Integrating the healthcare enterprise
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Integrating the Healthcare Enterprise. IHE Update. Charles Parisot , GE Healthcare IHE IT Infrastructure Technical Committee Co-chair. http://medical.nema.org/Dicom/minutes/Committee/2005/2005-03-31/Reports/IHE-Update.ppt. IHE IT Infrastructure 2004-2005. Personnel White Page. New.

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Integrating the healthcare enterprise

Integrating the Healthcare Enterprise

IHE Update

  • Charles Parisot, GE Healthcare

  • IHE IT Infrastructure Technical Committee Co-chair

http://medical.nema.org/Dicom/minutes/Committee/2005/2005-03-31/Reports/IHE-Update.ppt

IHE Update


Ihe it infrastructure 2004 2005

IHE IT Infrastructure 2004-2005

Personnel White Page

New

Access to workforcecontact information

New

Retrieve Information for Display

Retrieve Information for Display

Cross-Enterprise Document Sharing

Access a patient’s clinical information and documents in a format ready to be presentedto the requesting user

Access a patient’s clinical information and documents in a format ready to be presentedto the requesting user

Registration, distribution and access across health enterprises of clinical documents forming a patient electronic health record

Patient Demographics Query

New

Audit Trail & Node Authentication

New

Centralized privacy audit trail and node to node authentication to create a secured domain.

Enterprise User Authentication

Enterprise User Authentication

Consistent Time

Provide users a single nameand centralized authentication processacross all systems

Coordinate time across networked systems

Patient Synchronized Applications

Synchronize multiple applications on a desktop to the same patient

Patient Identifier Cross-referencing for MPI

Patient Identifier Cross-referencing for MPI

Map patient identifiers across independent identification domains

Map patient identifiers across independent identification domains

IHE Update


Integrating the healthcare enterprise

Sharing and accessing Documents

DocumentRepository

Submission of Document References

Retrieve of selected Documents

Documents Registry

EHR-LR:Longitudinal Recordas usedacross-encounters

Long Term Care

Acute Care (Inpatient)

Other Specialized Careor Diagnostics Services

PCPs and Clinics (Ambulatory)

EHR-CR: Care Record systemssupporting care delivery

IHE Update


Integrating the healthcare enterprise

Standards selection for IHE XDS

No single standard can addressCross-enterprise Document Sharing

Electronic BusinessStandards

ebXML Registry, SOAP, etc.

Internet Standards

HTML, HTTP,ISO, PDF, JPEG, etc.

HealthcareContent Standards

HL7 CDA, CEN EHRcomASTM CCRDICOM, etc.

Marriage of healthcare standards facilitates implementation and leverages complementary technologies (e.g. security & privacy).

IHE Update


Himss 2005 interoperability showcases

HIMSS 2005 Interoperability Showcases

HIMSS leverages its sponsorship of IHE to demonstrate practical interoperability in two large Showcase Exhibits:

  • cross-enterprise sharing of health information in the acute care (18 vendors) and ambulatory (14 vendors).

  • HIMSS Showcaseexhibitslinked with vendor booths (10 vendors) show-wide.

  • Show-wide interactive environment demonstrating attendees “patient” record in a “HIMSS RHIO”. Uses IHE Cross-enterprise Document Sharing:

    • Around a central document registry

    • Distributed document repositories

    • 17 EHR that publish/share documents (CCR, CDA, HL7-lab, PDF)

IHE Update


Himss 2005 interoperability showcases1

HIMSS 2005 Interoperability Showcases

HIMSS sponsors the testing and demonstration of IHE interoperability in two large Showcase Exhibits:

  • cross-enterprise sharing of health information in the acute care, 18 vendors:

    CedaraGE HealthcareMortara Instruments

    DictaphoneIDXNIST

    Eastman KodakInterSystemsNovell

    EclipsysInfinitt TechnologyOpen Text

    EmageonKryptiqSentillion

    EPICMedCommonsSiemens

  • ambulatory sharing of health information, 14 vendors:

    AllscriptsGE HealthcareMidMark

    CapMed/SanDiskHealthrampMisys

    CernerIDXNextGen

    EclipsysKrytiqWebMD

    ETIAMMediNotes

IHE Update


Himss highlights

HIMSS Highlights

IHE Update


Himss ihe highlights

HIMSS IHE Highlights

  • HIMSS: 700 Exhibitors - 23,000 Attendees

  • Over 2000 visited the IHE Booth.

  • 49 participants in IHE Interoperability booth

  • 15 vendors participated in XDS from their booth

  • 732 Attendees registered for their own EHR

  • 7,772 Documents registered in XDS Registry

  • 40,984 Queries to XDS Registry

  • US National IT Coordinator (Dr Brailer) held his press conference in IHE Booth and thanked IHE. 50 members of press toured.

