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HL7 New-Zealand- IHE and XDS-V3

VIEWS: 71 PAGES: 54

  • pg 1
									                  Overview of
  Integrating the Healthcare Enterprise (IHE)
and Cross-Enterprise Document Sharing (XDS)



 Charles Parisot, GE healthcare
 International HL7 Interoperability Conference,
 Auckland, New Zealand

 September, 2005                                  What IHE Delivers
     Presentation Objectives
Standards adoption and implementation – The
IHE process
Application to a hospital project
Application to regional and national Health
Information Exchange
World-wide deployment of IHE IT Infrastructure
Profiles




                                              1
 IHE: A Framework for Interoperability

A common framework for harmonizing the use,
implementing and testing multiple standards
Enables seamless health information movement
within and between enterprises, regions, nations
Promotes unbiased selection and coordinated use
of established healthcare and IT standards to
address specific clinical and administrative needs
at the international and country levels:
 HL7, DICOM, W3C, ISO, IEEE, SNOMED, LOINC,
  ASTM, OASIS, IETF, CDISC, CEN, ECMA, WHO, ETSI,
  and many more, etc.
                                               2
     Standards Adoption Process
                       Testing at
                       Connectathons   IHE
           Develop                     Demonstrations
          technical
      specifications
                                                   Products
Identify available                                 with IHE
standards (e.g. HL7,
DICOM, IETF, OASIS)




                  Timely access to
Document Use Case information             Easy to integrate
                                                        3
Requirements                              products
IHE Participants and Relationships
Sponsorship: Healthcare Professional Organizations
Open World-wide - Participants include:
 Users - Clinicians, Staff, Administrators, CIOs,
  Governments.
 Vendors - Information Systems and Equipment
   •   e.g., EMR/EHR, imaging, cardiology, devices
 Consultants
Maintains formal liaison with Standards
Development Organizations (SDOs):
 HL7, DICOM, ISO (Liaison D), others
ISO TC215 approved IHE Process and Profiles to be
published as technical reports
                                                     4
                   IHE Organizational Structure
               IHE (International) Strategic Development Committee

   Regional Deployment                                       Global Development

  IHE North America                   IHE Asia


                                   China     Japan        Radiology            IT           Laboratory
 Canada
                                                                         Infrastructure
               USA                 Korea    Taiwan


                                                          Cardiology     Patient Care        Pathology
   IHE Pacific ?       New Zealand ?       Australia ?                   Coordination


                   IHE Europe
                                                          Radiation      Patient Care        Eye care,
   France    Germany       Italy     Netherlands          Oncology         Devices          Quality, etc.

   Norway          Spain       Sweden        UK




Professional Societies / Sponsors                                                    Contributing &
  ACC                  GMSIH        COCIR   SIRM    ESC   JAHIS   METI-MLHW           Participating
  ACP                  SFR          EAR-ECR BIR           JIRA    MEDIS-DC
  HIMSS                SFIL         DRG     EuroRec
                                                                                        Vendors
                                                          JRS     JAMI
  RSNA
                                                                                                  5
                    International Adoption of IHE
             Local Deployment
             National Extensions (Local Adaptions)                                                     China
                                                                                           Spain
             Promotional & Live Demonstration Events
             Conformance Testing                                                        Holland

                                                                                  Norway
                                                                          Taiwan
                                                                         Korea
                                                                       Canada
                                                              UK
                                                      Japan
                                                    Italy
                                               Germany
                                         France
              USA




                                                                                                   (2005)




                                                                                                                (2006)
                                                                                                                Year 8
                                                                                                   Year 7
 (1999)




                    (2000)




                                (2001)




                                                 (2002)




                                                              (2003)




                                                                                (2004)
 Year 1




                    Year 2




                                Year 3




                                                 Year 4




                                                              Year 5




                                                                                Year 6
Pragmatic global standards harmonization + best practices sharing
                                                           6
Standards: Necessary…Not Sufficient
  Standards are
   Foundational - to interoperability and communications
   Broad - varying interpretations and implementations
   Narrow - may not consider relationships between
    standards domains
   Plentiful - often redundant or disjointed
   Focused - standards implementation guides focus only
    on a single standard

