Leveraging IHE to build RHIO Interoperability - PowerPoint PPT Presentation

1 / 37
About This Presentation
Title:

Leveraging IHE to build RHIO Interoperability

Description:

IHE IT Infrastructure Technical Committee co-chair. June 28-29, 2005 ... FujiFilm Medical Systems, USA, Inc. GE Healthcare. Heartlab, Inc. Hitachi Medical Corporation ... – PowerPoint PPT presentation

Number of Views:110
Avg rating:3.0/5.0
Slides: 38
Provided by: tri5367
Category:

less

Transcript and Presenter's Notes

Title: Leveraging IHE to build RHIO Interoperability


1
Leveraging IHE to buildRHIO Interoperability
Charles Parisot GE Healthcare IHE IT
Infrastructure Technical Committee co-chair
2
  • Providers and Vendors
  • Working Together to Deliver
  • Interoperable Health Information Systems
  • in the Enterprise
  • and Across Care Settings

3
Selected IHE Integration Profiles for RHIOsWhat
is available and is added in 2005
4
HIMSS 2005 Show-Wide Interoperability
Vendor System
HIMSS RHIO with Cross-enterprisedoc sharing
(17 vendors)
5
HIMSS 2005 InteroperabilityShow Case Vendors
  • 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
6
IHE North America Vendors (2004-2005)
  • Hologic
  • IDX Systems Corp.
  • INFINITT Technology
  • InSite One, Inc.
  • Intelerad Medical Systems
  • InterSystems Corporation
  • Konica-Minolta Medical Imaging, USA, Inc.
  • Kryptiq
  • Marotech
  • McKesson Information Solutions
  • MedCommons Inc.
  • MedCon, Inc.
  • Merge eFilm
  • Mortara Instrument, Inc.
  • Novell, Inc.
  • Philips Medical Systems
  • QRS Diagnostic
  • Quovadx
  • St. Jude Medical A.B.
  • Sectra Imtec A.B.
  • St. Jude Medical A.B.
  • Sectra Imtec A.B.
  • Sentillion
  • Siemens Medical Solutions
  • Stentor
  • Swissray International, Inc.
  • Tiani Medgraph A.G.
  • Tiani Spirit Gmbh
  • Toshiba Medical Systems Company
  • Vital Images
  • WebMD Practice Services
  • Agfa HealthCare
  • Allscripts
  • Camtronics Medical Systems
  • Cedara Software Corp.
  • Cerner Corporation
  • Dictaphone Corporation
  • Dynamic Imaging, LLC
  • Eastman Kodak Company
  • Eclipsys
  • Emageon
  • Epic Systems Corporation
  • ETIAM
  • FujiFilm Medical Systems, USA, Inc.
  • GE Healthcare
  • Heartlab, Inc
  • Hitachi Medical Corporation

7
At HIMSS in 2005 IHE-XDS
8
At HIMSS in 2005 IHE-XDS
  • Shared prototype content
  • Medical Summaries (Pre-CCR)
  • Discharge Summaries (CDA-R1)
  • Lab Results (HL7)
  • Other (PDF)

9
Demo a RHIO with IHE at HIMSS 2006 ?
  • Secured Sharing of
  • Medical Summaries
  • Images reports
  • ECG Reports
  • PDFs
  • Lab Results ?
  • Notif of Doc Avail.

1-Patient Authorized Inquiry
10
Document Life Cycle Management
Addendum to a registered document
Time
A two-way relationship between Original and
Addendum
Document
Addendum
Addendum
Replacing a registered document by a new document
Document 1 (Approved)
Time
A two-way relationship between Original and
Replacement Document.
Replacement
Replacement Document
Document 1 (Deprecated)
Registering an alternate form or a signature for
a registered document
Transform
A two-way relationship between Original and
Transform (alternative format with same scope or
DSG).
Document 2 (transform)
Document 1 (Approved)
11
Local Regional RHIOs Infrastructure and
Interoperability
  • Cross-Enterprise Document Sharing (XDS) minimizes
    clinical data management by the infrastructure.
    Transparency Ease of Evolution
  • XDS works with other IHE Integration Profiles
    patient Id mgt, security, etc. Flexibility of
    RHIO configuration
  • With introduction of new Integration Profiles,
    IHE ready to build regional health networks
    linking interoperable EHRs. Major milestone for
    2006 RHIO projects
  • Goal is to offer a consistent, standards-based
    and functional for EHRs and other ancillary
    systems.

