Leveraging IHE for Interoperability in the Enterprise

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Leveraging IHE forInteroperability in the
Enterprise
Michael H. Nusbaum MH Nusbaum
Associates michael_at_mhnusbaum.com
John T. Donnelly IntePro Solutions jtdonnelly_at_inte
pro.biz
IHE IT Infrastructure Planning Committee
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Healthcare in America is Broken

• Not Enough Time
• Not Enough Money
• Not Enough Courage
• Not Enough Brain
• Anecdotal versus Evidence Based Medicine
• Quality / Safety concerns
• Inefficient Processes
• No UNIVERSAL PATIENT Identification
• No Standards for the Use of Standards

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Healthcare IT is Broken

• Dis-Integrated Workflow
• Dis-Integrated Information Flow
• Dis-Integrated Systems
• Dis-Integrated Patient Care

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What is IHE?

• A process, with an intensive annual cycle
• Define problems
• Define technical solutions
• Common information model
• Common vocabulary
• Use existing standards
• Test product solutions between vendors
• Deploy these solutions in products
• Educate the public

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What is IHE NOT?

• Not a standard
• Not a standards development organization
• Not a certifying authority
• Not simply a demonstration project
• Demos are only one means to the end Adoption
• Backed up by documentation, tools, testing, and
  publication of information

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Integrating the Healthcare Enterprise

• IHE provides a common framework for passing
  health information seamlessly
• within the healthcare enterprise
• across multiple healthcare enterprises
• for local, regional national health information
  networks.
• IHE is sponsored by healthcare professional
  associations (ACC, HIMSS, RSNA, etc.).
• IHE drives standards adoption to address specific
  clinical needs.

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IHE Maturity and Acceptance

• More than 100 healthcare vendors worldwide have
  contributed to IHE and the delivery of
  ready-to-integrate products to benefit healthcare
  enterprises of all sizes.
• IHE scope, today and in the future
• radiology, cardiology, laboratory
• enterprise healthcare IT infrastructures
• cross-enterprise healthcare IT infrastructures
• RHIOs
• NHIN

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Vendors demonstrating at theInteroperability
Showcases

• Leadership Level
• CapMed/SanDisk
• Eclipsys
• GE Healthcare
• IDX
• InterSystems
• Kryptiq
• Quovadx/CareScience
• Siemens
• WebMD

Supporter Level AccessPt AGFA dbMotion Dinmar
Oacis EMC Healthvision Healthramp McKesson Va
lco Data Systems
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Driving healthcare through standards-based
integration
IHE Integration Profile A well-defined and
tested solution to a
specific information exchange problem
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Achievements and expanding scope
14 Active national chapters on 3 continents, 4
Technical Frameworks 27 Integration Profiles,
Testing at yearly Connectathons, Demonstrations
at major exhibitions world-wide
Vendors claim compliance to IHE Integration
Profiles by publishing an IHE Integration
Statement for each product.
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IHE Organizational Structure Multi-Domain
Multi-National
IHE Domain-related Planning Committee and
Technical Committee
Global DevelopmentRadiology,IT
Infrastructure,Cardiology,Lab, etc.
contribute
Participants
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Goals of IHE

• Speed up the rate and quality of integration in
  healthcare environments
• Foster communication among vendors and care
  providers
• Prove that integration is attainable based on
  standards
• Improve the efficiency and effectiveness of
  clinical practice
• Improve interoperability among care domains and
  build a foundation for the EHR
• Provide integration solutions used within and
  across healthcare enterprises

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IHE Deliverables

• Venue(s) for communication
• Integration Profiles
• Technical Framework
• Connect-a-thon
• Public Demonstrations

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The IHE Process
Vendor expertise
Provider expertise
Healthcare Site Includes IHE in RFP
Integration Profile
Proposed solution Using existing standards
Professional Societies Demonstrate/Educate That
solution exists
IHE Technical Framework details solution
Vendor tests solution at Connect-a-thon
Vendor implements solution into REAL product
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IHE Facilitates Standards Adoption
IHETechnicalFramework
User Site

• IHE Integration Profiles at the heart of IHE
• Detailed selection of standards and options each
  solving a specific integration problem
• A growing set of effective provider/vendor agreed
  solutions
• Vendors can implement with ROI
• Providers can deploy with stability

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Connect-a-thon

• 300 people
• 100 different products
• 50 vendors
• 5 days

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Connect-a-thon Results (on ihe.net)
Integration Profiles
Actors
Vendors
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Integration Statements
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IHE Model

• Actors in precisely defined roles
• Abstract the notion of information system
• Executing precisely defined transactions
• Using existing standards
• Solve real world process problem

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Integration Profiles for 2005
EHR
Identity Management
Security
Workflow
NEW for 2005
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Cross-Enterprise Document Sharing
(XDS)Transaction Overview
An Affinity Domain is made up of a well defined
set of Document Repositories, Document Sources
and Consumers that have agreed to share clinical
documents registered into a single Document
Registry.