      IHE provides a standard process for
        implementing multiple standards
                                                          7
  IHE: Connecting Standards to Care
  Healthcare professionals work with industry
  Coordinate implementation of standards to
  meet clinical and administrative needs
    Clinicians and HIT professionals identify the key
     interoperability problems they face
    Providers and industry work together to develop and
     make available standards-based solutions
    Implementers follow common guidelines in
     purchasing and integrating effective systems

IHE: A forum for agreeing on how to implement
standards and processes for making it happen
                                                         8
            IHE Connectathons
                Connectathons 2007: 430
                engineers, 80+ organizations,
                160+ systems and applications
                ….integrated in 5 days




Vendors do not pass…
until an IHE Project Manager attest it !   9
          Stakeholder Benefits
Healthcare providers and support staff
   Improved workflows
   Information whenever and wherever needed
   Fewer opportunities for errors
   Fewer tedious tasks/repeated work
   Improved report turnaround time
Vendors
 Align product interoperability with industry consensus
 Decreased cost and complexity of interface installation and
  management
 Focus competition on functionality/service space not information
  transport space
SDOs
 Rapid feedback to adjust standards to real-world
 Establishment of critical mass and widespread adoption


                                                                10
                                          Growth in IHE Domains
IHE Global Developments
Integration Profiles (# X) – Solutions to Real-World Interoperability                                                                                                                 Veterinary
                                                                                                                                                                                      Endoscopy
                                    Needs & Problems:                                                                                                                                 Pharmacy


 Within Clinical                         Departments e.g.:                                                                                                                            Quality

                 Radiology                                                                                                                                          Pathology (1)
                 Cardiology                                                                                                                              Patient Care Devices (1)
                 Lab
                                                                                                                                              Patient Care Coordination (5)
                 ...
                                                                                                                                              Radiation Oncology (1)
 Across                 Departmental &
                                                                                                                                                   Eye Care (3)
                Institutional Boundaries – XDS
                 RHIOs (Regional Healthcare                Information Organizations)                                                        Laboratory (6)
                 EHR Enablers                                                                                                                Cardiology (7)

                                                                                                                 IT Infrastructure for Healthcare (17)

                                                                                      Radiology (18)
                                                                                         Year 5 (2003)




                                                                                                         Year 6 (2004)




                                                                                                                                                     Year 8 (2006)




                                                                                                                                                                      Year 9 (2007)
                                                                      Year 4 (2002)




                                                                                                                              Year 7 (2005)
Year 1 (1999)




                          Year 2 (2000)




                                            Year 3 (2001)




                                                                                                                                                                                11
     Presentation Objectives
Standards adoption and implementation – The
IHE process
Application to a hospital project:
 Two examples,: devices and radiology
Application to regional and national Health
Information Exchange
World-wide deployment of IHE IT Infrastructure
Profiles



                                              12
IHE PCD Technical Framework
     Volume1 Integration Profiles




                                    13
IHE PCD Technical Framework
     Volume 2 Transactions




                              14
Device Enterprise Communication
          (DEC) Profile




                                  15
   DEC Profile Mapping Model

Periodic physiologic data (heart rate, invasive
blood pressure, respiration rate, etc.),
A-periodic physiologic data (non-invasive
blood pressure, patient weight, cardiac output, etc.)
Point-of-care laboratory tests (i.e. home blood
glucose, etc.)
May include contextual data such as the
patient ID, caregiver identification, and patient care
device configuration information



                                                         16
  DEC Profile Mapping Model

ISO/IEEE 11073 Domain Information Model
and Nomenclature mapped to HL7
Observation Report

ISO/IEEE 11073 Data Types mapped to
HL7 Data Types

Mapping preserves measurement context
for complex devices.



