September, 2005What IHE Delivers Charles Parisot, GE healthcare International HL7 Interoperability Conference, Auckland, New Zealand Overview of Integrating

September, 2005 What IHE Delivers

Charles Parisot, Charles Parisot, GE healthcareGE healthcare

International HL7 Interoperability Conference, International HL7 Interoperability Conference, Auckland, New ZealandAuckland, New Zealand

Overview of Overview of Integrating the Healthcare Enterprise Integrating the Healthcare Enterprise (IHE)(IHE)

and Cross-Enterprise Document Sharing and Cross-Enterprise Document Sharing (XDS)(XDS)

22

Presentation ObjectivesPresentation Objectives

Standards adoption and implementation – The Standards adoption and implementation – The IHE processIHE process

Application to a hospital projectApplication to a hospital project

Application to regional and national Health Application to regional and national Health Information ExchangeInformation Exchange

World-wide deployment of IHE IT Infrastructure World-wide deployment of IHE IT Infrastructure ProfilesProfiles

33

IHE: A Framework for InteroperabilityIHE: A Framework for Interoperability

A common framework for harmonizing the use, A common framework for harmonizing the use, implementing and testing multiple standardsimplementing and testing multiple standards

Enables seamless health information movement Enables seamless health information movement within and between enterprises, regions, nationswithin and between enterprises, regions, nations

Promotes unbiased selection and coordinated use Promotes unbiased selection and coordinated use of established healthcare of established healthcare andand IT standards to IT standards to address specific clinical and administrative needs address specific clinical and administrative needs at the international and country levels:at the international and country levels:

HL7, DICOM, W3C, ISO, IEEE, SNOMED, LOINC, HL7, DICOM, W3C, ISO, IEEE, SNOMED, LOINC, ASTM, OASIS, IETF, CDISC, CEN, ECMA, WHO, ETSI, ASTM, OASIS, IETF, CDISC, CEN, ECMA, WHO, ETSI, and many more, etc.and many more, etc.

44

Standards Adoption ProcessStandards Adoption Process

Document Use Case Document Use Case RequirementsRequirementsDocument Use Case Document Use Case RequirementsRequirements

Identify available Identify available standards (standards (e.g. HL7, e.g. HL7, DICOM, IETF, OASIS)DICOM, IETF, OASIS)

Identify available Identify available standards (standards (e.g. HL7, e.g. HL7, DICOM, IETF, OASIS)DICOM, IETF, OASIS)

Develop Develop technical technical

specificationsspecifications

Develop Develop technical technical

specificationsspecifications

Testing at Testing at ConnectathonsConnectathonsTesting at Testing at ConnectathonsConnectathons IHE IHE

DemonstrationsDemonstrationsIHE IHE DemonstrationsDemonstrations

Products Products with IHEwith IHEProducts Products with IHEwith IHE

Timely access to Timely access to informationinformationTimely access to Timely access to informationinformation Easy to integrate Easy to integrate

productsproductsEasy to integrate Easy to integrate productsproducts

55

IHE Participants and RelationshipsIHE Participants and Relationships

Sponsorship: Healthcare Professional OrganizationsSponsorship: Healthcare Professional Organizations

Open World-wide - Participants include:Open World-wide - Participants include: Users - Clinicians, Staff, Administrators, CIOs, Users - Clinicians, Staff, Administrators, CIOs,

Governments.Governments. Vendors - Information Systems and EquipmentVendors - Information Systems and Equipment

• e.g., EMR/EHR, imaging, cardiology, devicese.g., EMR/EHR, imaging, cardiology, devices ConsultantsConsultants

Maintains formal liaison with Standards Maintains formal liaison with Standards Development Organizations (SDOs):Development Organizations (SDOs): HL7, DICOM, ISO (Liaison D), othersHL7, DICOM, ISO (Liaison D), others

ISO TC215 approved IHE Process and Profiles to be ISO TC215 approved IHE Process and Profiles to be published as technical reportspublished as technical reports

66

IHE Organizational StructureIHE Organizational Structure

ACCACPHIMSSRSNA

JAHISJIRAJRS

METI-MLHWMEDIS-DCJAMI

GMSIHSFRSFIL

SIRMBIREuroRec

COCIREAR-ECRDRG

ESC

Professional Societies / Sponsors Contributing &Participating

Vendors

IHE (International) Strategic Development Committee

Global Development

Radiology

Cardiology

ITInfrastructure

Patient CareCoordination

Patient CareDevices

Laboratory

Pathology

Eye care, Quality, etc.

