HIMSS11_IHE.ITI_Update.v2 by zhouwenjuan

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									   IHE IT Infrastructure
     Domain Update


Karen Witting – IBM
IT Infrastructure Planning Committee co-
chair
       IT Infrastructure Domain (ITI)
• Supports profiles which supply necessary infrastructure
  for sharing healthcare information.

• IT Infrastructure domain began in 2003 and now has 27
  profiles that it supports.

• Key ITI profiles demonstrated today:
   – Information Exchange: XDS, XDM, XDS-SD, RFD
   – Security: ATNA, CT, XUA, BPPC
   – Identity Management: PIX, PDQ (HL7 V2 & V3)
 An Infrastructure Interoperability
          Component Is…

• An infrastructure Interoperability component…
  – Represents a common IT function or service that is used
    as a building block for a variety of use cases
  – May be imbedded in an application, but is often
    deployed as a shared resource within a Health
    Information Exchange
  – Is a necessary ingredient, but is rarely visible to the end
    user
          ITI Strategic Focus Categories
• Patient and Provider Identity
    – support the management of patient, provider and healthcare organization identity
      including their localization. This includes the ability to look up, cross-reference, update,
      remove, merge, link and general management of identities.
    – PIX, PDQ, PAM, PWP, XCPD, HPD, PIX/PDQ HL7 v3
• Health Record Sharing
    – support the ability to share patient specific healthcare information within and across
      Enterprises. This includes the ability to submit, locate/list, push, pull and retrieve patient
      specific healthcare information.
    – XCA, XDM, XDR, XDS, XDS-SD, MPQ, RID
• Security and Privacy
    – support the ability to ensure that healthcare information is managed consistent with a
      reasonable set of security and privacy policies .
    – ATNA, BPPC, XUA, DSG, EUA
• Workflow Enablers
    – support standard sequences for performing workflow activities.
    – DRR, DSUB, NAV, PSA, RFD
• Support Management
    – support the ability to share information needed for interoperable healthcare
      management such as clinical coding, technical or IT management information
    – CT, SVS
Categories of Healthcare Communication Services
 Exchange of Health Information                                 Hospitals
e.g. access last 6 mo.    e.g. get current list of    e.g. order lab test, track
   historical labs &       allergies or med list     status and receive results
encounter summaries            from source

  Source persisted             Specific info             2 or more entities
 and attested health            snapshot                    synchronize
      records              provided on demand                  a task

     Document             Dynamic Information               Workflow
      Sharing                  Access                      Management

                 Patient and Provider Identity Management
                              Security/Privacy
•   Security/Privacy            ITI Profiles
     – Cross-Enterprise User Assertion (XUA) ☼
     – Basic Patient Privacy Consents (BPPC) ☼
     – Enterprise User Authentication (EUA)
     – Consistent Time (CT) ☼
     – Audit Trail and Node Authentication (ATNA) ☼
     – Document Digital Signature (DSG)
•   Identify Management
     – Personnel White Pages (PWP)
     – Patient Identifier Cross-Referencing (PIX)☼
     – Patient Demographics Query (PDQ) ☼
     – Patient Identifier Cross-Referencing HL7 V3 (PIX V3)☼
     –   Patient Demographics Query HL7 V3 (PDQ V3) ☼
     –   Patient Administration Management (PAM)
     –   Pediatric Demographics Option
     –   Cross-Community Patient Discovery (XCPD) ☼
     –   Healthcare Provider Directory (HPD) ☼
▀ colored text designates 2010 new and updated profiles
☼ Designates profiles being demonstrated at HIMSS Interoperability Showcase 2011
                 ITI Profiles (continued)
•   Information Exchange
     –   Cross-Enterprise Document Sharing - b (XDS.b) ☼
     –   Cross-Enterprise Sharing of Scanned Documents (XDS-SD) ☼
     –   Cross Community Access (XCA) ☼
     –   Document Metadata Subscription (DSUB) ☼
     –   Multi-Patient Queries ☼
     –   Cross-Enterprise Document Media Exchange (XDM) ☼
     –   Cross-Enterprise Document Reliable Interchange (XDR)
     – Notification of Document Availability (NAV)
     – Retrieve Form for Data Capture (RFD) ☼
     – Retrieve Information for Display (RID)
     – Patient Synchronized Applications (PSA)
     – XDS Metadata Update
     – On-Demand Documents
     – Delayed Document Assembly
•   Terminology
     – Sharing Value Sets