                                        17
Measurement Context is Dynamic




                             18
IEEE 11073 Domain Information Model
       Defines Device Context
                           1
                               0
                               .
                               .
                               n




                                   19
Mapping preserves measurement context




                                   20
                   Example PCD-01 Message
MSH|^~\&|INFO_SRC_PHILIPS^ACDE48234567ABCD^EUI-64||||20061215153500||ORU^R01^ORU_R01|PMS116621490051|
     P|2.5|||NE|AL||8859/1
PID|||AB60001^^^Philips Medical^PI||Brooks^Albert^^^^^L||19610101|M
PV1||I|UNIT_1^^Bed1
OBR|1|PMS116621490051^INFO_SRC_PHILIPS^ACDE48234567ABCD^EUI-64|
     PMS116621490051^INFO_SRC_PHILIPS^ACDE48234567ABCD^EUI-64|
     69837^MDC_DEV_METER_PHYSIO_MULTI_PARAM_MDS^MDC|||20061215153500
OBX|1|ST|184326^MDC_ECG_STAT_ECT^MDC|1.5130.1.184326|""||||||F
OBX|2|ST|184327^MDC_ECG_STAT_RHY^MDC|1.5130.1.184327|Sinus Rhythm||||||F
OBX|3|NM|150456^MDC_PULS_OXIM_SAT_O2^MDC|1.5238.1.150456|99|262688^MDC_DIM_PERCENT^MDC|||||F
OBX|4|NM|147842^MDC_ECG_HEART_RATE^MDC|1.5130.1.147842|81|264864^MDC_DIM_BEAT_PER_MIN^MDC|||||F
OBX|5|NM|150037^MDC_PRESS_BLD_ART_ABP_SYS^MDC|1.5190.1.150036|126|266016^MDC_DIM_MMHG^MDC|||||F
OBX|6|NM|150038^MDC_PRESS_BLD_ART_ABP_DIA^MDC|1.5190.1.150036|76|266016^MDC_DIM_MMHG^MDC|||||F
OBX|7|NM|150039^MDC_PRESS_BLD_ART_ABP_MEAN^MDC|1.5190.1.150036|92|266016^MDC_DIM_MMHG^MDC|||||F
OBX|8|NM|148065^MDC_ECG_V_P_C_CNT^MDC|1.5130.1.148065|0|264864^MDC_DIM_BEAT_PER_MIN^MDC|||||F
OBX|9|NM|150045^MDC_PRESS_BLD_ART_PULM_SYS^MDC|1.5190.1.150044|26|266016^MDC_DIM_MMHG^MDC|||||F
OBX|10|NM|150046^MDC_PRESS_BLD_ART_PULM_DIA^MDC|1.5190.1.150044|9|266016^MDC_DIM_MMHG^MDC|||||F
OBX|11|NM|150047^MDC_PRESS_BLD_ART_PULM_MEAN^MDC|1.5190.1.150044|14|266016^MDC_DIM_MMHG^MDC|||||F
OBX|12|NM|149538^MDC_PLETH_PULS_RATE^MDC|1.5238.1.149538|55|264864^MDC_DIM_BEAT_PER_MIN^MDC|||||F
OBX|13|NM|150067^MDC_PRESS_BLD_ATR_LEFT_MEAN^MDC|1.5190.1.150064|4|266016^MDC_DIM_MMHG^MDC|||||F
OBX|14|NM|150087^MDC_PRESS_BLD_VEN_CENT_MEAN^MDC|1.5190.1.150084|12|266016^MDC_DIM_MMHG^MDC|||||F




                                                                                               21
  IHE PCD - US 2007 Connectathon Systems
  ADT          CT (Time)
                                                                                                                                            MWB
A04 Feed        Feed


                                                                            GE                                 Philips
DOC                           LiveData
                                                                        Centricity                            CareVue
                              OR Mgr
                                                                        Periop CIS                              CIS




