1September, 2005 What IHE Delivers

IHE Patient Care IHE Patient Care Coordination Domain Coordination Domain

Update Update HIMSS Interoperability Showcase February 2008HIMSS Interoperability Showcase February 2008Keith W. BooneKeith W. BooneInteroperability Architect, GE HealthcareInteroperability Architect, GE Healthcare

Co-chair, IHE PCCCo-chair, IHE PCCCo-chair, HL7 Structured DocumentsCo-chair, HL7 Structured DocumentsConvener, HITSP Care Management and Health Records Domain TCConvener, HITSP Care Management and Health Records Domain TC

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Patient Care CoordinationPatient Care Coordination

Established in 2005Established in 2005

ScopeScope

Integration issues that cross providers, patient problems or Integration issues that cross providers, patient problems or time. time.

General clinical care aspects such as General clinical care aspects such as • document exchange, document exchange,

• order processing, order processing,

• coordination with other specialty domains. coordination with other specialty domains.

Address workflows and the integration needs of specialty Address workflows and the integration needs of specialty areas without a separate domain within IHEareas without a separate domain within IHE

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Sponsors and Professional SocietiesSponsors and Professional Societies

SponsorsSponsors

Health Information Management Systems SocietyHealth Information Management Systems Society

American College of PhysiciansAmerican College of Physicians

Professional SocietiesProfessional Societies

American College of Obstetricians and GynecologistsAmerican College of Obstetricians and Gynecologists

American College of Emergency PhysiciansAmerican College of Emergency Physicians

93 Organizational Members of IHE93 Organizational Members of IHE

http://www.ihe.net/governance/member_organizations.cfmhttp://www.ihe.net/governance/member_organizations.cfm

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PCC Activities to DatePCC Activities to Date

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PCC Activities for 2008-2009PCC Activities for 2008-2009

Care ManagementCare Management Chronic Disease ManagementChronic Disease Management Immunization RegistriesImmunization Registries Cancer RegistriesCancer Registries

Clinical TrialsClinical Trials

Antepartum RecordAntepartum Record

Medical HomeMedical Home

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IHE PCC Nursing SubcommitteeIHE PCC Nursing Subcommittee

PCC Approved the formation of a Nursing PCC Approved the formation of a Nursing Subcommittee in November 2008Subcommittee in November 2008 Membership open to any IHE MemberMembership open to any IHE Member

• See See www.ihe.net/governancewww.ihe.net/governance Call for Co-chair Nominations occurring soonCall for Co-chair Nominations occurring soon

Initial FocusInitial Focus Review of ALL IHE Activities involving NursingReview of ALL IHE Activities involving Nursing Leading development of Nursing specific profilesLeading development of Nursing specific profiles Liason with other IHE DomainLiason with other IHE Domain

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Categories of Healthcare Communication ServicesCategories of Healthcare Communication Services

Security

DocumentSharing

Patient and Provider ID Mgt

DynamicInformation

Access

WorkflowManagement

Source persisted and attested health

records

Specific info snapshot

provided on demand

2 or more entitiessynchronize

a task

e.g. access to last 6 months historical

labs and encounter summaries

e.g. order a lab test, track status and receive results

e.g. get a current list of allergies or med list from a source

HospitalsHIEs and RHIOs

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Combining IHE ProfilesCombining IHE ProfilesDocument Content & Modes of Document ExchangeDocument Content & Modes of Document Exchange

Document Exchange Integration ProfilesDocument Exchange Integration Profiles

DocumentDocument SharingSharing

XDSXDS

MediaMediaInterchangeInterchange

XDMXDM

Reliable Pt-PtReliable Pt-PtInterchangeInterchange

XDRXDR

Doc Content Profiles Doc Content Profiles (Semantics content)(Semantics content)

Scanned DocScanned Doc

XDS-SDXDS-SD

Discharge &Discharge &ReferralsReferrals

XDS-MSXDS-MS

ImagingImaging

XDS-IXDS-I

ConsentConsent

BPPCBPPCEmergencyEmergency

EDREDRED EncounterED Encounter

SummarySummary

EDESEDES

Functional Status Functional Status AssessmentAssessment

FSAFSA

LaboratoryLaboratory

XD*-LabXD*-LabPHR PHR

ExchangeExchange

XPHRXPHR

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Use of a shared XDS InfrastructureUse of a shared XDS Infrastructure

