Slide 1

IHE - Collaboration A framework for SuccessChristopher Lindop,

MSEE GE Healthcare

Interoperability &

Standards

IHE Radiology Co-Chair

IHE Australia Board Member

Slide 2

Standards: Necessary…Not Sufficient

Standards are• Foundational - to interoperability and

communications• Broad - varying interpretations and

implementations• Narrow - may not consider relationships

between standards domains• Plentiful - often redundant or disjointed• Focused - standards implementation guides

focus only on a single standard

Slide 3

Integrating the Healthcare EnterprisePromotes standards-based integration and interoperability - accelerate the rate & quality of integration

Focused on practical solutions to key user-identified integration problems•Integration Profiles•Connectathons•Demonstrations

Cooperative effort involving clinicians and professional societies, vendors and industrial associations, governments and health care organizations

Slide 4

IHE - Connecting standards to care

Care providers work with vendors to coordinate the implementation of standards to meet their needs• Care providers identify the key

interoperability problems they face• Drive industry to develop and make

available standards-based solutions• Implementers follow common guidelines in

purchasing and integrating systems that deliver these solutions

A forum for agreeing on how to implement standards and processes for

making it happen

Slide 5

IHE Organizational Structure

ACCACPHIMSSRSNA

JAHISJIRAJRSADIA

METI-MLHWMEDIS-DCJAMIHIMAA

GMSIHSFRSFILMSIA

SIRMBIREuroRecRANZCR

COCIREAR-ECRDRGHISA

ESC

Professional Societies / Sponsors Contributing &Participating

Vendors

IHE (International) Board

Global Development

Radiology

Cardiology

ITInfrastructure

Patient CareCoordination

Patient CareDevices

Laboratory

Pathology

Pharmacy /Medication Admin

RadiationOncology

IHE Europe

IHE North America

France

USA

Canada

IHE Asia-Oceania

Japan

Korea Taiwan

Netherlands

Spain Sweden UK

ItalyGermany

Norway

China

Australia

Regional Deployment

Slide 6

Develop technical specificationsDevelop technical specifications

Leveraging the IHE Standards Adoption Process

Public Interoperability Demonstrations

Public Interoperability Demonstrations

Deploy multi-vendor Integrated SolutionsDeploy multi-vendor Integrated Solutions Develop

Easy to integrate products

Develop Easy to integrate products

Document Use Case RequirementsDocument Use Case Requirements

Identify available standardsIdentify available standards

Testing at ConnectathonsTesting at Connectathons

Slide 7

20092009--10 10 cyclecycle

IHE Domains Milestones – 20 month cycleDevelopment and Deployment

Proposed Scope

Approved Scope

Public Comment

Sponsors announce Connect-a-thon/Demos

with set of Implementation Profiles

Final Integration Profile

Trial Implementation

Connect-a-thon/Demo Vendor Participant

Registered

Vendor Participant passed Connectathon

Demo &Education Material

Vendors release products with IHE

Integration Statements

+ 9 ---

- 10 ---

- 7 ---

- 2 ---

0 ---

+ 2 ---

+ 5 ---

+ 6 ---

---

20102010--11 11 cyclecycle

Slide 8

An integration profile …Describes actors and transactions allowing exchange

to occur

Slide 9

IHE Profiles

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]

Patient

Registration [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]

Patient

Registration [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

Actor/Transaction Diagrams

Sequence Diagrams

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]

Textual Description

Slide 10

A content profile …

A sharable information component that can be exchanged…• within a Health Information Community

(XDS)• via Media or USB Device (XDM)• via Reliable Messages (XDR)

Document content using standards• HL7 CDA Release 2.0• HL7 Care Record Summary• ASTM/HL7 Continuity of Care Document

