IHE's contribution to standards harmonization for the Nationwide Health Information Network

1. IHE's contribution to standards harmonization for the Nationwide Health Information Network • Joyce Sensmeier MS, RN, FHIMSS, HIMSS • Glen Marshall, Siemens Healthcare • Charles Parisot, GE Healthcare

2. What is Standards Harmonization? Healthcare is a complex multi-specialty multi-stakeholder system. Multiple standard development organizations are necessary. Challenge is to achieve “interoperability” while implementing multiple standards to meet a broad range of information exchange needs: Application-to-application System-to-system Setting-to-setting Coordinate adoption of standards to meet clinical and administrative Use Cases Identify the key interoperability problems they face Providers and industry work together to develop and make available standards-based solution 2

3. Standards: Necessary…Not Sufficient • Standards are • Foundational - interoperability and communications • Broad - varying interpretations and implementations • Narrow - may not consider relationships between standards domains • Plentiful - often redundant or disjointed • Focused - standards implementation guides typically focus on a single standard Need a standard process for implementing multiple standards

4. US Federal Initiative for Health IT and Nationwide Health Information Network • The U.S. healthcare system is managed both at the federal level and the state-level. • Over 200 Health Information Exchange projects in the U.S. at the state level or regional communities within the states. • At the federal level, HHS has set-up a policy-level setting board (AHIC), a coordination office (ONC) and 4 supporting initiatives for standards harmonization, certification, privacy and implementation prototyping. • IHE-USA has been engaged in the organization of one of these supporting initiatives: HITSP. IHE and its sponsors (e.g. HIMSS, RSNA, ACCE, etc.) and participants contribute to those initiatives.

5. The Certification Commission for Healthcare Information Technology (CCHIT) Healthcare Information Technology Standards Panel (HITSP) American Health Information Community (AHIC) The Health Information Security and Privacy Collaboration (HISPC) Nationwide Health Information Network (NHIN) Architecture Projects The Community is the Hub that Drives Interoperability • AHIC, chaired by HHS Secretary provides strategic coordination. • CCHIT focuses on developing a mechanism for certification of health care IT products • HITSP brings together all relevant stakeholders to identify & harmonize appropriate standards • HISPC addresses variations in business policy and state law that affect privacy and security • NHIN is focused on interoperability pilots and implementation

6. HITSP Delivers Interoperability Specs to AHIC • The Healthcare Information Technology Standards Panel (HITSP) has addressed 7 business use cases for interoperability. • HITSP has nearly 400 member organizations representing all U.S. stakeholders including Standards Development Organizations (incl. X12, DICOM, HL7, etc.). • HITSP, through its standards-based interoperability specifications, is leveraging standard-based implementation guides such as those from Integrating the Healthcare Enterprise (IHE). • The IHE Connectathon and the HIMSS Interoperability Showcase play a visible role demonstrating the HITSP/IHE synergy.

7. From Standards to Solving a Use Case Business Use Case • AHIC/ONC • HITSP Interoperability Specifications + Constructs Standards Adoption/Profiling Technical Use Case Driven • IHE • HL7, NCPDP, • X12, DICOM, ISO, etc… Base Standards Foundations

8. 18 IHE Profiles used by HITSP Interoperability Specifications

9. IHE Profiles/HITSP Constructs reused across ISs for consistency

10. Conformance Testing & Certification • IHE Conformance Testing • CCHIT Certification Interoperability Specifications + Constructs Standards Adoption/Profiling Technical Use Case Driven Base Standards Foundations

11. HITSP GOALS and IHE • HITSP goals with respect to testing activities • Ensure 'fitness for use' of HITSP Interoperability Specifications • Has leveraged the IHE testing process to support overall collaborative testing activities • HITSP collaboration with IHE • 18 IHE Profiles are used as constructs in HITSP ISs • IHE Profiles provide globally accepted standards to HITSP • IHE Connectathon/HIMSS Showcase provide opportunity for collaboration to meet mutual goals • To access HITSP Interoperability Specifications: www.HITSP.org

12. HIMSS08 Interoperability Showcase40 out of 51 implementers demonstrated HITSP