Post on 27-Mar-2015
Jonathan L. Elion MD, FACC
Co-Chair, IHE Cardiology Planning Committee
The Basics of IHE:The Basics of IHE:Concepts and ProcessConcepts and Process
EyeEye Eh?Eh? ChiChi
August 12, 2005 IHE EP Subcommittee2
Professional Societies Sponsorship Healthcare Providers & Vendors
Healthcare IT Standards HL7, DICOM, etc.
General IT Standards Internet, ISO, etc.
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
IHE Process
Standards-Based Integration Standards-Based Integration Standards-Based Integration Standards-Based Integration
August 12, 2005 IHE EP Subcommittee3
IHE Organizational StructureIHE Organizational StructureMulti-Domain & Multi-NationalMulti-Domain & Multi-NationalIHE Organizational StructureIHE Organizational Structure
Multi-Domain & Multi-NationalMulti-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
SponsorCo-Chairs
Global
Interoperability
IHE Domain-related Planning and
Technical Committees
August 12, 2005 IHE EP Subcommittee4
Achievements and expanding scopeAchievements and expanding scope15 Active national chapters on 4 continents15 Active national chapters on 4 continents
4 Technical Frameworks4 Technical Frameworks39 Integration Profiles, Testing at yearly Connectathons,39 Integration Profiles, Testing at yearly Connectathons,
Demonstrations at major exhibitions world-wideDemonstrations at major exhibitions world-wide
Vendors claim compliance to IHE Integration Profiles by publishing an IHE Integration Statement for each product.
IHE
EHR- Longitudinal Record
IHE Cardiology
IHE Laboratory
IHE Radiology
New IHE Domains
Patient Care Coordination
IHE
IT Infrastructure
16 Integration Profiles
5 Integration Profiles
4 Integration Profiles
13 Integration Profiles
1 Integration Profile Oncology, Eye care, Intensive care devices, Pathology, etc.
August 12, 2005 IHE EP Subcommittee5
Proven Standards Adoption ProcessProven Standards Adoption Process
IHEIntegrationProfiles B
IHEIntegrationProfile A
Easy toIntegrateProducts
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– Process started in 1998; continuously improved
IHEIHEConnect-a-thonConnect-a-thon
ProductWith IHE
IHE Connect-a-thonResults
August 12, 2005 IHE EP Subcommittee6
Who is IHE?Who is IHE?
• IHE is a joint initiative among:
– American College of Cardiology (ACC)
– Radiological Society of North America (RSNA)
– Healthcare Information Management Systems Society (HIMSS)
– GMSIH, HPRIM, JAHIS (laboratory)
– American Society of Ophthalmology
– And many more….
• Began in 1997 in Radiology (RSNA) and IT (HIMSS)
• International effort: IHE- Europe and IHE-Japan
• Additional sponsors for Cardiology including ASE, ESC, ASNC, SCA&I, HRS and more
August 12, 2005 IHE EP Subcommittee7
IHE DeliverablesIHE Deliverables
• Venue(s) for communication (committees)
• Integration Profiles (what needs to be done)
• Technical Framework (how to do it)
• Maintenance of Integration Profiles (sustainability)
• Connect-a-thon (actually do it!)
• Public Demonstrations (ACC ’05 for Cardiology)
• Tools for Acquiring Conformant Products (RFP’s)
August 12, 2005 IHE EP Subcommittee8
What is IHE NOTWhat is IHE NOT
• IHE is not a standard• You conform to a standard• You comply with IHE integration profile and actors
• IHE is not a standards development organization• IHE is not a certifying authority• IHE is not simply a demonstration project
• Demos are only one means to the end: Adoption• Backed up by documentation, tools, testing, and publication of
information• IHE is not just for radiology and more!
