IHE Australia

1. IHE Australia Chris Lindop, GE healthcare IHE Co-chair radiology PC, IHE Australia-Asia/Pacific liaison HIMSS Asia Pac 2008, Hong Kong

2. Presentation Objectives • IHE Australia, Overview • History • 2008 plans • How to participate

3. Norway Germany Holland Canada Taiwan France Japan Korea China Spain USA Italy UK Australia International Adoption of IHE • Local Deployment • National Extensions (Local Adaptions) • Promotional & Live Demonstration Events • Conformance Testing Year 9 (2007) Year 10 (2008) Year 1 (1999) Year 2 (2000) Year 3 (2001) Year 4 (2002) Year 5 (2003) Year 6 (2004) Year 7 (2005) Year 8 (2006) Pragmatic global standards harmonization + best practices sharing

4. IHE International Global Development Regional Deployment IHE North America IHE Asia Japan China Radiology IT Infrastructure Laboratory Canada USA Korea Taiwan IHE Pacific Australia Cardiology Patient Care Coordination Pathology IHE Europe Radiation Oncology Patient Care Devices Eye care, Quality, etc. Netherlands France Germany Italy Spain UK Norway Sweden Professional Societies / Sponsors ACC ACP HIMSSRSNA Contributing & ParticipatingVendors GMSIH SFRSFIL COCIR EAR-ECR DRG SIRM BIR EuroRec ESC JAHISJIRAJRS METI-MLHW MEDIS-DCJAMI IHE Organizational Structure

5. The IHE 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 UseCase Requirements Easy to integrate products

6. Deployment – National Initiatives • IHE National Initiatives are responsible, within their geographical region, for promotion and deployment of IHE. • The primary activities of IHE National Initiatives are: • Selecting which Integration Profiles are appropriate for promotion in their locale/region. • Recruiting local/regional vendors and encouraging them to participate • Organizing local/regional demonstrations & Connectathons • Educating the local/regional healthcare community about IHE

7. IHE Australia • Scope: • Promoting IHE deployment with education, recruitment and organization in Australia • Incorporating other regional countries: NZ, Malaysia as they form to create a sub-regional group IHE Asia-Pacific • Key Profile Deployment: • PDI, SWF, XDS profiles • Supporting Events: • IHE Participation and Educational Workshop, June 12-13 • IHE Australia/Asia-Pacific Connectathon 2008, July 27-Aug 1 • Interoperability Showcase, HIC 2008, Aug 31-Sept 3 • Established in 2007 – undergoing IHE recognition process • Sponsors & Supporters: • Health Informatics Society Australia (HISA) • HL7 Australia • Medical Software Industry Association (MSIA) • Royal Australian and New Zealand College of Radiologists (RANZCR)

8. Interoperability Australia Showcase @ Med-Info 2007

9. IHE Conference – Dec 10-12, 2007 3 day meeting (NICTA) • Day 1 – Overview, more in depth discussion of use cases, profiles, infrastructure and organisation, applicability to Australia, use of Australian standards & HL7 CDA • Day 2 - IHE Radiology profile and XDS profiles • Day 3 – IHE Portable Data Imaging (CD)

10. 2008 Activities • Connectathon • Showcase • Radiology Conference – CD Challenge Contact: Peter MacIsaac: peter@macisaacinformatics.org Klaus Veil: klaus@veil.net.au Brendan Lovelock: brendan.lovelock@hisa.org.au

11. Local implementation problems: Key IHE Profiles for Australia • Portable Data for imaging • 1st level film-less interoperability provided to referrer • Scheduled Workflow • Top profile implemented by radiology vendors with over 200 Integration statements • XDS/XDS-I • The emerging technology worldwide for Health information exchange • Deployment of HL7 v2 – lab, radiology orders and results using Australian Standard AS4700.2 & .7 • Rigid adherence to local standards/implementation guide • Appropriate use of message and application acknowledgements

12. PDI -The Problems • In the film world, looking at prior studies was easy. In the digital world, this has been complicated • Can I read the CD? • Can I read the Digital Images? • Can I process the Digital Images I receive? • How do I handle Studies from other Institutions?

