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ihe_wkshp07 Overview - RPZ-REV1.ppt - IHE


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									          The IHE Initiative
Mission, Process, Achievements, Plans

Raymond Peter Zambuto,
President, Technology in Medicine, Inc.
Co-Chair, IHE PCD Domain
                Presentation Objectives

• IHE: What? Why? Who? How organized?
  – Healthcare stakeholder role in developing
    IHE framework
• IHE process for standards adoption and
• Strategies, growth, and benefits
         Providers and Vendors
       Working Together to Deliver
Interoperable Health Information Systems
            in the Enterprise
        and Across Care Settings
          IHE: A Framework for Interoperability

• A common framework for harmonizing and
  implementing multiple standards
  – Application-to-application
  – System-to-system
  – Setting-to-setting
• 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 needs
     Standards: Necessary…Not Sufficient

• Standards are
  – Foundational - to interoperability and
  – Broad - varying interpretations and
  – Plentiful - often redundant or disjointed
  – Focused - standards implementation guides focus
    only on a single standard, may not consider
    relationships between standards domains

   IHE provides a standard process for implementing
                   multiple standards
Why IHE? A Patient-centered Example

 Photo Courtesy of Philips
       Medical Systems
Why IHE? A Patient-centered Example

 Photo Courtesy of Philips
       Medical Systems
                     IHE Sponsors

• 1997: Founded in Radiology (RSNA) and IT (HIMSS)
• 2004: American College of Cardiology (ACC) joins Major Sponsors
• Many professional societies (stakeholder representation)
   – American Academy of Ophthalmology (AAO)
   – American College of Cardiology (ACC)
   – American College of Physicians (ACP)
   –   American College of Clinical Engineering (ACCE)
   –   American College of Emergency Physicians (ACEP)
   –   American Society for Therapeutic Radiation Oncology (ASTRO)
   –   GMSIH (IT France), JAHIS (IT Japan), SFIL (laboratory)
   –   Healthcare Information Management Systems Society (HIMSS)
   –   Radiological Society of North America (RSNA)
   –   And many more….
        IHE Participants and Relationships

• Participants include:
  – Users - Clinicians, Staff, Administrators, CIOs,
    Governments (e.g. NIST, VA).
  – Vendors - Information Systems and Equipment
     • e.g., imaging, cardiology, devices
  – Consultants
• Maintains formal liaison with Standards
  Development Organizations (SDOs):
  – HL7, DICOM, ISO (Liaison D), others
• ISO TC215 (including ANSI) approved IHE Process
  and Profiles to be published as technical reports
                 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
   – 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
             IHE Organizational Structure
                                             IHE International Board

   Global Development                                          Regional Deployment

                                                                IHE Americas                   IHE Asia-Oceania

Radiology            IT              Laboratory
                                                                                               China     Japan
               Infrastructure                                 Canada

                                                                                               Korea    Taiwan
Cardiology     Patient Care           Eye Care

                                                                               IHE Europe
Radiation      Patient Care            Quality
Oncology         Devices
                                                               France   Germany        Italy     Netherlands

                                                               Norway          Spain       Sweden        UK

    Contributing &              Professional Societies / Sponsors
     Participating                ACC       AAO       GMSIH   COCIR   SIRM    ESC JAHIS                METI-MLHW
       Vendors                    ACP       ASTRO     SFR     EAR-ECR BIR         JIRA                 MEDIS-DC
                                  HIMSS               SFIL    DRG     EuroRec     JRS                  JAMI
               New IHE Governance Model

• Reflects expanding breadth of IHE organization
  and formalizes governance of IHE process
• Establishes Board with broad representation from
  user and vendor organizations
• Details committee structures and procedures,
  voting rules, etc.
• IP policy including copyright and patent
  disclosure policies
• Clearly defined sponsorship rules
               IHE Governance Implementation

• Currently approved in principle
• Strategic Development Committee to approve as
  six-month interim governance model in June
• Uniform committee procedures, voting rules
• Member organizations required to formally apply
  for membership
• IHE International to be incorporated as a non-
  profit organization during interim period
                                                                           Growth in IHE Domains
IHE Global Developments
Integration Profiles (# X) – Solutions to Real-World Interoperability                                                                                                      Veterinary
                                    Needs & Problems:                                                                                                                      Pathology

