IHE Europe Organization

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Integrating the Healthcare Enterprise

• IHE Europe Organization

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Organization of IHE and its evolution
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Healthcare IT Main Obstacles

• Lack of financial funding
• IT 2.3 of hospital budget (in other industries
  2.8) Gartner
• Lack of national/regional guidelines incentives
• Lack of access to IT infrastructure
• Lack of solutions that meet clinical needs
• Lack of adequate healthcare IT standards and
  interoperability
• Integration cost 20 of hospital IT budget

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IHE Mission
IHE Integrating the Healthcare Enterprise

• Improve the quality and cost of healthcare by
  removing the interoperability barriers
• Access to Patient Information
• Clinical Workflow
• Provide an open interoperability framework, based
  on existing standards
• Enable cross-vendor environment (best-of-breed)
• Leverage the interoperability solutions in
  multiple domains (radiology, cardiology, clinical
  lab, enterprise, )

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IHE Expanding Scope



IHE



IT Infrastructure


Cross
-
Enterprise


Intra
-
Enterprise

13 Integration Profiles
IHE

IHE




Radiology

Cardiology



17 Integration Profiles

5 Integration Profiles

IHE

IHE



Patient Care Coord.
Laboratory



IHE


5 Integration Profiles
Future Domain


1 Integration Profile

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IHE Global Approach

• Solve real-world integration problems
• Close co-operation between users and vendors
• Users identify the integration problems
• Vendors provide technical solutions
• Incremental development deployment process with
  an annual heartbeat
• Common global technical framework, based on
  established standards (e.g. DICOM, HL7,..)

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IHE Development Deployment process for a new
profile

• Identify critical healthcare workflows and
  integration problems
• Research select existing standards to implement
  a solution
• Write, review and publish IHE Technical Framework
  (one per domain), trial implementation version
• Develop test tools
• Perform cross-testing at Connect-a-thon
• Demonstrate at tradeshows (HIMSS/RSNA)
• Finalize the profile specification (final text
  version)

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IHE Domains Milestones 20 month
cycleDevelopment and Deployment

• Proposed Scope

- 10 ---
Approved Scope
- 7 ---
Public Comment Intgr-profile
Sponsors announce Connect-a-thon/Demos with set
of Implementation Profiles
- 2 ---
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IHE Building Blocks

• IHE Technical Framework
• IHE Validation Process (connect-a-thon)
• IHE Integration Statements

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IHE Technical Framework

• Describes the different integration solutions
  (domain specific)
• Radiology, IT Infrastructure, Cardiology, Lab
• Key concepts are domain neutral
• Integration Profile
• Transactions
• Actors
• Data model
• Country Regional specialization
• Limited max. 5
• Based on existing standards

eHealth Application
eHealth Application
IHE Integration Profiles
IT Standards (http, ebxml)
Healthcare Standards (HL7, DICOM)
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IHE Technical Frameworks The books

• One Technical Framework for each one of the IHE
  Domains
• Cardiology
• IT Infrastructure
• Lab
• Radiology

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IHE Integration Profiles Examples

• Streamline the workflow sub-processes
• Patient ADT Ordering Data creation
  processing Reporting Treatment - Billing
• Cross referencing patient ids among hospitals
  (MPI)
• Access to clinical data from workstations and
  browsers
• Departmental reports (e.g.. Clinical lab,
  cardiology, radiology), measurements, images
• Quality control
• Consistent presentation of images on displays
  printers
• Security
• authentication, auditing
• Access to common longitudinal health record (EHR)
• Focus on sharing of health record among
  healthcare institutions

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IHE Integration Profiles - Content

• Set of Transactions among Actors
• Actor logical entity (e.g. modality, image
  manager, order filler)
• Transaction Sequence of messages among Actors
• Messages e.g. HL7, DICOM, ebXML,.
• Shaping existing communication standards
• Map data models, message content
• Restrict the options
• Clarify the semantics accession nr

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IHE Integration Profile - Diagram
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IHE Transactions - Sequence
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The IHE World.
IHETransaction
IHETransaction
IHE Actor
IHE Actor
IHETransaction
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The Product World..
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Mapping IHE to Products
IHETransaction
IHETransaction
IHE Actor
IHE Actor
IHETransaction
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IHE Validation Process