           Validated Vitals       Validated VS, Vent,      Unvalidated VS, Vent,   Unvalidated VS, Vent,    Validated VS, Vent,      Unvalidated Med
            export, Batch      Anesth & Med Export, max     Anesth. Data export     Anesth. Data export    Anesth & Med Export,      (Infusion System)
                                    every 3 minutes           every 1 minute          every 1 minute       max every 5 minutes    exported every 1 minute




       Welch Allyn              Draeger                    GE                      Philips                 Philips                B. Braun
DOR     Connex                 Innovian                   Aware                      IIC                   CareVue                DoseTrac
          CIS                     CIS                      GW                       GW                       CIS                     GW

                                Pt Mon, Vent,             Pt Mon, Vent,            Pt Mon, Vent,           Pt Mon, Vent,             Infusion
           VS Mon
                                 Anesthesia                Anesthesia               Anesthesia              Anesthesia                Devices

                                                                                                                                            22
Radiology Scheduled Workflow: Use Case


 Registration                                       Report
                                report
                                                   Repository


                                                                     Diagnostic      Film
                                                                     Workstation   Lightbox




    Orders Placed

                                                                                    Film
                                                                   Image Manager
                                                                                   Folder
                                                                     & Archive
                                               Acquisition
                                                Modality
                Orders Filled
                                                             acquisition
                                                             completed
                                acquisition                                        Film
                                in-progress
                                 completed                         images
                                                                   printed
                                              Modality                             23
                                                                To find IHE Profiles:
                                             www.ihe.net /technical_frameworks
IHE Global Developments
                                                                                                                                                                                   Veterinary
Over 60 Integration and content Profiles (# X)                                                                                                                                     Endoscopy
Solutions to Real-World Interoperability                                                                                                                                           Pharmacy

                                 Needs & Problems:                                                                                                                                  Quality

 Within Clinical Departments                                    e.g.:                                                                                            Pathology (1)
                  Radiology                                                                                                                           Patient Care Devices (1)
                  Cardiology
                  Lab                                                                                                                     Patient Care Coordination (5)
                  ...                                                                                                                     Radiation Oncology (1)
 Across Departmental                 &                                                                                                         Eye Care (3)
                Institutional Boundaries – XDS
                                                                                                                                           Laboratory (6)
                  RHIOs (Regional Healthcare Information Organizations)
                  EHR Enablers                                                                                                            Cardiology (7)

                                                                                                              IT Infrastructure for Healthcare (17)

                                                                                     Radiology (18)
                                                                                      Year 5 (2003)




                                                                                                      Year 6 (2004)




                                                                                                                                                  Year 8 (2006)




                                                                                                                                                                   Year 9 (2007)
                                                                     Year 4 (2002)




                                                                                                                           Year 7 (2005)
Year 1 (1999)




                             Year 2 (2000)




                                                Year 3 (2001)




                                                                                                                                                                           24
     Presentation Objectives
Standards adoption and implementation – The
IHE process
Application to a hospital project
Application to regional and national Health
Information Exchange
World-wide deployment of IHE IT Infrastructure
Profiles




                                              25
      Health Information Exchanges:
Linking diverse Care Delivery and Personal Health Records



      Integrated Care
      Delivery EMR’s                        Hospital
                                                       Personal Health
                                                           Record
                    Hospital
                     Group                                 Lab/pathology
                                        Health              Radiology
                                     Information
                                                              Pharmacy
                                      Exchange
                                                            Physician
                                                             Offices
                        Hospital                          Multi-
                                                       Practitioner
                                            Hospital     Clinics
                                Specific
                                             Group
                               Registries




                                                                           26
     Roles of Integrated Care Delivery EMRs
       and Health Information Exchanges

   Integrated Care Delivery EMR:
      •   Serves one care delivery organization or a set of closely integrated
          organizations.
      •   Cohesive practice and IT strategy
      •   Strong emphasis on advanced clinical decision support and tight
          care delivery workflows
      •   Typical: in-patient, hospital groups, affiliated clinics, a GP/PCP office.
   Health Information Exchange (HIE):
      •   Serves multiple independent care delivery organizations
      •   Loosely coordinated IT strategy
      •   Strong emphasis on care coordination, longitudinal health
          information, access to specific services (referral, diagnosis, etc.),
          personal health management.
      •   Typical: from the small community (hospitals+nearby GPs and clinics) to
          the specialized, regional and national health information network


