INTEGRATING THE HEALTHCARE ENTERPRISE Pathway to Interoperability
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Transcript of INTEGRATING THE HEALTHCARE ENTERPRISE Pathway to Interoperability
INTEGRATING THE HEALTHCARE ENTERPRISE
Pathway to Interoperability
IT Infrastructure Planning CommitteeMichael Nusbaum – MH Nusbaum & Assoc
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Contents
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Base StandardsBase Standards eHealth ProjectseHealth Projects
Interoperability:Highest Cause of Health IT project failures
Health Interoperability Standards: how can we realize the promise ?
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IHTSDOIHTSDO
IETFIETF
Profile Profile DevelopmentDevelopment
Base StandardsBase Standards eHealth ProjectseHealth Projects
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Interoperability: From a problem to a solution
Profiling Organizations Have Emerged
IHTSDOIHTSDO
IETFIETF
Specific ExtensionsSpecific Extensions
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Standards: Necessary…Not Sufficient
Standards are Foundational - to interoperability and communications Broad - varying interpretations and implementations Narrow - may not consider relationships between
standards domains Plentiful - often redundant or disjointed Focused - standards implementation guides focus only
on a single standard
IHE provides a standard process for IHE provides a standard process for implementing multiple standardsimplementing multiple standards
Connecting Standards to Care
Healthcare professionals work with industry
Coordinate implementation of standards to meet clinical and administrative needs Clinicians and HIT professionals identify the key
interoperability problems they face Providers and industry work together to develop and
make available standards-based solutions Implementers follow common guidelines in
purchasing and integrating effective systems
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IHE: A forum for agreeing on how to implement IHE: A forum for agreeing on how to implement standards and processes for making it happenstandards and processes for making it happen
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IHE: A Framework for Interoperability
A common technical framework for harmonizing and implementing multiple standards Application-to-application System-to-system Setting-to-setting
Enables seamless health information movement within and between enterprises, regions, nations
Promotes unbiased selection and coordinated use of established healthcare and IT standards to address specific clinical needs
Is IHE novel? Adopted?
What are the alternatives ? Ignore the issue Pick key standards, and hope for the best Rely on robust standards harmonization
ISO Health Informatics: TR28380 Global Standards Adoption – IHE Process and Profiles
Widespread adoption of IHE Profiles by National and Regional Projects around the world: USA, Canada, Europe, Asia
Home Health: CONTINUA and IHE work together.
12 Country European epSOS Project (IHE-Europe hosting Industry Team).
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Document Use Case Requirements
Identify available standards (e.g. HL7, DICOM, IETF, OASIS)
Develop technical specifications
Testing at Connectathons
IHEDemonstrations
Products declare IHE
Timely access to information Easy to integrate
products
RFPs with IHE reqs
IHE is a Proven Standards Adoption ProcessRecognized by the International Standards Organization: TR 28380
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IHE Organizational Structure
Contributing &Participating
Vendors
Example Deployment CommitteesExample Deployment Committees
IHE Europe
IHE North America
France
USA
Canada
IHE Asia-Oceania
Japan
Korea Australia
Netherlands
Spain Sweden UKItaly
Germany
Norway
China
Austria
Professional Societies / Sponsors
IHE International Board
Global Development DomainsGlobal Development Domains
Radiology
Cardiology
ITInfrastructure
Patient CareCoordination
Patient CareDevices
Laboratory
Pathology
Eye CareRadiationOncology
Public Health, Quality and Research
Pharmacy
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Endoscopy Dentistry
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14 Years of Steady Evolution 1998 – 2011
The IHE Development Domains
Pharmacysince 2009
Pathologysince 2006
Radiation Oncologysince 2004
Radiologysince 1998
Cardiologysince 2004
Patient Care Devicessince 2005
Patient Care Coordinationsince 2004
Eye Caresince 2006
QualityResearch & Public Health
since 2006
Laboratorysince 2004
(Healthcare)IT Infrastructure
since 2003
Endoscopysince 2010
Dentistrysince 2010
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International Participation in IHE
France
Local DeploymentNational ExtensionsPromotional & Live Demonstration EventsFunding
USA
Germany
Italy
JapanUK
Canada
Korea
Taiwan
Norway
Netherlands
SpainChina
Austria
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Pragmatic global standards harmonization + best practices sharing
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Australia
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IHE SponsorsProfessional societies: Healthcare Information Management Systems Society (HIMSS) American College of Physicians (ACP), American College of Emergency Physicians (ACEP) American College of Obstetricians and Gynecologists (ACOG) Many other American Professional Societies (ACCE), (AAO), (ASTRO), etc. British Institute of Radiology (BIR), British Computer Society (BCS) German Radiology Society (DRG) …ASIP (IT France), SFIL (laboratory), French
National Project (DMP), European Society of Cardiology Radiological Society of North America (RSNA) JAHIS (IT Japan), JIRA, JRS,… And many more
Government Agencies: French National Project (ASIP-Santé) Dutch National Project (NICTIZ) Austrian National Project (ELGA) Canada Health Infoway (CHI) Regional projects (Italy, USA, Japan) and many more…..
