september, 2005what ihe delivers 1 the fundamentals of ihe integrating enterprises and building...

1September, 2005 What IHE Delivers

The fundamentals of IHEThe fundamentals of IHEIntegrating Integrating EnterprisesEnterprises and building and building

standards-based standards-based regional and nationalregional and national health information networkshealth information networks

Israel Association for Medical Information Israel Association for Medical Information Tel-Aviv May 17, 2006Tel-Aviv May 17, 2006

Charles ParisotCharles ParisotGE Healthcare – IHE IT Infrastructure Technical Co-chairGE Healthcare – IHE IT Infrastructure Technical Co-chair

2

Standards are critical but alone are not enoughStandards are critical but alone are not enough

Standards offer generality, ambiguity and Standards offer generality, ambiguity and alternativesalternatives

Standard Implementation Guides are Standard Implementation Guides are focused on a single standardfocused on a single standard

Increasing complexityIncreasing complexity

IHE provides a standard process for IHE provides a standard process for

implementing multiple standards!implementing multiple standards!

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Connecting standards to careConnecting standards to care

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

problems they faceproblems they face Drive industry to develop and make available Drive industry to develop and make available

standards-based solutionsstandards-based solutions Implementers follow common guidelines in Implementers follow common guidelines in

purchasing and integrating systems that deliver these purchasing and integrating systems that deliver these solutionssolutions

IHE, effective way to establish those IHE, effective way to establish those

“standards” for how to implement standards“standards” for how to implement standards

4

What is What is Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise??

IHE provides a IHE provides a common frameworkcommon framework for passing for passing health information seamlessly:health information seamlessly: withinwithin the healthcare enterprise the healthcare enterprise acrossacross multiple healthcare enterprises multiple healthcare enterprises for local, regional & nationalfor local, regional & national health information networkshealth information networks

IHE is sponsored by IHE is sponsored by healthcare professional healthcare professional associationsassociations: HIMSS, RSNA, ACC, ACCE, ESC, : HIMSS, RSNA, ACC, ACCE, ESC, SFR, BIR, GMSIH, etc.SFR, BIR, GMSIH, etc.

IHE IHE drives standards adoptiondrives standards adoption to address specific to address specific clinical needsclinical needs

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More than 40 user organizations & close to 200 More than 40 user organizations & close to 200 healthcare vendors worldwide have contributed to healthcare vendors worldwide have contributed to IHEIHE

Delivery of ready-to-integrate products to benefit Delivery of ready-to-integrate products to benefit healthcare enterprises of all sizeshealthcare enterprises of all sizes

In clinical use today in enterprises and regional In clinical use today in enterprises and regional networksnetworks

IHE scope, today and in the futureIHE scope, today and in the future radiology, cardiology, laboratory, oncology, eye care, devicesradiology, cardiology, laboratory, oncology, eye care, devices enterprise healthcare IT infrastructuresenterprise healthcare IT infrastructures cross-enterprise healthcare IT infrastructurescross-enterprise healthcare IT infrastructures RHIO’s and NHINRHIO’s and NHIN

IHE Maturity and AcceptanceIHE Maturity and Acceptance

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Proven Standards Adoption ProcessProven Standards Adoption Process

Document Use Document Use Case Case RequirementsRequirements

Document Use Document Use Case 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

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IHE ConnectathonIHE Connectathon

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Electronic Health Record

Cardiology

Laboratory

Radiology

Oncology

Future Domains

IHE

IT Infrastructure

15 Integration Profiles



1133 IInntteeggrraattiioonn PPrrooffiilleess

Patient Care Coordination

1 Integration Profile

Patient Care

Devices

Pathology Eye Care

Endoscopy

Achievements and Expanding ScopeAchievements and Expanding ScopeClose to 200 vendors involved world-wide,Close to 200 vendors involved world-wide, 5 Technical Frameworks5 Technical Frameworks

48 Integration Profiles, Testing at Connectathons48 Integration Profiles, Testing at ConnectathonsDemonstrations at major conferences world-wideDemonstrations at major conferences world-wide

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IHE Organizational StructureIHE Organizational Structure

Participants

contribute

Global Development:Radiology,IT Infrastructure,Cardiology,Lab, etc.

Delegates

IHE Europe

IHE North America

IHE Asia/Oceania

Regional &NationalDeployment

supervises reports

IHE (International) Strategic Development Committee

SponsorsCo-Chairs

Global

Interoperability

IHE Domain-related Planning Committee and

Technical Committee

National Extensions

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What is IHE NOT?What is IHE NOT?