Patient Ident. Source


Patient Identity Feed ITI 18 ?

Query Documents

Document Consumer

Document Registry



Register Document Set ITI-14

Retrieve Document

Provide Register

ITI-17
Document Source
DocumentRepository
Document SetITI-15




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IHE Technical Specifications
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Enterprise Healthcare Needs Addressed by IHE

• Continuity Integrity of Patient Information
• Improved Patient Safety Through Ubiquitous Access
  to Data
• Clinical Workflow Optimization
• Efficient Integration of Clinical Events to
  Administrative/ Billing Requirements

Improving the Patient Care Process
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Benefits of IHE

• Clinicians
• Timely access to complete and consistent patient
  information
• Improved workflow
• Less paper, less sneakernet
• Fewer redundant steps
• Fewer manual processes, fewer opportunities for
  error

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Benefits of IHE

• Purchasers of Systems
• True interoperability
• Cheaper, less complicated deployments
• Easier management of interfaces
• Improved workflow

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Benefits of IHE

• Vendors
• Synergistic development across products
• Cheaper, less complicated deployments
• Fewer site specific customizations
• Support of common workflow and information models
• Better use of standards
• Focus competition on features and functionality,
  rather than on interoperability

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IHE Works!

• 22 user success stories deploying IHE
  (www.ihe.net)
• Complex problematic processes involving
  heterogeneous information systems
• Step-wise pragmatic process that yields
  real-world product solutions
• Uses existing standards
• First, within the Enterprise
• patient centric, bottom-up approach
• Now, address longitudinal dimension of the EHR
  with an inter-enterprise, patient centric,
  top-down approach

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Experience your HIMSS-WideElectronic Health
Record
Attendee Registration
Allscripts CapMed Cerner Eclipsys GE
Healthcare IDX Infinitt InterSystems Kryptiq MedCo
mmons MediNotes NextGen OpenText Siemens WebMD
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Cross-Enterprise Showcase

• Technical demonstration
• Featuring the IHE framework enabling
  standards-based health information exchange
  within and across multiple healthcare
  enterprises, available in products today
• Clinical scenarios
• Focusing on clinician access and document sharing
  within the acute care environment and across
  multiple settings
• Includes the Continuity of Care Record (CCR),
  radiology images, cardiology reports, laboratory
  results, etc.

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Ambulatory Care Showcase

• Demonstration of interoperability across a
  variety of settings, including a multi-specialty
  clinic and diagnostic center, a small primary
  care practice and the patients home
• Use cases will guide the attendee through the
  settings in the normal course of care
• Vendors display IHE and other interoperability
  solutions for effective continuity of care
• Theater area for related presentations

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IHE Survey Results

• 92 of respondents were aware of IHE
• Potential benefits of IHE ?
• Improved clinical workflow access of data
  63
• Benefits of IHE products ?
• Reduce deployment costs
• 56

HIMSS web-based survey in November 2004
163 participants
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What can you do?

• Learn about IHE
• Participate on IHE Committees
• Insist on IHE compliance in your RFPs and
  contract documents

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How can I participate?

• As a Provider or Vendor Contributor
• Offer Clinical Use Case Input to Drive IHE
  Profile Development
• Become a member of relevant domains Planning or
  Technical Committees or HIMSS IHE SIG (Special
  Interest Group)
• Become a member of relevant Regional/National
  Committees
• Help to shape IHEs future direction
• As a Vendor Participant
• Respond to Public Comments of Domain Supplements
• Attend the September Educational/Workshops
• Participate in Connect-a-thons and Demonstrations
• As a Provider/Consultant Participant
• Respond to Public Comments of Domain Supplements
• Attend the September Educational/Workshops
• Attend Demonstrations and include IHE Integration
  Profiles in your RFPs and Integration Projects.

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the effective bridge betweeninformation exchange
standards and theirpractical use in healthcare
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• Providers and Vendors
• Working Together to Deliver
• Interoperable Health Information Systems
• in the Enterprise and across Care Settings

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• Lets hear from the users!!

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Integrating the Healthcare Enterprisewww.ihe.net
Thank You! Questions ?