November 11, 2004 IHE and EHR Seminar

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  • **Consider making the cycle graphic Incremental approach: Can’t solve all at once Connectathon – Practical measure of progress, Validates the integration work accomplished. Refer the Scorecard. Demo – promotes standards based integration to users/purchasers
  • Generalized the systems because there are many ways vendors can bundle products. Some PACS may include a Report Creator, others may not. Some Modalities may include a Print Composer, others may not.
  • The Integration Profile is the global answer to a healthcare communication issue. For instance « Laboratory Scheduled Workflow » how the various systems of the hospital must interact with one another to establish the integrity of laboratory orders and observations throughout the hospital.
  • Specifies transactions that function to maintain the integrity of patient, image, and order information across systems Integrates modalities with information and imaging systems Biggest Value of IHE Smooth flow of patient, image and order information across systems Status updates of orders Integrates modalities with information and imaging systems
  • As Performed Procedure Step, the most recent of the four Service Classes become available, a fully integrated solution for the modalities is on the horizon. Implementing Modality Worklist is the first step and can be done today with most recent modality products. Closing this loop delivers many benefits to the overall operation efficiency of the radiology department in the context of the overall hospital.
  • Representation includes: healthcare providers, information systems vendors, imaging systems vendors, and standards groups participating
  • Representation includes: healthcare providers, information systems vendors, imaging systems vendors, and standards groups participating
  • Year one (2003) brought the first integration profile « Laboratory Scheduled Workflow ». This profile supports the most common situation: The tests are placed to and performed by a clinical laboratory on specimens collected from a patient correctly identified in the hospital. Year two (2004) is expected to complete the framework with four more profiles: « Laboratory Patient Information Reconciliation » profile provides the messaging to resolve all the exceptional situations: Tests performed on an unidentified patient. Urgent tests performed before the order was generated. Merging of a misidentified patient… « Laboratory Point Of Care Testing » supports specimen testing on the point of care or on the patient’s bedside, by the care unit staff, under the overall supervision of a clinical laboratory. « Laboratory Device Automation » describes the messaging between the laboratory automation manager and all the automated devices (analyzers, robotic decappers, centrifuges, conveyors, aliquoters, …). « Laboratory Code Set Distribution » enables the various actors to rely on a common dictionary of tests and batteries. Some of these new profiles will be achieved in 2004, some others may need one more cycle.
  • Which profiles will grab peoples attention? Tie national focus back to local level. Demonstration based on clinical scenarios which will drive use of integration profiles. Sample clinical scenario is an appendix in the ITI Technical Framework. Make it exciting and NOT overwhelming. Keep it simple. Work group to define clinical scenarios – present at Sept. 13-15 workshop Ambulatory IT showcase work group – 4 use cases in development. Need to do gap analysis between the two. List of documents that constrain what we will do in the demonstration needed by September workshop. e.g. 1) specification for CCR, CDA 2) coded entries for data elements such as provider number, demo database of content
