INTEGRATING THE HEALTHCARE ENTERPISE
This presentation is the property of its rightful owner.
Sponsored Links
1 / 37

FINteroperability in Health 2011 PowerPoint PPT Presentation


  • 82 Views
  • Uploaded on
  • Presentation posted in: General

INTEGRATING THE HEALTHCARE ENTERPISE Value of IHE P rofiles and testing for cross-institutional health services. FINteroperability in Health 2011 Charles Parisot, IHE International Board & IHE-Europe Steering Committee, GE healthcare . IETF. IHTSDO.

Download Presentation

FINteroperability in Health 2011

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Finteroperability in health 2011

INTEGRATING THE HEALTHCARE ENTERPISEValue of IHE Profiles and testing for cross-institutional health services

FINteroperabilityin Health 2011

Charles Parisot, IHE International Board & IHE-Europe Steering Committee, GE healthcare


Interoperability from a problem to a solution

IETF

IHTSDO

Interoperability: From a problem to a solution

Profile Development

Base Standards

eHealth Projects

Project Specific Extensions

Profiling Organizations are well established

2


Standards adoption process

Testing at Connectathons

IHE Demonstrations

Develop technical specifications

Products with IHE

Identify available standards (e.g. HL7, DICOM, IETF, OASIS)

Timely access to information

Document Use Case Requirements

Easy to integrate products

Standards Adoption Process

IHEInternational

IHE Europe & IHE National


Finteroperability in health 2011

The IHE Development Domains

Radiologysince 1998

Cardiologysince 2004

Pathologysince 2006

Laboratorysince 2004

Eye Caresince 2006

(Healthcare)IT Infrastructuresince 2003

Radiation Oncologysince 2004

QualityResearch & Public Healthsince 2006

Patient Care Coordinationsince 2004

Patient Care Devicessince 2005

13 Years of Steady Evolution 1998 – 2011

PharmacySince 2009

since 2008


International growth of ihe

International Growth of IHE

Switzerland

Netherlands

Germany

Turkey

Canada

Austria

Taiwan

France

Japan

China

USA

Italy

UK

Spain

2005

2006

2000

2007

1999

2001

2002

2003

2004

2009

2008

2010

  • Local Deployment, National Extensions

  • Promotional & Live Demonstration Events

  • Over 400 Organizational Members (see www.ihe.net/governance)

Malaysia

Australia

Pragmatic global standards harmonization + best practices sharing

5


What is ihe how much adopted

What is IHE, how much adopted ?

  • ISO Health Informatics: TR28380 Global Standards Adoption – IHE Process and Profiles

  • Home Health: CONTINUA and IHE work together. Partners in EU Project Smart Personal Health

  • Widespread adoption of IHE Profiles by National and Regional Projects around the world: USA, Europe, Asia

    • US National Health Information Network (NwHIN) leverages IHE profiles (XCA, XDR, XCPD, BPPC, ATNA)

    • 12 Country European epSOS Project: IHE-Europe hosting Industry Team, support project interoperability conformance testing (XCA, XCPD, ATNA, XUA, BPPC, CDA Content Modules from PCC).

    • In use in several national and regional projects (Austria, France, South Africa, Italy, Netherlands, USA, Japan, Switzerland, Canada)

    • EU Commission eHealthInterop Mandate 403 leverages IHE process

    • European HITCH project to roadmap conformance testing and certification leverages the IHE testing experience

6


Finteroperability in health 2011

eHealth and Interoperability: What’s new in IHE Profiles ?

  • Patient Care Devices

  • Patient Care Coordination

  • Radiology

  • IT Infrastructure

  • And more: Pharmacy, Eye Care, Endoscopy, Dentistry Domains


Finteroperability in health 2011

eHealth and Interoperability: What’s new in IHE Profiles ?

