2010 ihe webinar pharmacy domain

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IHE PharmacyA domain in

development

Jacqueline SurugueCo-Chair, IHE Pharmacy Planning CommitteeRepresenting users

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Simon LetellierSecretary, IHE Pharmacy Planning CommitteeRepresenting users



Our needs in our daily professional real life:

What do users need?

ea n orma on sys ems a e oexchange informations and to use the

informations they have exchanged



Our needs

in the community

Healthcare information s stems

allowing seamless carefor the patient



Our needsat hospital

ea care n orma on sys ems

allowing seamless care for the patient

on national and international level



Interoperability

Definition:

« The ability of 2 systems (or more) to exchange information

.

[From IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries, IEEE, 1990]

“The ability of information systems to work together within and across

organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities”

(From HIMSS Integration and Interoperability Steering Committee, 2005)



IHE: Integrating the Healthcare Enterprise

Mission:

IHE

Removing the interoperability barriers

in the domain of Health

From a user’s point of view, IHE = the solution



European initiatives for e-Health



What about IHE Pharmacy?

The history of IHE Pharmacy is linked to the history of IHE Europe:

• 9th Feb 2007, Berlin (D): Preliminary IHE Europe Committee invites the President of the European

Association of Hospital Pharmacists, (J. Surugue, F), to deliver on the domain “pharmacy”

•1st April 2008, Brussels (B): IHE Europe aisbl is created

• 10th January 2008, Brussels (B): IHE Europe Pharmacy first meeting

Karima Bourquard and Peter Kuenecke

First Co Chair “Users” and Co Chair “Vendors”

of IHE Europe aisbl



11 Years of Steady Evolution 199811 Years of Steady Evolution 1998 – – 20092009

PharmacyNEW 2009

Pathology

since 2006

Radiologysince 1998

Cardiologysince 2004

Eye Caresince 2006

Laboratorysince 2004

In 2009, Pharmacy was recognized as a IHE Domain

9The IHE Development Domains

Radiation Oncologysince 2004

Patient Care Devicessince 2005

Patient Care Coordinationsince 2004

QualityResearch & Public Health

since 2006

(Healthcare)IT Infrastructure

since 2003



The IHE global approach:

A close co-operation between users and vendors

•Users identify the integration problems

•Vendors provide technical solutions

IHE Pharmacy

Users:Pharmacists from the Community,

from healthcare structures,

Orders and pharmacy associations

Public healthcare authorities and IT specialists

VendorsHealthcare IT companies

in hospitals and community

Providers of IT solutions



IHE Pharmacy An international representation with different countries

and connections on global level

Regular meetings in Brussels (B), Paris (F), or during

Connectathon (first time this year, in Bordeaux (F)

A meeting hosted by COCIR,Diamant Building, Brussels

France, Italy, Netherlands and Greece

represented by the EAHP Web Group

members for Hospital Pharmacy

from left to right:

Jacqueline Surugue, Simon Letellier (F), Nino

Cozzolino (I), Rob Moss (ND), Leonidas Tzimis (Gr)

Support of sponsors:

Nictiz, Phast, Gmsih, EAHP, IHE Europe



This is a hospital use caseAdam Everyman was admitted to Good Health Hospital.Dr. Hippocrates, after having reviewed current treatment, prescribes Doliprane 1000 mgtablets, 1 orally three times a day for the duration of the inpatient admission.

IHE Pharmacy

Susie Supply, a hospital pharmacist, reviews the medication order, the current treatment,and local pharmacotherapy guidelines as well as the appropriateness of the medicine,form, strength, route and dose. She authorizes the dispensing of this medication. The order is then scheduled for administration.

Florence Nightingale, a nurse, does the drug administration round next morning andchecks the physician's order, electronic signature and the patient's identity. She opens theappropriate container, visually checks the medication, scans its barcode and administers itto Adam Everyman.