▀ colored text designates 2010 new and updated profiles
☼ Designates profiles being demonstrated at HIMSS Interoperability Showcase 2011
          XDS Scenario + Use of ATNA & CT

              EHR System PMS

       Physician Office                                                                                            ED Application

                                    XDS
                                    Document                              XDS
                                    Repository                            Document
                                                                          Registry                          PACS
                                                                                          XDS
                                                                                     Document
                                                                                     Repository
                                          Query Document              Register Document


PACS
                                        Secured Messaging                                                                EHR System
                                                          Retrieve Document                                        Provide & Register Docs
                      Lab Info.                                                Maintain Time
                      System
                                                                                            Maintain         Teaching Hospital
                                  Record Audit
       Community Clinic                                           Maintain                   Time
                                     Event
                                                   ATNA Audit      Time
                                                 record repository         CT Time server
                              Record Audit                                                   Record Audit
                                 Event                                                          Event
Document Content & Modes of Exchange
                Document Content Profiles
            Pre         Consent      Emergency          Scanned Doc
          Surgery
                        BPPC          EDR               XDS-SD
         PPH P
 Laboratory         Imaging               Discharge &              PHR
                                           Referrals             Exchange
XD*-Lab             XDS-I                 XDS-MS                 XPHR


     Document            Reliable          Media          Cross-Community
      Sharing          Interchange      Interchange            Access
       XDS                XDR             XDM                  XCA
      Document Exchange Integration Profiles
         XDS Scenario + Use of PIX & PDQ
PDQ Query to Acquire Affinity Domain
                                                                                          Patient Identity Feed
Patient ID                                            Patient Identity XRef Mgr
                                                                                                       Patient Identity Feed
                                                                    A87631
                                                               M8354673993
                                                      M8354673993            14355
           M8354673993

                                                    L-716           L-716       A87631


                                                            Affinity Domain Patient
               EHR System
                                                                     Identity Source
                                                 M8354673993                                                     ED Application
        Physician Office
                Patient Identity Feed                    Patient Identity Feed


                                                                                       PIX
                                       XDS                                    Document                    PACS
                                       Document                                        Query
                                                                              Registry                                            A87631
                                       Repository
                  L-716
                                               PIX
                                                                                              XDS
                                              Query                                      Document
                                                                                         Repository
                                                                                                                       EHR System
 PACS                                 Query Document (using Pt Id)             Register (using Pt ID)

 PACS                                                    Retrieve Document
                                                                                                            Provide & Register Docs
                          Lab Info.
                          System
                                                                                                           Teaching Hospital
        Community Clinic
                                                 ATNA Audit
                                               record repository             CT Time server
                                              Cross-Community
                            Demonstrating Sharing across regional boundaries
        NEW YORK

             Document
              Registry                                                                                     ILLINOIS
                                              XCPD / XCA / XDR transactions                                Document
Practice
 Practice                Hospitals
  Practice                Hospitals                                                                         Registry
   Practice                Hospitals
    Practice                Hospital
                             Hospital
                              Hospital
                                         Gateway
               Patient ID
               services                                                                        Practice
 Clinic
  Clinic                                                                       Gateway          Practice
                                                                                                 Practice
                                                                                                  Practice
                                                                                                                       Hospitals
                                                                                                                        Hospitals
                                                                                                                         Hospitals
   Clinic
    Clinic           Repository
                      Repository
                                                                                                             Patient ID
                                                                                                             services
                                                                                                 Clinic
                                                                                                  Clinic
                                                                                                                    Repository
                                                                                                                     Repository
         NORTH CAROLINA
                                               Gateway                 Gateway
                    Document
                     Registry
                                                                        CALIFORNIA