12
Creating a Health Information Network with IHE
Tier 1 EHRs and Ancillaries
Care Delivery IT system
Care Delivery IT system
Care Delivery IT system
13
Creating a Health Information Network with IHE
Tier 2 Community HIN
What and Where ?
Care Delivery IT system
Care Delivery IT system
XDS Document Registry
Care Delivery IT system
XDS Document Repository
XDS Document Repository
14
Creating a Health Information Network with IHE
Who, What and Where ?
Who, What and Where ?
Tier 2 Community HIN
C-HIN Patient Identity Source
Patient Demo Supplier
Care Delivery IT system
Care Delivery IT system
XDS Document Registry
Patient Id X-Ref Mgr
PDQ Consumer
Care Delivery IT system
Patient Id X-Ref Mgr
XDS Document Repository
XDS Document Repository
15
Creating a Health Information Network with IHE
Time Server
Tier 2 Community HIN
C-HIN Patient Identity Source
Patient Demo Supplier
Care Delivery IT system
Care Delivery IT system
XDS Document Registry
Patient Id X-Ref Mgr
PDQ Consumer
Who, What When and Where ?
Care Delivery IT system
Patient Id X-Ref Mgr
XDS Document Repository
XDS Document Repository
16
Creating a Health Information Network with IHE
Time Server
Tier 2 Community HIN
C-HIN Patient Identity Source
Patient Demo Supplier
Care Delivery IT system
Care Delivery IT system
XDS Document Registry
Patient Id X-Ref Mgr
PDQ Consumer
Who, What When and Where ? Trusted !
Care Delivery IT system
Patient Id X-Ref Mgr
XDS Document Repository
XDS Document Repository
17
Security for XDSLeverages IHE Audit Trail Node
AuthenticationA formal Security and Privacy
profile is provided for XDS
  • ATNA creates a secured domain
  • User Accountability (Audit trail)
  • Node-to-Node Access Control
  • Node-level user authentication
  • User access control provided by node
  • BUT Registry/repository based User-Level Access
    Control and policy agreements is beyond XDS.
  • User-level Access Control is
  • provided by XUA

Patient Identity Source
Secured Node
Patient Identity Feed
Secured Node
Query Documents
Document Consumer
Document Registry
Secured Node
Register Document Set
ProvideRegisterDocument Set
Retrieve Document
Secured Node
Document Repository
Document Source
Secured Node
Secured Node
18
Cross-Enterprise User AuthenticationTransaction
Diagram
XDS Repository
Identity Provider
2 Request Assertion (of who this user is)
5 Authentication Assertion
3 Request User ID
1 XDS Retrieve
Record Auditable Event
4 User Identity
ATNA Audit Repository
19
Is it possible to federate multiple XDS-based HIN
?
Tier2 Community-HINs e.g. XDS Affinity Domain
20
Federating Tier 2 Health Information NetworksOn
IHE Roadmap for 2006-2007 X-Registry
Federation(Addressed by ebXML Registry 3.0)
What are the document registries where a patient
has information ?
Federated Identification
Patient / Registry Locator Service
Tier 3 HIN e.g. State Level
RG
T2 C-HIN B e.g. XDS Affinity Domain
RG
Managed Identification
T2 C-HIN D e.g. XDS Affinity Domain
21
Federating Tier 2 Health Information NetworksOn
IHE Roadmap for 2006-2007 X-Registry Federation
Integrating existing IDNs Adaptor Registry
Federated Identification
Patient / Registry Locator Service
Tier 3 HIN e.g. State Level
RG
T2 C-HIN B e.g. XDS Affinity Domain
RG Adapt
RG
Managed Identification
RG Adapt
T2 C-HIN A e.g. IDN
T2 C-HIN D e.g. XDS Affinity Domain
T2 C-HIN C e.g. IDN
22
Federating Tier 3 Health Information NetworksOn
IHE Roadmap for 2006-2007 X-Registry
Communication
Nation-Wide Health Info network (Tier 4)
Patient / Registry Locator Service
Patient / Registry Locator Service
Patient / Registry Locator Service
e.g. State HIN
RG
RG
RG
T1-RHIO B e.g. XDS Affinity Domain
RG
T1-RHIO A e.g. IDN
T1-RHIO D e.g. XDS Affinity Domain
T1-RHIO C e.g. IDN
23
IHE RHIOs Interoperability Partner
  • IHE offers a solid technical foundation to
    establish interoperability for RHIOs.
  • Standards-based, open, multi-vendor,
    provider-led.
  • Yearly progress, validation testing built in,
    backed by a proven process. Implementation by
    many vendors.
  • IHE welcomes RHIOs technical architects active
    involvement.
  • The IHE Technical Framework accelerates RHIOs
    pilot development (e.g. XDS Affinity Domain).
  • This is being applied Norway, Italy, then
    Canada, soon USA, France, ?

