IHE in regional and national health information exchange around the WORLD

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IHE in regional and national health information
exchange around theWORLD

• HIMSS Interoperability Showcase February 2007
• Charles Parisot (GE)

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International Adoption of IHE

• Local Deployment
• National Extensions (Local Adaptions)
• Promotional Live Demonstration Events
• Funding

Pragmatic global standards harmonization best
practices sharing
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IHE Organizational Structure
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National and Regional projects

• It is difficult to provide a simple summary view
  of these projects
• These slides reflect information publicly
  available and current based on authors
  knowledge.
• IHE offers 18 Integration Content profiles
  applicable in health information exchange for
  communities, regions or nations. Each project
  discussed here uses different subsets of these
  profiles (IHE Modularity).
• These projects are multi-year and projects with
  complex decision making processes.

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Introduced at HIMSS in 2005 IHE-XDS
Community or sub-network
Repository ofDocuments
Repository ofDocuments
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Introduced at HIMSS in 2005 IHE-XDS
Community or sub-network
Repository ofDocuments
Repository ofDocuments
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IHE Integration Profiles for Health Info Nets
What is available and is added in 2006-2007
Clinical and PHR Content
Emergency Referrals
PHR Extracts/Updates
Format of the Document Content and associated
coded vocabulary
ECG Report Document
Format of the Document Content and associated
coded vocabulary
Lab Results Document Content
Format of the Document Content and associated
coded vocabulary
Scanned Documents
Format of the Document Content and associated
coded vocabulary
Imaging Information
Format of the Document Content
Medical Summary (Meds, Allergies, Pbs)
Format of the Document Content and associated
coded vocabulary
Format of the Document Content and associated
coded vocabulary
Health Data Exchange
Cross-Enterprise Document Sharing
Registration, distribution and access across
health enterprises of clinical documents forming
a patient electronic health record
Final Text Approved
Trial Implementation-2006 Final Txt 2007
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Sharing and Accessing Electronic Health Records

• IHE offers interoperability for local, regional,
  specific, or national health information exchange
• Goal is to enable exchange between providers
  clinical and administrative systems and ancillary
  IT systems (EHRs,Lab, Pharma, Payers, etc.) and
  personal health record systems.
• Objective is to empower the consumers in having
  shared EHR information between all of its
  potential healthcare providers (if authorized)
  and self.
• Objective is to empower the providers in choosing
  when and what information to share, and to trust
  the information they may use in the care of their
  patients.

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Categories of Healthcare Communication
ServicesMost HIEs in the World chose to start
with Document Sharing
HIEs and RHIOs
Hospitals
Patient and Provider ID Mgt
e.g. access to last 6 months historical labs and
encounter summaries
e.g. order a lab test, track status and receive
results
e.g. get a current list of allergies or med list
from a source
Security
Document Sharing
Dynamic Information Access
Workflow Management
Source persisted and attested health records
Specific info snapshot provided on demand
2 or more entities synchronize a task
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IHE, the only sets of harmonized global standards
already adopted by several national regional
projects
Italy (Conto Corrente Salute)
UK CfH (Radiology WF)
Denmark (Funen) Italy (Veneto) Spain (Aragon)
FranceDMP
Quebec, Toronto,Alberta, British ColumbiaCanada
Infoway
Austria
MA-Share MA
State Project NY
Philadelphia HIE
JAPAN-Nogaya Imaging Info Sharing
THINC- New York NCHICA N. Carolina
CHINA-MoH Lab results sharing
CHINA-Shangai Imaging Info Sharing
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Italy (Genoa Region)
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Italy (Genoa Region)

• In service since January 2006.
• 4 Hospitals and 500 physician offices.
• EMRs import and export documents from their local
  records.
• All vendor products required to pass IHE-Europe
  connectathon in April 2005.
• Patients chose to join through one of their care
  provider
• Infrastructure includes
• XDS Registry
• XDS Repository shared at the regional level
• PIX for patient Id linking
• Doc content is CDA with PDF content. Plan in
  place to move to CDA rel 2 with structured data.
  IHE (XD-Lab) CDA Lab primary candidate.