  • Which profiles will grab peoples attention? Tie national focus back to local level. Demonstration based on clinical scenarios which will drive use of integration profiles. Sample clinical scenario is an appendix in the ITI Technical Framework. Make it exciting and NOT overwhelming. Keep it simple. Work group to define clinical scenarios – present at Sept. 13-15 workshop Ambulatory IT showcase work group – 4 use cases in development. Need to do gap analysis between the two. List of documents that constrain what we will do in the demonstration needed by September workshop. e.g. 1) specification for CCR, CDA 2) coded entries for data elements such as provider number, demo database of content
  • November 11, 2004 IHE and EHR Seminar

    1. 1. Integrating the Healthcare Enterprise Process and Influence on Radiology and Clinical Workflow <ul><ul><li>Charles Parisot, GE Healthcare </li></ul></ul><ul><ul><li>IHE IT Infrastructure Technical Committee Co-chair </li></ul></ul><ul><ul><li>IHE and EHR Seminar </li></ul></ul><ul><ul><li>Helsinki, November 11, 2004 </li></ul></ul>
    2. 2. Agenda <ul><li>IHE Goals, Organization and Deliverables </li></ul><ul><li>IHE Integration Profiles and Influence on Clinical Workflow </li></ul>
    3. 3. Goals of IHE <ul><li>Speed up the rate and quality of integration in healthcare environments </li></ul><ul><li>Foster communication among vendors and care providers </li></ul><ul><li>Prove that integration is attainable based on standards </li></ul><ul><li>Improve the efficiency and effectiveness of clinical practice </li></ul><ul><li>Improve interoperability among care domains and build foundation for the EHR </li></ul><ul><li>Integration solutions within the healthcare enterprise and across healthcare enterprises </li></ul>
    4. 4. Understanding the IHE Initiative <ul><li>IHE has a clear focus </li></ul><ul><li>IHE is a healthcare domain-based initiative </li></ul><ul><li>IHE creates synergies for interoperability testing across domains </li></ul><ul><li>IHE addresses the standards adoption process </li></ul><ul><li>IHE is both regional and multi-national </li></ul><ul><li>IHE is both user lead and vendor driven </li></ul>
    5. 5. IHE: Domain-based for a stepwise approach Cardiology Labora- t ory Pharmacy,….. Radiolog y Patient Identifier Linkage, Registries, Security Electronic Health Record Other (e.g. Access Control, eHealthWorkflows) Patient Management Order Management
    6. 6. IHE 2004 – Four Active Domains 4 Technical Frameworks with 31 Integration Profiles Testing at yearly Connectathons in three continents Demonstrations at major conferences world-wide Provider-Vendor cooperation to accelerate standards adoption
    7. 7. A Proven Standards Adoption Process User Site IHE Technical Framework <ul><li>IHE Integration Profiles at the heart of IHE : </li></ul><ul><ul><li>Detailed selection of standards and options each solving a specific integration problem </li></ul></ul><ul><ul><li>A growing set of effective provider/vendor agreed solutions </li></ul></ul><ul><ul><li>Vendors can implement with ROI </li></ul></ul><ul><ul><li>Providers can deploy with stability </li></ul></ul>IHE Integration Profiles B IHE Integration Profile A Easy to Integrate Product s IHE Connect-a-thon Product With IHE IHE Demonstration RFP Standards Product IHE Integration Statement IHE Connect-a-thon Results
    8. 8. IHE Process <ul><li>Users identify desired functionality that require coordination and communication among multiple systems </li></ul><ul><ul><li>E.g., departmental workflow, single sign-on, sharing of documents </li></ul></ul><ul><li>Find and document standards-based transactions among systems to achieve desired functionality </li></ul><ul><ul><li>Apply necessary constraints to eliminate useless wiggle room </li></ul></ul><ul><li>Provide process and tools to encourage vendors to implement </li></ul><ul><ul><li>MESA software test tools + Connect-a-thon interoperability testing event </li></ul></ul><ul><li>Provide tools and education to help users acquire and integrate systems using these solutions </li></ul><ul><ul><li>Connect-a-thon results and public demonstrations </li></ul></ul><ul><ul><li>Integration statements </li></ul></ul>
