Public Health Data Standards Consortium phdsc

Public Health Data Standards Consortium http://www.phdsc.org

Functional Standards for Electronic Data Exchange between Clinical Care and Public Health

WORKING WITH VENDOR COMMUNITY:PHDSC COLLABORATION WITH IHE

Anna Orlova, PhDExecutive Director

PUBLIC HEALTH DATA STANDARDS CONSORTIUM~ 2007 BUSINESS MEETING OF MEMBERS ~

October 2-3, 2007, Hyattsville, MD

W W W . I H E . N E TW W W . I H E . N E T

Providers and Software DevelopersWorking Together to Deliver

Interoperable Health Information Systemsin the Enterprise

and Across Care Settings

Presented by Dan Russler, M.D., IHE PCC Co-chair

IHE Workshop – June 19, 2006

Integrating the Healthcare Enterprise (IHE) Overview

Why IHE?

1970’s—Mainframe Era--$100,000 per interface 1990’s—HL7 2.x--$10,000 per interface 2000’s—IHE Implementation Profiles—

Cheaper than a new phone line!

How? IHE Eliminates Options Found in Published Standards

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 American College of Physicians (ACP) American College of Clinical Engineering (ACCE) And many more….

Began in 1997 in Radiology (RSNA) and IT (HIMSS) International effort: IHE- Europe and IHE-Asia Additional sponsors for Cardiology including ASE, ESC, ASNC,

SCA&I, HRS and more

IHE Industry Professionals

Electronic Health Record

Cardiology

Laboratory

Radiology

Oncology

Future

Domains

IHE

IT Infrastructure

14 Integration Profiles



1133 IInntteeggrraattiioonn PPrrooffiilleess

Patient Care Coordination

1 Integration Profile

Patient Care

Devices

Pathology

Eye Care

IHE 2006 – Nine Active Domains IHE 2006 – Nine Active Domains Over 100 vendors involved world-wide,Over 100 vendors involved world-wide, 5 Technical 5 Technical

FrameworksFrameworks37 Integration Profiles, Testing at Connectathons37 Integration Profiles, Testing at ConnectathonsDemonstrations at major conferences world-wideDemonstrations at major conferences world-wide

15 Active national chapters on 4 continents15 Active national chapters on 4 continents

IHE Standards-Based Integration Solutions IHE Standards-Based Integration Solutions IHE Standards-Based Integration Solutions IHE Standards-Based Integration Solutions

Professional Societies Sponsorship Healthcare Providers & Software Developers

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 in 2007 – 18 Month Development Cycles IHE in 2007 – 18 Month Development Cycles

• First Cycle:First Cycle:• Planning Committee Proposals:Planning Committee Proposals: October, 2007October, 2007• Technical Committee Drafts: Technical Committee Drafts: June, 2008June, 2008• Public Comment Due:Public Comment Due: July 2008July 2008• Trial Implementation Version: Trial Implementation Version: August 2008August 2008• Mesa Tool Test Results Due:Mesa Tool Test Results Due: December 2008December 2008• IHE Connectathon: IHE Connectathon: January 2009January 2009• HIMSS Demo: HIMSS Demo: February 2009February 2009• Participant Comments Due:Participant Comments Due: March 2009March 2009• Final Implementation Version: Final Implementation Version: June 2009June 2009

IHE Technical Frameworks

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]



Order Placer

Acquisition Modality

ImageManager

ImageArchive

DSS/ Order Filler

Patient Update [RAD-12]


Storage Commitment

[CARD-3]

Evidence Creator Modality PS in Progress [CARD-1]

Modality PS Completed [RAD-7]

Instance Availability Notification [RAD-49]



Placer Order Management [RAD-2] Filler Order Management [RAD-3]

ADT

Query Images [RAD-14] Retrieve Images/Evidence [CARD-4]

Image Display


Storage Commitment

[CARD-3]


Procedure Updated [RAD-13]


Performed Procedure

Step Manager




Order Placer

Acquisition Modality

ImageManager

ImageArchive

DSS/ Order Filler

Patient Update [RAD-12]


Storage Commitment

[CARD-3]

Evidence Creator Modality PS in Progress [CARD-1]

Modality PS Completed [RAD-7]

Instance Availability Notification [RAD-49]


ADT Order Placer

Register J.Doe

AcquisitionModality

Placer OrderManagement –New [RAD-2]

Patient Reconciliation

Department System Scheduler/Order Filler

Schedule Procedure


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]


Perform Acquisition

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


ADT Order Placer

Register J.Doe

AcquisitionModality

Placer OrderManagement –New [RAD-2]

Patient Reconciliation

Department System Scheduler/Order Filler

Schedule Procedure


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]



Perform Acquisition



ImageManager/

PPS Manager

Filler Order Management -New [RAD-3]

One or the other methods of creating an order is used

Detailed standards implementation guides

HIMSS IHE Interoperability ShowcaseFebruary 2006 Participants

Leadership Level

Blue WareCernerGE Healthcare +IDX

IBMInitiate SystemsInterSystems MiSys Healthcare Quovadx Siemens

Implementer LevelAllscriptsCanonCapMedCardiac ScienceCGI-AMS CompassCareCPSI DictaphoneDR SystemsEastman KodakEclipsys Epic SystemsHIPAAT

HX TechnologiesINFINITT TechnologyKryptiqMcKesson MedAccess PlusMedical Informatics MediNotes MNINational Institute of Sci & TechNextGen Healthcare Philips Medical ScImageWitt Biomedical

Supporter Level:

Acuo

Bond

Carefx

Clearcube

Dairyland

EMC

Identrus

Intel

Mediserve

Medkey

Motion Comp.

