leveraging ihe for interoperability in the enterprise michael h. nusbaum mh nusbaum & associates...
TRANSCRIPT
Leveraging IHE forLeveraging IHE forInteroperability in the Enterprise Interoperability in the Enterprise
Michael H. NusbaumMH Nusbaum & [email protected]
John T. DonnellyIntePro [email protected]
IHE IT Infrastructure Planning Committee
Healthcare in America is Broken
1. Not Enough Time
2. Not Enough Money
3. Not Enough Courage
4. Not Enough Brain
5. Anecdotal versus Evidence Based Medicine
6. Quality / Safety concerns
7. Inefficient Processes
8. No UNIVERSAL PATIENT Identification
9. No Standards for the Use of Standards
Healthcare IT is Broken
• Dis-Integrated Workflow • Dis-Integrated Information Flow• Dis-Integrated Systems
Dis-Integrated Patient Care
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
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
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.
• 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– RHIO’s– NHIN
IHE Maturity and Acceptance
Leadership LevelLeadership Level
CapMed/SanDiskCapMed/SanDiskEclipsysEclipsysGE HealthcareGE HealthcareIDXIDXInterSystemsInterSystemsKryptiqKryptiqQuovadx/CareScienceQuovadx/CareScienceSiemensSiemensWebMDWebMD
Participant LevelAllscriptsAllscripts
Cedara Cedara
CernerCerner
Dictaphone Dictaphone
Eastman KodakEastman Kodak
EclipsysEclipsys
EmageonEmageon
EpicEpic
ETIAMETIAM
INFINITT Tech.INFINITT Tech.
MedcomSoft MedcomSoft
MediNotesMediNotes
MedCommonsMedCommons
MidMarkMidMark
Mortara Instrument, IncMortara Instrument, IncNational Institute National Institute ofof Standards and TechnologyStandards and Technology
NextGenNextGen
NovellNovell
Open TextOpen Text
SentillionSentillion
Supporter LevelSupporter LevelAccessPtAccessPt AGFAAGFA dbMotiondbMotion Dinmar – OacisDinmar – OacisEMCEMC HealthvisionHealthvision HealthrampHealthramp McKessonMcKesson
Valco Data SystemsValco Data Systems
Vendors demonstrating at theInteroperability Showcases
Prof. Societies Sponsorship
Healthcare Providers & Vendors
Healthcare IT Standards HL7, DICOM, etc.
General IT Standards Internet, ISO, etc.
IHE Process
IHE Integration Profile: A well-defined and tested solution to a specific information exchange problem
Interoperable Healthcare IT Solution Specifications
IHE Integration Profile Interoperable Healthcare IT
Solution Specifications IHE Integration Profile
Interoperable Healthcare IT Solution Specifications
IHE Integration Profile Interoperable Healthcare IT
Solution Specifications IHE Integration Profile
Driving healthcarethrough standards-based integration
IHE
EHR- Longitudinal Record
IHE Cardiology
IHE Laboratory
IHE Radiology
IHE
Oncology
IHE
Future Domain
IHE
IT Infrastructure Intra-Enterprise
Cross-Enterprise
14 Integration Profiles
1 Integration Profile
3 Integration Profiles
9 Integration Profiles
Achievements and expanding scope14 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.
IHE Organizational StructureMulti-Domain & Multi-National
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
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
IHE Deliverables
• Venue(s) for communication
• Integration Profiles
• Technical Framework
• Connect-a-thon
• Public Demonstrations
Vendorexpertise
Integration Profile
Proposed solutionUsing existing standards
IHE Technical Frameworkdetails solution
Vendor implements solutioninto
REAL product
Vendor tests solutionat
Connect-a-thon
Professional SocietiesDemonstrate/EducateThat solution exists
Healthcare SiteIncludes IHE
in RFP
The IHE ProcessProviderexpertise
IHEIntegrationProfiles B
IHEIntegrationProfile A
Easy toIntegrateProducts
IHEIHEConnect-a-thonConnect-a-thon
ProductWith IHE
IHEIHEDemonstrationDemonstration
User Site
RFPRFP
StandardsStandards
IHETechnical
Framework
Product IHE IntegrationStatement
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
IHE Connect-a-thonResults
IHE Facilitates Standards Adoption
Connect-a-thon
• 300 people• 100 different products• 50 vendors• 5 days
Connect-a-thon Results (on ihe.net)
Vendors
IntegrationProfiles
Actors
Integration Statements
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
Integration Profiles for 2005
Workflow
Security
Identity Management
EHR
NEW for 2005
Cross-Enterprise Document Sharing (XDS)Transaction Overview
Document Source
Document Consumer
Document
Registry
DocumentRepository
Provide & Register
Document Set[ITI-15]
Register Document Set [ITI-14]
Retrieve Document
[ITI-17]
Query Documents
[ITI-16]
Patient Ident. Source
Patient Identity Feed
[ITI – 18]
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.
IHE Technical Specifications
• 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
Enterprise Healthcare Needs Addressed by IHE
Improving the Patient Care Process
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
Benefits of IHE™
• Purchasers of Systems– True interoperability– Cheaper, less complicated deployments– Easier management of interfaces– Improved workflow
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
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
HIMSS “RHIO” withHIMSS “RHIO” withIHE-XDS Cross-enterpriseIHE-XDS Cross-enterprise
doc sharingdoc sharing
AttendeeRegistration
Experience your HIMSS-WideElectronic Health Record
Ambulatory Showcase BoothAmbulatory Showcase Booth
HomeHome
PCP
MultispecialtyMultispecialtyClinicClinic
Diag CenterDiag Center
Cross-enterprise Showcase Booth
Cardiology Workup
ComprehensivePatient Care
RadiologyRadiology CoordinatedCoordinatedPatient EvaluationPatient Evaluation
ITInfrastructure
Vendor BoothVendor Booth
Vendor BoothVendor Booth
Vendor BoothVendor Booth
Vendor BoothVendor Booth
Vendor BoothVendor Booth
Vendor BoothVendor Booth
HL7 Demonstration HL7 Demonstration
AllscriptsCapMedCerner
EclipsysGE Healthcare
IDXInfinitt
InterSystemsKryptiq
MedCommonsMediNotesNextGenOpenTextSiemensWebMD
• 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.
Cross-Enterprise Showcase
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 patient’s 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
**HIMSS web-based survey in November 2004 – 163 participants
6%
14%
18%
28%
35%
Fewer Point-to-PointInterfaces
Improved Use of Data
Enhanced PatientSafety
Improved Access toData
Improved ClincalWorkflow
22%
30%
52%
56%
Other
Increased Sales
Technical Framework ProvidesInformation to Marketing Staff
Reduced Deployment Costs
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%
What can you do?
• Learn about IHE
• Participate on IHE Committees
• Insist on IHE compliance in your RFPs and contract documents
As a Provider or Vendor Contributor• Offer Clinical Use Case Input to Drive IHE Profile Development• Become a member of relevant domain’s Planning or Technical Committees or
HIMSS IHE SIG (Special Interest Group)• Become a member of relevant Regional/National Committees• Help to shape IHE’s 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.
How can I participate?
the effective bridge betweeninformation exchange standards
and theirpractical use in healthcare
Providers and VendorsWorking Together to Deliver
Interoperable Health Information Systemsin the Enterprise and across Care Settings
Let’s hear from the users!!
Thank You!Questions ?
Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise
www.ihe.net