August 12, 2005 IHE EP Subcommittee9
IHE Domains Milestones: 20 month cycleIHE Domains Milestones: 20 month cycleDevelopmentDevelopment and and DeploymentDeployment
Proposed Supplement Scope
Approved Supplement Scope
Public Comment Int. profile Sponsors announce Connectathon/Demos with set
of Implementation Profiles
• Final Int. profile + 9 ---
- 10 ---
- 7 ---
- 2 ---
Trial Implementation int. profile 0 ---
Connectathon/Demo Vendor Participant Registered+ 2 ---
Vendor Participant passed Connectathon+ 5 ---
+ 6 --- Demo &Education Material
Vendors release products with IHE Integration Statements
---
August 12, 2005 IHE EP Subcommittee10
IHE Annual Cycle IHE Annual Cycle
1. Clinicians identify clinical problems to be addressed -“Integration Profiles”
2. Engineers from vendors collaborate to define technical specification (using existing standards such as DICOM and HL7)
3. Vendors implement the technical specification and participate in the “Connectathon”
4. Demonstrations at trade shows (ACC, HIMSS, etc.)
5. Vendors publish IHE Integration Statements
6. Customers reference IHE profiles in RFP’s
August 12, 2005 IHE EP Subcommittee11
Cardiology Example (Year 1)Cardiology Example (Year 1)
The Planning Committee identified three initial clinical problems to be addressed:
1. The ability to view an ECG from many locations - quickly and easily
2. Lab systems integration of patient, order, and procedure information in an Echo Lab, including mobile echo
3. Lab systems integration of patient, order, and procedure information in a Cath Lab, including angio, hemo, and IVUS
► “Retrieve ECG for Display”
► “Echocardiography Workflow”
► “Cardiac Catheterization Workflow”
August 12, 2005 IHE EP Subcommittee12
IHE Annual Cycle IHE Annual Cycle
1. Clinicians identify clinical problems to be addressed -“Integration Profiles”
2. Engineers from vendors collaborate to define technical specification (using existing standards such as DICOM and HL7)
3. Vendors implement the technical specification and participate in the “Connectathon”
4. Demonstrations at trade shows (ACC, HIMSS, etc.)
5. Vendors publish IHE Integration Statements
6. Customers reference IHE profiles in RFP’s
August 12, 2005 IHE EP Subcommittee13
IHE Technical FrameworksIHE Technical Frameworks
Pt. Registration [RAD-1] Patient Update [RAD-12]
Pt. Registration [RAD-1] Patient Update [RAD-12]
Placer Order Management [RAD-2] Filler Order Management [RAD-3]
ADT
Query Images [RAD-14] Retrieve Images/Evidence [CARD-4]
Image Display
Modality Image/Evidence Stored [CARD-2]
Storage Commitment
[CARD-3]
Procedure Scheduled [RAD-4]
Procedure Updated [RAD-13]
Query Modality Worklist [RAD-5]
Performed Procedure
Step Manager
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Order Placer
Acquisition Modality
ImageManager
ImageArchive
DSS/ Order Filler
Patient Update [RAD-12]
Modality Image/Evidence Stored [CARD-2]
Storage Commitment
[CARD-3]
Evidence Creator Modality PS in Progress [CARD-1]
Modality PS Completed [RAD-7]
Instance Availability Notification [RAD-49]
Pt. Registration [RAD-1] Patient Update [RAD-12]
Pt. Registration [RAD-1] Patient Update [RAD-12]
Placer Order Management [RAD-2] Filler Order Management [RAD-3]
ADT
Query Images [RAD-14] Retrieve Images/Evidence [CARD-4]
Image Display
Modality Image/Evidence Stored [CARD-2]
Storage Commitment
[CARD-3]
Procedure Scheduled [RAD-4]
Procedure Updated [RAD-13]
Query Modality Worklist [RAD-5]
Performed Procedure
Step Manager
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Modality PS in Progress [CARD-1] Modality PS Completed [RAD-7]
Order Placer
Acquisition Modality
ImageManager
ImageArchive
DSS/ Order Filler
Patient Update [RAD-12]
Modality Image/Evidence Stored [CARD-2]
Storage Commitment
[CARD-3]
Evidence Creator Modality PS in Progress [CARD-1]