RadiationOncology

IHE Europe

IHE North America

France

USA

Canada

IHE Asia

Japan

Korea Taiwan

Netherlands

Spain Sweden UK

ItalyGermany

Norway

Regional Deployment

China

IHE Pacific ? New Zealand ? Australia ?

77

International Adoption of IHEInternational Adoption of IHE

France

Local Deployment National Extensions (Local Adaptions) Promotional & Live Demonstration Events Conformance Testing

USA

Germany

Italy

JapanUK

Canada

Korea

Taiwan

Norway

Holland

SpainChina

Yea

r 1

(199

9)

Yea

r 2

(200

0)

Yea

r 3

(200

1)

Yea

r 4

(200

2)

Yea

r 5

(200

3)

Yea

r 6

(200

4)

Yea

r 7

(200

5)

Yea

r 8

(200

6)

Pragmatic global standards harmonization + best practices sharing Pragmatic global standards harmonization + best practices sharing

88

Standards: Necessary…Not SufficientStandards: Necessary…Not Sufficient

Standards areStandards are Foundational - to interoperability and communicationsFoundational - to interoperability and communications Broad - varying interpretations and implementationsBroad - varying interpretations and implementations Narrow - may not consider relationships between Narrow - may not consider relationships between

standards domainsstandards domains Plentiful - often redundant or disjointedPlentiful - often redundant or disjointed Focused - standards implementation guides focus only Focused - standards implementation guides focus only

on a single standardon a single standard

IHE provides a standard process for IHE provides a standard process for implementing multiple standardsimplementing multiple standards

99

IHE: Connecting Standards to CareIHE: Connecting Standards to Care

Healthcare professionals work with industryHealthcare professionals work with industry

Coordinate implementation of standards to Coordinate implementation of standards to meet clinical and administrative needsmeet clinical and administrative needs Clinicians and HIT professionals identify the key Clinicians and HIT professionals identify the key

interoperability problems they faceinteroperability problems they face Providers and industry work together to develop and Providers and industry work together to develop and

make available standards-based solutionsmake available standards-based solutions Implementers follow common guidelines in Implementers follow common guidelines in

purchasing and integrating effective systemspurchasing and integrating effective systems

IHE: A forum for agreeing on how to implement IHE: A forum for agreeing on how to implement standards and processes for making it happenstandards and processes for making it happen

1010

IHE ConnectathonsIHE ConnectathonsConnectathons 2007: 430 Connectathons 2007: 430 engineers, 80+ organizations, engineers, 80+ organizations, 160+ systems and applications160+ systems and applications……..integrated in 5 daysintegrated in 5 days

Vendors do not pass…Vendors do not pass…until an IHE Project Manager attest it !until an IHE Project Manager attest it !

1111

Stakeholder BenefitsStakeholder BenefitsHealthcare providers and support staffHealthcare providers and support staff Improved workflowsImproved workflows Information whenever and wherever neededInformation whenever and wherever needed Fewer opportunities for errorsFewer opportunities for errors Fewer tedious tasks/repeated workFewer tedious tasks/repeated work Improved report turnaround timeImproved report turnaround time

VendorsVendors Align product interoperability with industry consensusAlign product interoperability with industry consensus Decreased cost and complexity of interface installation and Decreased cost and complexity of interface installation and

managementmanagement Focus competition on functionality/service space not information Focus competition on functionality/service space not information

transport spacetransport space

SDOsSDOs Rapid feedback to adjust standards to real-worldRapid feedback to adjust standards to real-world Establishment of critical mass and widespread adoptionEstablishment of critical mass and widespread adoption