    9. 9. IHE Contributors & Participants <ul><li>Societies Representing Healthcare Segments </li></ul><ul><ul><li>RSNA, HIMSS, ACC, CAR, CHI, ACCE, Many Other Professional Societies… </li></ul></ul><ul><ul><li>Any Healthcare Stakeholder Organization </li></ul></ul><ul><li>Users </li></ul><ul><ul><li>Clinicians, Medical Staff, Administrators, CIOs, … </li></ul></ul><ul><li>Information Systems & Equipment (e.g. imaging) Vendors </li></ul><ul><li>Consultants </li></ul><ul><li>In addition, active liaison with Standards Development Organizations (SDOs) </li></ul><ul><ul><li>HL7, DICOM, NCCLS, ASTM, ISO, others … </li></ul></ul>
    10. 10. IHE Organizational Structure IHE Europe IHE North America France USA Canada IHE Asia-Oceania Japan Korea Taiwan Netherlands Spain Sweden UK Italy Germany Norway Regional Deployment Radiology Planning Committee Radiology Technical Committee IT Infrastructure Planning Committee IT Infrastructure Technical Committee Pharmacy Exploratory Sub-Committee Global Development Cardiology Planning Committee Cardiology Technical Committee Laboratory Planning and Technical Committee IHE Strategic Development Committee ACC ITAC/CHITTA HIMSS CHI RSNA CAR JAHIS JIRA JRS METI-MLHW MEDIS-DC JAMI GMSIH SFR SFIL SIRM BIR EuroRec COCIR EAR-ECR DRG ESC Professional Societies / Sponsors Contributing and participating Vendors
    11. 11. Organization of the IHE Initiative <ul><li>IHE distributes its operations between a regional/national level and an international level </li></ul><ul><li>IHE is not a standards development organization </li></ul><ul><li>IHE operates on overlapping yearly cycle </li></ul><ul><li>IHE leverages dependencies and complementary interests between stakeholders </li></ul><ul><li>IHE is an open and flexible organization </li></ul>A novel approach to meet these challenges
    12. 12. IHE Process <ul><li>Users and vendors work together to identify and design solutions for integration problems </li></ul><ul><li>Intensive process with annual cycles : </li></ul><ul><ul><li>Identify key healthcare workflows and integration problems </li></ul></ul><ul><ul><li>Research & select standards to specify a solution </li></ul></ul><ul><ul><li>Write, review and publish IHE Technical Framework </li></ul></ul><ul><ul><li>Perform cross-testing at “Connectathon” </li></ul></ul><ul><ul><li>Demonstrations at tradeshows (HIMSS/RSNA…) </li></ul></ul>
    13. 13. IHE Domains Milestones – 20 month cycle Development and Deployment Proposed Supplement Scope Approved Supplement Scope Public Comment of Supplements Sponsors announce Connectathon/Demos with set of Implementation Profiles - 10 --- - 7 --- - 2 --- Final Intgr-profile + 9 --- Trial Implementation Intgr-profile 0 --- Connectathon/Demo Vendor Participant Registered + 2 --- Vendor Participants pass Connectathon + 5 --- + 6 --- Demo & Education Material Vendors release products with IHE Integration Statements ---
    14. 14. How to participate to IHE? <ul><li>As a User or Vendor Contributor </li></ul><ul><li>Become a member of relevant Domains Planning or Technical Committees </li></ul><ul><li>Become a member of relevant Regional/National Committees </li></ul><ul><li>As a Vendor Participant </li></ul><ul><li>Respond to Public Comments of Domain Supplements </li></ul><ul><li>Attend Yearly IHE Regional Educational/Workshops </li></ul><ul><li>Participate to Regional Connect-a-thons and Demonstrations </li></ul><ul><li>As a User/Consultant Participant </li></ul><ul><li>Respond to Public Comments of Domain Supplements </li></ul><ul><li>Attend Yearly Regional Educational/Workshops </li></ul><ul><li>Attend Demonstrations and include IHE Integration Profiles in your RFPs and Integration Projects. </li></ul>IHE Canada, your entry point
