Expectations and prospects on FHIR and

Interoperability

(Gemini and GCeHI collaboration)

IHE Työkokous12.05.2020

Jürgen BrandstätterGemini Steering Committee

Member, IHE International Board

Deputy Co-chair, IHE Europe

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Director Standards Development, x-tention GmbH

CodeWerk Software Services and Development GmbH

First

Creation of an HIE

is not „the“

problem anymore

12.05.2020 FHIR and Interoperability (Gemini and GCeHI collaboration) 2

HIE

First

Creation of an HIE

is not „the“

problem anymore

12.05.2020 FHIR and Interoperability (Gemini and GCeHI collaboration) 3

HIE

Second

Standards and

Blueprints

are available

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What is a „global“ blueprint?

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Blueprint

eHealth Landscape

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Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Blueprint Blueprint

Blueprint

Blueprint

Blueprint

Blueprint Blueprint

Blueprint Blueprint

Patient

Identification

Audit and

Logging

Document-

sharing

Governance needs blueprints

• EC Recommendation on EHRxformat− eHDSI cross-border of …

• Patient Summary

• ePrescription / eDispense

• Medical Imaging and Reports

• Laboratory Results

• Hospital Discharge Reports

− Based on • Established IHE Profiles

• HL7 CDA content

− Future developments: FHIR• -> Blueprints need yet to crystallize first!

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ITI PCC QRPH

PHARM

FHIR-based IHE profiles

12.05.2020 FHIR and Interoperability (Gemini and GCeHI collaboration)

MHD

PIXmPDQm

mACM mXDE

QEDm

MMAUPB

QORE

8

FHIR ATNA

mCSD

SOLE NPFSm

PMDTPCS

RIPTACDC

RECON

GAO

CMAPDCTM

DCP

BFDE-EmRFD

mADXPRQ

VRDR

Overview on IHE Profiles: https://wiki.ihe.net/index.php/Profiles (marked with )

FHIR IG Overview on fhir.org: http://www.fhir.org/guides/registry

ITI PCC QRPH

PHARM

FHIR-based IHE profiles

12.05.2020 FHIR and Interoperability (Gemini and GCeHI collaboration)

MHD

PIXmPDQm

mACM mXDE

QEDm

MMAUPB

QORE

9

FHIR ATNA

mCSD

SOLE NPFSm

PMDTPCS

RIPTACDC

RECON

GAO

CMAPDCTM

DCP

BFDE-EmRFD

mADXPRQ

VRDR

Overview on IHE Profiles: https://wiki.ihe.net/index.php/Profiles (marked with )

FHIR IG Overview on fhir.org: http://www.fhir.org/guides/registry

How it should be orchestrated

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Requirements Implementation

Developing thebase standards

Profiling the standard for particular communities

Driving Solutions intoproduction in the market

International collaborations …

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• Governmental bodies start engaging

• Global Digital Health Partnership (GDHP)− 30 countries + WHO

− Informal gov-gov collaboration

• Gemini - A Joint Initiative of IHE and HL7 toAdvance Use of FHIR for Interoperability

• Global Consortium for eHealth Interoperability− HIMSS / IHE / HL7

www.gdhp.org

globalhealthinterop.org

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Gemini

A Joint Initiative of IHE and HL7

to Advance Use of FHIR for

Interoperability

In the special case of FHIR

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Projectathon

Standards

Profiles

Interoperability

Specifications

IHE Conformity

Assessment

eHealth Projects

Product

Test ReportISO17025

Product

Transactions

Actors

Workflow

Use-case

Content

Re

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Re

s

Pro

file

d

FH

IR r

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Re

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Re

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Wo

rkfl

ow

sF

HIR

IG

s

:

Path from Standard to Tested Interoperable Product

Mandate, Mission, Parity

• Mandate− Project GEMINI operates under the Statement of

Understanding between IHE and HL7

• Mission− Tighten collaboration between IHE and HL7 in the

context of FHIR

• Parity− GEMINI is a „Joint“ IHE / HL7 project

− Joint ownership and steering under equal parity

• Main work− Coordinate! Establish connections!

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About Gemini

• Area 1: Development and Tooling of „FHIR-based IHE profiles“− FHIR-based IHE profiles remain under IHE governance, but participation and

contribution of HL7 shall be encouraged (as well as participation of IHE in HL7)

− This includes collaborative work, alignment of tooling, mutual notification of new work-items, etc.

• Area 2: Publication of „FHIR-based IHE profiles“− Align publication of FHIR Implementation Guides and FHIR-based IHE profiles by

referencing FHIR-based IHE profiles on fhir.org

• Area 3: Testing− Positioning of the current testing initiatives, such as HL7 FHIR Connectathons, IHE

Connectathons, IHE Conformity Assessment and coordination of the test tooling ecosystem across both organizations

• Area 4: Pilot projects− Identify, agree and execute joint IHE/HL7 pilot projects and demonstrations

• Area 5: Joint Messaging and Marketing− Maintain joint messaging/marketing/education on HL7 FHIR and FHIR-based IHE

profiles on fhir.org

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Gemini Projects

Medical Imaging for Cancer Care

• Gemini shall coordinate …− Specification development

− Progressively more rigorous interoperability testing

− Implementation activities

− Appropriately timed communications and public demonstrations

• Partners− SMART on FHIR/Sync for Science

− HL7 Imaging Integration WG/DICOM WG20

− FHIRcast

− Clinical Interoperability Council/Clinical Information Modeling Initiative

− ACR-RSNA Common Data Elements Steering Committee

− IHE Radiology

− IHE-USA and IHE-Europe

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Gemini Projects

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Source: QRPH Presentation on CCG Profile, Derek Ritz

