theater presentation

brought to you bybrought to you by

IHE Sponsors and Committee MembersIHE Sponsors and Committee Members

Welcome to theWelcome to theInteroperability ShowcaseInteroperability Showcase

IHE: A Framework for Interoperability

Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise

• A common framework for harmonizing and A common framework for harmonizing and implementing multiple standardsimplementing multiple standards

• Enables seamless health information movement Enables seamless health information movement within and between enterprises, regions, nationswithin and between enterprises, regions, nations

• Promotes unbiased selection and coordinated use Promotes unbiased selection and coordinated use of established healthcare of established healthcare andand IT standards to IT standards to address specific clinical needsaddress specific clinical needs

Standards: Necessary…Not Sufficient

• Standards areStandards are– Foundational - to interoperability and communicationsFoundational - to interoperability and communications– Broad - varying interpretations and implementationsBroad - varying interpretations and implementations– Narrow - may not consider relationships between Narrow - may not consider relationships between

standards domainsstandards domains– 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

IHE provides a standard process for IHE provides a standard process for implementing multiple standardsimplementing multiple standards

IHE: Connecting Standards to Care

• Healthcare professionals working with industryHealthcare professionals working with industry• Coordinate implementation of standards to meet Coordinate implementation of standards to meet

clinical and administrative needsclinical 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

IHE: A forum for agreeing on how to implement IHE: A forum for agreeing on how to implement standards and processes for making it happenstandards and processes for making it happen

Integrating the Healthcare Enterprise

““Achieving Interoperability through Implementation of Standards”Achieving Interoperability through Implementation of Standards”

1997: Founded in Radiology (RSNA) and IT (HIMSS)1997: Founded in Radiology (RSNA) and IT (HIMSS)• Many professional societies (stakeholder Many professional societies (stakeholder

representation)representation)– American Academy of Ophthalmology (AAO)American Academy of Ophthalmology (AAO)– American College of Cardiology (ACC)American College of Cardiology (ACC)– American College of Physicians (ACP)American College of Physicians (ACP)– American College of Clinical Engineering (ACCE) American College of Clinical Engineering (ACCE) – American College of Emergency Physicians (ACEP) American College of Emergency Physicians (ACEP) – American Society for Therapeutic Radiation Oncology (ASTRO)American Society for Therapeutic Radiation Oncology (ASTRO)– GMSIH (IT France), JAHIS (IT Japan), SFIL (laboratory)GMSIH (IT France), JAHIS (IT Japan), SFIL (laboratory)– Healthcare Information Management Systems Society (HIMSS)Healthcare Information Management Systems Society (HIMSS)– Radiological Society of North America (RSNA)Radiological Society of North America (RSNA)– And many more….And many more….

IHE Participants and Relationships

• Participants include:Participants include:– Users - Clinicians, Staff, Administrators, CIOs, Governments (e.g. Users - Clinicians, Staff, Administrators, CIOs, Governments (e.g.

NIST, VA).NIST, VA).– Vendors - Information Systems and EquipmentVendors - Information Systems and Equipment

• e.g., imaging, cardiology, devicese.g., imaging, cardiology, devices

– ConsultantsConsultants

• Relationship with Standards Development Organizations Relationship with Standards Development Organizations (SDOs):(SDOs):– HL7, DICOM, ISO, CDISC, ASTM, W3C, IEEE, IETF, and many HL7, DICOM, ISO, CDISC, ASTM, W3C, IEEE, IETF, and many

othersothers

• Approved via ISO/TC 215 allowing for IHE profiles to be Approved via ISO/TC 215 allowing for IHE profiles to be published as ISO deliverablespublished as ISO deliverables

IHE Organizational Structure

ACCACPHIMSSRSNA

JAHISJIRAJRS

METI-MLHWMEDIS-DCJAMI

GMSIHSFRSFILACCE

SIRMBIREuroRec

COCIREAR-ECRDRG

ESC

Professional Societies / Sponsors Contributing &Participating

Vendors

IHE (International) Strategic Development Committee

Global Development

Radiology

Cardiology

ITInfrastructure

Patient CareCoordination

Patient CareDevices

Laboratory

Pathology

Pharmacy /Medication Admin

RadiationOncology

IHE Europe

IHE North America

France

USA

Canada

IHE Asia-Oceania

Japan

Korea Taiwan

Netherlands

Spain Sweden UK

ItalyGermany

Norway

Regional Deployment

China

International Adoption of IHE

FranceUSA

Germany

Italy

JapanUK

Canada

Korea

Taiwan

Norway

Holland

SpainChina

Yea

r 1

(199

9)

Yea

r 2

(200

0)

Yea

r 3

(200

1)

Yea

r 4

(200

2)

Yea

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(200

3)

Yea

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(200

4)

Yea

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(200

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Yea

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6)

IHE based Regional and National EHR Projects (Operational and Planned)