  • Patient Care Devices

  • Patient Care Coordination, Radiology

  • IT Infrastructure

  • Testing, Tools and Connectathons

  • And more: Pharmacy, Eye Care, Endoscopy, Dentistry Domains


General device communication architecture

9

General Device - Communication Architecture

Courtesy: Continua Alliance


Finteroperability in health 2011

10

Single data interface architecture: all Continua Personal Health Devices, all IHE-PCD Medical Devices, and all IHE EMRs!


Dec profile pcd 01 transaction

DEC Profile: PCD-01 Transaction

  • It profiles HL7 V2.6 + IEEE Device Data Terminology

  • IHE DEC Profile: PCD-01 transaction

    • Two transport: TCP/IP+MLLP or WS (ITI TF App V)

    • One profiled message format (HL7 V2.6): compact, common

    • One simple data model for all devices (data levels, values, units, etc.)

  • IHE RTM Profile: Rosetta Terminology Mapping

    For each specific home and care device (over 300):

    • Consistent ‘containment hierarchy’ and value sets for coded data

    • Consistent use of units-of-measure for enumerated values

A revolution: a consistentapproach

to importing device data in a medical record


Finteroperability in health 2011

eHealth and Interoperability: What’s new in IHE Profiles ?

  • Patient Care Devices

  • Patient Care Coordination

  • Radiology

  • IT Infrastructure

  • Testing, Tools and Connectathons

  • And more: Pharmacy, Eye Care, Endoscopy, Dentistry Domains


Patient care coordination

Patient Care Coordination

  • Strategy to define library of “practical” reusable “data modules” (or template, molecules, archetypes, data element models) for CDA Rel 2 now reaching maturity :

    • Initiated by IHE PCC moved to HL7 with CCD Implementation Guide

    • PCC TF includes now over 300 “modules” aligned with CCD

    • All IHE domains defining CDA R2 based Document Content profiles (PCC, Lab, Pharmacy, QRPH, ITI) reuse same module library.

    • Consistency across IHE Doc Content Profiles and HL7 implementation Guides under review under auspices of US ONC. Minor discrepancies consolidated and place under OHT-Model Driven Health Tools.

A consistentapproach

to standardized modular definition of clinical content


Road to semantic interoperability a huge step

Road to semantic interoperability: a huge step

Header

  • Terminology Value Sets:

  • Snomed

  • ICD

  • LOINC

  • IEEE

  • Etc.

Templates

Modules

Data Elements

Archetypes

Result in a Flexible but Consistent set of Document Types

Section A

Section B

CDA Rel2

Section K

A revolution: a consistentapproach

to standardized modular definition of clinical content

Section L


Patient care coordination1

Patient Care Coordination

  • Maternal and Baby Care now supported with a complete set of CDA documents:

    • Antepartum Education (APE)

    • Antepartum Laboratory (APL)

    • Antepartum History and Physical (APHP)

    • Antepartum Summary (APS)

    • Labor and Delivery History and Physical (LDHP)

    • Labor and Delivery Summary (LDS)

    • Maternal Discharge Summary (MDS)

    • Newborn Discharge Summary (NDS)

    • Postpartum Visit Summary (PPVS)

All relying on the standardized modular definition of clinical content


Finteroperability in health 2011

eHealth and Interoperability: What’s new in IHE Profiles ?

  • Patient Care Devices

  • Patient Care Coordination

  • Radiology

  • IT Infrastructure

  • Testing, Tools and Connectathons

  • And more: Pharmacy, Eye Care, Endoscopy, Dentistry Domains


Radiology

Radiology

  • XDS-I continues to receive much attention

    • Multi-Community Clarifications with XCA-I

    • Implementation is now widespread and feedback is positive

  • Radiation Exposure Monitoring ready for prime time

    • Most new modality products support REM to track actual exposure

    • Imaging Departments: PACS, RIS, dedicated applications emerging

    • Some national dose registries in pilot

    • Regulations made explicit in many countries


Finteroperability in health 2011

eHealth and Interoperability: What’s new in IHE Profiles ?