Library of Reusable Parts

Slide 11

Integration StatementsIntegration Statements

Slide 12

ConnectathonConnectathon

Slide 13

2009 Connectathon StatusNorth American Connectathon

• February 23-27 7 • 77 companies, 126 systems• Chicago, Ill

European Connectathon• April 23-27• 73 companies, 94 systems• Vienna, Austria

Japan Connectathon• October 26-30• 40 vendors, 86 systems• Tokyo, Japan

Australia Connectathon• Sydney, AU• July 27 – 31

China Connectathon• Shanghai, China• Beijing, China May 25- May 29

Malaysia Connectathon• Kuala Lumpur 12-14 January

Slide 14

IHE in AustraliaAustralian IHE Member Organizations

Clinicians & Professional Societies

Health Informatics Society of AustraliaRoyal Australian and New Zealand College of RadiologistsHealth Information Management Association of Australia 42 Organizations worldwide

Trade Associations

Medical Software Industry AustraliaAustralian Diagnostic Imaging Association

6 organizations worldwide

Government Agencies and Public-Private Partnerships

12 Organizations worldwide

Standards Development Orgs (SDOs)

HL7 (including HL7 Australia)

6 Organizations worldwide

Vendors & consultants

Over 177 vendors and consultant firms worldwide

Australian IHE Supporters

Government Agencies and Public-Private Partnerships

NICTA

DOHA

Standards Development Orgs (SDOs)

AHML

www.ihe.netJ une - September 2009 333

IHE Organizational Structure

Contributing &Participating

Vendors

Regional Deployment

ACCACCEACEP

JAHISJIRAJRS

METI-MLHWMEDIS-DCJAMI

RSNA SFRSFIL

SIRMBIREuroRec

COCIREAR-ECRDRG

ESCMSCMDEC

Professional Societies / SponsorsACPGMSIHIMSS

Global Development

Radiology

Cardiology

ITInfrastructure

Patient CareCoordination

Patient CareDevices

Laboratory

Pathology

Eye CareRadiationOncology

Public Health, Quality and Research

IHE International Board

IHE Europe

IHE North America

France

USA

Canada

IHE Asia-Oceania

Japan

Korea

Taiwan

Netherlands

Spain Sweden UKItaly

Germany

Norway

China

Austria

Australia

Malaysia

Slide 15

IHE Organizational Structure

MSIA HISAHL7 Australia RANZCRADIA HIMAA

Australia Professional Societies / Sponsors Contributing &Participating

Vendors

IHE (International) Board

Global Development

Radiology

Cardiology

ITInfrastructure

Patient CareCoordination

Patient CareDevices

Laboratory

Pathology

Pharmacy /Medication Admin

RadiationOncology

IHE Europe

IHE North America

France

USA

Canada

IHE Asia-Oceania

Japan

Korea Taiwan

Netherlands

Spain Sweden UK

ItalyGermany

Norway

Regional Deployment

China

AustraliaPatient CareCoordination

Slide 16

IHE Profile Development : Chronic Care Coordination

Problem to be solved

To provide efficient support for planned care and follow-up in Chronic Disease Management (CDM)

In CDM, guidelines are typically embodied in a simple care plan that specifies referrals to a care team. Tracking of referral with reporting by exception on clinical issues is an efficient way to support care management.

Existing care planning and management systems are already implementing this functionality and would benefit from a standardised approach

Slide 17 33

Profile Development CycleProfile Development Cycle

SydneyIHE Australia

Supplement Development Workshop

Dec 9-10

AustraliaIHE Australia – ConnectathonTBD

WebRelease Trial Implementation SupplementsMay 2010

TeleconferenceTechnical Committee

Reconcile Public Comment Supplements

Mar/April 2010

WebTechnical Committee

Publish Public Comment Supplements

Feb 2010

TeleconferencePlanning Committee

Makes Final Decision on Profiles

TBD

Technical Committee

Finalize Supplements for public comment

Technical Committee

Develop Technical Framework Content

Technical Committee

Review Detailed Proposed Profiles

RSNA HeadquartersNov 10-11

TBDJan 2010

TeleconferenceTBD