Not a standard, Not a standard, although it leverages themalthough it leverages them

A vendor initiative, A vendor initiative, although they participatealthough they participate

Not a certifying authority, Not a certifying authority, although IHE although IHE provides compliance testingprovides compliance testing

Not simply a demonstration projectNot simply a demonstration project Demos are only one means to the end: Demos are only one means to the end: AdoptionAdoption Backed up by documentation, tools, testing, and Backed up by documentation, tools, testing, and

publication of Technical Frameworks and Product publication of Technical Frameworks and Product Integration Statements. Integration Statements.

IHE, critical for standardizing interoperabilityIHE, critical for standardizing interoperability

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IHE ModelIHE Model

Actors in precisely defined rolesActors in precisely defined roles Abstracts a specific function of information systemAbstracts a specific function of information system

……Executing precisely defined transactionsExecuting precisely defined transactions Using existing standardsUsing existing standards

…………To solve real world interoperabilityTo solve real world interoperability problems problems Specifying Integration ProfilesSpecifying Integration Profiles

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IHE Technical FrameworksIHE Technical FrameworksImplementation Guide for each Integration ProfileImplementation Guide for each Integration Profile

An Integration Profile :An Integration Profile : A Set of A Set of ActorsActors Exchanging Exchanging TransactionsTransactions

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]


Perform Acquisition

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


ADT Order Placer

Register J.Doe

AcquisitionModality

Placer OrderManagement –New [RAD-2]

Patient Reconciliation

Department System Scheduler/Order Filler

Schedule Procedure


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]



Perform Acquisition



ImageManager/

PPS Manager

Filler Order Management -New [RAD-3]

One or the other methods of creating an order is used

Use casesUse casesProcess FlowsProcess Flows

For each transaction:For each transaction: Std referencedStd referenced Options specifiedOptions specified Mapping requiredMapping required

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 Updated [RAD-13]


Performed Procedure

Step Manager

Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]



Order Placer

Acquisition Modality

ImageManager

ImageArchive

DSS/ Order Filler

Patient Update [RAD-12]


Storage Commitment

[CARD-3]

Evidence Creator Modality PS in Progress [CARD-1]

Modality PS Completed [RAD-7]

Instance Availability Notification [RAD-49]



Placer Order Management [RAD-2] Filler Order Management [RAD-3]

ADT

Query Images [RAD-14] Retrieve Images/Evidence [CARD-4]

Image Display


Storage Commitment

[CARD-3]


Procedure Updated [RAD-13]


Performed Procedure

Step Manager




Order Placer

Acquisition Modality

ImageManager

ImageArchive

DSS/ Order Filler

Patient Update [RAD-12]


Storage Commitment

[CARD-3]

Evidence Creator Modality PS in Progress [CARD-1]

Modality PS Completed [RAD-7]

Instance Availability Notification [RAD-49]

ActorsActors TransactionsTransactions

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IHE Solutions within the EnterpriseIHE Solutions within the Enterprise

eMPIeMPIUser AuthUser Auth

EnterpriseEnterpriseIT InfrastructureIT Infrastructure

LaboratoryLaboratory

LISLIS

Auto MgrAuto Mgr AnalyzerAnalyzer

EMR - HISEMR - HISEMR - HISEMR - HIS

CardiologyCardiology

CISCIS

CathCath ECGECG

RadiologyRadiology

RISRIS

PACSPACSImg AcqImg Acq

-Radiation-Radiation Therapy Therapy

-Patient Care-Patient Care Devices Devices

-Pathology-Pathology

-Eye Care-Eye Care

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IHE Solutions within the Enterprise IHE Solutions within the Enterprise CardiologyCardiology

RadiologyRadiology CardiologyCardiology LaboratoryLaboratory


EMR - HISEMR - HIS

RISRIS


CISCIS

CathCath ECGECG

LISLIS





-Eye Care-Eye Care

Cardiology Integration ProfilesCardiology Integration ProfilesCardiac Catheterization Lab WorkflowCardiac Catheterization Lab Workflow

Echocardiography Lab WorkflowEchocardiography Lab Workflow

Retrieve ECG for DisplayRetrieve ECG for Display

Displayable ReportsDisplayable Reports

Cath and Echo Evidence DocumentsCath and Echo Evidence Documents


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IHE Solutions within the Enterprise IHE Solutions within the Enterprise LaboratoryLaboratory



EMR - HISEMR - HIS

RISRIS


CISCIS

CathCath ECGECG

LISLIS





-Eye Care-Eye Care

Laboratory Integration ProfilesLaboratory Integration ProfilesLaboratory Scheduled WorkflowLaboratory Scheduled Workflow