                                                                           27
Integrated Care Delivery EHRs and HIEs
   Why different but synergistic IT architecture approaches ?

                          Integrated Care Delivery EHR:
                           •   A centralized Clinical Data Repository with a fine
                               grained health information data model shared over the
                               entire organization.
                           •   A rich set of applications delivering the value of the
                               CDR, with:
                                •   clinical decision support consistent with CDR data models.
                                •   Proactive workflows, care plans.
                           •   Applications and CDR must evolve together.
                           Health Information Exchange (HIE):
                           •   Shared clinical data should be managed both
                               centralized and distributed to account for organizations
                               with different operational constraints.
                           •   Level of structure and coding in the shared data will lag
                               some of the Care Delivery EHRs (span of
                               standardization, installed base).
                           •   Longitudinal record consistency and depth, trust by
                               source attestation drives encapsulation of
                               encounter/service clinical data into documents.
                           •   Cost, ease of evolution and robustness of shared
                               infrastructure best served with Document
                               Repository/Registry.
                                                                                  28
                 Interoperability Dimensions for Health Info Nets
                                         Health
                    Security            Records           Dynamic           Workflow
                               Id Mgt                     Queries         Transactions
                    Privacy             Sharing
                                         Examples:       Immunization
                                                            Examples:           Examples:
                                                               History
   Content




                                        Care Record       Immunization       ePrescription
                                             Service          Queries
                                                            Medication
                                                               History        Laboratory
                                                            Medication      Order/Results
                                                               History
Infrastructure




                                                  From EHR Vendor Association Interop Roadmap:
                                                                                 www.ehrva.org
                                                                                      29
                 Interoperability Dimensions for Health Info Nets
                                           Health
                      Security            Records           Dynamic           Workflow
                                 Id Mgt                     Queries         Transactions
                      Privacy             Sharing
   Content
Infrastructure




                 HC


                 IT
                                                    From EHR Vendor Association Interop Roadmap:
                                                                                   www.ehrva.org
                                                                                        30
 Document Registry/Repository Model:
                      Document
                       Registry                 Submit
 Document
               Submit                           Doc Meta-data
 Repository
               Doc Meta-data                    + References
               + References
                               Query for Docs
                               References                       Document
                 Retrieve                                       Repository
                 Documents               Retrieve
                                         Documents      Document
                                                         Source

    Submit                      Document
   Documents                    Consumer


Document
 Source



                                                                        31
Health Information Exchanges Interoperability:
     Cross-enterprise Document Sharing

• Performance, Scalability and Cost: Registry and Repository
    are simple
•   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 a portal view, easy to
    integrate in applications
•   Supports centralized and distributed approaches. XDS
    Domains may be federated.
•   Real Interoperability: Standards and profiles in place 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
                                                           32
Example: Providing Access to Prior Health Information
                                             Longitudinal Record as used
  Shared Document                            across-encounters
  Repository                                                                   Public
                                                                               Health




                                                                   Long Term Care




                Acute Care
                (Inpatient)
                                             Other Specialized Care
                                             or Diagnostics Services


            PCPs and Clinics
            (Ambulatory)       Encounter Medical Summary (med-prescribed &
                               dispensed, allergies, pbs, etc)
                               Lab Report (structured & coded tests results)
                               Radiology Report and Images Links
                               EKG Report                                        33
                          IHE Profiles for Health Info Nets
                            Leverages HL7 V2 and V3
                 Security                        Record              Dynamic           Workflow
                                Id Mgt           Sharing             Queries         Transactions
                 Privacy
                                              Scanned Doc
                                              Imaging
Content