1212

Growth in IHE DomainsGrowth in IHE Domains

Radiology (18)

IT Infrastructure for Healthcare (17)

Cardiology (7)

Laboratory (6)

Radiation Oncology (1)

Patient Care Coordination (5)

Patient Care Devices (1)

Quality

Eye Care (3)

Veterinary

EndoscopyPharmacy

IHE Global DevelopmentsIHE Global DevelopmentsIntegration Profiles (# X) – Solutions to Real-World Interoperability Integration Profiles (# X) – Solutions to Real-World Interoperability

Needs & Problems:Needs & Problems:

Within Clinical Departments e.g.:Within Clinical Departments e.g.:RadiologyRadiologyCardiologyCardiologyLabLab ......

Across Departmental &Across Departmental &Institutional Boundaries – XDSInstitutional Boundaries – XDS

RHIOsRHIOs (Regional Healthcare Information Organizations) (Regional Healthcare Information Organizations)

EHR EnablersEHR Enablers

Yea

r 1

(199

9)

Yea

r 2

(200

0)

Yea

r 3

(200

1)

Yea

r 4

(200

2)

Yea

r 5

(200

3)

Yea

r 6

(200

4)

Yea

r 7

(200

5)

Yea

r 8

(200

6)

Yea

r 9

(200

7)

Pathology (1)

1313



Application to a hospital project:Application to a hospital project: Two examples,: devices and radiologyTwo examples,: devices and radiology



1414

IHE PCD Technical Framework IHE PCD Technical Framework Volume1 Integration ProfilesVolume1 Integration Profiles

1515

IHE PCD Technical Framework IHE PCD Technical Framework Volume 2 TransactionsVolume 2 Transactions

1616

Device Enterprise Communication Device Enterprise Communication (DEC) Profile(DEC) Profile

1717

DEC Profile Mapping ModelDEC Profile Mapping Model

Periodic physiologic data (heart rate, invasive blood pressure, respiration rate, etc.),

A-periodic physiologic data (non-invasive blood pressure, patient weight, cardiac output, etc.)

Point-of-care laboratory tests (i.e. home blood glucose, etc.)

May include contextual data such as the patient ID, caregiver identification, and patient care device configuration information

1818

DEC Profile Mapping ModelDEC Profile Mapping Model

ISO/IEEE 11073 Domain Information Model and Nomenclature mapped to HL7 Observation Report

ISO/IEEE 11073 Data Types mapped to HL7 Data Types

Mapping preserves measurement context for complex devices.

1919

Measurement Context is DynamicMeasurement Context is Dynamic

2020

IEEE 11073 Domain Information Model IEEE 11073 Domain Information Model Defines Device ContextDefines Device Context

10..nMedical Device System (MDS)

Virtual Medical Device (VMD)

Channel (Chan)

Numeric

Enumeration

1

*

1

*

1

*

1

0..*

Metric

2121

Mapping preserves measurement contextMapping preserves measurement context

Medical Device System (MDS)

Virtual Medical Device (VMD)

Channel (Chan)