  • Patient Care Devices

  • Patient Care Coordination

  • Radiology

  • IT Infrastructure

  • Testing, Tools and Connectathons

  • And more: Pharmacy, Eye Care, Endoscopy, Dentistry Domains


It infrastructure

IT Infrastructure

Growing understanding of the strength and breadth of the “XD*” family of profiles

  • XDM on e-mail for ubiquitous pt-to-pt send or CD/USBfor media

  • XDR on SOAP/WS for point-to-point exchange

  • XDS for registry-centric exchange in a “community”*

  • XCA for peer to peer federation of “communities”*

    To be combined with different patient identification strategies:

  • PDQ Shared stable source of Identities*

  • PIX for “MPI” centric patient Id linkage

  • XCPD for discovery & ID linkage across communities

  • XCPD for location discovery with a shared source of identities*

    * Most likely suited for Finland


It infrastructure1

IT Infrastructure

XDSand related Profiles extend deployment:

  • Off-the shelf sharing of records/documents (Finns invention !)

  • Robust service: submission sets, replace/amend, etc.

  • Open source and support by well over 100 products (infrastructure & EPRs).

  • Projects range from communities (a few hospitals/clinics) to regions and nations. A few registries/repositories with more than 1 million patients.

  • Implementation feedback is positive: moving beyond interfacing to user experience.


Ihe global standards based profiles adopted in national regional projects sample

IHE, Global Standards-Based Profiles Adopted in National & Regional Projects (sample)

Austria

Lower

Austria

NETHERLANDS

Friesland

Natn’l Mamography

Italy Conto Corrente

Venetto - Friuli

VITL-Vermont

FranceDMP

Quebec, Toronto,Alberta, British ColumbiaCanada Infoway

SuisseSt Gallen

Lausane

Wales

Imaging

France Imaging IDF

Boston Medical Center - MA

For more complete list see: tinyurl.com/wwXDS

Philadelphia HIE

Belgium

Flemish-Leuven

KeyHIE Pennsylvania

CareSpark – TN & VA

SHARP CA

South Africa

THINC- New York

NCHICA – N. Carolina

Providence Health System - OR

CHINA-Shanghai

Imaging Info Sharing

CHINA-MoH

Lab results sharing

JAPAN-Nagoya

Imaging Info Sharing,

Nationwide PDI guideline

21

21


It infrastructure2

IT Infrastructure

Completed the regional & national infrastructure needs:

  • Terminology Value Set distribution/updates with extended SVS profile:

    • Retrieve value Sets by unique identifier

    • Queries to search and access value set descriptions

  • Healthcare Provider Directory (HPD)

    • Based on LDAP

    • Support Provider Persons or Provider Organizations or both (with optional relationships)

  • Security and Privacy increasingly better understood:

    • Encryption and Audit Trail (ATNA)

    • Basic Patient Privacy Consent (BPPC)

    • User Assertion (XUA) now enriched with explicit attributes


Xdw necessity

XDW - Necessity

Many different worldwide projects have as goals to paperless/digitizing of clinical processes. At the bases of all these projects there is the management of workflows across multiple organizations:

  • For example various eReferral, chronic care workflows

  • Flexible nature and processes for these workflows

  • Clinical, economic, social and organizational impact value


Xdw key elements

XDW – Key Elements

Focuses on the Cross-Enterprise Workflow for Document Sharing in support of workflow document and status management.

Key elements:

  • Managing multi-organizational workflows

  • Workflow associated information in referenced documents

  • Tracking the past steps of the workflow related to specific clinical event that triggered it

  • Flexibility: any entities to join in workflow

  • Generic workflow infrastructure: workflow specifics are known only in point of care systems (Workflow federation)


A use case example of xdw 1

A Use Case Example of XDW (1)

Creation of eReferral Document

Creation of Clinical Report

Workflow Document

(3)

Workflow Document (1)

Workflow Document

(4)

Workflow Document (2)


A use case example of xdw 3

A Use Case Example of XDW (3)

WorkflowDocument

Structure


Xdw standards

XDW Standards

  • XDW: a new content profile for a workflow management document

  • No new transaction are introduced. Leverages existing ITI IHE Profiles:

  • XDS.b, DSUB, BPPC, ATNA,

  • No XDS Metadata extension expected, but specific rules about Metadata content and update rules for the workflow Document

  • Public Comment opens late May 2011 (one month)

  • Trial implementation available in August 2011.


