Integrating the Healthcare Enterprise The IHE Process: Developing Standards-based Solutions Kevin...

Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise

The IHE Process: Developing Standards-based Solutions

Kevin O’DonnellCo-chair, IHE Radiology Planning Committee

Manager, Systems Solutions, Toshiba Medical Systems

April 30, 2004 IHE Canada Videoconference 2

Goals of IHEGoals of IHE

Increase the rate and quality of integration in healthcare environments.

Foster communication among vendors. Prove that integration is attainable through

the use of standards. Improve the efficiency and effectiveness of

clinical practice.


““Improve the efficiency and Improve the efficiency and effectiveness of clinical practice”effectiveness of clinical practice”

Improve WorkflowImprove Information AccuracyImprove Information AvailabilityEnable Cross-System Functionality


How Does IHE Work?How Does IHE Work?A joint initiative to improve systems integration:

Clinicians define system integration needs Vendors use a well-defined process to develop

standards-based solution profiles – the IHE Technical Framework.

Societies (HIMSS/RSNA/ACC) supervise documentation, testing, demonstration, and promotion of the profiles.


Prof. 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

““IHE drives standards-based integration IHE drives standards-based integration in healthcare”in healthcare”


Key IHE ConceptsKey IHE Concepts


ActorActor A generalized system function:

– Order Placer– Order Filler– Acquisition Modality– Image Manager– Report Creator

Implementers choose which Actors to include in a system

Systems may group several Actors


TransactionTransaction An interaction or exchange of data between actors Based on open standards Strictly specified to avoid incompatible implementations

(retire options, clarify data model, etc.)

Represents an actors interface with the rest of the world System internal functions are out of scope, e.g.

– single system functions– transactions between actors inside the same system


Integration ProfileIntegration ProfileA Problem/Solution Scenario

For each Integration Profile:– the context is described

(what real-world problem is addressed)– the actors are defined

(what systems are involved)– the transactions are defined

(what do they have to do)


IHE ProcessIHE Process Identify a specific information flow between several systems Define a coherent set of actors & transactions For each transaction:

– Select an existing standard (e.g. HL7, DICOM)– Detail how to use the standard to implement the

transaction Bundle it up as an “Integration Profile” Do Cross-vendor testing at a “Connectathon” Use Integration Profiles as a Common Language for:

– Vendors to claim in Integration Statements– Users to request in RFPs


IHE Technical FrameworkIHE Technical Framework

Volume 1: The Profiles Identifies the actors and transactions Describes the integration scenario

Volume 2 (and 3): The Transactions Provides implementation specification for each

transaction

Volume 4: The National Appendices Documents national clarifications and extensions


IHE ConnectathonIHE ConnectathonVoluntary ParticipationProject Management by MallinckrodtPre-Validation Tools (MESA)Defined Test Protocols with VerificationEngineering event

– code changes are not a problemMassive Cross-vendor Testing


RFPs & IHE Integration StatementsRFPs & IHE Integration Statements Be Brief?

– “The system must support DICOM” Be Effective?

– “The system must support the following DICOM services according to the following 100 pages of specifications”

Be Both:– “The system must support IHE Scheduled

Workflow as an Acquisition Modality”– IHE Integration Statements

Version 2.1 of the Jupiter 3 CT supports IHE Scheduled Workflow as an Acquisition Modality


IHEIntegrationProfiles B

A Proven Standards Adoption ProcessA Proven Standards Adoption Process

Standards

Easy toIntegrateProducts

IHEIntegrationProfile A

IHEDemonstration

IHEConnectathon

ProductWith IHE

User SiteRFPRFP

IHETechnical

Framework

Product IHE IntegrationStatement

IHE ConnectathonResults


4 active Domains, Over 80 vendors involved, Connectathons on 3 Continents,

Demonstrations at major exhibitions world-wide

IHE Domains in 2004IHE Domains in 2004

IHECardiology

IHELaboratory

IHERadiology

IHEFuture Domain

IHEFuture Domain

IHEIT Infrastructure

Intra-Enterprise

Cross-Enterprise

12 Integration Profiles

1 Integration Profile

5 Integration Profiles

EHR Solutions


IHE Radiology Integration ProfilesIHE Radiology Integration Profiles

Patient Info.

Recon-ciliation

Access to Radiology Information

Consistent Present-ation of Images

Basic Security

-

EvidenceDocs

KeyImageNotes

Simple Image & Numeric Reports

Presentation of Grouped Procedures

Post-

Processing Workflow

Reporting Workflow

Charge Posting

Scheduled Workflow

Media Distribution

NMImage


IHE IT Infrastructure Integration ProfilesIHE IT Infrastructure Integration Profiles

Enterprise User Authentication

Provide users a single nameand

centralized authentication process

across all systems

Enterprise User Authentication

Provide users a single name and

centralized authentication process

across all systems

Retrieve Information for Display

Access a patient’s clinical information and documents in a format ready to be

presentedto the requesting

user

Retrieve Information for Display

Access a patient’s clinical information

and documents in a format ready to be presented to the

requesting user

Patient Identifier Cross-referencing

for MPI

Map patient identifiers across independent

identification domains

Patient Identifier Cross-referencing

for MPI

Map patient identifiers across independent

identification domains

Synchronize multiple applications on a

desktop to the same patient

Patient Synchronized Applications

Synchronize multiple applications on a

desktop to the same patient

Patient Synchronized Applications

Consistent Time

Coordinate time across networked systems

Consistent Time

Coordinate time across networked systems


IHE AdvantagesIHE Advantages The problems are identified by the users The solutions are vendor/application neutral The profiles package relevant chunks of

standards into useful real-world bundles– Where HL7 & DICOM provide Dictionaries,

IHE provides a Phrasebook The connectathon enables broad cross-

vendor testing of implementations The profiles simplify effective communication

between vendors and users


Where Is More Information Where Is More Information Available?Available?

www.rsna.org/IHE ; www.himss.org/IHE– IHE Radiology Technical Framework V5.5– IHE IT Technical Framework V1.0– IHE Lab Technical Framework V1.0

– IHENews Mailing List– IHE Primer and IHE FAQ– IHE Integration Profiles: Guidelines for Buyers– IHE Presentations– IHE Connectathon Results– IHE Integration Statement Links

Integrating the Healthcare Enterprise The IHE Process: Developing Standards-based Solutions Kevin...

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