                                              Lab Reports
             HL7 V3 CDA                       Med Summary         Query            Request
                                              Personal             Existing
                                               Record Extract
                                                                                      Form for
                                              Emergency            Data (med,        Data
                                               Record               allegies,         capture
                  Consent
                                              Etc…                 immunizations,
                   Mgt
                  Digit Sign                                       etc.)
                   Docs
                                 Patient     Doc Sharing
                  Audit          Id X-ref    X-Community
                                 Patient
Infrastructure




                   Trail-Node                 Pt-Pt Doc Trf
                   Authentic      Demogra     Media Interchange
                   ation          phics
                  User           Query
                   Authentic
                   ation




                                             HL7 V3 (and V2) Messages                        34
Key Profiles for Document Content and Exchange

                     Doc Content Profiles
             Pre         Consent   Emergency   Scanned Doc
           Surgery
                         BPPC      EDER        XDS-SD
           PPHP
 Imaging             Laboratory         Discharge &            PHR
                                         Referrals           Exchange
 XDS-I           XD*-Lab
                                        XDS-MS               XPHR


      Doc Sharing               Pt-Pt Doc            Media
                              Interchange         Interchange
           XDS                    XDR                 XDM
       Doc Exchange Integration Profiles                         35
     IHE Patient Care Coordination
A family of HL7 V3 CDA-based documents content profiles




           Referral Summary Specification




                                                  36
     IHE Patient Care Coordination
A family of HL7 V3 CDA-based documents content profiles




             Current Meds




                                                  37
     IHE Patient Care Coordination
A family of HL7 V3 CDA-based documents content profiles




                                                  38
     IHE Patient Care Coordination
A family of HL7 V3 CDA-based documents content profiles




                                                  39
     IHE Patient Care Coordination
A family of HL7 V3 CDA-based documents content profiles




                           Medications




                                                  40
     IHE Patient Care Coordination
A family of HL7 V3 CDA-based documents content profiles




                                                  41
                        IHE Profiles for Health Info Nets
                      Common use of SOA & Web Services
                    Security                    Record              Dynamic           Workflow
                                   Id Mgt       Sharing             Queries         Transactions
                    Privacy
                                             Scanned Doc
                                             Imaging
Content




                                             Lab Reports
                                             Med Summary         Query
                                             Personal                              Request
                                              Record Extract       Existing          Form for
                                             Emergency            Data (med,        Data
                     Consent
                                              Record               allegies,         capture
                                             Etc…
                      Mgt                                          immunizations,
                     Digit Sign                                   etc.)
                      Docs
                                   PIX      Doc Sharing
                     Audit                  X-Community
                                   PDQ
Infrastructure




                      Trail-Node             Pt-Pt Doc Trf
                      Authentic              Media Interchange
                      ation
                     User
                      Authentic     Web Services - SOA
                      ation



                 Introduced in 2007: XDS.b, XCA, XDR, PIX/PDQ V3, QED, RFP, XUA
                                                                                            42
        IHE-XDS The Legs of HL7 CDA


• The semantic power of CDA runs on top of XDS

• Doc content independent  Evolution

• A web service/SOA approach (improved with XDS.b)

• Either distributed or centralized

• High performance and scales upward

• Account fot the healthcare specifics sharing workflow

• Support records sharing and shared records



                                                     43
         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
                                                                                  Maintain Time
                      Lab Inf o.
                      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

                                                                                                                                         45
        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


                                         XDS
                                                                                            PIX
                                                                                   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                                                                                                            Provide & Register Docs
                           Lab Inf o.                        Retrieve Document
                           System
                                                                                                                 Teaching Hospital
        Community Clinic
                                                   ATNA Audit
                                                 record repository                CT Time server




                                                                                                                                        46
                                                        Hierarchical Exchange
        From Cross Community Information Exchange White Paper
                                              Which community holds
                                              records for a patient ? Community
                                                                                                          Locator service
Regional Network B                                                                                                                                            Regional Network A
                                                                               IHE XCA                                                            Cross
    Longitudinal Record
                          Document Registry                                  Transactions                                                         Community       Longitudinal Record
                                                                                                                                                                  as used
                                                                                                                                                                                        Document Registry

    as used
    across-encounters                                                                                                                             Bridge          across-encounters