Laboratory Information Reconciliation Laboratory Information Reconciliation

Laboratory Point Of Care TestingLaboratory Point Of Care Testing

Laboratory Device Automation Laboratory Device Automation

Laboratory Code Set DistributionLaboratory Code Set Distribution


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IHE Solutions within the EnterpriseIHE Solutions within the EnterpriseIT Infrastructure (Enterprise)IT Infrastructure (Enterprise)


RISRIS


CISCIS

CathCath ECGECG

LISLIS





-Eye Care-Eye Care


EMR - HISEMR - HIS

IT Infrastructure Integration ProfilesIT Infrastructure Integration Profiles

Patient Administration ManagementPatient Administration Management

Patient Demographics Query Patient Demographics Query

Patient Identifier Cross-referencingPatient Identifier Cross-referencing

Retrieve Information for DisplayRetrieve Information for Display

Enterprise User AuthenticationEnterprise User Authentication

Consistent TimeConsistent Time

Patient Synchronized ApplicationsPatient Synchronized Applications

Audit Trail and Node AuthenticationAudit Trail and Node Authentication

Personnel White PagesPersonnel White Pages


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IHE Solutions within the Enterprise IHE Solutions within the Enterprise RadiologyRadiology



EMR - HISEMR - HIS

RISRIS


CISCIS

CathCath ECGECG

LISLIS





-Eye Care-Eye Care


Radiology Integration ProfilesRadiology Integration Profiles

Radiology Scheduled WorkflowRadiology Scheduled Workflow

Patient Information ReconciliationPatient Information Reconciliation

Access to Radiology InformationAccess to Radiology Information

Portable Data for ImagingPortable Data for Imaging

Consistent Presentation of ImagesConsistent Presentation of Images

Key Image NoteKey Image Note

Presentation of Grouped ProceduresPresentation of Grouped Procedures

Evidence DocumentsEvidence Documents

Audit trail and Node Authentication Audit trail and Node Authentication (Rad option)(Rad option)

Teaching Files and Clinical Trials ExportTeaching Files and Clinical Trials Export

Post-processing WorkflowPost-processing Workflow

Reporting WorkflowReporting Workflow

Charge PostingCharge Posting

Simple Image and Numeric ReportsSimple Image and Numeric Reports

How to use IHE ?How to use IHE ?

IHEIHE Radiology Radiology

HandbookHandbook

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IHE Scheduled Workflow (SWF) and IHE Scheduled Workflow (SWF) and Patient Information Reconciliation (PIR)Patient Information Reconciliation (PIR)

PIR = Fulfilling a request for imaging service PIR = Fulfilling a request for imaging service in in the absence of key informationthe absence of key information??How do I deal with trauma and “non-registered patients”?How do I deal with trauma and “non-registered patients”?

What if the ADT/ Patient Registration is down?What if the ADT/ Patient Registration is down?

What if the Order Placer is down?What if the Order Placer is down?

SWF = Fulfilling a request for imaging service SWF = Fulfilling a request for imaging service with maximum efficiencywith maximum efficiency??How do I avoid reentering information on modalities?How do I avoid reentering information on modalities?

How do I avoid entering in my RIS what my modality already How do I avoid entering in my RIS what my modality already knows ?knows ?

How do I ensure that in all cases no study is lost, remains unread, How do I ensure that in all cases no study is lost, remains unread, or read incomplete.or read incomplete.

How do I ensure that all necessary information is automatically on How do I ensure that all necessary information is automatically on my PACS and RIS?my PACS and RIS?

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imagesstored

patientinformation

RIS

examination orders

imagesretrieved

HIS

PACS

procedurescheduled

Prefetch any relevantprior studies

modalityworklist

report

report

Scheduled Workflow ProfileScheduled Workflow Profile

Registration

Orders Placed

Orders Filled

Film

FilmFolder

Image Manager& Archive

FilmLightbox

report ReportRepository

DiagnosticWorkstation

Modality

acquisitionacquisitionin-progressin-progressacquisitioncompleted

acquisitioncompleted

imagesprinted

AcquisitionModality

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IHE for Regional or National EHRIHE for Regional or National EHRSharing Health RecordsSharing Health Records

across different care settingsacross different care settings

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Sharing and Accessing Electronic Health Sharing and Accessing Electronic Health RecordsRecords

IHE offers interoperability for local, regional, specific, IHE offers interoperability for local, regional, specific, or national health information exchangeor national health information exchange

Goal is to enable exchange between providers’s EHR Goal is to enable exchange between providers’s EHR systems and ancillary IT systems (Lab, Pharma, systems and ancillary IT systems (Lab, Pharma, Payers) and personal health record systems.Payers) and personal health record systems.

