IHE/HL7 positions

Expectations and prospects on FHIR and

Interoperability

(Gemini collaboration)

Jürgen BrandstätterGemini Steering Committee

Co-chair, IHE Europe

Member, IHE International Board

Grahame GrieveGemini Steering Committee

FHIR Product Director

First

Interoperability is

essential for

digital transformation

07.10.2019 IHE AsiaPac Summit 2019 2

Second

Creation of an HIE

is not „the“

problem anymore

07.10.2019 IHE AsiaPac Summit 2019 3

HIE

How IHE works

07.10.2019 IHE AsiaPac Summit 2019 4

Base standards

Complex use-cases:

Standards combined!

Simple use-cases:

Only one standard!

Globally different

solutions for the same

How IHE works

07.10.2019 IHE AsiaPac Summit 2019

Globally different

solutions for the same

5

Base standards „Profiled“ base standards

Compose what‘s

globally common

Interoperability use-cases

Interoperability use-cases

Non-for-profit SDO

Complex use-cases:

Standards combined!

How IHE works

07.10.2019 IHE AsiaPac Summit 2019

Globally different

solutions for the same

6

Base standards „Profiled“ base standards

Compose what‘s

globally common

Tested products!

Competition!

Cost-savings!

Sustainable!

You only have to

deal with your

country-specific

extensions!

Interoperability use-cases

Non-for-profit SDO

Globally similar

solutions for the same

Market

How FHIR Works

• 3 legs: − Platform standards

− Profiling Communities (HL7 Affiliates, IHE)

− Market Impact (Regulation, etc.)

• Many parties involved (HL7, IHE, 100s)

• Seamless experience in the community− Orgs have to interoperate!

• Everybody needs to work together more closely

07.10.2019 IHE AsiaPac Summit 2019 7

How FHIR Works

• FHIR invested deeply in computability:

− Terminology use (and services)

− Profiling Use of FHIR + more

− Documenting Use Cases

− Testing Frameworks

• Our intention:

− Empower publication, implementation, testing (Text + Narrative)

− Build consistent toolchain with bi-directional feedback

07.10.2019 IHE AsiaPac Summit 2019 8

Third

Standards and

Blueprints

are available

07.10.2019 IHE AsiaPac Summit 2019 9

What is a „global“ blueprint?

07.10.2019 IHE AsiaPac Summit 2019 10

Blueprint

eHealth Landscape

07.10.2019 IHE AsiaPac Summit 2019 11

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Use-case

Blueprint Blueprint

Blueprint

Blueprint

Blueprint

Blueprint Blueprint

Blueprint Blueprint

Patient

Identification

Audit and

Logging

Document-

sharing

Governance needs blueprints

• EC Recommendation on EHRxformat− eHDSI cross-border of …

• Patient Summary

• ePrescription / eDispense

• Medical Imaging and Reports

• Laboratory Results

• Hospital Discharge Reports

− Based on • Established IHE Profiles

• HL7 CDA content

− Future developments: FHIR• -> Blueprints need yet to crystallize first!

07.10.2019 IHE AsiaPac Summit 2019 12

ITI PCC QRPH

PHARM

FHIR-based IHE profiles

07.10.2019 IHE AsiaPac Summit 2019

MHD

PIXmPDQm

mACM mXDE

QEDm

MMAUPB

QORE

13

FHIR ATNA

mCSD

SOLE NPFSm

PMDTPCS

RIPTACDC

RECON

GAO

CMAPDCTM

DCP

BFDE-EmRFD

mADXPRQ

VRDR

Overview on IHE Profiles: https://wiki.ihe.net/index.php/Profiles (marked with )

FHIR IG Overview on fhir.org: http://www.fhir.org/guides/registry

ITI PCC QRPH

PHARM

FHIR-based IHE profiles

07.10.2019 IHE AsiaPac Summit 2019

MHD

PIXmPDQm

mACM mXDE

QEDm

MMAUPB

QORE

14

FHIR ATNA

mCSD

SOLE NPFSm

PMDTPCS

RIPTACDC

RECON

GAO

CMAPDCTM

DCP

BFDE-EmRFD

mADXPRQ

VRDR

Overview on IHE Profiles: https://wiki.ihe.net/index.php/Profiles (marked with )

FHIR IG Overview on fhir.org: http://www.fhir.org/guides/registry

Significant FHIR Projects

• USA− Argonaut (Patient Access, EHR extensibility)

