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Public Health Data Standards Consortium http://www.phdsc.org. Functional Standards for Electronic Data Exchange between Clinical Care and Public Health WORKING WITH VENDOR COMMUNITY: PHDSC COLLABORATION WITH IHE Anna Orlova, PhD Executive Director. - PowerPoint PPT Presentation
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Public Health Data Standards Consortium http://www.phdsc.org
Functional Standards for Electronic Data Exchange between Clinical Care and Public Health
WORKING WITH VENDOR COMMUNITY:PHDSC COLLABORATION WITH IHE
Anna Orlova, PhDExecutive Director
PUBLIC HEALTH DATA STANDARDS CONSORTIUM~ 2007 BUSINESS MEETING OF MEMBERS ~
October 2-3, 2007, Hyattsville, MD
W W W . I H E . N E TW W W . I H E . N E T
Providers and Software DevelopersWorking Together to Deliver
Interoperable Health Information Systemsin the Enterprise
and Across Care Settings
Presented by Dan Russler, M.D., IHE PCC Co-chair
IHE Workshop – June 19, 2006
Integrating the Healthcare Enterprise (IHE) Overview
Why IHE?
1970’s—Mainframe Era--$100,000 per interface 1990’s—HL7 2.x--$10,000 per interface 2000’s—IHE Implementation Profiles—
Cheaper than a new phone line!
How? IHE Eliminates Options Found in Published Standards
Who is IHE? IHE is a joint initiative among:
American College of Cardiology (ACC) Radiological Society of North America (RSNA) Healthcare Information Management Systems Society (HIMSS) GMSIH, HPRIM, JAHIS (laboratory) American Society of Ophthalmology American College of Physicians (ACP) American College of Clinical Engineering (ACCE) And many more….
Began in 1997 in Radiology (RSNA) and IT (HIMSS) International effort: IHE- Europe and IHE-Asia Additional sponsors for Cardiology including ASE, ESC, ASNC,
SCA&I, HRS and more
IHE Industry Professionals
Electronic Health Record
Cardiology
Laboratory
Radiology
Oncology
Future
Domains
IHE
IT Infrastructure
14 Integration Profiles
5 Integration Profiles
4 Integration Profiles
1133 IInntteeggrraattiioonn PPrrooffiilleess
Patient Care Coordination
1 Integration Profile
Patient Care
Devices
Pathology
Eye Care
IHE 2006 – Nine Active Domains IHE 2006 – Nine Active Domains Over 100 vendors involved world-wide,Over 100 vendors involved world-wide, 5 Technical 5 Technical
FrameworksFrameworks37 Integration Profiles, Testing at Connectathons37 Integration Profiles, Testing at ConnectathonsDemonstrations at major conferences world-wideDemonstrations at major conferences world-wide
15 Active national chapters on 4 continents15 Active national chapters on 4 continents
IHE Standards-Based Integration Solutions IHE Standards-Based Integration Solutions IHE Standards-Based Integration Solutions IHE Standards-Based Integration Solutions
Professional Societies Sponsorship Healthcare Providers & Software Developers
Healthcare IT Standards HL7, DICOM, etc.
General IT Standards Internet, ISO, etc.
Interoperable Healthcare IT Solution Specifications
IHE Integration Profile Interoperable Healthcare IT
Solution Specifications IHE Integration Profile
Interoperable Healthcare IT Solution Specifications
IHE Integration Profile Interoperable Healthcare IT
Solution Specifications IHE Integration Profile
IHE Process
IHE in 2007 – 18 Month Development Cycles IHE in 2007 – 18 Month Development Cycles
• First Cycle:First Cycle:• Planning Committee Proposals:Planning Committee Proposals: October, 2007October, 2007• Technical Committee Drafts: Technical Committee Drafts: June, 2008June, 2008• Public Comment Due:Public Comment Due: July 2008July 2008• Trial Implementation Version: Trial Implementation Version: August 2008August 2008• Mesa Tool Test Results Due:Mesa Tool Test Results Due: December 2008December 2008• IHE Connectathon: IHE Connectathon: January 2009January 2009• HIMSS Demo: HIMSS Demo: February 2009February 2009• Participant Comments Due:Participant Comments Due: March 2009March 2009• Final Implementation Version: Final Implementation Version: June 2009June 2009