IHE Connectathon
Open invitation to any vendor and other implementers
Advanced IHE testing tools (MESA, GAZELLE)
Testing organized and supervised by independent project management team
Thousands of cross-vendor tests performed
Results recorded and published http://connectathon-results.ihe-europe.net/
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IHE N.A. Connectathon Tested Systems
Radiology
40 Systems
Cardiology
30 Systems
Devices
20 Systems
Intra-enterprise InteroperabilityEnterprise-level: 44 Systems
Cross-enterprise Interoperability
EHR/PHR/Edge Systems
2008: 14 Systems2009: 24 Systems
2010: 56 Systems
HIE/HIO Infrastructure
2008: 5 Systems2009: 6 Systems
2010: 30 Systems
HIMSS Interoperability Showcase
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IHE, Global Standards-Based Profiles Adopted in National & Regional Projects
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http://tinyurl.com/WWXDS
IHE, Global Standards-Based Profiles Adopted in National & Regional Projects
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http://tinyurl.com/WWXDS
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Supplies infrastructure for sharing healthcare information, which is independent of any particular clinical domain.
An infrastructure interoperability component represents a common IT function that is used as a building block for a variety of use cases... a necessary ingredient, but rarely visible to the end user.
These components may be embedded in an application, but are often deployed as a shared resource within a health information exchange environment.
The IT Infrastructure Domain
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Categories of Healthcare Communication Services
Security/PrivacySecurity/Privacy
Health RecordSharing
Patient and Provider Identity Management
WorkflowEnablers
Source persisted and attested health
records
2 or more entitiessynchronize
a task
e.g. access last 6 mo. historical labs &
encounter summariese.g. order lab test, track
status and receive results
HospitalsExchange of Health Information
Support Management
ITI Strategic FocusCategory Description
Patient and Provider Identity
Profiles in the Patient and Provider Identity category support the management of patient, provider and healthcare organization identity including their localization. This includes the ability to look up, cross-reference, update, remove, merge, link and general management of identities.
Health Record Sharing
Profiles in the Health Record Sharing category support the ability to share patient specific healthcare information within and across Enterprises. This includes the ability to submit, locate/list, push, pull and retrieve patient specific healthcare information.
Security and Privacy Profiles in the Security and Privacy category support the ability to ensure that healthcare information is managed consistent with a reasonable set of security and privacy policies.
Workflow Enablers Profiles in the Workflow Enablers category support standard sequences for performing workflow activities.
Support Management Profiles in the support management category support the ability to share information needed for interoperable healthcare management such as clinical coding, technical or IT management information
http://wiki.ihe.net/index.php?title=ITI_Strategic_Planning
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More Information
IHE Web site: www.ihe.net IHE official materialTechnical Framework documents
IHE Wiki site: wiki.ihe.net IHE committee pages Implementation Notes Ongoing committee work
IHE ITI technical committee mailing list http://www.ihe.net/IT_infra/committeesAt the bottom of the page is a place to join the mailing list
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