Toronto, Quebec, Alberta, BCCanada Infoway

Austria

THINC- New YorkNCHICA – N. Carolina

Italy (Conto Corrente Salute)

MA-Share – MA

FranceDMP

Philadelphia

HIE

CHINA-MoHLab results sharing

New York HIE

Proven Standards Adoption Process

Document Use Case RequirementsDocument Use Case Requirements

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 technical specifications

Develop technical specifications

Testing at ConnectathonsTesting at Connectathons

IHEDemonstrationsIHEDemonstrations

Products with IHEProducts with IHE

Timely access to informationTimely access to information

Easy to integrate productsEasy to integrate products

Growth in IHE Domains

Radiology (18)

IT Infrastructure for Healthcare (17)

Cardiology (7)

Laboratory (6)

Radiation Oncology (1)

Patient Care Coordination (5)

Patient Care Devices (1)

Quality

Eye Care (3)

VeterinaryEndoscopyPathologyPharmacy

Ye

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1

(19

99

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Ye

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2

(20

00

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Ye

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(20

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Ye

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(20

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Ye

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(20

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Ye

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(20

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(20

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(20

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)

Ye

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(20

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)

• Over 100 vendors involved world-wideOver 100 vendors involved world-wide• 8 Technical Frameworks8 Technical Frameworks• 58 Integration Profiles58 Integration Profiles

•Testing at “Connectathons” worldwideTesting at “Connectathons” worldwide• Demonstrations at major conferences worldwideDemonstrations at major conferences worldwide

•Clinical Departments:Clinical Departments:•Radiology, Cardiology, Lab,…Radiology, Cardiology, Lab,…

•Across Departmental &Across Departmental & Institutional Boundaries – XDS Institutional Boundaries – XDS

•RHIOs, HER EnablersRHIOs, HER Enablers

IHE Integration Profiles for Health Info Nets What is available and has been added in 2006/07

Cross-Enterprise Document Sharing

Registration, distribution and access across health enterprises of clinical

documents forming a patient

electronic health record

Emergency Referrals Format of the Document Content

and associated coded vocabulary PHR Extracts/Updates

Format of the Document Content and associated coded vocabulary

ECG Report Document


Lab Results Document Content


Scanned Documents Format of the Document ContentImaging Information


Medical Summary (Meds, Allergies, Pbs)

Format of the Document Contentand associated coded vocabulary

Consistent TimeCoordinate time across networked

systems

Audit Trail & Node Authentication

Centralized privacy audit trail and node to node authentication to create

a secured domain.

Basic Patients Privacy Consents

Establish Consents & Enable Access Control

Document Digital Signature

Attesting “true-copy and origin

SecuritySecurityClinical and PHR ContentClinical and PHR Content

Health Data ExchangeHealth Data Exchange

Patient Demographics Query

Patient Identifier Cross-referencing

Map patient identifiers across independent identification

domains

Notification of Document Availability

Notification of a remote provider/ health enterprise

Request Formfor Data Capture

External form with custom import/export scripting

Patient ID MgmtPatient ID Mgmt

OtherOther

Cross-Enterprise Document Pt-Pt Reliable Interchange

Final Text ApprovedFinal Text Approved

Trial Implementation-2006 Trial Implementation-2006 –– Final Txt 2007Final Txt 2007

Cross-Enterprise Document Media Interchange

Compliance with US National Health Info NetHITSP Interoperability Specs and CCHIT RoadmapHITSP Interoperability Specs and CCHIT Roadmap

Patient Demographics Query

Patient Identifier Cross-referencing

Map patient identifiers across independent identification

domains

Cross-Enterprise Document Sharing

Registration, distribution and access across health enterprises of clinical

documents forming a patient

electronic health record

Cross-Enterprise Document Media Interchange

Emergency Referrals Format of the Document Content

and associated coded vocabulary PHR Extracts/Updates


ECG Report Document


Lab Results Document Content


Scanned Documents Format of the Document ContentImaging Information


Medical Summary (Meds, Allergies, Pbs)

Format of the Document Contentand associated coded vocabulary

Patient ID MgmtPatient ID Mgmt

Consistent TimeCoordinate time across networked

systems

Audit Trail & Node Authentication

Centralized privacy audit trail and node to node authentication to create

a secured domain.