Modality PS Completed [RAD-7]
Instance Availability Notification [RAD-49]
Query Modality Worklist [RAD-5]
ADT Order Placer
Register J.Doe
AcquisitionModality
Placer OrderManagement –New [RAD-2]
Patient Reconciliation
Department System Scheduler/Order Filler
Schedule Procedure
Procedure Scheduled [RAD-4]
Modality Procedure Step Completed [RAD-7]J.Doe ->
J.Smith
Patient Update/Merge [RAD-12]
Modality Procedure Step Completed [RAD-7]
PatientRegistration [RAD-1]
Patient Update/
Merge [RAD-12]
Modality Procedure Step In Progress [CARD-1]
Modality Procedure Step In Progress [CARD-1]
Perform Acquisition
Filler Order Mgmt - Status Update [RAD-3]
Filler Order Mgmt - Status Update [RAD-3]
ImageManager/
PPS Manager
Filler Order Management -New [RAD-3]
One or the other methods of creating an order is used
Query Modality Worklist [RAD-5]
ADT Order Placer
Register J.Doe
AcquisitionModality
Placer OrderManagement –New [RAD-2]
Patient Reconciliation
Department System Scheduler/Order Filler
Schedule Procedure
Procedure Scheduled [RAD-4]
Modality Procedure Step Completed [RAD-7]J.Doe ->
J.Smith
Patient Update/Merge [RAD-12]
Modality Procedure Step Completed [RAD-7]
PatientRegistration [RAD-1]
Patient Update/
Merge [RAD-12]
Modality Procedure Step In Progress [CARD-1]
Modality Procedure Step In Progress [CARD-1]
Perform Acquisition
Filler Order Mgmt - Status Update [RAD-3]
Filler Order Mgmt - Status Update [RAD-3]
ImageManager/
PPS Manager
Filler Order Management -New [RAD-3]
One or the other methods of creating an order is used
Detailed standards implementation guides
–Cardiology
–IT Infra
–Lab
–Radiology
August 12, 2005 IHE EP Subcommittee14
Organization of TFsOrganization of TFs
• Volume 1: Integration Profiles
– Describes clinical need and use cases
– Identifies the actors and transactions
• Volume 2+ of Technical Framework
– Provides implementation specification for each transaction by specific reference to Standards
August 12, 2005 IHE EP Subcommittee15
Transactions & Actors:Transactions & Actors:Displayable Reports ExampleDisplayable Reports Example
Encapsulated Report Storage [CARD-9]
Report Repository
ReportManager
Enterprise Report
Repository
Encapsulated Report Query [CARD-10]Encapsulated Report Retrieve [CARD-11]
Report Reader
Report Creator
Encapsulated Report Submission [CARD-7]
Storage Commitment [RAD-10]
Encapsulated Report Submission [CARD-7]
Display
Retrieve Specific Info for Display [ITI-11] Retrieve Document for Display [ITI-12]
InformationSource
Report Reference Submission [CARD-8]
Retrieve Information for Display (RID) Profile Retrieve Information for Display (RID) Profile
August 12, 2005 IHE EP Subcommittee16
IHE Annual Cycle IHE Annual Cycle
1. Clinicians identify clinical problems to be addressed -“Integration Profiles”
2. Engineers from vendors collaborate to define technical specification (using existing standards such as DICOM and HL7)
3. Vendors implement the technical specification and participate in the “Connectathon”
4. Demonstrations at trade shows (ACC, HIMSS, etc.)
5. Vendors publish IHE Integration Statements
6. Customers reference IHE profiles in RFP’s
August 12, 2005 IHE EP Subcommittee17
IHE ConnectathonIHE Connectathon
• Open invitation to vendor community
• Advance testing tools (MESA)
• Testing organized and supervised by project management team
• Thousands of cross-vendor tests performed
• Results recorded and published
August 12, 2005 IHE EP Subcommittee18
IHE Connectathon, January 2005IHE Connectathon, January 2005
300 participants, 110 systems (31 Cardiology)300 participants, 110 systems (31 Cardiology)43 vendors (14 Cardiology)43 vendors (14 Cardiology)2800 monitored test cases2800 monitored test cases
August 12, 2005 IHE EP Subcommittee19
Looks like it’s working
just fine!