Numeric

Enumeration

1

*

1

*

1

*

1

0..*

Metric

2222

Example PCD-01 MessageExample PCD-01 Message

MSH|^~\&|INFO_SRC_PHILIPSÂCDE48234567ABCDÊUI-64||||20061215153500||ORU^R01ÔRU_R01|PMS116621490051| P|2.5|||NE|AL||8859/1 PID|||AB60001^^^Philips Medical^PI||BrooksÂlbert^^^^^L||19610101|M PV1||I|UNIT_1^^Bed1 OBR|1|PMS116621490051ÎNFO_SRC_PHILIPSÂCDE48234567ABCDÊUI-64| PMS116621490051ÎNFO_SRC_PHILIPSÂCDE48234567ABCDÊUI-64| 69837^MDC_DEV_METER_PHYSIO_MULTI_PARAM_MDS^MDC|||20061215153500 OBX|1|ST|184326^MDC_ECG_STAT_ECT^MDC|1.5130.1.184326|""||||||F OBX|2|ST|184327^MDC_ECG_STAT_RHY^MDC|1.5130.1.184327|Sinus Rhythm||||||F OBX|3|NM|150456^MDC_PULS_OXIM_SAT_O2^MDC|1.5238.1.150456|99|262688^MDC_DIM_PERCENT^MDC|||||F OBX|4|NM|147842^MDC_ECG_HEART_RATE^MDC|1.5130.1.147842|81|264864^MDC_DIM_BEAT_PER_MIN^MDC|||||F OBX|5|NM|150037^MDC_PRESS_BLD_ART_ABP_SYS^MDC|1.5190.1.150036|126|266016^MDC_DIM_MMHG^MDC|||||F OBX|6|NM|150038^MDC_PRESS_BLD_ART_ABP_DIA^MDC|1.5190.1.150036|76|266016^MDC_DIM_MMHG^MDC|||||F OBX|7|NM|150039^MDC_PRESS_BLD_ART_ABP_MEAN^MDC|1.5190.1.150036|92|266016^MDC_DIM_MMHG^MDC|||||F OBX|8|NM|148065^MDC_ECG_V_P_C_CNT^MDC|1.5130.1.148065|0|264864^MDC_DIM_BEAT_PER_MIN^MDC|||||F OBX|9|NM|150045^MDC_PRESS_BLD_ART_PULM_SYS^MDC|1.5190.1.150044|26|266016^MDC_DIM_MMHG^MDC|||||F OBX|10|NM|150046^MDC_PRESS_BLD_ART_PULM_DIA^MDC|1.5190.1.150044|9|266016^MDC_DIM_MMHG^MDC|||||F OBX|11|NM|150047^MDC_PRESS_BLD_ART_PULM_MEAN^MDC|1.5190.1.150044|14|266016^MDC_DIM_MMHG^MDC|||||F OBX|12|NM|149538^MDC_PLETH_PULS_RATE^MDC|1.5238.1.149538|55|264864^MDC_DIM_BEAT_PER_MIN^MDC|||||F OBX|13|NM|150067^MDC_PRESS_BLD_ATR_LEFT_MEAN^MDC|1.5190.1.150064|4|266016^MDC_DIM_MMHG^MDC|||||F OBX|14|NM|150087^MDC_PRESS_BLD_VEN_CENT_MEAN^MDC|1.5190.1.150084|12|266016^MDC_DIM_MMHG^MDC|||||F

2323

IHE PCD - US 2007 Connectathon SystemsIHE PCD - US 2007 Connectathon Systems

LiveDataLiveDataOR MgrOR Mgr

GEGECentricity Centricity Periop CISPeriop CIS

PhilipsPhilipsCareVueCareVue

CISCIS

DOR

DOC

ADTA04 Feed MWB

DraegerDraegerInnovianInnovian

CISCIS

GEGEAwareAware

GWGW

PhilipsPhilipsIICIICGWGW

B. BraunB. BraunDoseTracDoseTrac

GWGW

Welch AllynWelch AllynConnexConnex

CISCIS

Validated VS, Vent, Anesth & Med Export, max

every 3 minutes

Validated Vitals export, Batch

Unvalidated VS, Vent, Anesth. Data export

every 1 minute

Unvalidated VS, Vent, Anesth. Data export

every 1 minute

VS MonPt Mon, Vent,Anesthesia

Pt Mon, Vent,Anesthesia


InfusionDevices

CT (Time)Feed

PhilipsPhilipsCareVueCareVue

CISCIS


Validated VS, Vent, Anesth & Med Export, max every 5 minutes

Unvalidated Med (Infusion System)

exported every 1 minute

2424

imagesstored

patientinformation

RIS

examination orders

imagesretrieved

HIS

PACS

procedurescheduled

Prefetch any relevantprior studies

modalityworklist

report

report

Radiology Scheduled Workflow: Use CaseRadiology Scheduled Workflow: Use Case

Registration

Orders Placed

Orders Filled

Film

FilmFolder

Image Manager& Archive

FilmLightbox

report ReportRepository

DiagnosticWorkstation

Modality

acquisitionacquisitionin-progressin-progressacquisitioncompleted

acquisitioncompleted

imagesprinted

AcquisitionModality

2525

To find IHE Profiles:To find IHE Profiles:www.ihe.net /technical_frameworks www.ihe.net /technical_frameworks