IHE Update


Himss 2005 show wide interoperability

Cross-enterprise Showcase Booth

ITInfrastructure

& Lab

Radiology

Vendor Booth

Vendor Booth

Vendor Booth

Vendor Booth

Vendor Booth

Vendor Booth

In-Patient/Out-patient

Cardiology

Radiology

PCP

Diag Center

MultispecialtyClinic

Home

Vendor Booth

Ambulatory Showcase Booth

Vendor Booth

Vendor System

HIMSS 2005 – Show-Wide Interoperability

Allscripts

Eclipsys

GE Healthcare

Healthramp

IDX

Infinitt

InterSystems

MedCommons

Novell

OpenText

Siemens

HIMSS “RHIO” with

Cross-enterprisedoc sharing

IHE Update


Integrating the healthcare enterprise

Imaging Information Content

Simple Document Content

For Display Document Content

Lab Results Document Content

Continuity of Care Document Content

Personnel White Page

Access to workforcecontact information

Format of the Document Content

and associated coded vocabulary

Format of the Document Content and associated coded vocabulary

Format of the Document Content and associated coded vocabulary

Format of the Document Content

Format of the Document Content and associated coded vocabulary

Patient Identifier Cross-referencing

Cross-Enterprise Document Sharing

Cross-Enterprise Notification

Map patient identifiers across independent identification domains

Notification of a remote provider/ health enterprise

Registration, distribution and access across health enterprises of clinical documents forming a patient electronic health record

Patient Demographics Query

Audit Trail & Node Authentication

Centralized privacy audit trail and node to node authentication to create a secured domain.

User Identity, Authentication and Permissions

Consistent Time

Enable Basic Access Control

Coordinate time across networked systems

IHE Profiles for a “Regional Health Info Organization”What are the gaps to be filled in 2005 ?

IHE Update


Infrastructure and interoperability

Infrastructure and Interoperability

  • Cross-Enterprise Document Sharing (XDS) minimizes clinical data management by the infrastructure. Transparency = Ease of Evolution, increase efficiencies.

  • XDS needs other IHE Integration Profiles:

    • Audit Trail and Node Authentication (ATNA)

    • Patient Id Cross-referencing (PIX)

    • Patient Demographics Query (PDQ)

  • In 2005, IHE plans to complement a set of integration profiles to build a RHIO, candidates:

    • Security: Identity Management + Info for Access Control

    • Content Profiles: Core CCR, HL7-CDA, HL7-Lab, PDF (legacy)

    • Provider Notification (with doc reference) and Point-to-point Transfer

    • Dynamic Clinical Data Mgt (Allergy lists, Problem Lists)

       Prioritization of Candidate Integration Profiles November-December 2004. Technical development January-July 2005. Open to all.

IHE Update


Ihe radiology integration profiles

IHE Radiology Integration Profiles

Extensions

Charge Posting

Presentation of Grouped Procedures

Reporting Workflow

New

KeyImageNotes

Simple Image & Numeric Reports

NMImage

Consistent Present-ation of Images

EvidenceDocs

New

Access to Radiology Information

Portable Data for Imaging

Scheduled Workflow

-

Patient Info. Recon-ciliation

Post-Processing Workflow

Basic Security

IHE Update


Laboratory ihe integration profiles

Laboratory IHE Integration Profiles

In Dev.

Laboratory Scheduled Workflow (LSWF)

Completed in 2003

Laboratory Point Of Care Testing (LPOCT) In Process –TI Nov 2004

Tests performed by a laboratory for an identified inpatient or outpatient

Tests performed on point of care or patient’s bedside

In Dev.

In Dev.

Laboratory Patient Information Reconciliation (LPIR) In Process

Laboratory Device Automation (LDA)In Process –TI Nov 2004

Tests performed on an unidentified or misidentified patient

Pre-analytic process, analysis

and post-analytical treatment

Laboratory Code Set Distribution (LCSD) In Process

In Dev.

Sharing the batteries and tests code sets throughout the enterprise

IHE Update


Ihe cardiology 2004 2005

IHE Cardiology 2004-2005

Retrieve Information for Display

EchoCardiography Worklflow

Access a patient’s clinical information and documents in a format ready to be presentedto the requesting user

Admit, order, schedule, acquire images, notify of completed steps, on fixed and mobile stress echo modalities.

New

Retrieve ECG for Display

Provide high-quality ECG and related reports

to the enterprise and outside in a ready-to-display format

New

Cardiac Catheterization Workflow

New

Scheduled & unscheduled acquisition and management of cathlab information, notification of completed steps.

IHE Update


Acc 2005 ihe demonstration

ACC 2005 IHE Demonstration

ACC sponsors the testing and demonstration of IHE interoperability in their exhibit – March 2005

  • 11 vendors:

    AgfaGE Healthcare Schiller

    CamtronicsHeartlabPhilips

    CernerIDX Toshiba

    Emageon Medcon

  • Scenario:

    • Emergency Cath, Change of Lab mid-procedure

    • Scheduled Echo+Mobile Modality, Stress Echo

  • Echo demo planned for ASE (Boston June 2005)

  • Full demonstration planned for ESC (August 2005)

IHE Update


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