    15. 15. What IHE is NOT! <ul><li>A standards development organization </li></ul><ul><ul><li>Uses established standards (HL7, DICOM, others) to address specific clinical needs </li></ul></ul><ul><ul><li>Activity complementary to SDOs, formal relationship with HL7, ISO, DICOM, NCCLS, etc. </li></ul></ul><ul><li>Simply a demonstration project </li></ul><ul><ul><li>Demos, only one means to the end—adoption </li></ul></ul><ul><ul><li>Backed up by documentation, tools, testing, and publication of information </li></ul></ul>
    16. 16. Benefits to IHE Participants <ul><li>Clinicians </li></ul><ul><ul><li>Improved workflow </li></ul></ul><ul><ul><li>Information when and where needed </li></ul></ul><ul><ul><li>Fewer opportunities for errors </li></ul></ul><ul><ul><li>Fewer tedious tasks/repeated work </li></ul></ul><ul><li>Administrators </li></ul><ul><ul><li>Improved efficiency </li></ul></ul><ul><ul><li>Best of breed opportunities </li></ul></ul><ul><ul><li>Decreased cost and complexity of interface deployment and management </li></ul></ul>
    17. 17. Benefits to IHE Participants <ul><li>Vendors </li></ul><ul><ul><li>Align product interoperability with industry consensus </li></ul></ul><ul><ul><li>Decreased cost and complexity of interface installation and management </li></ul></ul><ul><ul><li>Focus competition on functionality/service space not information transport space </li></ul></ul><ul><li>SDOs </li></ul><ul><ul><li>Rapid feedback to adjust standards to real-world </li></ul></ul><ul><ul><li>Establishment of critical mass and widespread adoption </li></ul></ul>Plus, IHE meets fixed deadlines
    18. 18. IHE Technical Frameworks
    19. 19. Key IHE Concepts <ul><li>Generalized Systems -> Actors </li></ul><ul><li>Interactions between Actors -> Transactions </li></ul><ul><li>Problem/Solution Scenarios -> Integration Profiles </li></ul><ul><li>For each Integration Profile: </li></ul><ul><ul><li>the context is described (which real-world problem) </li></ul></ul><ul><ul><li>the actors are defined (what systems are involved) </li></ul></ul><ul><ul><li>the transactions are defined (what must they do) </li></ul></ul>
    20. 20. Key concept: Integration Profile <ul><li>Examples:  </li></ul><ul><li>Enterprise User Authentication </li></ul><ul><li>Retrieve Information for Display </li></ul><ul><li>Laboratory Scheduled Workflow </li></ul><ul><li>Echo Laboratory Workflow </li></ul><ul><li>Cross-Enterprise Document Sharing </li></ul><ul><li>Solves an Integration Problem: </li></ul><ul><ul><li>A collection of real world information exchange capabilities supported by a set of specific Actors using Standards-based Transactions </li></ul></ul>Referenced standard (e.g. HL7) Detailed messaging info -------------------------- Roles Integration Profile Actor Actor Actor … Transaction Transaction Transaction Transaction Transaction … … …
    21. 21. IHE Connectathon <ul><li>Open invitation to vendor community </li></ul><ul><li>Advanced testing tools (MESA) </li></ul><ul><li>Testing organized and supervised by project management team </li></ul><ul><li>Thousands of cross-vendor tests performed </li></ul><ul><li>Results recorded and published </li></ul>
    22. 22. Massive yearly events : 40-50 vendors 120-160 engineers 70-80 systems … .integrated in 5 days IHE Connectathons Vendors do not pass… until an IHE Project Manager attest it !
    23. 24. Integration Statements