Radiology (18)

IT Infrastructure for Healthcare (17)

Cardiology (7)

Laboratory (6)

Radiation Oncology (1)

Patient Care Coordination (5)

Patient Care Devices (1)

Quality

Eye Care (3)

Veterinary

EndoscopyPharmacy

IHE Global DevelopmentsIHE Global DevelopmentsOver 60 Integration and content Profiles (# X)Over 60 Integration and content Profiles (# X)Solutions to Real-World Interoperability Solutions to Real-World Interoperability

Needs & Problems:Needs & Problems:

Within Clinical Departments e.g.:Within Clinical Departments e.g.: RadiologyRadiology CardiologyCardiology LabLab ......

Across Departmental &Across Departmental &Institutional Boundaries – XDSInstitutional Boundaries – XDS

RHIOsRHIOs (Regional Healthcare Information Organizations) (Regional Healthcare Information Organizations)

EHR EnablersEHR Enablers

Yea

r 1

(199

9)

Yea

r 2

(200

0)

Yea

r 3

(200

1)

Yea

r 4

(200

2)

Yea

r 5

(200

3)

Yea

r 6

(200

4)

Yea

r 7

(200

5)

Yea

r 8

(200

6)

Yea

r 9

(200

7)

Pathology (1)

2626



Application to a hospital projectApplication to a hospital project



2727

Health Information Exchanges:Health Information Exchanges:Linking diverse Care Delivery and Personal Health RecordsLinking diverse Care Delivery and Personal Health Records

Health Information Exchange

HospitalGroup

Integrated Care Delivery EMR’s

HospitalGroup

Hospital

Hospital Multi-Practitioner

Clinics

Physician Offices

Lab/pathology

Radiology

Pharmacy

Personal Health Record

Specific Registries

2828

Roles of Integrated Care Delivery EMRsRoles of Integrated Care Delivery EMRs and Health Information Exchanges and Health Information Exchanges

Integrated Care Delivery EMR:• Serves one care delivery organization or a set of closely integrated

organizations.• Cohesive practice and IT strategy• Strong emphasis on advanced clinical decision support and tight

care delivery workflows• Typical: in-patient, hospital groups, affiliated clinics, a GP/PCP office.

Health Information Exchange (HIE): • Serves multiple independent care delivery organizations• Loosely coordinated IT strategy• Strong emphasis on care coordination, longitudinal health

information, access to specific services (referral, diagnosis, etc.), personal health management.

• Typical: from the small community (hospitals+nearby GPs and clinics) to the specialized, regional and national health information network

2929

Integrated Care Delivery EHR:• A centralized Clinical Data Repository with a fine

grained health information data model shared over the entire organization.

• A rich set of applications delivering the value of the CDR, with:

• clinical decision support consistent with CDR data models.• Proactive workflows, care plans.

• Applications and CDR must evolve together.

Health Information Exchange (HIE): • Shared clinical data should be managed both

centralized and distributed to account for organizations with different operational constraints.

• Level of structure and coding in the shared data will lag some of the Care Delivery EHRs (span of standardization, installed base).

• Longitudinal record consistency and depth, trust by source attestation drives encapsulation of encounter/service clinical data into documents.

• Cost, ease of evolution and robustness of shared infrastructure best served with Document Repository/Registry.

Integrated Care Delivery EHRs and HIEsIntegrated Care Delivery EHRs and HIEsWhy different but synergistic Why different but synergistic IT architecture approachesIT architecture approaches ? ?