13. PDI – Actors and Transactions Distribute Imaging Information on Media Display Image Display Portable Media Creator Report Reader Print Composer Media Importer

14. Import Reconciliation WorkflowScheduled Import Transaction Diagram DICOM Transactions • Modality Worklist (MWL) • Modality Performed Procedure Step (MPPS) • Object Storage • Storage Commitment

15. Import Reconciliation WorkflowUnscheduled Import Transaction Diagram HL7 Transactions • Patient Demographics Query (QBP^22) DICOM Transactions • Modality Performed Procedure Step (MPPS) • Object Storage • Storage Commitment

16. Radiology Scheduled Workflow: Use Case Registration report Film Lightbox Image Manager & Archive Orders Filled Film Folder Diagnostic Workstation Film Report Repository Orders Placed AcquisitionModality acquisitioncompleted acquisitionin-progress imagesprinted Modality acquisitioncompleted

17. IHE Integration Profiles for Health Info NetsWhat is available and has been added in 2006/07 Security Patient ID Mgmt Basic Patients Privacy Consents Patient Demographics Query Establish Consents & Enable Access Control Patient Identifier Cross-referencing Medical Summary (Meds, Allergies, Pbs) Map patient identifiers across independent identification domains Document Digital Signature Format of the Document Content and associated coded vocabulary Attesting “true-copy and origin Audit Trail & Node Authentication Other Centralized privacy audit trail and node to node authentication to create a secured domain. Request Formfor Data Capture External form with custom import/export scripting Consistent Time Notification of Document Availability Cross-Enterprise Document Pt-Pt Reliable Interchange Coordinate time across networked systems Notification of a remote provider/ health enterprise Cross-Enterprise Document Media Interchange Clinical and PHR Content Emergency Referrals PHR Extracts/Updates Format of the Document Content and associated coded vocabulary ECG Report Document Format of the Document Content and associated coded vocabulary Lab Results Document Content Format of the Document Content and associated coded vocabulary Scanned Documents Format of the Document Content and associated coded vocabulary Imaging Information Format of the Document Content Format of the Document Content and associated coded vocabulary Health Data Exchange Cross-Enterprise Document Sharing Registration, distribution and access across health enterprises of clinical documents forming a patient electronic health record Final Text Approved Trial Implementation-2006 –Final Txt 2007

18. SubmitDoc Meta-data + References SubmitDoc Meta-data + References Query for DocsReferences Retrieve Documents Retrieve Documents DocumentRepository Submit Documents Document Consumer Document Registry/Repository Model: Document Registry DocumentRepository Document Source Document Source

19. Shared DocumentRepository Example: Providing Access to Prior Health Information Longitudinal Record as usedacross-encounters Public Health Long Term Care Acute Care (Inpatient) Other Specialized Careor Diagnostics Services PCPs and Clinics (Ambulatory) Encounter Medical Summary (med-prescribed & dispensed, allergies, pbs, etc) Lab Report (structured & coded tests results) Radiology Report and Images Links EKG Report

20. Veterinary Endoscopy Pharmacy To find IHE Profiles:www.ihe.net /technical_frameworks IHE Global Developments Over 60 Integration and content Profiles (# X) Solutions to Real-World Interoperability Needs & Problems: • Within Clinical Departments e.g.: • Radiology • Cardiology • Lab • ... • Across Departmental &Institutional Boundaries – XDS • RHIOs (Regional Healthcare Information Organizations) • EHR Enablers Quality Pathology (1) Patient Care Devices (1) Patient Care Coordination (5) Radiation Oncology (1) Eye Care (3) Laboratory (6) Cardiology (7) IT Infrastructure for Healthcare (17) Radiology (18) Year 5 (2003) Year 6 (2004) Year 8 (2006) Year 9 (2007) Year 4 (2002) Year 7 (2005) Year 1 (1999) Year 2 (2000) Year 3 (2001)

21. How to Participate As a Committee Member Become a member of relevant Domains Planning or Technical Committees As as Interested Observer Provide Public Comments on Technical Framework Supplements Attend Demonstrations, Educational Events and Workshops

22. How to Use IHE As a Vendor Implementer Implement IHE Integration Profiles Test systems through Connectathon process Publish an IHE Integration Statement for products As a User Implementer or Consultant Use IHE Integration Profiles to develop interoperability strategy Use Connectathon Results and Integration Statements to evaluate vendors Demand IHE Integration Profile compliance in RFPs

23. Stakeholders Working Together to Deliver Interoperable Health Information Systems in the Enterprise and Across Care Settings http://www.ihe.net http://www.ihe.net.au

24. More Resources - www.ihe.net • Integration Profiles in Technical Frameworks: • Cardiology • IT Infrastructure • Laboratory • Patient Care Coordination • Patient Care Devices • Radiation Oncology • Radiology • Connectathon Results – world-wide • Vendor Products Integration Statements • Participation in Domain Committees • Participation in IHE Australia www.ihe.net.au • Connectathon • Interoperability showcase