    24. 25. Leveraging IHE Integration Statements <ul><li>Vendors </li></ul><ul><ul><li>Claim IHE Compliance in an explicit way </li></ul></ul><ul><ul><li>Can rely on an objective and thorough specification (IHE Technical Framework) </li></ul></ul><ul><ul><li>Willing to accept contractual commitments </li></ul></ul><ul><ul><li>Willing to correct “implementation errors” </li></ul></ul><ul><li>Buyers </li></ul><ul><ul><li>Can compare product integration capabilities </li></ul></ul><ul><ul><li>Simplify and strengthen their RFPs </li></ul></ul><ul><ul><li>Can leverage a public and objective commitment </li></ul></ul><ul><ul><li>Decreased cost and complexity of interface deployment and management </li></ul></ul>
    25. 26. Participating and Contributing Vendors (America) <ul><li>Agfa HealthCare </li></ul><ul><li>Allscripts </li></ul><ul><li>Algotec Systems, Ltd. </li></ul><ul><li>Berdy </li></ul><ul><li>Camtronics </li></ul><ul><li>Canon Medical Systems </li></ul><ul><li>CapMed </li></ul><ul><li>Carefx </li></ul><ul><li>Cedara Software Corp. </li></ul><ul><li>Cerner Corporation </li></ul><ul><li>CSIST </li></ul><ul><li>Dictaphone </li></ul><ul><li>DR Systems </li></ul><ul><li>Dynamic Imaging </li></ul><ul><li>Eastern Informatics </li></ul><ul><li>Eastman Kodak Company </li></ul><ul><li>Emageon </li></ul><ul><li>Eclipsys </li></ul><ul><li>EPIC </li></ul><ul><li>ETIAM </li></ul><ul><li>Fujifilm Medical Systems </li></ul><ul><li>GE Healthcare </li></ul><ul><li>Healthramp </li></ul><ul><li>Heartlab </li></ul>Novell Opentext Procom Philips Medical Systems RASNA Imaging Systems Sectra Sentillion Siemens Medical Solutions Softmedical Stentor, Inc StorCOMM, Inc Swissray International, Inc Tiani Medgraph AG Toshiba America Medical Sys. UltraVisual Medical Systems Vital Images, Inc. Voxar Limited WebMD XIMIS Hitachi Medical Corporation Hologic, Inc IDX Systems Corporation IMCO Technologies InSiteOne INFINITT Intersystems Konica Minolta Marotech, Inc. McKesson Information Soln. Medcon MedCommons Medical Manager Health Sys. Mediface Co., Ltd. MediNotes Merge eFilm MidMark Misys Mortara NextGen In yellow, companies with IHE Committees Chairs (Summer 2004)
    26. 27. Participating and Contributing Vendors (Europe) AGFA Healthcare AISoftw@re Medical Solutions Algotec ARES SA aycan Digitalsysteme ConVis DEDALUS Dianoema Eastman Kodak Company Ebit Sanita EDL ELFIN s.r.l. Engineering Sanità Enti Locali ESAOTE ETIAM Ferrania Fujifilm GE Healthcare GMD GIE Convergence-Profils Rogan-Delft Sago spa Sectra Imtec AB Siemens Medical Solutions Soluzioni Informatiche srl Stentor Inc. Swissray Medical AG Symphonie On Line Synapsis TELEMIS S.A. TIANI MEDGRAPH AG TOREX GAP Medical Toshiba Medical Systems TSI groupe europMedica VEPRO AG VISUS Technology Transfer WAID XR PARTNER GWI Research IASI Srl IdeoPass Image Device-Cerner Company INFINITT INOVIT McKesson MED2RAD MEDASYS SA Medavis Medigration GmbH MEDIMON Ltd. MEDOS AG Merge eFilm METAFORA Konica Minolta Europe Omnilab Philips Medical Systems Rasna Imaging Systems RAYPAX INC. In yellow, companies with IHE Committees Chairs (Summer 2004)
    27. 28. Participating and Contributing Vendors (Asia) Japan AGFA Gevaert Japan EBM Japan INFINITT Japan A&T Canon Goodman Climb Medical Systems Konica Minolta MG Shimadzu SONY Toshiba Medical Systems Toyo Technica Nihon Kohden Olympus NEC Pioneer (Marotech) Hitachi Hitachi Medico Fujitsu Fuji Film Medical Yokogawa Taiwan INFINITT Shing Shian INQ GEN TEP Tah Ya Korea AGFA Korea GE Healthcare Korea INFINITT LG CNS Marotech, Inc. Medical Standard Peoplenet Communications Samsung SDS
    28. 29. IHE approach to standards <ul><li>IHE, starts from user defined needs and priorities in a domain </li></ul><ul><li>Then selects the standards that: </li></ul><ul><ul><li>Best address the problem </li></ul></ul><ul><ul><li>Have the broadest practical acceptance (world-wide) </li></ul></ul><ul><ul><li>Are Technically stable </li></ul></ul><ul><ul><li>Offer potential reuse/integration with other existing or future integration profiles. </li></ul></ul>Problem & effectiveness drives standards selection  On-going dialogue with HL7, ISO TC215, DICOM, OASIS, IETF, etc .