                                                                               Document
       Practice
        Practice                Hospitals                                       Registry
         Practice                Hospitals
                                  Hospitals
                      Patient ID
                      services                                    Practice
                                                                   Practice                Hospitals
        Clinic                                                      Practice
                                                                     Practice               Hospitals
                                                                                             Hospitals
                                                                      Practice                Hospital
                                                                                               Hospital
                                Repository                                                      Hospital
                                                                                 Patient ID
                                                                                 services
                                                                   Clinic
                                                                    Clinic
                                                                     Clinic
                                                                      Clinic           Repository
                                                                                        Repository
       2010 Committee Activities
• ITI Technical committee 2010
   – Delivered 2010 versions of Technical Framework and Supplements
       • Processing of numerous Change Proposals (CPs)
       • Integration of CPs into 2010 versions of documentation
   – Delivered new supplements
       •   Healthcare Provider Directory (HPD)
       •   Cross-Enterprise User Assertion - Attribute Extension (XUA++)
       •   XDS Metadata Update
       •   SVS Extension
       •   On-Demand Documents
       •   Delayed Document Assembly
• ITI Planning Committee 2010
   – ITI Strategic Planning
       • Definition of ITI Categories
       • Development of Liaisons and Outreach plan
   – Selection of new work for 2011
       • review proposals and identify new work for each development cycle
       IHE ITI Completed Work for 2010
•   Healthcare Provider Directory (HPD)
     – Supports interoperable feed and query transactions for healthcare provider
        information
     – Supports individual and organizational providers
     – Transactions are based on LDAP and DSML
•   Cross-Enterprise User Assertion - Attribute Extension (XUA++)
     – Extends XUA based on feedback on attributes
     – Adds attributes supporting Role-Based-Access Control , Consent/Authorization, Purpose of
       Use and general descriptive attributes
•   XDS Metadata Update
     – Enables update and deletion of metadata in the XDS/XCA/XDR profiles
•   SVS Extension
     – Update integrated directly into SVS supplement
     – adds value set metadata and search capability in support of publication and distribution of
       value sets.
•   On-Demand Documents
     – Supports sources of healthcare data which prefer to build most up-to-date document
       content at the time of retrieve, on-demand
•   Delayed Document Assembly
     – Allows source systems to register the existence of stable document content but defer
       actually assembling the document content only if and when it is retrieved. This approach is
       adopted for efficiency reasons.
        2011 Committee Activities
• ITI Technical Committee
  – New Supplements/Handbook For 2011 (next chart)
  – Change Proposal processing
  – Delivery of 2011 updated version of Technical Framework
    and prior year Supplements
• ITI Planning Committee
  – Preparation of Educational Material – development of
    reusable PPT decks on key ITI topics
  – Strategic Planning and Liaison Activity – build liaisons with
    other IHE committees
  – Selection of Trial Implementation Supplements to become
    Final Text Profiles
  – Selection of new work for 2012
           IHE ITI New Work for 2011
• XDS Affinity Domain Patient Identifier Change Management
  (XPID)
   – Communication of link, unlink and merge events to XDS Document
     Registry
• Cross-Enterprise Document Workflow (XDW)
   – Tracking the steps of workflows to support care coordination and clinical
     pathways
• XCA Query and Retrieve
   – Combining XCA Query and XCA Retrieve transactions
• Direct Project use of XDS Metadata
   – Adjustment of XDS metadata requirements when used in XDR and
      XDM environments with minimal metadata knowledge
• Document Encryption
   – Standard mechanism for encrypting health documents
• Pseudonymisation and De-Identification in IHE Profiles
  (Handbook)
   – Providing guidelines to industry on the application of pseudonymisation
IHE IT Infrastructure Schedule for 2011


• Development Schedule:
  •   Planning Committee decision ……… December 2010
  •   Issue Public Comment version …….. May 2011
  •   Public Comment Due ……………….. June 2011
  •   Issue Trial Implementation version … August 2011
  •   IHE Connectathon …………………… January 2012
  •   HIMSS Demo ………………………… February 2012
Learn More and Start to Participate
• Join the ITI Planning Committee at
  our HIMSS 11 Recruitment Meeting
  –Meet key IT Infrastructure Committee
   participants
  –Q&A on any ITI related topic
  –Tuesday 10:30 – 11:30 Room 305 A&B
• Q&A

								
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