3030

Interoperability Dimensions for Health Info NetsInteroperability Dimensions for Health Info Nets

SecuritySecurityPrivacyPrivacy Id MgtId Mgt

HealthHealthRecordsRecordsSharingSharing

WorkflowWorkflowTransactionsTransactions

DynamicDynamicQueriesQueries

Content

Content

InfrastructurInfrastructuree

From EHR Vendor Association Interop Roadmap: www.ehrva.org

Immunization Immunization HistoryHistory

Medication Medication HistoryHistory

Examples:Examples:

ePrescriptionePrescription

Laboratory Laboratory Order/ResultsOrder/Results

Examples:Examples:

Care Record Care Record ServiceService

Examples:Examples:

Immunization Immunization QueriesQueries

Medication Medication HistoryHistory

3131

Interoperability Dimensions for Health Info NetsInteroperability Dimensions for Health Info Nets


HealthHealthRecordsRecordsSharingSharing



Content

Content


ITIT

HCHC

From EHR Vendor Association Interop Roadmap: www.ehrva.org

3232

DocumentDocumentSourceSource

DocumentDocumentSourceSource

Document Registry/Repository Model:Document Registry/Repository Model:

DocumentDocumentRepositoryRepository Submit

Doc Meta-data+ References

SubmitDocuments

DocumentDocumentRepositoryRepository

SubmitDoc Meta-data+ References

DocumentDocumentRegistryRegistry

RetrieveDocuments

Query for DocsReferences

DocumentDocumentConsumerConsumer

RetrieveDocuments

3333

Health Information Exchanges Interoperability: Health Information Exchanges Interoperability: Cross-enterprise Document SharingCross-enterprise Document Sharing

• Performance, Scalability and Cost: Registry and Repository are simple

• Content Evolution: Registry and Repositories support any document content (e.g. enable use of HL7 CDA, DICOM, PDF, etc.).

• Real end-to-end structured data: not a portal view, easy to integrate in applications

• Supports centralized and distributed approaches. XDS Domains may be federated.

• Real Interoperability: Standards and profiles in place and in use

• Products are available: over 100 vendors world-wide. Tested at IHE Connectathons.

• Selected by a significant number of regional and national programs

3434

Example: Example: Providing Access to Prior Health InformationProviding Access to Prior Health Information

Acute Care (Inpatient)

PCPs and Clinics (Ambulatory)

Long Term Care

Other Specialized Careor Diagnostics Services

Shared DocumentRepository

Longitudinal Record as usedacross-encounters

Encounter Medical Summary (med-prescribed & dispensed, allergies, pbs, etc)Lab Report (structured & coded tests results)

Radiology Report and Images Links

EKG Report

PublicHealth

3535

IHE Profiles for Health Info NetsIHE Profiles for Health Info NetsLeverages HL7 V2 and V3Leverages HL7 V2 and V3


RecordRecordSharingSharing



Doc Doc SharingSharingX-CommunityX-CommunityPt-Pt Doc Trf Pt-Pt Doc Trf Media InterchangeMedia Interchange

Query Query Existing Existing Data Data (med, (med, allegies, allegies, immunizations, immunizations, etc.)etc.)

Patient Patient Id X-refId X-ref

Patient Patient DemograDemographics phics QueryQuery

Consent Consent MgtMgt

Digit Sign Digit Sign DocsDocs

Audit Audit Trail-Node Trail-Node AuthenticAuthenticationation

User User AuthenticAuthenticationation

Scanned DocScanned Doc ImagingImagingLab ReportsLab Reports Med SummaryMed Summary Personal Personal

Record ExtractRecord ExtractEmergency Emergency

RecordRecord Etc…Etc…

Content

Content


Request Request Form for Form for Data Data capturecapture

HL7 V3 CDAHL7 V3 CDA

HL7 V3 (and V2) MessagesHL7 V3 (and V2) Messages

3636Doc Exchange Integration ProfilesDoc Exchange Integration Profiles

Key Profiles for Document Content and ExchangeKey Profiles for Document Content and Exchange