Objective is to empower the consumer in having Objective is to empower the consumer in having “shared EHR information” between all of its potential “shared EHR information” between all of its potential healthcare providers (if authorized) and self.healthcare providers (if authorized) and self.

IHE goal is not:IHE goal is not:

To create a “perfect health record”, the truth about a patient To create a “perfect health record”, the truth about a patient health.health.

To create an other “health record”, next to the one(s) To create an other “health record”, next to the one(s) managed by the provider and the consumer.managed by the provider and the consumer.

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Community orsub-network

Clinical Encounter

Clinical IT System Index of patients records(Document-level)

Aggregate Patient Info

4-Patient data 4-Patient data presented to presented to

PhysicianPhysician

Sharing SystemSharing System

Clinic Record Specialist Record

Hospital Record

2-Reference2-Referenceto Records to Records for Inquiryfor Inquiry

Introduced at HIMSS in 2005 : IHE-XDSIntroduced at HIMSS in 2005 : IHE-XDS

3-Records3-RecordsReturnedReturned

ReferenceReferenceto recordsto records

Repository ofDocuments

Repository ofDocuments

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

Cross-Enterprise Document Sharing minimizes clinical Cross-Enterprise Document Sharing minimizes clinical data management by the infrastructure. data management by the infrastructure. Transparency = Ease of EvolutionTransparency = Ease of Evolution

Patients have guaranteed portability and providers may Patients have guaranteed portability and providers may share information without concerns of aggregation errors.share information without concerns of aggregation errors.Digital Documents = Patients Digital Documents = Patients andand providers empowerment providers empowerment

Supports Supports both centralized and decentralizedboth centralized and decentralized repository repository architectures. Ease of architectures. Ease of federationfederation nationally. nationally. Flexible Flexible privacy,privacy, Flexibility of configurationsFlexibility of configurations

Workflows addressed in a second step in a much simpler Workflows addressed in a second step in a much simpler manner.manner.Point-to-Point messages best suited for workflows mgtPoint-to-Point messages best suited for workflows mgt

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Cross-Enterprise Document Sharing (XDS) Cross-Enterprise Document Sharing (XDS) Standards UsedStandards Used

HealthcareContent Standards

HL7 CDA, CEN EHRcomHL7, DICOM …

Internet StandardsHTML, HTTP,

ISO, PDF, JPEG …

Electronic BusinessStandards

ebXML Registry, SOAP …

Implemented world-wide by more than 30 vendors/open Implemented world-wide by more than 30 vendors/open source. source. Final text published August 2005. Final text published August 2005.

Adopted in several national & regional projectsAdopted in several national & regional projects (Italy, (Italy, France, Canada, Austria, USA, etc.)France, Canada, Austria, USA, etc.)

IHE XDS, based on ISO 15000 standard:IHE XDS, based on ISO 15000 standard:15800 “Google” references (Jan’ 06) 15800 “Google” references (Jan’ 06) 38900 (April’ 06) 38900 (April’ 06)

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Cross-Enterprise Document Sharing (XDS) Cross-Enterprise Document Sharing (XDS) Clinical Information in the Digital DocumentClinical Information in the Digital Document

Two “categories” of standards usedTwo “categories” of standards used

XDS Infrastructure(Document sources, consumers,

registries, repostories)

XDS Doc Content

• Medical Summaries Medical Summaries (HL7 CDA/CRS+V3)(HL7 CDA/CRS+V3)• Imaging Imaging (DICOM)(DICOM)• ECG Reports ECG Reports (PDF+)(PDF+)• Next lab, nursing, etc.Next lab, nursing, etc.

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IHE-XDS is part of a family of profilesIHE-XDS is part of a family of profiles

Regional, national, local or disease centric networks need Regional, national, local or disease centric networks need a consistent set of Integration Profilesa consistent set of Integration Profiles

NineNine Integration Profiles completed and tested, plus Integration Profiles completed and tested, plus sevenseven in development = Standards-based interoperability in development = Standards-based interoperability building blocks forbuilding blocks for Rich Document Content for end-to-end application interoperability. Rich Document Content for end-to-end application interoperability.

Available is a structured medical summary (incl meds, allergies, pbs) Available is a structured medical summary (incl meds, allergies, pbs) and imaging information (incl. Images and reports).and imaging information (incl. Images and reports). More in More in development.development.