Picis

Pulse

Sentillion

Organizational participant:

American Coll. of Clinical Eng.

Catholic Healthcare West

US Dept of Defense

US Dept of Veterans Affairs

DMP–French Natl. Personal EHRHealth Level 7 HTP IEEEMidmark Diagostics GroupHIMSS RHIO FederationLiberty AllianceUniv. of Washington

IHE Connectathon, January 2006•300+ participants, 120+ systems300+ participants, 120+ systems•60+ systems developers60+ systems developers•Four Domains: Cardiology, IT Infrastructure, Four Domains: Cardiology, IT Infrastructure,

Patient Care Coordination, RadiologyPatient Care Coordination, Radiology•2800+ monitored test cases2800+ monitored test cases

ResultsOver 3000 attendees visited the HIMSS RHIO

Showcase37 vendors demonstrated 48 systems700 attendees created and tracked their own

health record63 educational sessions were presented5 International delegations3 VIP tours16 clinical scenarios were demonstrated

IHE Integration Profiles for Health Info NetsWhat is available and has been added in 2005 and is for 2006

Patient Demographics Query

Patient Identifier Cross-referencing

Map patient identifiers across independent identification

domains

Cross-Enterprise Document Sharing

Registration, distribution and access across health enterprises of clinical

documents forming a patient

electronic health record

Cross-enterprise Document Point-Point Interchange

Media-CD/USB & e-mail push

Emergency Referrals

Format of the Document Content and associated coded vocabulary

PHR Extracts/Updates


ECG Report Document


Lab Results Document Content


Scanned Documents

Format of the Document ContentImaging Information


Medical Summary (Meds, Allergies, Pbs)

Format of the Document Contentand associated coded vocabulary

Consistent TimeCoordinate time across networked

systems

Audit Trail & Node Authentication

Centralized privacy audit trail and node to node authentication to create

a secured domain.

Basic Patients Privacy Consents

Establish Consents & Enable Access Control

Document Digital Signature

Attesting “true-copy and origin

Notification of Document Availability

Notification of a remote provider/ health enterprise

Request Formfor Data Capture

External form with custom import/export scripting

Patient Id MgtPatient Id MgtSecuritySecurityClinical and PHRClinical and PHRContentContent

Health Data ExchangeHealth Data Exchange OtherOther

AHIC-ONC BIO Consolidated Use Case

Component

Lab Report Document

BaseStd

HL7 V2.5

BiosurveillancePatient-Level Data to Public Health

Document-based Submission

IHEPIXPDQ

IHEXDS

BaseStdHL7

CDA r2

IHE XDS-LAB

BaseStd

ISO 15000ebRS 2.1/3.0

Transaction Package

Manage Sharing of Docs

Transaction

Notif of Doc Availability

IHE NAV

Component

Lab Terminology

BaseStd

LOINC

HITSP

IHE XDS-MS

IHE XDS-I

BaseStd

DICOMHCPCS

CPT

CCCICD 9/10

NCCLS

UB-92

FIPS 5-2

HL7 V3

HL7 V2.5SNOMED-CT

LOINC

UCUM

HAVE

TerminologyStandards

URL

SNOMED-CT

Document-basedScenario

Transaction Package

Consumer/Patient Id X-ref

Component

Anonymize

Transaction

Pseudonymize

BaseStdISODTS/25237

HIPAA

DICOM

Biosurveillance – Patient-level and Resource Utilization Interoperability Specification

BaseStdHL7

QBP^Q23RSP^K23

PHDSC was Invited to Form PHDSC was Invited to Form

Public Health Domain at IHEPublic Health Domain at IHE

Providers and Software DevelopersWorking Together to Deliver

Interoperable Health Information Systemsin the Enterprise

and Across Care Settings

2007 PHDSC Activities at IHE

May – October PHDSC-IHE Task Force to Develop a

White Paper on Building a Roadmap for Interoperability for Public Health

Over 60 participants from public health and clinical communities

To be presented at the IHE Planning Meeting in October Public Health Profile Proposal

Public Health Registry Examples of Cancer and Immunization Domains

IHE Profile Change Proposal Extended PDQ (Patient Data Query) for demographic

information exchanges with public health systems Examples of Cancer and Immunization Domains

IHE White Paper on Public Health Decision Support Examples of Cancer and Immunization Domains

2007-2008 PHDSC Activities at IHE

JOIN THE PHDSC-IHE TASK FORCE

E-mail to Anna Orlova, PHDSC at [email protected]

PHDSC was Invited to Form PHDSC was Invited to Form

A Public Health Domain at IHEA Public Health Domain at IHE

Providers, PUBLIC HEALTH and Software Developers

Working Together to DeliverInteroperable Health Information Systems

in the Enterpriseand Across Care Settings

Public Health Data Standards Consortium phdsc

Documents

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