Doc Content ProfilesDoc Content Profiles

Doc SharingDoc Sharing

XDSXDS

MediaMediaInterchangeInterchange

XDMXDM

Pt-Pt DocPt-Pt DocInterchangeInterchange

XDRXDR

ConsentConsent

BPPCBPPCEmergencyEmergency

EDEREDERPrePre

SurgerySurgery

PPHPPPHP

Scanned DocScanned Doc

XDS-SDXDS-SD

LaboratoryLaboratory

XD*-LabXD*-LabPHR PHR

ExchangeExchange

XPHRXPHR

Discharge &Discharge &ReferralsReferrals

XDS-MSXDS-MS

ImagingImaging

XDS-IXDS-I

3737

IHE Patient Care CoordinationIHE Patient Care CoordinationA family of HL7 V3 CDA-based documents content profilesA family of HL7 V3 CDA-based documents content profiles

Referral Summary Specification

3838


Current Meds

3939


4040


4141


Medications

4242


4343

IHE Profiles for Health Info NetsIHE Profiles for Health Info Nets Common use of Common use of SOA & Web ServicesSOA & Web ServicesSecuritySecurityPrivacyPrivacy Id MgtId Mgt

RecordRecordSharingSharing



Doc Doc SharingSharingX-CommunityX-CommunityPt-Pt Doc Trf Pt-Pt Doc Trf Media InterchangeMedia Interchange

Query Query Existing Existing Data Data (med, (med, allegies, allegies, immunizations, immunizations, etc.)etc.)

PIXPIXPDQPDQ

Consent Consent MgtMgt

Digit Sign Digit Sign DocsDocs

Audit Audit Trail-Node Trail-Node AuthenticAuthenticationation

User User AuthenticAuthenticationation

Scanned DocScanned Doc ImagingImagingLab ReportsLab Reports Med SummaryMed Summary Personal Personal

Record ExtractRecord ExtractEmergency Emergency

RecordRecord Etc…Etc…

Content

Content


Request Request Form for Form for Data Data capturecapture

Web Services - SOAWeb Services - SOA

Introduced in 2007: Introduced in 2007: XDS.b, XCA, XDR, PIX/PDQ V3, QED, RFP, XUAXDS.b, XCA, XDR, PIX/PDQ V3, QED, RFP, XUA

4444

IHE-XDS The Legs of HL7 CDAIHE-XDS The Legs of HL7 CDA

• The semantic power of CDA runs on top of XDS

• Doc content independent Evolution

• A web service/SOA approach (improved with XDS.b)

• Either distributed or centralized

• High performance and scales upward

• Account fot the healthcare specifics sharing workflow

• Support records sharing and shared records

4646

Community Clinic

Lab Info. System

PACS

Teaching Hospital

PACS

ED Application

EHR System

Physician Office

EHR System

XDS Scenario + use of ATNA & CTXDS Scenario + use of ATNA & CT

PMS

Retrieve DocumentRetrieve Document

Register DocumentRegister DocumentQuery DocumentQuery Document

XDS Document Registry

ATNA Audit record repository CT Time server

Record AuditRecord AuditEventEvent

MaintainMaintainTimeTime

MaintainMaintainTimeTimeRecord AuditRecord Audit

EventEvent

Maintain TimeMaintain TimeProvide & Register Docs

Record AuditRecord AuditEventEvent

XDS Document Repository

XDSDocumen

t Reposito

rySecured MessagingSecured Messaging

4747

Community Clinic

Lab Info. System

PACS

Teaching Hospital

PACS

ED Application

EHR System

Physician Office

EHR System

XDS Scenario + use of PIX & PDQXDS Scenario + use of PIX & PDQ

A87631

PACS

L-716

Affinity Domain Patient Identity Source

M8354673993

Retrieve Document Provide & Register Docs

Register (using Pt ID)Query Document (using Pt Id)

Patient Identity Feed

Document Registry

14355M8354673993

L-716

A87631


PIX Query

PIX Query


Patient Identity XRef MgrPatient Identity FeedPDQ Query to Acquire Affinity Domain Patient ID

M8354673993

A87631L-716

M8354673993

XDS Document Repository

XDSDocument

Repository

ATNA Audit record repository CT Time server

4848

Regional Network BRegional Network B



Long Term Care


Document Registry

DocumentRepository

Longitudinal Recordas usedacross-encounters

Regional Network CRegional Network C



Long Term Care


Document Registry

DocumentRepository


Regional Network ARegional Network A



Long Term Care


Document Registry

DocumentRepository


Hierarchical ExchangeHierarchical ExchangeFrom Cross Community Information Exchange White PaperFrom Cross Community Information Exchange White Paper

Cross Community Cross Community BridgeBridge

Which community holds Which community holds records for a patient ?records for a patient ?