Patient identification managementPatient identification management Security and privacySecurity and privacy Basic workflow Basic workflow (Notif of doc availbility)(Notif of doc availbility)

IHE-XDS + related IHE Integration profiles provide a IHE-XDS + related IHE Integration profiles provide a complete interoperability solutioncomplete interoperability solution

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IHE Integration Profiles for Health Info NetsIHE Integration Profiles for Health Info NetsWhat What is availableis available and and has been addedhas been added in 2005 and in 2005 and is for 2006is for 2006

Consistent TimeCoordinate time across

networked systems

Audit Trail & Node Authentication

Centralized privacy audit trail and node to node authentication

to create a secured domain.

Patient Demographics Query

Cross-Enterprise Document Sharing

Registration, distribution and access across health enterprises of clinical

documents forming a patient electronic health record

Patient Identifier Cross-referencing

Map patient identifiers across independent identification

domains

Emergency Referrals

Format of the Document Content and associated coded vocabulary

Patient Created Summaries


ECG Report Document


Lab Results Document Content


Scanned Documents

Format of the Document Content

Cross-enterprise User Authentication

Authentication & Auditing: Enhanced Access Control

Cross-enterpriseDocument InterchangeMedia-CD/USB & e-mail push

Notification of Document Availability

Notification of a remote provider/ health enterprise

Imaging Information


Medical Summary (Meds, Allergies, Pbs)

Format of the Document Contentand associated coded vocabulary

Document Digital Signature

Attesting “true-copy and origin

28XDS Affinity Domain (NHIN sub-network)

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 ATNA Audit record repositoryrecord repository CT Time serverCT 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

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SSttrruuccttuurreedd CCoonntteenntt wwii tthh ccooddeedd sseecctt iioonnss::

Reason for Referral Vital Signs

MMeeddiiccaattiioonn

Studies AAlllleerrggiieess

Social History PPrroobblleemmss

Care Plan

XDS-MS Medical Summary XDS-MS Medical Summary (HL7 CDA)(HL7 CDA)

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 required as highly structured text. Text easy to import/parse

Text StructureEntry

Level 3Level 3

Med Problems and Allergies have a required fine-grain structure with optional coding. Procesable health data import

Coded Section Entry

Coded Section Entry

Coded Section Entry

Level 3Level 3

XDS-MS enables both semantical XDS-MS enables both semantical interoperability and simple viewing !interoperability and simple viewing !

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Use of a shared XDS infrastructure to access Use of a shared XDS infrastructure to access Radiology Reports and Images (XDS-I)Radiology Reports and Images (XDS-I)

HospitalHospital

Imaging CenterImaging CenterPhysician PracticePhysician Practice

Between Radiology and :Between Radiology and :• IImaging specialistsmaging specialists• Non-imaging cliniciansNon-imaging clinicians PACS Y

PACS Z

Radiology -to-Radiology -to-RadiologyRadiology

Radiology -to-Radiology -to-PhysiciansPhysicians

Same XDS InfrastructureSame XDS Infrastructure (Registry and Repositories) (Registry and Repositories)

for medical summaries and imaging information !for medical summaries and imaging information !

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HIMSS Feb 2006 Interoperability ShowcaseHIMSS Feb 2006 Interoperability Showcase

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Successful showcase - Over 3000 visitorsSuccessful showcase - Over 3000 visitorsReal-world implementations. Effective IHE interoperabilityReal-world implementations. Effective IHE interoperability 36 vendor products:36 vendor products: EHR & Ancillary IT systems, PHR systems, EHR & Ancillary IT systems, PHR systems,

Registries, Repositories, MPIs, etc. Registries, Repositories, MPIs, etc.

4 Federal entities or grantees4 Federal entities or grantees (VA, DoD, NIST, CDC/UW) (VA, DoD, NIST, CDC/UW)

All implementations passed IHE ConnectathonAll implementations passed IHE Connectathon tests tests

Scenario focused on health information exchange:Scenario focused on health information exchange: Within the enterpriseWithin the enterprise (Cardiology, Radiology, etc.) (Cardiology, Radiology, etc.)