HospitalHospital

Ambulatory or Ambulatory or Specialty CenterSpecialty CenterHomeHome

Between Providers and :Between Providers and :• SSpecialistspecialists• PatientsPatients

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Community Community Network ANetwork A

Document Registry

PracticePracticePractice

ClinicClinicClinicClinic

HospitalsHospitalsHospitalsHospital

Diag Test

Other

PracticePractice HospitalHospital

Community Community Network CNetwork C

Document Registry

PracticePractice

Clinic

Hospitals

Hospitals

HIMSS NHIN: Network of networksHIMSS NHIN: Network of networksThe largest multi-vendor HIE Prototype ever built !The largest multi-vendor HIE Prototype ever built !

3 infrastructure3 infrastructure7 local systems7 local systems

3 infrastructure3 infrastructuresystemssystems

Community Community Network BNetwork B

Document Registry

PracticePracticePracticePracticePractice

ClinicClinicClinicClinic

HospitalsHospitalsHospitals

Diag Test

Community Community Network DNetwork D

Document Registry

PracticePractice

Clinic

Hospitals

Hospitals

6 infrastructure6 infrastructure9 local systems9 local systems

3 infrastructure3 infrastructure9 local systems9 local systems 2 infrastructure2 infrastructure

4 local systems4 local systems

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2008 HIMSS Interoperability Showcase2008 HIMSS Interoperability Showcase

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IHE, global standards-based profiles adopted by IHE, global standards-based profiles adopted by several national & regional projectsseveral national & regional projects

Quebec, Toronto,Alberta, British Columbia

Canada Infoway

Denmark (Funen)Italy (Veneto)Spain (Aragon)

THINC- New YorkNCHICA – N. Carolina

Italy (Conto Corrente

Salute)

Boston Medical

Center - MA

FranceDMP

UK CfH(Radiology WF)

Philadelphia HIE

CHINA-MoHLab results sharing

CPHIC – Pennsylvani

a

CHINA-ShanghaiImaging Info Sharing

JAPAN-NagayaImaging Info Sharing

South Africa

Malaysia

VITL-Vermont

CareSpark – TN & VA

NetherlandAmsterdam

LowerAustria

Austria

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NHIN-2 ProjectsNHIN-2 Projects

CareSpark – Tricities region CareSpark – Tricities region of Eastern Tennessee and of Eastern Tennessee and Southwestern VirginiaSouthwestern Virginia

Delaware Health Information Delaware Health Information NetworkNetwork

Indiana UniversityIndiana University

Long Beach Network for Long Beach Network for HealthHealth

Lovelace Clinic Foundation Lovelace Clinic Foundation – New Mexico– New Mexico

MedVirginiaMedVirginia

New York eHealth CollaborativeNew York eHealth Collaborative

North Carolina Healthcare North Carolina Healthcare Information and Communications Information and Communications Alliance, Inc. (NCHICA)Alliance, Inc. (NCHICA)

West Virginia Health Information West Virginia Health Information NetworkNetwork

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The PCC Technical Framework The PCC Technical Framework enable both semantic enable both semantic

interoperability and simple viewing !interoperability and simple viewing !

SSttrruuccttuurreedd CCoonntteenntt wwii tthh ccooddeedd sseecctt iioonnss::

Reason for Referral Vital Signs

MMeeddiiccaattiioonn

Studies AAlllleerrggiieess

Social History PPrroobblleemmss

Care Plan

PCC PCC TechnicalTechnical Framework FrameworkHL7 HL7 ClinicalClinical Document Architecture (CDA) Release 2 Document Architecture (CDA) Release 2

and ASTM/HL7 and ASTM/HL7 ContinuityContinuity of Care of Care

Structured and Coded Header Patient, Author, Authenticator, Institution, Time of Service, etc.

