publish Documents/RecordsSummaries, (Labs, D/Cs, Image Reports/Links, etc.)
EMR
EMR-Hosted
EMR-Lite
Portal
EMR /HIS
PACS Archive
EMR / PMS
PACS Archive
LabLab
Patient Identity FeedQuery for shared Id
77
IHE PIX / XDSIHE PIX / XDS
PATIENTS
PUBLIC HEALTH
Hospital Other Practices
PHARMACY
Clinics/GPsINSURANCES
Personal Health Record
Claim Data
Registries
LAB
Results
Rx History
Practice Mgmt
XDSRep
PIX mgr
XDS Reg
Consume Documents/Records(Summaries, Labs, D/Cs, Image Reports/Links, etc.)
Patient Id FeedQuery for Patient
Query forDocuments Retrieve
Documents
EMR
EMR-Hosted
EMR-Lite
Portal
EMR / PMS
PACS Archive
EMR / PMS
PACS Archive
LabLab
88
Health Information Exchanges Interoperability: Health Information Exchanges Interoperability: Cross-enterprise Document SharingCross-enterprise Document Sharing
• Performance, Scalability and Cost: Registry and Repository are simple and efficient
• Content Evolution: Registry and Repositories support any document content (e.g. enable use of HL7 CDA, DICOM, PDF, etc.).
• Real end-to-end structured data: not only a portal view, easy to integrate in healthcare applications
• Supports centralized and distributed approaches. Repositories centralized or distributed. XDS Domains may be federated.
• Real Interoperability: Standards and profiles in place, proven and in use
• Products are available: over 100 vendors world-wide. Tested at IHE Connectathons.
Selected by a significant number of regional and national programs world-wide
99
Example: Example: Providing Access to Prior Health InformationProviding Access to Prior Health Information
Acute Care (Inpatient)
PCPs and Clinics (Ambulatory)
Long Term Care
Other Specialized Careor Diagnostics Services
Shared DocumentRepository
Longitudinal Record as usedacross-encounters
Encounter Medical Summary (med-prescribed & dispensed, allergies, pbs/diagnosis, etc)Lab Report (structured & coded tests results)
Radiology Report and Images
EKG Report
PublicHealth
1010Doc Exchange Integration ProfilesDoc Exchange Integration Profiles
Related Profiles for Semantic InteroperabilityRelated Profiles for Semantic Interoperability
Doc Content ProfilesDoc Content Profiles
Doc SharingDoc Sharing
XDSXDS
MediaMediaInterchangeInterchange
XDMXDM
Pt-Pt DocPt-Pt DocInterchangeInterchange
XDRXDR
ConsentConsent
BPPCBPPCEmergencyEmergency
EDEREDERPrePre
SurgerySurgery
PPHPPPHP
Scanned DocScanned Doc
XDS-SDXDS-SD
LaboratoryLaboratory
XD*-LabXD*-LabPHR PHR
ExchangeExchange
XPHRXPHR
Discharge &Discharge &ReferralsReferrals
XDS-MSXDS-MS
ImagingImaging
XDS-IXDS-I
TerminologiesTerminologies(e.g. SNOMED, LOINC, etc.(e.g. SNOMED, LOINC, etc.
1111
IHE Profiles for Health Info NetsIHE Profiles for Health Info Nets Broad Healthcare Information & Broad Healthcare Information & Web Services Web Services
SecuritySecurityPrivacyPrivacy Id MgtId Mgt
RecordRecordSharingSharing
WorkflowWorkflowTransactionsTransactions
DynamicDynamicQueriesQueries
Doc Doc SharingSharingX-CommunityX-CommunityPt-Pt Doc Trf Pt-Pt Doc Trf Media InterchangeMedia Interchange
Query Query Existing Existing Data Data (med, (med, allegies, allegies, immunizations, immunizations, etc.)etc.)