IHE Technical Frameworks
Pt. Registration [RAD-1] Patient Update [RAD-12]
Pt. Registration [RAD-1] Patient Update [RAD-12]
Placer Order Management [RAD-2] Filler Order Management [RAD-3]
ADT
Query Images [RAD-14] Retrieve Images/Evidence [CARD-4]
Image Display
Modality Image/Evidence Stored [CARD-2]
Storage Commitment
[CARD-3]
Procedure Scheduled [RAD-4]
Procedure Updated [RAD-13]
Query Modality Worklist [RAD-5]
Performed Procedure
Step Manager
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Order Placer
Acquisition Modality
ImageManager
ImageArchive
DSS/ Order Filler
Patient Update [RAD-12]
Modality Image/Evidence Stored [CARD-2]
Storage Commitment
[CARD-3]
Evidence Creator Modality PS in Progress [CARD-1]
Modality PS Completed [RAD-7]
Instance Availability Notification [RAD-49]
Pt. Registration [RAD-1] Patient Update [RAD-12]
Pt. Registration [RAD-1] Patient Update [RAD-12]
Placer Order Management [RAD-2] Filler Order Management [RAD-3]
ADT
Query Images [RAD-14] Retrieve Images/Evidence [CARD-4]
Image Display
Modality Image/Evidence Stored [CARD-2]
Storage Commitment
[CARD-3]
Procedure Scheduled [RAD-4]
Procedure Updated [RAD-13]
Query Modality Worklist [RAD-5]
Performed Procedure
Step Manager
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Order Placer
Acquisition Modality
ImageManager
ImageArchive
DSS/ Order Filler
Patient Update [RAD-12]
Modality Image/Evidence Stored [CARD-2]
Storage Commitment
[CARD-3]
Evidence Creator Modality PS in Progress [CARD-1]
Modality PS Completed [RAD-7]
Instance Availability Notification [RAD-49]
Query Modality Worklist [RAD-5]
ADT Order Placer
Register J.Doe
AcquisitionModality
Placer OrderManagement –New [RAD-2]
Patient Reconciliation
Department System Scheduler/Order Filler
Schedule Procedure
Procedure Scheduled [RAD-4]
Modality Procedure Step Completed [RAD-7]J.Doe ->
J.Smith
Patient Update/Merge [RAD-12]
Modality Procedure Step Completed [RAD-7]
PatientRegistration [RAD-1]
Patient Update/
Merge [RAD-12]
Modality Procedure Step In Progress [CARD-1]
Modality Procedure Step In Progress [CARD-1]
Perform Acquisition
Filler Order Mgmt - Status Update [RAD-3]
Filler Order Mgmt - Status Update [RAD-3]
ImageManager/
PPS Manager
Filler Order Management -New [RAD-3]
One or the other methods of creating an order is used
Query Modality Worklist [RAD-5]
ADT Order Placer
Register J.Doe
AcquisitionModality
Placer OrderManagement –New [RAD-2]
Patient Reconciliation
Department System Scheduler/Order Filler
Schedule Procedure
Procedure Scheduled [RAD-4]
Modality Procedure Step Completed [RAD-7]J.Doe ->
J.Smith
Patient Update/Merge [RAD-12]
Modality Procedure Step Completed [RAD-7]
PatientRegistration [RAD-1]
Patient Update/
Merge [RAD-12]
Modality Procedure Step In Progress [CARD-1]
Modality Procedure Step In Progress [CARD-1]
Perform Acquisition
Filler Order Mgmt - Status Update [RAD-3]
Filler Order Mgmt - Status Update [RAD-3]
ImageManager/
PPS Manager
Filler Order Management -New [RAD-3]
One or the other methods of creating an order is used
Detailed standards implementation guides
HIMSS IHE Interoperability ShowcaseFebruary 2006 Participants
Leadership Level
Blue WareCernerGE Healthcare +IDX
IBMInitiate SystemsInterSystems MiSys Healthcare Quovadx Siemens
Implementer LevelAllscriptsCanonCapMedCardiac ScienceCGI-AMS CompassCareCPSI DictaphoneDR SystemsEastman KodakEclipsys Epic SystemsHIPAAT
HX TechnologiesINFINITT TechnologyKryptiqMcKesson MedAccess PlusMedical Informatics MediNotes MNINational Institute of Sci & TechNextGen Healthcare Philips Medical ScImageWitt Biomedical
Supporter Level:
Acuo
Bond
Carefx
Clearcube
Dairyland
EMC
Identrus
Intel
Mediserve
Medkey
Motion Comp.
Picis
Pulse
Sentillion
Organizational participant:
American Coll. of Clinical Eng.