 Within                 Clinical Departments e.g.:
                 Radiology                                                                                                                                                 Quality
                 Cardiology                                                                                                                   Patient Care Devices (1)
                                                                                                                                    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)
                                                    International Adoption of IHE

             Local Deployment
             National Extensions (Local Adaptions)                                                        China
             Promotional & Live Demonstration Events
             Funding                                                                       Holland




                                                                                                      Year 7

                                                                                                                   Year 8

 Year 1

                    Year 2

                                Year 3

                                                    Year 4

                                                                 Year 5

                                                                                   Year 6





Pragmatic global standards harmonization + best practices sharing                  (2004)
                 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
              The IHE Adoption Process

                       Testing at
                       Connectathons   IHE
           Develop                     Demonstrations
Identify available                                 with IHE
standards (e.g. HL7,

                  Timely access to
Document Use Case information             Easy to integrate
Requirements                              products
               2007 HIMSS Interoperability Showcase
                              February 26 – March 1, 2007

             Morial Convention Center, New Orleans, LA
•   9,000 square feet of exhibit space
•   67 Showcase participants
•   Secured HIExchange with broad
•   HIE with patient care devices
•   Personal health record solutions
•   New directions focus (Life Sciences
    Bio-Pharma, HL7 v3.0 PIX/PDQ,
    ELINCS Lab)
•   HITSP interoperability specifications
•   Financial and administrative systems
•   Expanded distributed demonstration
    in a RHIO format
•   Focused tours – International, VIP,
    Congressional, Media
•   Theater – Education sessions
          IHE Implementation Objectives

• Leverage established standards to allow rapid deployment and
  plan for future
  Pragmatic, Ease of Evolution
• Enable architectural freedom (patient vs. provider centric,
  centralized vs. decentralized, scalable (from office to
  enterprise to IDN to RHIO)
   Configuration flexibility
• Support breakthrough use cases: variety of care settings, care
  coordination, public health, PHR, EHR
  Interoperability for broad constituencies

IHE: Offers consistent, standards-based record sharing for
           EHRs and other information systems
                      IHE Integration Profiles for Health Info Nets
                                              What is available and has been added in 2006/07

Clinical and PHR Content
                                                         Security                       Patient ID Mgmt
              Emergency Referrals
           PHR Extracts/Updates
            Format of the Document Content
            andReport Document
        ECG associated coded vocabulary          Basic Patients Privacy                 Patient Demographics
          Format of the Document Content
          and associated coded vocabulary
      Lab ResultsDocument Content                      Consents                                 Query
        Format of the                              Establish Consents & Enable
     Scanned Documents
        and associated coded vocabulary                   Access Control
      Format of the Document Content                                                       Patient Identifier
    Imaging Information
      and of the Document vocabulary
   Formatassociated coded Content
    Medical Document Content
  Format of theSummary
  and(associated coded vocabulary
                                                     Document Digital                    Map patient identifiers across
      Meds, Allergies, Pbs)                             Signature                         independent identification
 Format of the Document Content                                                                    domains
 and associated coded vocabulary                  Attesting “true-copy and origin

Health Data Exchange                                Audit Trail & Node
      Cross-Enterprise                               Authentication                              Other
     Document Sharing                        Centralized privacy audit trail and node
                                               to node authentication to create a          Request Form
  Registration, distribution and access
  across health enterprises of clinical                 secured domain.                   for Data Capture
     documents forming a patient                                                         External form with custom
        electronic health record                                                          import/export scripting

                                                     Consistent Time
Cross-Enterprise Document                                                                  Notification of
                                               Coordinate time across networked
 Pt-Pt Reliable Interchange                                 systems
                                                                                        Document Availability
 Cross-Enterprise Document                                                                Notification of a remote
                                                                                         provider/ health enterprise
       Media Interchange

                                                     Final Text Approved
                                                     Trial Implementation-2006 – Final Txt 2007
            IHE: Supporting HHS Goals for NHIN

              Certification                               Healthcare
             Commission for                              Information
                Healthcare                          Technology Standards
               Information                              Panel (HITSP)
           Technology (CCHIT)                          Standards harmonization
Interoperability testing
                                 American Health       and adoption