                                                                     Cross
                                                        Long Term Care                                                                                                                                                Long Term Care



                                                                     Community
                                                                                                                                                                                Acute Care
Document
Repository
                  Acute Care
                  (Inpatient)
                                        Other Specialized Care       Bridge                                                                                   Document
                                                                                                                                                              Repository
                                                                                                                                                                                (Inpatient)
                                                                                                                                                                                                      Other Specialized Care
                                                                                                                                                                                                      or Diagnostics Services
                                        or Diagnostics Services

              PCPs and Clinics                                                                                                                                              PCPs and Clinics
               (Ambulatory)
                                                                                                                                  Cross Community                            (Ambulatory)



                                                                                                                                  Bridge
                                                                                                                                                    Each region notifies Community
                                                                                                                                                     Location Service when new
                                                                         Regional Network C                                                          patient is registered or first data is
                                                                                                                                                     stored.
                                                                             Longitudinal Record
                                                                                                   Document Registry                                Cross Community Bridges query
                                                                             as used
                                                                             across-encounters
                                                                                                                                 Long Term Care
                                                                                                                                                     Community Locator Service
                                                                                                                                                     (future)
                                                                         Document
                                                                                           Acute Care
                                                                                           (Inpatient)
                                                                                                                                                    Cross-Community Bridges query
                                                                         Repository                              Other Specialized Care


                                                                                       PCPs and Clinics
                                                                                                                 or Diagnostics Services
                                                                                                                                                     and retrieve records (2007 &
                                                                                        (Ambulatory)
                                                                                                                                                     future)

                                                                                                                                                                                                              47
     Presentation Objectives
Standards adoption and implementation – The
IHE process
Application to a hospital project:
Application to regional and national Health
Information Exchange
World-wide deployment of IHE IT
Infrastructure Profiles




                                              48
   IHE, the only sets of harmonized global standards already
         adopted by several national & regional projects
                                                                          Italy
                                                                 (Conto Corrente Salute)
   UK CfH
(Radiology WF)      France      Denmark (Funen)
                                Italy (Veneto)         Austria                                 Quebec, Toronto,
                     DMP        Spain (Aragon)                                             Alberta, British Columbia
                                                                                               Canada Infoway




                                                                                                     MA-Share – MA



                                                                                                  State Project – NY




                                                                                                 Philadelphia
                                                    JAPAN-Nogaya                                      HIE
                                                  Imaging Info Sharing


           CHINA-Shangai            CHINA-MoH                         THINC- New York
         Imaging Info Sharing    Lab results sharing                  NCHICA – N. Carolina
                                                                                                        49
Committed National Programs:
                    IHE XDS, PIX, PDQ, ATNA, CT, etc.
Austria
  Lower Austria Region: live since end of 2006, 1.5 Million Patients, Entire Country 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.Several regional projects: VT, NC, CareSpark, Geisinger, Philiadelphia
    HIE, CT, etc.
Netherlands
  Amsterdam region network project launched with NICTIZ. Implementation early 2008.
Japan
  One implemented project. One pilot to be launched in 2007.
China:
  MoH selected XDS and XD*-Lab (CDA) for two large pilots.
  XDS-I in Shangai.
Sweden
  Gotteborg region network project launched in 2006
                                                                                                 50
Broad Industry Adoption: HIMSS 2007
        Over 200 vendors world-wide




                                      51
             Stakeholders
      Working Together to Deliver
Interoperable Health Information Systems
            in the Enterprise
       and Across Care Settings


           http://www.ihe.net

                                           52
More Resources - www.ihe.net
 Frequently Asked Questions
 Integration Profiles in Technical Frameworks:
   Cardiology
   IT Infrastructure
   Laboratory
   Patient Care Coordination
   Patient Care Devices
   Radiation Oncology
   Radiology
 Connectathon Results
 Vendor Products Integration Statements
 Participation in Committees and Connectathons

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September, 2005   What IHE Delivers

								
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