Catholic Healthcare West
US Dept of Defense
US Dept of Veterans Affairs
DMP–French Natl. Personal EHRHealth Level 7 HTP IEEEMidmark Diagostics GroupHIMSS RHIO FederationLiberty AllianceUniv. of Washington
IHE Connectathon, January 2006•300+ participants, 120+ systems300+ participants, 120+ systems•60+ systems developers60+ systems developers•Four Domains: Cardiology, IT Infrastructure, Four Domains: Cardiology, IT Infrastructure,
Patient Care Coordination, RadiologyPatient Care Coordination, Radiology•2800+ monitored test cases2800+ monitored test cases
ResultsOver 3000 attendees visited the HIMSS RHIO
Showcase37 vendors demonstrated 48 systems700 attendees created and tracked their own
health record63 educational sessions were presented5 International delegations3 VIP tours16 clinical scenarios were demonstrated
IHE Integration Profiles for Health Info NetsWhat is available and has been added in 2005 and is for 2006
Patient Demographics Query
Patient Identifier Cross-referencing
Map patient identifiers across independent identification
domains
Cross-Enterprise Document Sharing
Registration, distribution and access across health enterprises of clinical
documents forming a patient
electronic health record
Cross-enterprise Document Point-Point Interchange
Media-CD/USB & e-mail push
Emergency Referrals
Format of the Document Content and associated coded vocabulary
PHR Extracts/Updates
Format of the Document Content and associated coded vocabulary
ECG Report Document
Format of the Document Content and associated coded vocabulary
Lab Results Document Content
Format of the Document Content and associated coded vocabulary
Scanned Documents
Format of the Document ContentImaging Information
Format of the Document Content and associated coded vocabulary
Medical Summary (Meds, Allergies, Pbs)
Format of the Document Contentand associated coded vocabulary
Consistent TimeCoordinate time across networked
systems
Audit Trail & Node Authentication
Centralized privacy audit trail and node to node authentication to create
a secured domain.
Basic Patients Privacy Consents
Establish Consents & Enable Access Control
Document Digital Signature
Attesting “true-copy and origin
Notification of Document Availability
Notification of a remote provider/ health enterprise
Request Formfor Data Capture
External form with custom import/export scripting
Patient Id MgtPatient Id MgtSecuritySecurityClinical and PHRClinical and PHRContentContent
Health Data ExchangeHealth Data Exchange OtherOther
AHIC-ONC BIO Consolidated Use Case
Component
Lab Report Document
BaseStd
HL7 V2.5
BiosurveillancePatient-Level Data to Public Health
Document-based Submission
IHEPIXPDQ
IHEXDS
BaseStdHL7
CDA r2
IHE XDS-LAB
BaseStd
ISO 15000ebRS 2.1/3.0
Transaction Package
Manage Sharing of Docs
Transaction
Notif of Doc Availability
IHE NAV
Component
Lab Terminology
BaseStd
LOINC
HITSP
IHE XDS-MS
IHE XDS-I
BaseStd
DICOMHCPCS
CPT
CCCICD 9/10
NCCLS
UB-92
FIPS 5-2
HL7 V3
HL7 V2.5SNOMED-CT
LOINC
UCUM
HAVE
TerminologyStandards
URL
SNOMED-CT
Document-basedScenario
Transaction Package
Consumer/Patient Id X-ref
Component
Anonymize
Transaction
Pseudonymize
BaseStdISODTS/25237
HIPAA
DICOM
Biosurveillance – Patient-level and Resource Utilization Interoperability Specification
BaseStdHL7
QBP^Q23RSP^K23
PHDSC was Invited to Form PHDSC was Invited to Form
Public Health Domain at IHEPublic Health Domain at IHE
Providers and Software DevelopersWorking Together to Deliver
Interoperable Health Information Systemsin the Enterprise
and Across Care Settings
2007 PHDSC Activities at IHE
May – October PHDSC-IHE Task Force to Develop a
White Paper on Building a Roadmap for Interoperability for Public Health
Over 60 participants from public health and clinical communities
To be presented at the IHE Planning Meeting in October Public Health Profile Proposal
Public Health Registry Examples of Cancer and Immunization Domains
IHE Profile Change Proposal Extended PDQ (Patient Data Query) for demographic
information exchanges with public health systems Examples of Cancer and Immunization Domains
IHE White Paper on Public Health Decision Support Examples of Cancer and Immunization Domains
2007-2008 PHDSC Activities at IHE
JOIN THE PHDSC-IHE TASK FORCE
E-mail to Anna Orlova, PHDSC at [email protected]
PHDSC was Invited to Form PHDSC was Invited to Form
A Public Health Domain at IHEA Public Health Domain at IHE
Providers, PUBLIC HEALTH and Software Developers
Working Together to DeliverInteroperable Health Information Systems
in the Enterpriseand Across Care Settings