CrossCrossCommunityCommunityBridgeBridge

CrossCrossCommunityCommunityBridgeBridge

CommunityCommunityLocator serviceLocator service

Each region notifies Community Each region notifies Community Location Service when new Location Service when new patient is registered or first data is patient is registered or first data is stored.stored.

Cross Community Bridges query Cross Community Bridges query Community Locator Service Community Locator Service (future)(future)

Cross-Community Bridges query Cross-Community Bridges query and retrieve records (2007 & and retrieve records (2007 & future)future)

IHE XCA IHE XCA TransactionsTransactions

4949



Application to a hospital project:Application to a hospital project:


World-wide deployment of IHE IT World-wide deployment of IHE IT Infrastructure ProfilesInfrastructure Profiles

5050

IHE, the only sets of harmonized global standards already IHE, the only sets of harmonized global standards already adopted by several national & regional projectsadopted by several national & regional projects

Quebec, Toronto,Alberta, British Columbia

Canada Infoway

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

Austria

THINC- New YorkNCHICA – N. Carolina

Italy (Conto Corrente

Salute)

MA-Share – MA

FranceDMP

UK CfH(Radiology WF)

Philadelphia HIE

CHINA-MoHLab results sharing

State Project – NY

CHINA-ShangaiImaging Info Sharing

JAPAN-NogayaImaging Info Sharing

5151

Committed National Committed National Programs:Programs:

IHE XDS, PIX, PDQ, ATNA, CT, etc.IHE XDS, PIX, PDQ, ATNA, CT, etc.Austria Lower Austria Region: live since end of 2006, 1.5 Million Patients, Entire Country by 2008.

Italy 4 regional projects. Genoa region, live since early 2006. National deployment planned.

Canada 7 regional projects coordinated by Infoway. Scheduled to go on-line in 2008.

France Implementation tender to be awarded in September 2007.

USA IHE Profiles adopted formally.Several regional projects: VT, NC, CareSpark, Geisinger, Philiadelphia

HIE, CT, etc.

Netherlands Amsterdam region network project launched with NICTIZ. Implementation early 2008.

Japan One implemented project. One pilot to be launched in 2007.

China: MoH selected XDS and XD*-Lab (CDA) for two large pilots. XDS-I in Shangai.

Sweden Gotteborg region network project launched in 2006

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Broad Industry Adoption: HIMSS 2007Broad Industry Adoption: HIMSS 2007Over 200 vendors world-wideOver 200 vendors world-wide

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StakeholdersStakeholders

Working Together to DeliverWorking Together to Deliver

Interoperable Health Information SystemsInteroperable Health Information Systems

in the Enterprisein the Enterprise

and Across Care Settingsand Across Care Settings

http://www.ihe.net

http://www.ihe.net/

http://www.ihe.net/

http://www.ihe.net/

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More Resources - More Resources - www.www.iheihe.net.net

Frequently Asked QuestionsFrequently Asked Questions

Integration Profiles in Technical Frameworks:Integration Profiles in Technical Frameworks: CardiologyCardiology IT InfrastructureIT Infrastructure LaboratoryLaboratory Patient Care CoordinationPatient Care Coordination Patient Care DevicesPatient Care Devices Radiation OncologyRadiation Oncology RadiologyRadiology

Connectathon ResultsConnectathon Results

Vendor Products Integration StatementsVendor Products Integration Statements

Participation in Committees and ConnectathonsParticipation in Committees and Connectathons

http://www.ihe.net/

http://www.ihe.net/

http://www.ihe.net/

September, 2005 What IHE Delivers