Header always structured and coded

Title-coded sections with non-structured nor coded content (text, lists, tables). Simple Viewing (XML Style sheet)

Level 1Level 1

Level 2Level 2

Text StructureEntry

Text Structure Entry

Med, Problems and Allergies as highly structured text. Text easy to import/parse

Text StructureEntry

Level 3Level 3

CC

HIT

08C

CH

IT 08

Med Problems and Allergies have afine-grain structure with optional coding. Coding Scheme explicitly identified.

Coded Section Entry

Coded Section Entry

Coded Section Entry

Level 3Level 3

CC

HIT

09C

CH

IT 09

151515

IHE Profiles are IHE Profiles are consistent with HHS consistent with HHS Accepted StandardsAccepted Standards(HITSP Interoperability (HITSP Interoperability

Specifications)Specifications)

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As a Provider or Vendor ContributorAs a Provider or Vendor Contributor

Offer Clinical Use Case Input to Drive IHE Profile DevelopmentOffer Clinical Use Case Input to Drive IHE Profile Development

Become a member of relevant domain’s Planning or Technical Become a member of relevant domain’s Planning or Technical CommitteesCommittees

Become a member of relevant Regional/National CommitteesBecome a member of relevant Regional/National Committees

Help to shape IHE’s future directionHelp to shape IHE’s future direction

As a Vendor ParticipantAs a Vendor Participant

Respond to Public Comments of Domain SupplementsRespond to Public Comments of Domain Supplements

Attend the June Educational WorkshopAttend the June Educational Workshop

Participate in Connect-a-thons and DemonstrationsParticipate in Connect-a-thons and Demonstrations

As a Provider/Consultant ParticipantAs a Provider/Consultant Participant

Respond to Public Comments of Domain SupplementsRespond to Public Comments of Domain Supplements

Attend the June Educational Workshop Attend the June Educational Workshop

Attend Demonstrations and include IHE Integration Profiles in your RFPs Attend Demonstrations and include IHE Integration Profiles in your RFPs and Integration Projects.and Integration Projects.

How can I participate?How can I participate?

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What can you do?What can you do?

Attend the IHE Domain specific sessions in these Attend the IHE Domain specific sessions in these Theaters during HIMSS 2007 (Orange sessions)Theaters during HIMSS 2007 (Orange sessions)

Learn about IHE, Learn about IHE, www.ihe.netwww.ihe.net

Insist on relevant IHE profiles compliance in your Insist on relevant IHE profiles compliance in your RFPs and contract documents:RFPs and contract documents:

Select Integration Profiles, and Appropriate Actor(s) Select Integration Profiles, and Appropriate Actor(s)

Ask vendors for their products “IHE Integration Ask vendors for their products “IHE Integration Statements”.Statements”.

Need more interoperability ? Need more interoperability ?

Contribute to IHE CommitteesContribute to IHE Committees

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IHE Web site:IHE Web site: www.IHE .netwww.IHE .net Frequently AskedFrequently Asked QuestionsQuestions

Integration Profiles in Technical Frameworks: Integration Profiles in Technical Frameworks: See Volume 1 of each TF for Use casesSee Volume 1 of each TF for Use cases

CardiologyCardiology Eye CareEye Care IT InfrastructureIT Infrastructure LaboratoryLaboratory Patient Care CoordinationPatient Care Coordination Patient Care DevicesPatient Care Devices PathologyPathology QualityQuality Radiation Oncology Radiation Oncology RadiologyRadiology

Connectathon Result: Connectathon Result: www.ihe.net/Events/connectathon_results.cfmwww.ihe.net/Events/connectathon_results.cfm

Vendor Products Integration StatementsVendor Products Integration Statements

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ANSI/HITSP Call for ANSI/HITSP Call for ParticipationParticipation

Care Management and Health Records Domain TCCare Management and Health Records Domain TC Health Information Management ProfessionalsHealth Information Management Professionals Architects and Implementers of EHR SystemsArchitects and Implementers of EHR Systems Experts in Clinical Vocabularies Experts in Clinical Vocabularies

• LOINCLOINC• SNOMEDSNOMED• RxNORMRxNORM

Architects and Implementers of Clinical Decision Support SystemsArchitects and Implementers of Clinical Decision Support Systems HL7 CDA R2 knowledge and implementation experienceHL7 CDA R2 knowledge and implementation experience

20September, 2005 What IHE Delivers