IHE, Integrating the Healthcare Enterprise, creates solutions for interoperability problems in healthcare by developing standards based interface specifications. Healthcare ICT products that have implemented the IHE specifications make the integration efforts for an eHealth solution much easier. Conformity assessment in the deployment process towards an operational application portfolio is supported by a proven test methodology and Open Source test tools.

1. IHE Product Selection and
Acceptance Testing

2. Streamlining Product Selection and
Acceptance Testing
v Effective and efficient performance of Business Use Cases are enabled by
a connected set of administrative and clinical applications
v Initial challenge:
Ø Selection of suppliers and systems
Ø Integrate systems, educate users, and start-up the operation
v On-going challenge: Maintain the operational ICT Application portfolio
Ø New releases
Ø New systems
Ø New connections
Ø New functionality
v IHE profiles for exchange, content, terminology, workflow, security and
privacy enable this in a multi-vendor setting.
v Supported by the IHE Test Tools and Procedures in the Conformance
Assessment continuum.

3. Deployment: the Road to Production
IHE Profiles
Connectathon:
IHE profile level
Testing
Product Release
Testing
IHE Profiles
Interoperability
Specifications
Entrance Rules
Governance
Product Accredited Testing (ISO17025:2005)
Projectathon:
Interoperability
Specification
Testing
Acceptance
Testing
Production

4. Connectathon key figures

5. Connectathon results matrix
On-line registry showing for all Connectathons worldwide which vendors have
successfully passed the tests with their products for a selected set of IHE Profiles.
v Health IT suppliers have the opportunity to showcase the IHE
competency of their company.
v Health IT buyers can easily search for evidence of supplier’s IHE claims.
http://connectathon-results.ihe.net/

6. eHealth Product Release
Connectathon
Results Matrix
Product Registry
IHE Integration
Statements
IHE Profiles
Development
In-house prerelease testing
ISO 9000 QMS
ISO 14971 Risk Management
IEC 62304 Software Lifecycle Processes
Connectathon
participation
In-house final
release testing

7. Product Registry
On-line Product Registry for
commercially available health IT
products that conform to the
specifications of a selected set of
IHE Profiles.
v Health IT suppliers have
the opportunity to
showcase the IHE
capabilities of their
products.
v Health IT buyers can
easily search for available
products fulfilling their IHE
integration needs.
http://product-registry.ihe.net/PR/
home.seam

8. Public Health
Patients
Healthcare Professionalls
Example:
Services of the eSanté platform
Actors
Multi services portal
System of communication and dissemination of information
eHealth platform
Professional
portal
Secure
messaging
Provider Signature
and encryption
Directory
structure
security
Patient
portal
Traceability
Repository XDS
Empowerment
Hospitals
GPs
Labs
Registry
XDS-B XDS-I
Administration
portal
Directory
structure
patient
E-RCP
EAI
SOA
Web
services
Terminology
server
Pharmacies
Care facility
Emergency
care
API
CNS
Message Broker
Patient ID
PIX Manager
National HPD ID
Medical Facility
Guide
PCN
epSOS
Medical application
SaaS

9. Interoperability Specification
Key health systems
objectives
Project
Interoperability
Specification
IHE Profile
for
Content
Technical
Use case 1
Technical
Use case 2
Technical
Use case 3
IHE
Profile for
Content
IHE Profile
Sharing Doc
Services
IHE
Profile for
Security
Custom
Profile for
Terms
IHE Profile
Patient Id
Mgt
IHE
Profile for
Privacy
Combination / Glue
Business Use case A
Profiles
Custom
Profile for
Terms
IHE Profile
Sharing Doc
Services
IHE Profile
Patient Id
Mgt
IHE Profile
for
Security
IHE Profile
for
Privacy

10. Complexity of eHealth Integration
N.(N-1)
2N
Challenges: semantics of exchanged content, localization, and workflow
v DICOM (images, reports, treatment plans, etc.)
v CDA documents (Lab, Pharmacy, Patient Summary, etc.)
v HL7 v2, v3 message

11. Tools for Interoperability and
Conformance Assessment
Specifications/Standards
Validators
Conformance
checks
System A
Vendor A
Test Management
Conformance
checks
System B
Interoperability
testing
Vendor B
Simulators

12. Interoperability & Conformance Tests
ü Checks Evidences
ü Verifies test performs as planned
ü Grades
Monitor
Simulator
System Under Test
Information
exchange
ü Configure
ü Interacts
Information
exchange
Proxy
Value Sets
Validator
Validator
Validator
Validator
Validator
Test Plan
ü Get Test Plan
ü Find Test Partner
ü Log Evidences
ü Get Test Report
TF Model
Test
Management
ü Configure
ü Interacts
Gazelle Test Platform
ü Get Test Plan
ü Find Test Partner
ü Log Evidences
ü Get Test Report

13. Available IHE Validation Tools
v HL7v2 messages
v DICOM objects
v XML documents/messages
Ø HL7 CDA Structured Document
Ø HL7v3 messages
Ø IHE XD* transactions metadata
Ø DSUB metadata
Ø HPD messages
Ø Sharing Value Set messages content (SVS)
Ø Workflow documents (XDW)
Ø ATNA audit messages
Ø X509 certificates
Ø SAML Assertions

14. Available IHE Simulators
v Patient Manager
Ø ITI profiles relative to patient demographics exchange
Ø PAM, PIXv2, PDQv2, ADT part of SWF
v Order Manager
Ø Profiles dealing with management of orders
Ø LAW, LTW, SWF, EYECARE workflow
v XD* Client : Initiators from the XD* profiles, DSUB, XDS-I.b
v Sharing Value Set
v Healthcare Provider Directory
v Hospital Medication Workflow (Pharmacy)
v Lab Barcode Labelling
v Lab Code Set Distribution

15. Contributors to IHE Test Tools
v Open source, freely available, yet need on-going development and maintenance
v Parties contributing to pool of tools
Ø Government initiatives funding tool development via eHealth projects
• NIST
• EC
• Japan
Ø IHE USA, IHE Europe
• Vendors participating in Connectathon
Ø Professional Societies as IHE Domain sponsors:
• HIMSS
• RSNA
• ACC
• ASTRO
• AAO
v http://ihewiki.wustl.edu/wiki/index.php/
Index_to_Preconnectathon_Test_Software#Index_to_IHE_Test_Tools
v http://hitch-project.eu/testing-tools

16. Example eSanté:
Standalone Document Validation
1 - HTTP : Upload
of document
System under test
EVS Front End
3 – XML Report
Model Based
CDA Validator
2 – WS
Call
eSanté
CDA Guidelines

17. Your Contribution to a Sustainable
eHealth Interoperability Ecosystem
IHE
Profiles
Include IHE
Test Tools
creation in
eHealth
programs,
and
contribute to
Open Source
pool of IHE
Test Tools.
Test
Tools
Foster the creation new IHE
Profiles for emerging
interoperability challenges
Healthcare
providers
eHealth
Suppliers
Include IHE
profiles in
eHealth
solution
architecture
and RFPs.
Timely release products to
market with IHE Integration
Statements

18. Value from applying IHE
v Suppliers of eHealth systems
Ø Reduce cost for development and maintenance of product
communication interfaces (reduced diversity, Open Source tool box)
Ø Access to bigger market (reduced market entry threshold)
v Users of eHealth systems
Ø Freedom to choose products with best-fit functionality (competition)
v ICT Department
Ø Reduce integration cost (reduced diversity, reduced complexity,
Open Source tool box)
Ø Reduce on-going maintenance cost for the ICT Application portfolio
(reduced diversity, Open Source tool box)