PIXPIXPDQPDQ
Scanned DocScanned Doc ImagingImagingLab ReportsLab Reports Med SummaryMed Summary Personal Personal
Record ExtractRecord ExtractEmergency Emergency
RecordRecord Etc…Etc…
Content
Content
InfrastructurInfrastructuree
General General RequestsRequests
Request Request Form for Form for Data Data capturecapture
Web ServicesWeb Services
Introduced in 2007: Introduced in 2007: XDS.b, XCA, PIX/PDQ V3, QED, RFD, XUAXDS.b, XCA, PIX/PDQ V3, QED, RFD, XUA
Consent Consent MgtMgt
Digit Sign Digit Sign DocsDocs
Audit Audit Trail-Node Trail-Node AuthenticAuthenticationation
User User AuthenticAuthenticationation
1212
Regional Network BRegional Network B
Acute Care (Inpatient)
PCPs and Clinics (Ambulatory)
Long Term Care
Other Specialized Careor Diagnostics Services
Document Registry
DocumentRepository
Longitudinal Recordas usedacross-encounters
Regional Network CRegional Network C
Regional Network ARegional Network A
Acute Care (Inpatient)
PCPs and Clinics (Ambulatory)
Long Term Care
Other Specialized Careor Diagnostics Services
Document Registry
DocumentRepository
Longitudinal Recordas usedacross-encounters
Hierarchical ExchangeHierarchical ExchangeCross Community Information Exchange (XCA, ATNA, PIX, PDQ)Cross Community Information Exchange (XCA, ATNA, PIX, PDQ)
Cross Community Cross Community BridgeBridge
Which community holds Which community holds records for a patient ?records for a patient ?
CrossCrossCommunityCommunityBridgeBridge
CrossCrossCommunityCommunityBridgeBridge
CommunityCommunityLocator serviceLocator service
Each region notifies Community Each region notifies Community Location Service when new Location Service when new patient is registered or first data is patient is registered or first data is stored.stored.
Cross Community Bridges query Cross Community Bridges query Community Locator ServiceCommunity Locator Service
Cross-Community Bridges query Cross-Community Bridges query and retrieve recordsand retrieve records
Spans across XDS and non-XDS Spans across XDS and non-XDS based communities.based communities.
IHE XCA IHE XCA TransactionsTransactions
Non-XDS basedNon-XDS basedCommunityCommunity
1313
IHE, global standards-based profiles adopted by IHE, global standards-based profiles adopted by several national & regional projectsseveral national & regional projects
Quebec, Toronto,Alberta, British Columbia
Canada Infoway
Denmark (Funen)Italy (Veneto)Spain (Aragon)
THINC- New YorkNCHICA – N. Carolina
Italy (Conto Corrente
Salute)
Boston Medical
Center - MA
FranceDMP
UK CfH(Radiology WF)
Philadelphia HIE
CHINA-MoHLab results sharing
CPHIC – Pennsylvani
a
CHINA-ShanghaiImaging Info Sharing
JAPAN-NagoyaImaging Info Sharing
South Africa
Malaysia
VITL-Vermont
CareSpark – TN & VA
NetherlandAmsterdam
LowerAustria
Austria
1414
Committed National Committed National Programs:Programs:
IHE XDS, PIX, PDQ, ATNA, CT, etc.IHE XDS, PIX, PDQ, ATNA, CT, etc.Austria Lower Austria Region (NOMED WAN): live since end of 2006, 1.5 Million Patients, Entire Country
(ELGA) by 2008.
Italy 4 regional projects. Genoa region, live since early 2006. National deployment planned.
Canada 7 regional projects coordinated by Infoway. Scheduled to go on-line in 2008.
France Implementation tender to be awarded in September 2007.
USA IHE Profiles adopted formally by HHS at Federal level (HITSP). Several regional projects: VT, NC,
CareSpark, CPHC, Philiadelphia Ex, CT, etc.
Netherlands Amsterdam region network project launched with NICTIZ. Implementation early 2008.
Japan One implemented project. One pilot (Nagoya) to be on-line late 2007.
China: MoH selected XDS and XD*-Lab (CDA) for two large pilots (2008). XDS-I in Shanghai.
South Africa One regional network project awarded in 2007 - 2008 production.
1515
StakeholdersStakeholders
Working Together to DeliverWorking Together to Deliver
Interoperable Health Information SystemsInteroperable Health Information Systems
in the Enterprisein the Enterprise
and Across Care Settingsand Across Care Settings
http://www.ihe.net
1616
More Resources - More Resources - www.www.iheihe.net.net Frequently Asked QuestionsFrequently Asked Questions
Integration Profiles in Technical Frameworks:Integration Profiles in Technical Frameworks:www.ihe.net/technical_frameworkswww.ihe.net/technical_frameworks : :
CardiologyCardiology IT InfrastructureIT Infrastructure LaboratoryLaboratory Patient Care CoordinationPatient Care Coordination Patient Care DevicesPatient Care Devices Radiation OncologyRadiation Oncology RadiologyRadiology
Connectathon ResultsConnectathon Results
Vendor Products Integration StatementsVendor Products Integration Statements
Participation in Committees and Connectathons:Participation in Committees and Connectathons:
www.ihe-europe.orgwww.ihe-europe.org
September, 2005 What IHE Delivers