• Goal
• Validate implementations of IHE TF in products
• Approach
• IHE is not a certification authority
• IHE stimulates auto-validation
• Vendors are responsible for validating and
  documenting IHE implementations
• IHE provide tools and infrastructure
• IHE Validation tools
• Mesa testing toolkit
• Connect-a-thon
• IHE Integration statement

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MESA Test Toolkit

• Software library
• Emulate the various actors in the different
  implementation profiles
• Supports single product, single vendor testing
• Pre-requisite for connectathon participation
• Implementers submit test logs prior to
  connectathon

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Connect-a-thon

• Connectathon connectivity marathon
• Validate the Integration Profiles for a
  particular IHE demo
• Pre-requisite for participating at IHE demos
• 1 week validation session in Europe, USA and
  Japan
• End-to-end scenario testing
• Multi-product multi-vendor multi-domain
• Multi-vendor, multi products
• 2004 50 companies, 100 systems
• 2005 77 companies, 118 systems
• Multi-domain Integration Profiles
• Rad, ITI, Lab, Cardio
• European connectathons
• Paris (2001, 2002), Aachen (2003), Padova (2004)
• Noordwijkerhout (April 2005)
• Results are published on www.ihe-europe.org

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Connect-a-thon at work
2003 Aachen
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Connect-a-thon results
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IHE Integration Statements

• Vendors
• Document the IHE implementation per product
• Content
• List of supported actors
• List of supported integration profiles (per
  actor)
• contractual commitment
• Buyers
• Uniform mechanism to compare product integration
  capabilities
• Enables validation on paper

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IHE Organization

• Global Structure
• Why IHE Europe

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IHE Organizational Structure
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IHE Members
Stakeholders of healthcare interoperability
solution

• Users
• Clinicians, Medical Staff, Administrators, CIOs,
  
• Vendors
• Information Systems Imaging Equipment (80
  vendors)
• Societies Representing Healthcare Segments
• EAR, ESC, Other Professional Societies
• Governmental agencies
• e.g. GMSIH
• Active liaison with Standards Development
  Organizations (SDOs)
• HL7, DICOM, ASTM, others

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IHE in Europe - Why

• Similar integration problems ask for similar
  (IHE) solutions
• Provide European vendors (RIS/HIS) with a
  platform to develop and test world-class
  interoperability
• Address European specific requirements
• Multi-language aspect
• Limited acceptance of HL7
• Country specific RIS vendors
• Country specific congresses exhibitions
• Represent European needs in the different global
  IHE Development committees

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IHE Europe vs. National IHE
Connectathon
IHE Europe Committee
Education and promotion
IHEInter-national
Strategic Development
New Integration Profiles
Vendor Participation
National TF extensions
IHE Netherlands Committee
IHE Germany Committee
IHE xxx Committee
Demonstrations
Education
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IHE-Europe Deployment Activities

• National IHE Committees (8)
• 2001 France, Germany
• 2002 Italy, UK
• 2003 Norway, Denmark, Netherlands
• 2004 Spain
• Demos
• Radiology centric demos JFR, DRK, SIRM, UKRC,
  ECR
• Hospital centric demos Hopital Expo, Medica,
  HCC
• 400 visitors/demo (average)
• 40 local vendors 60 international vendors

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IHE Europe Development Activities

• Participate in global IHE Development activities
• National extensions of Technical Framework
• Champion of IHE Clinical Lab
• Joint effort of IHE France and IHE Japan
• Other countries join USA, Germany
• Assess new IHE initiatives in Pathology Surgery
• IHE test tool development
• Extensions of MESA Test tools for clinical lab
• Web based test management tool

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Update on IHE activities in Europe for 2006
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IHE Europe Activities 2006

• IHE Connect-a-thon
• Barcelona, 24-28 April 2006
• All IHE domains Radiology, IT Infrastructure,
  Cardiology, Clinical Lab, PCC
• IHE Demos
• Radiology France, Germany, Italy, Geneva ?
• Cardiology ESC congress (WCC Barcelona in
  Sept. 2006)
• Lab France ?
• IT, PCC Italy, France, Geneva

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IHE Europe Activities 2006

• IHE Domain development
• IT Infrastructure
• Patient Care Coordination
• Radiology
• Cardiology
• Laboratory
• Mammography
• Patient Care Devices
• Pathology
• Radiation/Oncology
• Eyecare