Across inpatient and physician offices care settingsAcross inpatient and physician offices care settings in a RHIO for in a RHIO for health status information health status information (meds, allergies, pbs, etc.),(meds, allergies, pbs, etc.), reports, reports, images, legacy docsimages, legacy docs

Empowered with your own health record:Empowered with your own health record: Show-wide record submission and accessShow-wide record submission and access (11 vendor booths) (11 vendor booths)

““HIMSS RHIO” InfrastructureHIMSS RHIO” Infrastructure: secured access & communications, : secured access & communications, distributed repositories, document registries, patient Id X-distributed repositories, document registries, patient Id X-referencingreferencing

HIMSS IHE Interoperability ShowcaseHIMSS IHE Interoperability ShowcaseFebruary 2006 ParticipantsFebruary 2006 Participants

Leadership LevelLeadership Level

Blue WareBlue Ware

CernerCerner

GE Healthcare GE Healthcare +IDX +IDX

IBMIBM

Initiate SystemsInitiate Systems

InterSystems InterSystems

MiSys Healthcare MiSys Healthcare

Quovadx Quovadx

Siemens Siemens

Implementer LevelImplementer Level

AllscriptsAllscripts

CanonCanon

CapMedCapMed

Cardiac ScienceCardiac Science

CGI-AMS CGI-AMS

CompassCareCompassCare

CPSI CPSI

DictaphoneDictaphone

DR SystemsDR Systems

Eastman KodakEastman Kodak

Eclipsys Eclipsys

Epic SystemsEpic Systems

HIPAATHIPAAT

HX TechnologiesHX Technologies

INFINITT TechnologyINFINITT Technology

KryptiqKryptiq

McKesson McKesson

MedAccess PlusMedAccess Plus

Medical Informatics Medical Informatics

MediNotes MediNotes

MNIMNI

National Institute of Sci & TechNational Institute of Sci & Tech

NextGen Healthcare NextGen Healthcare

Philips Medical Philips Medical

ScImageScImage

Witt Biomedical Witt Biomedical

Supporter Level:Supporter Level:

AcuoAcuo

BondBond

CarefxCarefx

ClearcubeClearcube

DairylandDairyland

EMCEMC

IdentrusIdentrus

IntelIntel

MediserveMediserve

Medkey Medkey

Motion Comp.Motion Comp.

PicisPicis

PulsePulse

SentillionSentillion

Organizational participant:Organizational participant:

American Coll. of Clinical Eng.American Coll. of Clinical Eng.

Catholic Healthcare WestCatholic Healthcare West

US Dept of DefenseUS Dept of Defense

US Dept of Veterans AffairsUS Dept of Veterans Affairs

DMP–French Natl. Personal EHRDMP–French Natl. Personal EHR

Health Level 7 HTP IEEEHealth Level 7 HTP IEEE

Midmark Diagostics GroupMidmark Diagostics Group

HIMSS RHIO FederationHIMSS RHIO Federation

Liberty AllianceLiberty Alliance

Univ. of WashingtonUniv. of Washington

34

EndorsementsEndorsements

National & Regional ProjectsNational & Regional Projects ItalyItaly CanadaCanada AustriaAustria FranceFrance JapanJapan USA (NHIN prototypes and RHIOs)USA (NHIN prototypes and RHIOs)

VendorsVendors US EHR Vendor Association (95% market): US EHR Vendor Association (95% market):

Interoperability Roadmap: Interoperability Roadmap: www.himssehrva.orgwww.himssehrva.org Europe: COCIREurope: COCIR

http://www.himssehrva.org/

36

Participating and Contributing Vendors (America)Participating and Contributing Vendors (America)

Agfa HealthCareAgfa HealthCare

AlgotecAlgotec

Allscripts HealthcareAllscripts Healthcare

BerdyBerdy

BluewareBlueware

CamtronicsCamtronics

Canon Medical SystemsCanon Medical Systems

CapMedCapMed

Cardiac Science Corp.Cardiac Science Corp.

CarefxCarefx

Cedara Software Corp.Cedara Software Corp.

Cerner CorporationCerner Corporation

CGI-AMSCGI-AMS

CSISTCSIST

DictaphoneDictaphone

DR SystemsDR Systems

Dynamic ImagingDynamic Imaging

Eastman Kodak CompanyEastman Kodak Company

EBM TechnologiesEBM Technologies

EclipsysEclipsys

EmageonEmageon

Raining DataRaining Data

RASNA Imaging Systems RASNA Imaging Systems

ScImage Inc.ScImage Inc.

Sectra ImtecSectra Imtec

SentillionSentillion

Shimadzu CorpShimadzu Corp

Siemens Medical Solutns’Siemens Medical Solutns’

SoftmedicalSoftmedical

Stentor, IncStentor, Inc

St. Jude MedicalSt. Jude Medical

StorCOMM, IncStorCOMM, Inc

Swissray International, IncSwissray International, Inc

Tiani-SpiritTiani-Spirit

Toshiba Medical SystemsToshiba Medical Systems

T-SystemsT-Systems

UltraVisual Medical Syst.UltraVisual Medical Syst.

Vital Images, Inc.Vital Images, Inc.

