Integrating the Healthcare Enterprise

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Integrating the Healthcare Enterprise

• IHE, beyond cardiology and radiology
• An interoperability strategy for the enterprise

Charles Parisot, GE Healthcare IHE IT
Infrastructure Co-chair
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Goals of IHE

• Speed up the rate and quality of integration in
  healthcare environments
• Foster communication among vendors
• Prove that integration is attainable based on
  standards
• Improve the efficiency and effectiveness of
  clinical practice

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IHE drives healthcare standards based-integration

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A Proven Standards Adoption Process
IHE Connect-a-thonResults
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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IHE 2004 achievements and expanding scope
Over 80 vendors involved world-wide, 4 Technical
Frameworks 31 Integration Profiles, Testing at
yearly Connectathons, Demonstrations at major
exhibitions world-wide
Provider-Vendor cooperation to accelerate
standards adoption
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IHE Deliverables

• Venues for discussion between users and vendors
• Common vocabulary/ view of the world based on
• Standard information models (HL7, DICOM, etc.)
• Coded information and their meaning
• Technical Framework An Implementation Guide
• ACTORS in roles performing TRANSACTIONS to
  accomplish Specific Processes
• Together they form INTEGRATION PROFILES
• Connectathon Cross-vendor testing opportunity.
• Public Demonstrations / Education/ Publications
• Marketing Tools for compliant products
• Connectathon results published
• Products claim conformance with Integration
  Statement

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What IHE is NOT!

• A standards development organization
• Uses established standards (HL7, DICOM, others)
  to address specific clinical needs
• Activity complementary to SDOs, formal
  relationship with HL7 and DICOM
• Simply a demonstration project
• Demos only one means to the endadoption
• Backed up by documentation, tools, testing, and
  publication of information

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IHE A stepwise approach
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Key IHE Concepts

• Generalized Systems -gt Actors
• Interactions between Actors -gt Transactions
• Problem/Solution Scenarios -gt Integration
  Profiles
• For each Integration Profile
• the context is described (which real-world
  problem)
• the actors are defined (what systems are
  involved)
• the transactions are defined (what must they do)

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IHE Radiology Integration profiles




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IHE Penetration in Radiology

• Now entering Year 6 !!
• 50 vendors worldwide
• 100 systems in annual Connectathons
• Geographic spread
• U.S., France, Germany, Japan, Italy, Korea,
  Taiwan, U.K, Norway, Netherlands, Spain, etc.
• Well over 100 commercial products available

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IHE IT Infrastructure 2004-2005
Patient Synchronized Applications
Synchronize multiple applications on a desktop to
the same patient
Patient Identifier Cross-referencing for MPI
Patient Identifier Cross-referencing for MPI
Map patient identifiers across independent
identification domains
Map patient identifiers across independent
identification domains
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IHE Penetration in IT Infrastructure and
Laboratory

• Has just completed Year 1 !!
• About 20 vendors worldwide
• 40 systems in annual Connectathons
• Geographic spread
• U.S., France, Italy, Japan, Germany, etc.
• Commercial products appearing

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IHE Laboratory Integration Profiles
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IHE 2004 achievements and expanding scope
Over 80 vendors involved world-wide, 4 Technical
Frameworks 31 Integration Profiles, Testing at
yearly Connectathons, Demonstrations at major
exhibitions world-wide
Provider-Vendor cooperation to accelerate
standards adoption
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An Example ofIHE IT InfrastructureIntegration
Profile
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Introduction EHR Cross-Enterprise Document
Sharing
First step towards the longitudinal dimension of
the EHR Focus Support document sharing
between EHRs in different care settings and
organizations
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Typically, a patient goes through a sequence of
encounters in different Care Settings
Long Term Care
Acute Care (Inpatient)
Other Specialized Care(incl. Diagnostics
Services)
GPs and Clinics (Ambulatory)
Continuity of Care Patient Longitudinal Record
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Finding the records of a patient-Manual tedious
The challenge Finding and accessing
easily documents from other care providers
In the community.
Clinical IT System
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Sharing records that have been published
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Building and accessing Documents
Documents Registry
EHR-LRLongitudinal Recordas usedacross-encount
ers
Long Term Care
Acute Care (Inpatient)
Other Specialized Careor Diagnostics Services
PCPs and Clinics (Ambulatory)
EHR-CR Care Record systemssupporting care
delivery
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XDS Value Proposition

• Foundation for Health IT Infrastructures Shared
  Electronic Health Record, in a community, region,
  etc.
• Effective means to contribute and access clinical
  documents across health enterprises.
• Scalable sharing of documents between private
  physicians, clinics, long term care, pharmacy,
  acute care with different clinical IT systems.
• Easy access Care providers are offered means to
  query and retrieve clinical documents of interest.

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XDS - Value Proposition

• Distributed Each Care delivery organization
  publishes clinical information for others.
  Actual documents may remain in the source EHR-CR.
• Cross-Enterprise A Registry provides an index
  for published information to authorized care
  delivery organizations belonging to the same
  clinical affinity domain (e.g. an LHII).
• Document Centric Published clinical data is
  organized into clinical documents. using
  agreed standard document types (HL7-CDA,
  ASTM-CCR, PDF, DICOM, etc.).
• Document Content Neutral Document content is
  processed only by source and consumer IT systems.
• Standardized Registry Attributes to ensure
  deterministic document searches.

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XDS Conclusion

• Foundation for EHR Health IT Infrastructures
• Effective contribution and access to shared
  documents across all types of health enterprises
• Scalable, Flexible and Easy access

• XDS to be one of the major highlights of 2005
  Annual HIMSS Conference Exhibition. Dallas,
  Tex., Feb. 13-17
• used as a foundation for an on-site demonstration
  of interoperability in support of a National
  Health Information Networks.
• Attendees at the conference will be able to
  create and share their own health records across
  vendor booths as well as in the ambulatory and
  acute care settings on the conference exhibit
  floor.

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How real is XDS ?

• Specification work since Nov 2003
• Under Public Comments June-July 2004
• 600 constructive comments received,
• Stable specification IHE TF Aug 15th, 2004
• IHE Connectathon January 2005 (USA)
• HIMSS Feb 2005 show-wide demonstration
• IHE Connectathon April 2005 (Europe)

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IHE, The practical solutions to the effective
use of information exchange standards in
healthcare
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IHE

• Thank You !

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More information.

• IHE Web sites
• http//www.ihe-europe.org
• http//www.himss.org/IHE
• http//www.rsna.org/IHE
• http//www.acc.org/quality/ihe.htm.
• Technical Frameworks
• ITI V1.0, RAD V5.5, LAB V1.0, CARD V1.0
• Technical Framework Supplements - Trial
  Implementation
• May 2004 Radiology
• August 2004 Cardiology, IT Infrastructure
• December 2004 Laboratory
• Non-Technical Brochures
• IHE Fact Sheet and FAQ
• IHE Integration Profiles Guidelines for Buyers
• IHE Connect-a-thon Results
• Vendor Products Integration Statements