                                                    Nationwide Health
          Health Information                       Information Network
         Security and Privacy                      Architecture Projects
         Collaboration (HISPC)                            (NHIN)
                                                   Specifications for standards-
Security and privacy standards                     based EHR functionality to
                                                   support RHIOs
                     HITSP Recommended Standards

• Biosurveillance
  – ICD-9CM – International Classification of Diseases v. 9 Clinical
  – ICD-10 CM – Diagnoses and Procedures
  – IHE-XDS – Integrating the Healthcare Enterprise (IHE) Cross-
    Enterprise Document Sharing
  – IHE-XDS Lab – IHE Laboratory Report Document Sharing
  – IHE-RFD – IHE Retrieve Form for Data Capture
  – IHE-PIX – IHE Patient Identification Cross-Referencing
  – IHE-RAD – XDS-I – IHE Cross-Enterprise Sharing of Images
  – IHE-NAV – IHE Notification of Document Availability
  – IHE-XDS-MS – IHE Medical Summary Document Sharing
  – ISO/TC215 -DTS 25237 - Health Informatics Pseudonymisation
  – LOINC – Logical Observation Identifiers Names and Codes
  – NCCLS – National Committee for Clinical Laboratory
  – RxNorm – National Library of Medicine RxNorm

     IHE contributes to HITSP’s success
                   HITSP Recommended Standards

• Consumer Empowerment
  – IHE-XDS – Integrating the Healthcare Enterprise (IHE)
    Cross-Enterprise Document Sharing
  – IHE-PIX – IHE Patient Identification Cross-Referencing
  – IHE-PDQ – IHE Patient Demographics Query
  – Health Level Seven (HL7) CDA R2 – HL7 Clinical
    Document Architecture Release 2
  – HL7 CCD – HL7 Continuity of Care Document with
    mappings from ASTM E 2369-05 Continuity of Care Record
    (CCR), X12 N 270/271 and NCPDP Script 8.1.
  – HL7 EHR Systems Functional Model Draft Standard for
    Trial Use (DSTU)
  – Logical Observation Identifiers Names and Codes
                       HITSP Recommended Standards

• Electronic Health Record Exchange
   –   IHE-XDS Lab – IHE Laboratory Report Document Sharing
   –   IHE-PIX – IHE Patient Identification Cross-Referencing
   –   IHE-PDQ – IHE Patient Demographics Query
   –   Health Level Seven (HL7) CDA R2 – HL7 Clinical Document
       Architecture Release 2
   –   HL7 v. 2.5
   –   Clinical Laboratory Improvement Amendments (CLIA)
   –   Logical Observation Identifiers Names and Codes (LOINC)
   –   Health Insurance Portability and Accountability Act (HIPAA)
   –   Systematized Nomenclature of Medicine – Clinical Terms
       (SNOMED – CT)
   –   Unified Code for Units of Measure (UCUM)
                      IHE based Regional and National EHR Projects
                                             (Operational and Planned)

              Toronto, Quebec, Alberta, BC
                    Canada Infoway             MA-Share – MA
                                                        New York
                                                          HIE                              Austria

                                                Philadelphia             France
                                                     HIE                  DMP

                           THINC- New York                                          Italy (Conto
                           NCHICA – N. Carolina                                   Corrente Salute)

Lab results sharing
                     How to Participate

As a Committee Member
• Become a member of relevant Domains Planning
  or Technical Committees
As as Interested Observer
• Provide Public Comments on Technical
  Framework Supplements
• Attend Demonstrations, Educational Events and
                         How to Use IHE

As a Vendor Implementer
• Implement IHE Integration Profiles
• Test systems through Connectathon process
• Publish an IHE Integration Statement for products
As a User Implementer or Consultant
• Use IHE Integration Profiles to develop
  interoperability strategy
• Use Connectathon Results and Integration
  Statements to evaluate vendors
• Demand IHE Integration Profile compliance in RFPs
       More Resources - www.ihe.net
• Frequently Asked Questions
• Integration Profiles in Technical Frameworks:
   – Cardiology
   – Eye Care
   – IT Infrastructure
   – Laboratory
   – Patient Care Coordination
   – Patient Care Devices
   – Radiation Oncology
   – Radiology
• Connectathon Results
• Vendor Products Integration Statements
• Participation in Committees and Connectathons
         Providers and Vendors
       Working Together to Deliver
Interoperable Health Information Systems
            in the Enterprise
        and Across Care Settings


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