Voxar LimitedVoxar Limited

WebMD Practice ServicesWebMD Practice Services

Witt Biomedical Corp.Witt Biomedical Corp.

XIMISXIMIS

Epic Systems Corp.Epic Systems Corp.

ETIAMETIAM

FujifilmFujifilm

GE HealthcareGE Healthcare

HeartlabHeartlab

HIPAAT Inc.HIPAAT Inc.

Hitachi Medical Corp.Hitachi Medical Corp.

HologicHologic

Hx TechnologiesHx Technologies

IDX Systems CorporationIDX Systems Corporation

Imco TechnologiesImco Technologies

INFINITTINFINITT

Initiate Systems Inc.Initiate Systems Inc.

InSiteOneInSiteOne

Intelerad Medical SystemsIntelerad Medical Systems

IBMIBM

Intersystems CorporationIntersystems Corporation

Konica Minolta Konica Minolta

KrypticKryptic

Marotech, Inc.Marotech, Inc.

McKessonMcKesson

In yellow, companies with IHE Committees Chairs (Spring 2006)

MedAccessPlus HealthMedAccessPlus Health

MedCommons IncMedCommons Inc

MedconMedcon

Medical Informatics Eng.Medical Informatics Eng.

Medical Manager Health Medical Manager Health

Mediface Co.Mediface Co.

MedinotesMedinotes

Medis Medical ImagingMedis Medical Imaging

Merge eFilmMerge eFilm

MisysMisys

MNI MedicosMNI Medicos

Mortara Mortara

NextGenNextGen

NovellNovell

Open Text Corp.Open Text Corp.

Philips Medical SystemsPhilips Medical Systems

Procom TechnologyProcom Technology

Prosolv CardiovascularProsolv Cardiovascular

QRS DiagnosticsQRS Diagnostics

QuovadxQuovadx

RADinfo SystemsRADinfo Systems

37

Participating and Contributing Vendors (Europe)Participating and Contributing Vendors (Europe)

AGFA HealthcareAGFA Healthcare

AISoftw@re MedicalAISoftw@re Medical

Algotec Algotec

ARES SA ARES SA

aycan Digitalsysteme aycan Digitalsysteme

CEGEDIMCEGEDIM

Cerner Corp.Cerner Corp.

CHILICHILI

CMT Medical Tech.CMT Medical Tech.

Conto Corrente SaluteConto Corrente Salute

ConVisConVis

CTI Mirada SolutionsCTI Mirada Solutions

Data Processing SPAData Processing SPA

DEDALUSDEDALUS

DianoemaDianoema

Eastman Kodak Co. Eastman Kodak Co.

Ebit SanitaEbit Sanita

EDL EDL

ELFIN s.r.l. ELFIN s.r.l.

Engineering SanitàEngineering Sanità

ESAOTEESAOTE

MEDASYS SAMEDASYS SA

MedavisMedavis

Medical CommunicationsMedical Communications

Medigration GmbH Medigration GmbH MEDIMON Ltd. MEDIMON Ltd.

MEDIWAREMEDIWARE

MEDOS AG MEDOS AG

Merge eFilm Merge eFilm

METAFORA METAFORA

Mevis Diagnostics Mevis Diagnostics

Konica Minolta Konica Minolta

Omnilab Omnilab

Philips Medical SystemsPhilips Medical Systems

POLYMEDISPOLYMEDIS

Rasna Imaging SystemsRasna Imaging Systems

RAYPAX INC. RAYPAX INC.

REMREM

Rogan-DelftRogan-Delft

Sago spa Sago spa

Sectra Imtec AB Sectra Imtec AB

SeeBeyond TechnologySeeBeyond Technology

ETIAMETIAM

Ferrania Ferrania

Fujifilm Fujifilm

GE HealthcareGE Healthcare

GIE Convergence-Profils GIE Convergence-Profils

Global Imaging Online Global Imaging Online

GWI Research GWI Research

Hi. techHi. tech

IASI Srl IASI Srl

IdeoPass IdeoPass

INFINITT INFINITT

INFOPATIENTINFOPATIENT

INOVITINOVIT

INSIELINSIEL

Intersystems Corp.Intersystems Corp.

InvitaInvita

ITZ MedicomITZ Medicom

iSoftiSoft

McKesson McKesson

MED2RAD MED2RAD

MEDarchiverMEDarchiver

In yellow, companies with IHE Committees Chairs (Winter 2005)

Siemens MedicalSiemens Medical

Soluzioni Informatiche srl Soluzioni Informatiche srl

Stentor Inc. Stentor Inc.