24
Clinicians access XDS Servicesthrough their
clinical IT system (EHRs)
DocumentRepositories
Index of patients records (Document-level)
ClinicalIT System
25
Sharing Radiology Reports and Images with XDSin
a Regional Health Information Network
Regional Health Information Network
Radiology Enterprise B
PACS B
Radiology-to-radiology
Radiology-to-Physicians
PACS A
Radiology Enterprise A
Physician Office
26
Sharing Radiology Reports and Imagesin a
Regional Health Information Network
Regional Health Information Network
Radiology Enterprise B
PACS B
  • Patient Id 3547F45
  • Report 5/21/1998 CT Head ?B
  • Study 5/21/1998 CT Head ?B
  • Report 2/18/2005 Chest Xray ?A
  • Study 2/18/2005 Chest Xray ?A

Cross-Enterprise Registry
PACS A
Radiology Enterprise A
Physician Office
27
Physicians and Systems within a Regional Health
Network - Routine Imaging Referral
Regional Health Information Network
Radiology Enterprise B
Cross-Enterprise Registry
  • Patient Id 3547F45
  • Report 5/21/1998 CT Head ?B
  • Study 5/21/1998 CT Head ?B

Radiology Enterprise A
Physician Office
28
Physicians and Systems within a Regional Health
Network - Routine Imaging Referral
Regional Health Information Network
Radiology Enterprise B
Cross-Enterprise Registry
Radiology Enterprise A
Physician Office
29
Physicians and Systems within a Regional Health
Network for a Routine Imaging Referral
Regional Health Information Network
Radiology Enterprise B
  • Patient Id 3547F45
  • Report 5/21/1998 CT Head ?B
  • Study 5/21/1998 CT Head ?B
  • Report 2/18/2005 Chest Xray ?A
  • Study 2/18/2005 Chest Xray ?A

Cross-Enterprise Registry
Radiology Enterprise A
Physician Office
30
Regional Health Information NetworkImages and
reports part of a shared health record
Regional Health Information Network
Enterprise B
Register Documents for sharing
Retrieve Prior Documents
Retrieve PriorDocuments
Cross-Enterprise Registry
Register Documents for sharing
Query for Documents
Query for documents
Notification of Doc Availability
Retrieve Documents
Enterprise A
Physician Office
31
Requirements for care delivery IT system in a
RHIO(e.g. EHR, Lab, Imaging, etc.)
Audit Trail Node Authentication
Centralized privacy audit trail and node to node
authentication to create a secured domain.
32
IHE Interoperability for RHIOs
  • By starting with a secured document sharing
    infrastructure, RHIOs have a a platform on which
    to build clinical content (more structure coded
    terminology, specialized content).
  • Solid SAML 2.0 authentication and document
    digital signature (need a PKI).
  • Practical HL7 V3 approach with CDA-R2 and other
    content (e.g. imaging, CCR, legacy, PDF, etc.).
  • Establishing a critical mass of products
    implementations, both in clinical applications
    and infrastructure for deployment in 2006.
  • An architecture that caters to various RHIOs
    architectures centralized, decentralized and
    mixed (operational decision).

33
More information.
  • IHE Web sites www.ihe.net
  • Technical Frameworks, Supplements
  • Fill in relevant supplements and frameworks
  • Non-Technical Brochures
  • Calls for Participation
  • IHE Fact Sheet and FAQ
  • IHE Integration Profiles Guidelines for Buyers
  • IHE Connect-a-thon Results
  • Vendor Products Integration Statements

34
IHE Patient Id management for RHIOsUse of PIX
and PDQ Integration Profiles
35
Patient Identification ManagementPIX Cross
Referencing (coexist with PDQ)
Patient Identity Source
Patient Identification Domain C
Patient Identification Domain D2
Patient Identification Domain XAD
XDS Document Registry


DmD2 PidPd
DmC PidPc
XDS Document Repository
36
Patient Identification ManagementPDQ Discovery
Local mapping (coexist with PIX)
Patient Identity Source
Patient Identification Domain C
Patient Identification Domain D2
Patient Identification Domain XAD
XDS Document Registry


XDS Document Repository
37
  • Providers and Vendors
  • Working Together to Deliver
  • Interoperable Health Information Systems
  • in the Enterprise
  • and Across Care Settings
Write a Comment
User Comments (0)
About PowerShow.com