    29. 30. <ul><li>Continuity & Integrity of Patient Information </li></ul><ul><li>Clinical Workflow Optimization </li></ul><ul><li>Foster Communication Among Diverse Medical Information Systems </li></ul><ul><li>Avoid Repeating Tasks </li></ul><ul><li>Eliminate Data Redundancy </li></ul>Healthcare Needs Addressed by the IHE Initiative Improving the Patient Care Process
    30. 31. Agenda <ul><li>IHE Goals, Organization and Deliverables </li></ul><ul><li>IHE Integration Profiles and Influence on Clinical Workflow </li></ul>
    31. 32. IHE Radiology Integration Profiles Patient Info. Recon-ciliation Basic Security - Post-Processing Workflow Scheduled Workflow Access to Radiology Information Consistent Present- ation of Images Evidence Docs Key Image Notes Simple Image & Numeric Reports Presentation of Grouped Procedures Reporting Workflow Charge Posting Portable Data for Imaging NM Image New Extensions New
    32. 33. Example: IHE Rad Scheduled Workflow ADT (Registration) Order Placer Order Filler Print Server Film Folder Image Manager & Archive Film Lightbox report Report Repository Image Display Modality acquisition in-progress acquisition completed acquisition completed images printed Acquisition Modality
    33. 34. IHE Scheduled Workflow PACS & Archive RIS <ul><li>A Closed Loop </li></ul><ul><li>Update IS Scheduling </li></ul><ul><li>Match Procedure with Order </li></ul><ul><li>Support Billing Based on MPPS </li></ul><ul><li>Avoid Reading incomplete Procedures </li></ul>Store Images Storage Commitment Storage Commitment List of Images Modality Performed Procedure Step Performed Step: Status = Completed Performed CT Head Pat Name/ID, Dose, Accession #, Study UID Complete List of Images Modality Worklist Worklist Procedure Scheduled Patient Registration/Update Order Management
    34. 35. IHE Workflow Concepts <ul><li>Procedure Steps : The smallest unit of work in the workflow: SCHEDULED PROCEDURE STEP : ‘A unit of work to do’ PERFORMED PROCEDURE STEP : ‘A unit of work done ’ </li></ul>IHE identifies four fundemental workflow information units : REQUESTED PROCEDURE : A Unit of Reporting Work with associated codified, billable acts ORDER : A request for radiologic service
    35. 36. Multiple Modality Steps ORDER A request for Radiologic Service Radiology Department Set of Codifiable, Billable, Acts Requested Procedure 1 Acquisition Modality Acquisition Modality One or more series of images Performed Procedure Step P1 Scheduled Procedure Step B Scheduled Procedure Step A Report One or more series of images Performed Procedure Step P2 DICOM Modality Worklist DICOM Modality Worklist
    36. 37. IHE – Presentation of Grouped Procedures Requested Procedure: CHEST Requested Procedure: ABDOMEN RIS / PACS MODALITY Report: CHEST Report: ABDOMEN Performs a single exam Operator group s 2 procedures Chest View Abdomen View Chest View Abdomen View Scheduled Procedure Step Chest Scheduled Procedure Step Abdo
    37. 38. Laboratory IHE Integration Profiles Laboratory Device Automation (LDA) In Process –TI Nov 2004 Pre-analytic process, analysis and post-analytical treatment Laboratory Scheduled Workflow (LSWF) Completed in 2003 Tests performed by a laboratory for an identified inpatient or outpatient Laboratory Patient Information Reconciliation (LPIR) In Process Tests performed on an unidentified or misidentified patient Laboratory Code Set Distribution (LCSD) In Process Sharing the batteries and tests code sets throughout the enterprise Laboratory Point Of Care Testing (LPOCT) In Process –TI Nov 2004 Tests performed on point of care or patient’s bedside In Dev. In Dev. In Dev. In Dev.
    38. 39. IHE Cardiology 2004-2005 Cardiac Catheterization Workflow Scheduled & unscheduled acquisition and management of cathlab information, notification of completed steps. Provide high-quality ECG and related reports to the enterprise and outside in a ready-to-display format Retrieve ECG for Display New New New Retrieve Information for Display Access a patient’s clinical information and documents in a format ready to be presented to the requesting user EchoCardiography Worklflow Admit, order, schedule, acquire images, notify of completed steps, on fixed and mobile stress echo modalities.