− Da Vinci (Fix payer/provider interface issues)

− Quality Measures (CMS payment rules)

− Cancer initiatives

−

• International− National Record Aggregation/exchange

− Patient based Access / Exchange

− Regional / Disease Specific Repositories

• + Data Analytics everywhere

07.10.2019 IHE AsiaPac Summit 2019 15

International collaborations …

07.10.2019 IHE AsiaPac Summit 2019 16

• Governmental bodies start engaging

• Gemini - A Joint Initiative of IHE and HL7 to

Advance Use of FHIR for Interoperability

• GDHP

• Other

initiatives

07.10.2019 IHE AsiaPac Summit 2019 17

Gemini

A Joint Initiative of IHE and HL7

to Advance Use of FHIR for

Interoperability

In the special case of FHIR

07.10.2019 IHE AsiaPac Summit 2019 18

Projectathon

Standards

Profiles

Interoperability

Specifications

IHE Conformity

Assessment

eHealth Projects

Product

Test ReportISO17025

Product

Transactions

Actors

Workflow

Use-case

Content

Re

s

Re

s

Pro

file

d

FH

IR r

es

Re

sR

es

Re

s

Wo

rkfl

ow

sF

HIR

IG

s

:

Path from Standard to Tested Interoperable Product

Mandate, Mission, Parity

• Mandate− Project GEMINI operates under the Statement of

Understanding between IHE and HL7

• Mission− Tighten collaboration between IHE and HL7 in the

context of FHIR

• Parity− GEMINI is a „Joint“ IHE / HL7 project

− Joint ownership and steering under equal parity

• Main work− Coordinate! Establish connections!

07.10.2019 IHE AsiaPac Summit 2019 19

About Gemini

• Area 1: Development and Tooling of „FHIR-based IHE profiles“− FHIR-based IHE profiles remain under IHE governance, but participation and

contribution of HL7 shall be encouraged (as well as participation of IHE in HL7)

− This includes collaborative work, alignment of tooling, mutual notification of new work-items, etc.

• Area 2: Publication of „FHIR-based IHE profiles“− Align publication of FHIR Implementation Guides and FHIR-based IHE profiles by

referencing FHIR-based IHE profiles on fhir.org

• Area 3: Testing− Positioning of the current testing initiatives, such as HL7 FHIR Connectathons, IHE

Connectathons, IHE Conformity Assessment and coordination of the test tooling ecosystem across both organizations

• Area 4: Pilot projects− Identify, agree and execute joint IHE/HL7 pilot projects and demonstrations

• Area 5: Joint Messaging and Marketing− Maintain joint messaging/marketing/education on HL7 FHIR and FHIR-based IHE

profiles on fhir.org

07.10.2019 IHE AsiaPac Summit 2019 20

Gemini Projects

• Medical Imaging for Cancer Care

− Gemini shall coordinate …• Specification development

• Progressively more rigorous interoperability testing

• Implementation activities

• Appropriately timed communications and public demonstrations

− Partners• SMART on FHIR/Sync for Science

• HL7 Imaging Integration WG/DICOM WG20

• FHIRcast

• Clinical Interoperability Council/Clinical Information Modeling Initiative

• ACR-RSNA Common Data Elements Steering Committee

• IHE Radiology

• IHE-USA and IHE-Europe

07.10.2019 IHE AsiaPac Summit 2019 21

Gemini Projects

07.10.2019 IHE AsiaPac Summit 2019 22

Source: QRPH Presentation on CCG Profile, Derek Ritz

Gemini Projects

07.10.2019 IHE AsiaPac Summit 2019 23

Source: QRPH Presentation on CCG Profile, Derek Ritz

Gemini Projects

07.10.2019 IHE AsiaPac Summit 2019 24

Source: QRPH Presentation on CCG Profile, Derek Ritz

Gemini Projects

07.10.2019 IHE AsiaPac Summit 2019 25

Source: QRPH Presentation on CCG Profile, Derek Ritz

See detailed explanation video at

https://vimeo.com/356829962

Changing the Way Healthcare CONNECTS

http://www.ihe.net

Jürgen Brandstätter

juergen.brandstaetter@ihe-europe.net

LinkedIn: https://www.linkedin.com/in/jbrandstaetter

Twitter: JuBrandstaetter

Grahame Grieve

grahame@hl7.org

LinkedIn: https://www.linkedin.com/in/grahamegrieve

Twitter: @GrahameGrieve