Basic Patients Privacy Consents

Establish Consents & Enable Access Control

Document Digital Signature

Attesting “true-copy and origin

SecuritySecurityClinical and PHR ContentClinical and PHR Content

Health Data ExchangeHealth Data Exchange

Notification of Document Availability

Notification of a remote provider/ health enterprise

Request Formfor Data Capture

External form with custom import/export scripting

OtherOther

Cross-Enterprise Document Reliable Interchange

Accepted by HITSP in 2006Accepted by HITSP in 2006

Candidate for HITSP & CCHIT in 07Candidate for HITSP & CCHIT in 07

How to Participate

As a User or Vendor Committee MemberAs a User or Vendor Committee Member• Become a member of a Domain’s Planning or Become a member of a Domain’s Planning or

Technical CommitteesTechnical Committees

As a User, Consultant or Vendor Interested As a User, Consultant or Vendor Interested ObserverObserver

• Provide Public Comments on Technical Provide Public Comments on Technical Framework SupplementsFramework Supplements

• Attend Demonstrations, Educational Events and Attend Demonstrations, Educational Events and WorkshopsWorkshops

How to Use IHE

As a Vendor ImplementerAs a Vendor Implementer• Implement IHE Integration ProfilesImplement IHE Integration Profiles• Test systems through Connectathon processTest systems through Connectathon process• Publish an IHE Integration Statement for productsPublish an IHE Integration Statement for products

As a User Implementer or ConsultantAs a User Implementer or Consultant• Use IHE Integration Profiles to develop Use IHE Integration Profiles to develop

interoperability strategyinteroperability strategy• Use Connectathon Results and Integration Use Connectathon Results and Integration

Statements to evaluate vendorsStatements to evaluate vendors• Demand IHE Integration Profile compliance in RFPsDemand IHE Integration Profile compliance in RFPs

Brought toBrought toyou by…you by…

Debuting this year in the Showcase…

• Secured Health Information Secured Health Information Exchange with broad contentExchange with broad content

• New Directions Focus (Life New Directions Focus (Life Sciences [Bio-Pharma], PIX/PDQ Sciences [Bio-Pharma], PIX/PDQ v3.0, ELINCS Lab)v3.0, ELINCS Lab)

• HITSP Interoperability HITSP Interoperability SpecificationsSpecifications

• Clinical data exchange amongst Clinical data exchange amongst patient care devicespatient care devices

20072007 20062006

Vendors Vendors ConnectedConnected 5151 3535

SupportersSupporters 1616 1414

Other Other participantsparticipants 99 1212

TotalTotal 7676 6161• Personal health record solutionsPersonal health record solutions

• Financial and administrative systems for billing and claims Financial and administrative systems for billing and claims attachments (CAQH/CORE)attachments (CAQH/CORE)

• Clinical scenarios focusing on clinician and patient access, and Clinical scenarios focusing on clinician and patient access, and information sharing across the full continuum of careinformation sharing across the full continuum of care

A Growing CastA Growing Cast

Community Community Network BNetwork B

Document Registry

PracticePracticePractice

ClinicClinicClinicClinic

HospitalsHospitalsHospitalsHospital

Diag Test

Other

PracticePractice HospitalHospital

Community Community Network CNetwork C

Document Registry

PracticePractice

Clinic

Hospitals

Hospitals

HIMSS Interoperability ShowcaseThe largest multi-vendor prototype ever built !The largest multi-vendor prototype ever built !

18 edge systems18 edge systems4 infrastructure systems4 infrastructure systems

5 edge systems 5 edge systems 4 infrastructure systems4 infrastructure systems

13 edge systems13 edge systems3 infrastructure systems3 infrastructure systems

3 infrastructure3 infrastructuresystemssystems

Community Community Network ANetwork A

Document Registry

PracticePracticePracticePracticePractice

ClinicClinicClinicClinic

HospitalsHospitalsHospitals

Diag Test

G

Your Guide to the Showcase Theatre

supported by: Infrastructure

• Patient Identity ManagementPatient Identity Management– incl. New Directions – using HL7v3incl. New Directions – using HL7v3

• XDS Document RegistriesXDS Document Registries

• XDS Document RepositoriesXDS Document Repositories

• Audit RepositoryAudit Repository

…and also starring

• HITSP Theater (M)HITSP Theater (M)– Showcasing breakthrough use cases and public health Showcasing breakthrough use cases and public health

protectionprotection

• ELINCS Theater (N)ELINCS Theater (N)– Interoperability between EHR & LabInteroperability between EHR & Lab

• CAQH Theater (M)CAQH Theater (M)– Interoperability between Provider & Health PlanInteroperability between Provider & Health Plan

• Life Sciences (L)Life Sciences (L)– New Directions bridging research/surveillance and EHR’sNew Directions bridging research/surveillance and EHR’s

• Standards Area – Standards Area – HL7, ISO, CDISC, NIST, HITSP, CAQHHL7, ISO, CDISC, NIST, HITSP, CAQH

…held over from last season

The “Distributed Demo”The “Distributed Demo”

The first 200 people to return a fully-The first 200 people to return a fully-stamped “autograph sheet” to the stamped “autograph sheet” to the Showcase reception kiosk will win a Showcase reception kiosk will win a IHE USB key!!IHE USB key!!

What happens next?

• Docents will guide you to a story/act/cast, Docents will guide you to a story/act/cast, each demonstrating interoperabilityeach demonstrating interoperability

OROR

• A presentation begins immediately in this A presentation begins immediately in this theatretheatre

Providers and VendorsProviders and Vendors

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

http://www.ihe.net/