    39. 40. IHE IT Infrastructure 2004-2005 Patient Identifier Cross-referencing for MPI Map patient identifiers across independent identification domains Patient Identifier Cross-referencing for MPI Map patient identifiers across independent identification domains Synchronize multiple applications on a desktop to the same patient Patient Synchronized Applications Enterprise User Authentication Enterprise User Authentication Provide users a single name and centralized authentication process across all systems Retrieve Information for Display Access a patient’s clinical information and documents in a format ready to be presented to the requesting user Retrieve Information for Display Access a patient’s clinical information and documents in a format ready to be presented to the requesting user Consistent Time Coordinate time across networked systems Audit Trail & Node Authentication Centralized privacy audit trail and node to node authentication to create a secured domain. New Patient Demographics Query New Personnel White Page Access to workforce contact information New Cross-Enterprise Document Sharing Registration, distribution and access across health enterprises of clinical documents forming a patient electronic health record New
    40. 41. Introduction: EHR Cross-Enterprise Document Sharing First step towards the longitudinal dimension of the EHR Focus: Support document sharing between EHRs in different care settings and organizations
    41. 42. Acute Care (Inpatient) PCPs and Clinics (Ambulatory) Long Term Care Other Specialized Care or Diagnostics Services Sharing and accessing Documents EHR-CR: Care Record systems supporting care delivery Documents Registry EHR-LR: Longitudinal Record as used across-encounters Document Repository Submission of Document References Retrieve of selected Documents
    42. 43. Standards selection for IHE XDS No single standard can address Cross-enterprise Document Sharing Marriage of healthcare and IT standards facilitates implementation and leverages complementary technologies (e.g. security & privacy). Healthcare Content Standards HL7 CDA, CEN EHRcom ASTM CCR DICOM, etc. Internet Standards HTML, HTTP, ISO, PDF, JPEG, etc. Electronic Business Standards ebXML Registry, SOAP, etc.
    43. 44. Workshops and Connect-a-thon <ul><li>IHE Workshops: </li></ul><ul><ul><li>September 13-15 2004 – North America </li></ul></ul><ul><ul><li>February 7-10 2005 – Europe </li></ul></ul><ul><li>2005 IHE Connect-a-thons: </li></ul><ul><ul><li>January 17-21 – North America </li></ul></ul><ul><ul><li>February – Japan </li></ul></ul><ul><ul><li>April 25-29 – Europe (week before HL7 in NL) </li></ul></ul><ul><ul><li>To Be Announced – Taiwan and Korea. </li></ul></ul>
    44. 45. HIMSS 2005 Interoperability Showcase <ul><li>HIMSS leverages its sponsorship of IHE to demonstrate practical interoperability in two large Showcase Exhibits: </li></ul><ul><li>cross-enterprise sharing of health information in the acute care (18 vendors) and ambulatory (14 vendors). </li></ul><ul><li>HIMSS Showcase exhibits linked with vendor booths (10 vendors) show-wide. </li></ul><ul><li>Show-wide interactive environment demonstrating attendees “patient” record in a “HIMSS RHIO”. Uses IHE Cross-enterprise Document Sharing: </li></ul><ul><ul><li>Around a central document registry </li></ul></ul><ul><ul><li>Distributed document repositories </li></ul></ul><ul><ul><li>17 EHR that publish/share documents (CCR, CDA, HL7-lab, PDF) </li></ul></ul>
    45. 46. Infrastructure and Interoperability <ul><li>Cross-Enterprise Document Sharing (XDS) minimizes clinical data management by the infrastructure. Transparency = Ease of Evolution </li></ul><ul><li>XDS works with other IHE Integration Profiles: </li></ul><ul><ul><li>Audit Trail and Node Authentication (ATNA) </li></ul></ul><ul><ul><li>Patient Id Cross-referencing (PIX) </li></ul></ul><ul><ul><li>Patient Demographics Query (PDQ) </li></ul></ul><ul><li>In 2005, IHE plans to complement a set of integration profiles to build regional Health networks, candidates: </li></ul><ul><ul><li>Security: Identity Management + Info for Access Control </li></ul></ul><ul><ul><li>Content Profiles: DICOM, HL7-CDA, HL7-Lab, PDF (legacy) </li></ul></ul><ul><ul><li>Provider Notification (with doc reference) and Point-to-point Transfer </li></ul></ul><ul><ul><li>Dynamic Clinical Data Mgt (Allergy lists, Problem Lists) </li></ul></ul><ul><li> Prioritization of Candidate Integration Profiles November-December 2004. Technical development January-July 2005. Open to all. </li></ul>
    46. 47. IHE, the effective bridge between information exchange standards and their practical use in healthcare
    47. 48. IHE today, more info. IHE Radiology  www.rsna.org/ihe TF RAD V5.5 + 4 Trial Impl. Supplements IHE IT Infrastructure  www.himss.org/ihe TF ITI V1.1 + 4 Trial Impl. Supplements IHE Laboratory  www. himss .org/ihe TF LAB V1.0 IHE Cardiology  www.acc.org/quality/ihe.htm TF CARD V1.0 for Trial Implementation IHE Europe  IHE–Europe.org

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