Finteroperability in health 2011

eHealth and Interoperability: What’s new in IHE Profiles ?

  • Patient Care Devices

  • Patient Care Coordination

  • Radiology

  • IT Infrastructure

  • Testing, Tools and Connectathons

  • And more: Pharmacy, Eye Care, Endoscopy, Dentistry Domains


Implementation tools

Implementation Tools

Open source implementations are available for XDS, XCA, XCPD, PIX, PDQ, ATNA, CT, and more:

HIE-OS under Source Forge http://sourceforge.net/projects/hieos/

Microsoft under codeplexhttp://ihe.codeplex.com/

NIST under Source Forge http://sourceforge.net/projects/iheos/

OHT – IHE Profiles Charter https://iheprofiles.projects.openhealthtools.org

OHT – Model Driven Health Tools-Charter https://mdht.projects.openhealthtools.org

29


Interoperability testing n eeds an ecosystem

Testing at Connectathons

IHE Demonstrations

Develop technical specifications

Products with IHE

Identify available standards (e.g. HL7, DICOM, IETF, OASIS)

Timely access to information

Document Use Case Requirements

Easy to integrate products

Interoperability Testing Needs an Ecosystem


Ihe connectathon

IHE Connectathon

  • Open invitation to vendor and other implementers community

  • Advanced testing tools (GAZELLE)

  • Testing organized and supervised by project management team

  • Thousands of cross-vendor tests performed

  • Results recorded and published


Finteroperability in health 2011

IHE Connectathons

2011 Connectathon:

Chicago, USA, January 17-21, 2011

Pisa, ITALY, April 11-15, 2011

Australia, July 2011

Japan, October 2011

Massive yearly events :

70-80 vendors

250-300 engineers

100-120 systems

….integrated in 5 days


Interoperability from a problem to a policy

Interoperability: From a problem to a policy

Countries/Regions with such a process:

Austria (ELGA, Regions)

France (ASIP)

USA (NwHIN)

Italy (Venetto, etc.)

China (MoH)

Switzerland (ehealthsuisse)

Canada (Infoway)

IETF

Recognized:

Profile A

Profile B

Profile C…..

eHealth ProjectsInteroperability Specifications

Base Standards

Profile Development

& Testing

Simple and EffectiveProfile RecognitionProcess & Policy

Leverage Synergies of Global Standards and Profiles

33


Finteroperability in health 2011

IHE- Roles of Different levels

International Governance

IHE International Board

Global Profile Development

Radiology

IT

Infrastructure

Laboratory

Cardiology

Patient Care

Coordination

Pathology

InternationalUse Cases & Profiles

Radiation

Oncology

Patient Care

Devices

Eye Care

Public Health, Quality

and Research

Pharmacy

Open

to

all

Stakeholders

Regional Profile Deployment

European CoordinationTesting & Education

IHE Europe

Austria

France

Germany

Netherlands

National Engagement

Projects

IHEFinland

Italy

Switzerland

Spain

UK

Turkey

34


Finteroperability in health 2011

IHE based “Interoperability” experience has demonstrated significant benefits to national and regional programs:

  • Reduce specification consensus time

  • Simplify implementation efforts

  • Reuse of testing tools and processes

  • Shared implementation experience

35


Finteroperability in health 2011

Providers and Vendors

Working Together to Deliver

Interoperable Health Information Systems

in the Enterprise

and Across Care Settings

http://www.ihe.net


  • Login