Gemini Projects

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Source: QRPH Presentation on CCG Profile, Derek Ritz

Gemini Projects

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Source: QRPH Presentation on CCG Profile, Derek Ritz

Gemini Projects

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Source: QRPH Presentation on CCG Profile, Derek Ritz

See detailed explanation video at

https://vimeo.com/356829962

Gemini Projects

Device Interoperability using SDPi+FHIR

• Collaborative initiative between HL7 Devices and IHE Devices Domain

• Consolidate various device interoperability projects:− HL7 FHIR (and the Devices on FHIR Implementation Guide work)

− IHE Service-oriented Device Point-of-care Interoperability (SDPi) technical framework specifications

• Focus− High-acuity Point-of-Care, Healthcare enterprise, and home/mobile

• Goals− Simplify the device interoperability story presented by both orgs

− Gain participant efficiency and productivity

− Achieve a more tightly coupled, coherent set of specifications

• Includes collaboration with related activities in− IEEE 11073, ISO/TC 215 & IEC/SC 62A JWG 7

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Gemini Projects

Device Interoperability using SDPi+FHIR

• One set of cohesive, coordinated deliverables

− IHE SDPi Supplement – published 2020 JUL, PAT/CAT testing Q3/4 ’20

− HL7 Devices on FHIR IG supporting SDC integration & Alerting – ballot in 2020

• DoF IG (proposed) for Device Information Consumers (title TBD)

− Joint White Papers:

• “Safe, Effective & Secure MDI Using SDC/SDPi + FHIR” – Quality / Regulatory / Legal Considerations

• “What is a device?” - including AI/ML SAMD, across use context geographies

• Governance based on HL7 or IHE project home organization processes

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GCeHI

• Global Consortium for eHealth Interoperability (HIMSS / IHE / HL7)

• Launched at ONC Annual Meeting in Washington, D.C, January 27, 2020− https://www.himss.org/resource-news/announcing-

global-consortium-ehealth-interoperability

• Rapidly advance global digital health efficiency through next generation API-based interoperability

• Founded to become a global community− Collaborate to succeed!

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• Covene stakeholders to …− Support the implementation of safe, usable and

effective health data standards

− Accelerate the development and adoption of secure and open standards-based APIs

− Define an on-ramp for exchange via APIs

− Facilitate the establishment of implementation communities around the world

• Participation model (fee-based)− Government agencies / MoH / NGOs

− Provider organizations

− SDOs

− Market suppliers

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GCeHI

GCeHI

• Current (first) activity of GCeHI: COVID-19 Listening sessions

− Session 1 Focus – Clinical Care: Clinicians and Provider Organizations on the Frontline of COVID-19

• Data exchange needs and pain points

• Wednesday, April 29th at 1:00-2:30 PM CT. Register Here.

− Session 2 Focus - Technology: HIT Professionals and Market Suppliers

• Accelerating Interoperability by Leveraging Existing Resources

• Wednesday, May 27th at 2:00-3:30 PM CT. Register Here.

− Session 3 Focus – Policy: How Governments and Ministries of Health are Working with the Industry to Respond to COVID

• Wednesday, June 24th at 2:00-3:30 PM CT. Register Here.

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GCeHI

• Future work (ideas and draft)− GCeHI Portal

− More listening sessions

− Interoperability dashboard (Info on projects)

− Global master standards list (info on established standards)

− Interoperability measurement/maturity models

− Shared use cases, best practices around implementation/deployment

• Plus: Work-items brought by participants, e.g.− Coordinated work on new standards / blueprints

Everything which is too big/complex for one of the organizations alone

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Links

• Gemini− https://confluence.hl7.org/display/GP/Project+Gemini

• Global Consortium for eHealth Interoperability (GCeHI)− http://globalhealthinterop.org

• GDHP, Global Digital Health Partnership− https://www.gdhp.org

• Interesting publications− eHealth Suisse Summary IHE / HL7 / FHIR

• https://www.e-health-suisse.ch/fileadmin/user_upload/Dokumente/E/overview-ihe-hl7-fhir.pdf

− The 3 Legs of the Health Informatics Standards Process• http://www.healthintersections.com.au/?p=2921

− The 4 aspects that change the game in eHealth Interoperability• https://www.linkedin.com/pulse/4-aspects-change-game-ehealth-interoperability-j%C3%BCrgen-

brandst%C3%A4tter

− European Commission recognizes 27 IHE profiles that should be referenced in public procurement documents

• http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=OJ:JOL_2015_199_R_0011

12.05.2020 28FHIR and Interoperability (Gemini and GCeHI collaboration)

Links

• IHE Homepage

− http://www.ihe.net/

− http://www.ihe-europe.net/

• IHE Wiki

− http://wiki.ihe.net/

• IHE International Social Media

− YouTube channel: https://www.youtube.com/user/IHEIntl

− IHE Webinars: http://www.ihe.net/Webinars/

− Twitter: https://twitter.com/IHEIntl

• Google groups

− https://groups.google.com/forum/#!search/ihe

12.05.2020 29FHIR and Interoperability (Gemini and GCeHI collaboration)

Changing the Way Healthcare CONNECTS

http://www.ihe.net

Jürgen Brandstätter

juergen.brandstaetter@ihe-europe.net

LinkedIn: https://www.linkedin.com/in/jbrandstaetter

Twitter: JuBrandstaetter