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France (National DMP)

• Prototype RFP call for tender mid-2005. 3 small
  prototypes in place, confirmed requirement to use
  to IHE profiles XDS, ATNA, PIX, etc.
• Encourage vendors to submitt their products to
  the IHE-Europe Connectathon (April 2006-Berlin).
• Infrastructure to include
• XDS Registry
• XDS Repositories shared at the regional level
• PIX for patient Id linking and ATNA for audit
  trail and node authentication.
• Doc content to be CDA rel 2 patient summary
  (close to XDS-MS), Hprim with migration to IHE
  XD-Lab for Lab, Scanned Doc (PDF) and imaging
  (XDS-I).

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USA (Philapdelphia Region)

• Philadelphia Health Info Exchange in service
  since 2005. Focused on images and reports
  sharing.
• 5 Hospitals Imaging Center Public Health
• The Hospital of the University of Pennsylvania
• Thomas Jefferson University Hospital
• Childrens Hospital of Philadelphia
• Presbyterian Medical Center
• Pennsylvania Hospital
• UPHS Community Radiology
• Philadelphia Department of Public Health
• Migration to XDS, ATNA, PIX and XDS-I in 2006 to
  be completed early 2007.
• Demonstrated live at RSNA-Chicago Nov 2006

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USA (Other)

• New York State issued an RFP for imaging info
  sharing communities based on XDS-I. Responses
  due January 2007.
• HITSP (HHS sponsored) approved 8 IHE Integration
  profiles for Lab results distribution and
  sharing, Registration and Medication History for
  Consumers, Biosurveillance.
• 2 NHIN Pilots (CSC and IBM) leverage IHE profiles
  (Med Summaries and Lab).
• Several RHIOs projects are actively planning the
  use of IHE
• North Carolina
• Tennessee
• Vermont
• .

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Canada

• Canada Health Infoway national Commitment to
  XDS/XDS-I for imaging sharing
• 3 infrastructure tenders awarded and 1 more to
  come early 2007 resulting in over 1/3 of Canadian
  patients covered
• Toronto East Network - Ontario
• Montreal McGill - Quebec
• Alberta
• British Columbia
• Includes XDS, ATNA, PIX and XDS-I.
• Planned to become live January 2008 in Quebec, 1Q
  2008 in Ontario, Alberta, British Columbia.
• Telehealth Project launched (remote
  consultation), based on XDS.

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Other Commitments

• Austria
• Lower Austria Region schedule to get live in 4Q
  2006.
• China
• MoH selected XDS and XD-Lab (CDA) for two large
  pilots.
• XDS-I in Shangai.
• Netherlands
• Amsterdam region network project launched Nov
  2006. XDS-I followed by XD-Lab.
• Japan
• Nagoya region network project launched in 2006.
  XDS, XDS-I
• Sweden
• Gotteborg region network project launched in
  2006. XDS, XDS-I

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HIMSS RHIO Network of networksThe largest
multi-vendor RHIO Prototype ever built !
3 infrastructure systems
18 edge systems4 infrastructure systems
13 edge systems3 infrastructure systems
5 edge systems 4 infrastructure systems
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IHE, the only sets of harmonized global standards
already adopted by several national regional
projects
Italy (Conto Corrente Salute)
UK CfH (Radiology WF)
Denmark (Funen) Italy (Veneto) Spain (Aragon)
FranceDMP
Quebec, Toronto,Alberta, British ColumbiaCanada
Infoway
Austria
MA-Share MA
State Project NY
Philadelphia HIE
JAPAN-Nogaya Imaging Info Sharing
THINC- New York NCHICA N. Carolina
CHINA-MoH Lab results sharing
CHINA-Shangai Imaging Info Sharing
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