Welcome to the HIMSS09 Interoperability Showcase

1. Welcome to theHIMSS09 Interoperability Showcase brought to you by IHE Sponsors and Committee Members

2. IHE: A Framework for Interoperability A common framework for harmonizing and implementing multiple standards Application-to-application System-to-system Setting-to-setting Enables seamless health information movement within and between enterprises, regions, nations Promotes unbiased selection and coordinated use of established healthcare and IT standards to address specific clinical needs 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 IHE provides a standard process for implementing multiple standards

4. IHE: Connecting Standards to Care • Coordinate implementation of standards to meet clinical and administrative needs • Clinicians and HIT professionals identify the key interoperability problems they face • Providers and industry work together to develop and make available standards-based solutions • Implementers are able to follow common guidelines in purchasing and integrating effective systems IHE: A forum for agreeing on how to implement standards and processes for making it happen

5. IHE Sponsors 1997: Founded in Radiology (RSNA) and IT (HIMSS) Many professional societies (stakeholder representation) American Academy of Ophthalmology (AAO) American College of Physicians (ACP) American College of Clinical Engineering (ACCE) American College of Emergency Physicians (ACEP) American Society for Therapeutic Radiation Oncology (ASTRO) GMSIH (IT France), JAHIS (IT Japan), SFIL (laboratory) Healthcare Information Management Systems Society (HIMSS) National Quality Forum (NQF) National Institute of Standards and Technology (NIST) Radiological Society of North America (RSNA) And many more…. 5

6. IHE Participants and Relationships • Participants include: • Users - Clinicians, Staff, Administrators, CIOs, Governments • Vendors of Information Systems and Equipment • Consultants • Relationship with Standards Development Organizations (SDOs): • HL7, DICOM, ISO, CDISC, ASTM, W3C, IEEE, IETF, and many others • Approved via ISO/TC 215 allowing for IHE profiles to be published as ISO deliverables • National Adoption of Healthcare IT Standards • HITSP, Infoway, many others worldwide

7. Global Development IHE North America IHE Asia-Oceania China Japan Radiology IT Infrastructure Laboratory Canada USA Korea Taiwan Cardiology Patient Care Coordination Pathology IHE Europe Radiation Oncology Patient Care Devices Eye Care Austria France Germany Netherlands Public Health, Quality and Research Italy Norway Spain UK Sweden Professional Societies / Sponsors ACC ACCE ACEP ACP GMSIHIMSS Contributing & ParticipatingVendors COCIR EAR-ECR DRG SIRM BIR EuroRec RSNA SFRSFIL ESC JAHISJIRAJRS METI-MLHW MEDIS-DCJAMI IHE Organizational Structure IHE International Board Regional Deployment 7

8. The IHE International Organization • Established IHE as an International Organization (end of 2007) ~ 250+ Member Organizations • Healthcare Professional Associations • Healthcare Provider Organizations • Healthcare Education / Research Orgs • Trade Associations • Healthcare IT Companies • Government Agencies • Standards Organizations (SDOs) • Health Information Exchanges (HIEs)

9. Radiologysince 1998 PharmacyNEW 2009 Cardiologysince 2004 Pathologysince 2006 Laboratorysince 2004 Eye Caresince 2006 (Healthcare)IT Infrastructuresince 2003 QualityResearch & Public Healthsince 2006 Radiation Oncologysince 2004 Patient Care Devicessince 2005 Patient Care Coordinationsince 2004 The IHE Development Domains 11 Years of Steady Evolution 1998 – 2009 Laying the Groundwork1998

10. International Growth of IHE Australia Netherlands Germany Norway Canada Austria Taiwan France Japan Korea China USA Italy UK Spain 2005 2006 2000 2007 2009 1999 2001 2002 2003 2004 2008 • Local Deployment • National Extensions • Promotional & Live Demonstration Events • Funding Pragmatic global standards harmonization + best practices sharing 10

11. National and Regional Projects Using IHE Profiles Lower Austria Austria Netherland Amsterdam Italy (Conto Corrente Salute) UK CfH (Radiology WF) Denmark (Funen) Italy (Veneto) Spain (Aragon) FranceDMP Quebec, Ontario,Alberta, British ColumbiaCanada Health Infoway VITL-Vermont Boston Medical Center - MA Philadelphia HIE CPHIC – Pennsylvania CareSpark – TN & VA South Africa THINC- New York NCHICA – N. Carolina Malaysia CHINA-MoH Lab results sharing JAPAN-Nagoya Imaging Info Sharing CHINA-Shanghai Imaging Info Sharing 11

12. Proven Standards Adoption Process Testing at Connectathons Develop technical specifications IHE Demonstrations Products with IHE Identify available standards (e.g. HL7, DICOM, IETF, OASIS) Document Use Case Requirements Easy to integrate products Timely access to information

13. Growth in IHE Domains Veterinary Endoscopy Pharmacy • Over 300 vendors involved world-wide • 9 Technical Frameworks • 64 Integration Profiles • Testing at “Connectathons” world-wide • Demonstrations at major conferences world-wide Public Health, Quality and Research Pathology Patient Care Devices (3 profiles) Patient Care Coord. (5 profiles) Radiation Oncology (3 profiles) Eye Care (4 profiles) Laboratory (6 profiles) Cardiology (7 profiles) IT Infrastructure for Healthcare (20 profiles) Radiology (18 profiles) 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

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

15. IHE andUS Healthcare IT Standards Harmonization 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 Architecture Projects(NHIN)

16. 18 IHE Profiles adopted byHITSP Interoperability Specifications IHE contributes to HITSP’s success 16

17. How to Participate As a User or Vendor Committee Member • Become a member of a Domain’s Planning or Technical Committees • As a User, Consultant or Vendor Interested Observer • Provide Public Comments on Technical Framework Supplements • Attend Demonstrations, Educational Events and Workshops

18. 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

19. 2009 Interoperability Showcase Sponsors

20. Featured this year in the Showcase… The 2009 Cast: • 76 connected applications, 32 IHE profiles • Secured Health Information Exchange with broad content • Clinical Scenarios, focusing on clinician and patient access and information sharing across the continuum of care • Population Health, Quality and Research • Privacy and Security • HITSP Interoperability Specifications Health information exchange with patient care devices Personal health record solutions Financial and administrative systems for billing and claims attachments (CAQH/CORE) Expanded distributed demonstration in an HIE format showing connectivity with vendor booths

21. Sample Scenario Handout

22. supported by: Infrastructure • Patient Identity Management • XDS Document Registries • XDS Document Repositories • Audit Repository

23. The Distributed Demo… win an IPOD! 3 Stickers enters you in the daily draw!! Get your badge scanned, and be entered for a daily drawing!

24. What happens next? • Docents are standing by to guide you to through a clinical story demonstrating IHE interoperability OR • A presentation begins immediately in this theatre

25. Providers and Vendors Working Together to Deliver Interoperable Health Information Systems in the Enterprise and Across Care Settings http://www.ihe.net