Egad! They’ve totally misunderstood the
Technical Framework!
Ohmagawd – we’re next!
August 12, 2005 IHE EP Subcommittee20
IHE Annual Cycle IHE Annual Cycle
1. Clinicians identify clinical problems to be addressed -“Integration Profiles”
2. Engineers from vendors collaborate to define technical specification (using existing standards such as DICOM and HL7)
3. Vendors implement the technical specification and participate in the “Connectathon”
4. Demonstrations at trade shows (ACC, HIMSS, etc.)
5. Vendors publish IHE Integration Statements
6. Customers reference IHE profiles in RFP’s
August 12, 2005 IHE EP Subcommittee21
Total ACC’05 attendance was over 28,000.Total ACC’05 attendance was over 28,000.
August 12, 2005 IHE EP Subcommittee22
Over 1,000 visitors from 47 countries attended theOver 1,000 visitors from 47 countries attended theIHE presentations and demonstrations.IHE presentations and demonstrations.
August 12, 2005 IHE EP Subcommittee23
IHE Annual Cycle IHE Annual Cycle
1. Clinicians identify clinical problems to be addressed -“Integration Profiles”
2. Engineers from vendors collaborate to define technical specification (using existing standards such as DICOM and HL7)
3. Vendors implement the technical specification and participate in the “Connectathon”
4. Demonstrations at trade shows (ACC, HIMSS, etc.)
5. Vendors publish IHE Integration Statements
6. Customers reference IHE profiles in RFP’s
August 12, 2005 IHE EP Subcommittee24
IHE Integration StatementIHE Integration Statement
August 12, 2005 IHE EP Subcommittee25
IHE Annual Cycle IHE Annual Cycle
1. Clinicians identify clinical problems to be addressed -“Integration Profiles”
2. Engineers from vendors collaborate to define technical specification (using existing standards such as DICOM and HL7)
3. Vendors implement the technical specification and participate in the “Connectathon”
4. Demonstrations at trade shows (ACC, HIMSS, etc.)
5. Vendors publish IHE Integration Statements
6. Customers reference IHE profiles in RFP’s
August 12, 2005 IHE EP Subcommittee26
Your Request for Proposals (RFPs)Your Request for Proposals (RFPs)
• Incorporate IHE framework into RFP documents & product selection
• Much easier to specify an IHE Integration Profile than detailed technical specs
– “Device must support IHE Echo Integration Profile, and vendor must supply an IHE Integration Statement.”
• Use IHE framework to evaluate your current workflow, even if not buying now
• Vendors build product functions that are requested by customers
Ask for IHE Integration Loud & Often !!
August 12, 2005 IHE EP Subcommittee27
More information….More information….
• IHE Web site: http://www.ihe.nethttp://www.himss.org/IHE http://www.rsna.org/IHEhttp://www.acc.org/quality/ihe.htm
• Technical Frameworks• Technical Framework Supplements – Trial Implementation• Non-Technical Brochures :
– Calls for Participation– IHE Fact Sheet and FAQ– IHE Integration Profiles: Guidelines for Buyers– IHE Connect-a-thon Results– Vendor Products Integration Statements
Questions?
Questions?
August 12, 2005 IHE EP Subcommittee28
W W W . I H E . N E TW W W . I H E . N E T
Providers and VendorsProviders and Vendors
Working Together to DeliverWorking Together to Deliver
Interoperable Health Information SystemsInteroperable Health Information Systems
in the Enterprisein the Enterprise
and Across Care Settingsand Across Care Settings