This is a sequence diagramme

IHE Pharmacy



Standards Adoption Process

Testing atTesting at

ConnectathonsConnectathons

Testing atTesting at

ConnectathonsConnectathons IHEIHE

DemonstrationsDemonstrations

IHEIHE

DemonstrationsDemonstrations

Develop technicalDevelop technicalspecificationsspecifications

Develop technicalDevelop technicalspecificationsspecifications

14

with IHEwith IHE

with IHEwith IHE

Timely access toTimely access to

informationinformation

Timely access toTimely access to

informationinformationDocument Use CaseDocument Use CaseRequirementsRequirementsDocument Use CaseDocument Use CaseRequirementsRequirements

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

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

Easy to integrateEasy to integrateproductsproductsEasy to integrateEasy to integrateproductsproducts



2006

K. Bourquard



IHE Medication Management

White Paper - 2003

HITSP Medication Management

Interoperability Specification - 2007

Key past documentation



What has been done?

An IHE White Paper

•Final version (integration of

comments collected after having been put

•70 pages

•Community Pharmacy use cases

•Hospital Pharmacy use cases•Harmonization of actors

definitions

ftp://ftp.ihe.net/Pharmacy/White%20Paper/IHE_Eur_Pharmacy_White_Paper_Final_Text_1.2.pdf



UseUse cases

• HMW

• CMPD



• Organization of the TF

Technical Framework

TF documentation

documentation

After a doodle on the meeting paperboard [ J. Brandstätter (Codewerk – IHE Austria)]



Elaboration of the Technical Framework documents:

Put for public comment 2010 - 2011

TF documentation

TF Supplement

for community Pharmacy

[CMPD profile]

TF Supplement

for hospital Pharmacy

[HMW profile]

TF SupplementCommon parts

from the White Paper



Common actors

• Creates Prescription Orders – Informs the other actors that a

prescription is available /updated

• Receives prescriptions andchecks them to

• Requests and ReceivesCurrent Treatment from

Pharmaceutical AdviserPrescription Placer

– Receives up ates a out t e

actions for the prescription other repositories (insideor outside hospital (Not yet covered))

• Receives prescription orders and advice, to dispense Medication for apatient

• Also does all the actions and management required to deliver the

medication to the patient’s stock – including stock redistribution if needed(Not yet detailed).

Medication Dispenser



Community Pharmacy Manager (CMPD)

• Receives and send Prescriptions, Dispense documents andPharmaceutical Advice

•

Dedicated actors

Med. Administration Informer (HMW)

• Receives Prescriptions, Dispense messages andPharmaceutical Advice to administer the medication at thedefined time.

• Sends the report of administration to the other actors.

placers/dispensers/advisers and repositories/registries.



Hospital medication

workflow showing

actors and

transactions

Hospital Pharmacy : HMW

between them

From the white paper



HMW :HL7v2 transaction flow diagram

Hospital medication

HL7v2.5 completedwith v2.6 message

definitions



HMW :Hospital Medication Workflow

P

R

ES

C

R

I

P

T

IO

N

Supply chain



CMPD: Community Pharmacy



Pharmacy/Medication managementHL7v3 Dispense event with full prescription



Resources• Wiki site :

– http://wiki.ihe.net/index.php?title=Pharmacy

• Ftp site :

– ftp://ftp.ihe.net/Pharmacy(username :iheyr2; password : interop)

• Google groups (mailing list):

– groups.google.com/group/ihe-pharmacy



Sept. 2010 – Internal review of

Technical Framework

Oct. 2010 - Public Review and

Release for Trial Implementation

Milestones

Pisa, Italy, 11-15 April 2011Connectathon, a « connectivity marathon »

•Massive yearly event :

•80 vendors•250-300 engineers

•100-120 systems

•….integrated in 5 days

Results will be published on www.ihe-europe.org



Milestones Achieving Interoperability of health systems on the global level requires a

considerable lot of work.

Get involved!

If you are a vendor,

come at onnectat ons an test your systems

Next Connectathon: Leopolda Storica in Pisa, Italy, 11 -15 April 2011

For patients’ transnational seamless care

between hospital and ambulatory all over the world.

Results will be published on www.ihe-europe.org

2010 ihe webinar pharmacy domain

Documents