St. JudeSt. Jude

Swissray Medical AG Swissray Medical AG

Symphonie On LineSymphonie On Line

Synapsis Synapsis

Synchro-MedSynchro-Med

TECHNIDATATECHNIDATA

TELEMIS S.A. TELEMIS S.A.

Tiani-SpritTiani-Sprit

Tomtec Imaging Tomtec Imaging

TOREX GAP MedicalTOREX GAP Medical

Toshiba Medical SystemsToshiba Medical Systems

TSI groupe europMedica TSI groupe europMedica

T-SystemsT-Systems

Uni-medicineUni-medicine

VEPRO AG VEPRO AG

VISUS Technology VISUS Technology Transfer Transfer

WAIDWAID

XR PARTNERXR PARTNER

38

Participating and Contributing Vendors (Asia)Participating and Contributing Vendors (Asia)

JapanJapanEBMJEBMJPSPPSPPANASONICPANASONICALOKAALOKAKONICA MINOLTAKONICA MINOLTAHitachi Medical Co.Hitachi Medical Co.KODAKKODAKHITACHIHITACHISBSSBSINFOCOMINFOCOMCLIMBMSCLIMBMSTECHMATRIXTECHMATRIXCANONCANONVIEWSENDVIEWSEND

TaiwanTaiwanINFINITTINFINITTShing ShianShing ShianINQ GENINQ GENTEPTEPTah YaTah Ya

KoreaKoreaAGFA KoreaAGFA Korea GE Healthcare GE Healthcare KoreaKoreaINFINITTINFINITTLG CNS LG CNS Marotech, Inc.Marotech, Inc.Medical StandardMedical StandardPeoplenet CommunicationsPeoplenet CommunicationsSamsung SDSSamsung SDS

JapanJapanITECITECWINTCSWINTCSNECNECAGFAAGFAJMACJMACGEYMSGEYMSAJSAJSTOSHIBATOSHIBAYOKOGAWAYOKOGAWAGOODMANGOODMANFUJITSUFUJITSUAANDTAANDTFUJIFILMFUJIFILM

39

What can you do?What can you do?

Learn about IHELearn about IHE

Insist on IHE compliance in your RFPs and Insist on IHE compliance in your RFPs and contract documents: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 ?

Join Join IHE IsraelIHE Israel

Contribute to Global IHE CommitteesContribute to Global IHE Committees

40

Call for TendersCall for TendersBe Brief (but ineffective) ?Be Brief (but ineffective) ? ““The system must support DICOM” The system must support DICOM” ““The system must support HL7”The system must support HL7”

Be Effective (but lengthy) ?Be Effective (but lengthy) ? ““The system must support the following DICOM or HL7 services The system must support the following DICOM or HL7 services

according to the following 100 pages of specifications: …”according to the following 100 pages of specifications: …”

Be Both brief and effective:Be Both brief and effective: Quote IHE profiles and actors: “The system must support the Quote IHE profiles and actors: “The system must support the

IHE Scheduled Workflow as the Order Filler actor.”IHE Scheduled Workflow as the Order Filler actor.”

Request IHE Integration StatementsRequest IHE Integration Statements Version 2.1 of the SuperX CT supports IHE Scheduled Version 2.1 of the SuperX CT supports IHE Scheduled

Workflow, Patient Information Reconciliation and Key Image Workflow, Patient Information Reconciliation and Key Image Note as an Acquisition ModalityNote as an Acquisition Modality

41

IHE Integration StatementsIHE Integration Statements

Explicit claim by the vendor,Explicit claim by the vendor, for for a specific product versiona specific product version

Lists profiles, actors, optionsLists profiles, actors, options

Short (1 page) & SweetShort (1 page) & Sweet

Compare apples with apples. Compare apples with apples. e.g.: The number of IHE Integration Profiles actually delivered on e.g.: The number of IHE Integration Profiles actually delivered on different PACS products varies greatly:different PACS products varies greatly:

http://http://www.ihe.netwww.ihe.net/resources//resources/

ihe_integration_statements.cfmihe_integration_statements.cfm

42

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 Committees Become a member of relevant Regional/National Committees IHE Israel IHE Israel

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 Educational WorkshopsAttend Educational Workshops

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 Educational Workshops Attend Educational Workshops

Include IHE Integration Profiles in your RFPs and Integration Projects.Include IHE Integration Profiles in your RFPs and Integration Projects.

How can I participate?How can I participate?

43

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 IT InfrastructureIT Infrastructure LaboratoryLaboratory Patient Care CoordinationPatient Care Coordination 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

Participation in Committees & ConnectathonsParticipation in Committees & Connectathons