2. CCHIT and IHE Interaction CCHIT looks to IHE to provide specifications for EHR interoperability and functionality. Current In-Patient Certification Specifications for cardiovascular medicine are in process. CCHIT needs specification assistance from IHE in areas like: Variable Definition Image Access Summary Data Reports

3. Variable Definition As increasing demand for data from registries and government grow, data points take on different meaning. Seemingly like data points have different definitions, some intentional and some not intentional, which causes misunderstanding in cardiology service line areas.

4. Variable Definition Problem Statement What is the right definition? No place to check No independent coordinating body Continual “Reinventing the Wheel” Variable Type Free Text Field Size Yes/No coding Abbreviations Inaccurate field analysis Difficult to use variables in reports - need to create summary variables  programming Complexity Unintentional Definition variance “Many” meds for one med Varying techniques for maintenance

5. Variable Definition Standards IHE ITI Public Health Metadata Registry & Vocabulary Services (2010 cross domain project) ICD9 ICD10 SNOMED CMS JCAHO ACC STS AHA HRS HIMMS

6. Image Access Image technology has made great strides in providing ability to view images at proprietary workstations and the demand that faces cardiologists is moving those images from proprietary systems to various communities in a timely and accurate fashion. Some video images of procedures are very large, occupying 4gb of information or even larger. The problem that is faced is how to get the information from the source in a usable manner.

7. Image Access Problems Timeliness - Long download time Viewer accuracy Many different Viewer Requirement Image Request Monitor Resolution Security

8. Image Access Standards DICOM IHE XDS.b IHE Access Control

9. Summary Data Reports There is a need to access summary patient information form various communities. Content is subject to vendors discretion, but format of the file should follow a standard like HL7 or XML. What is needed is the format specification and then the recommended way to display whatever was sent, including possibility of a device like an IPhone or Smartphone.

10. Summary Data Reports Problems Many different formats from many different vendors Inconsistent Look Inconsistent Header information

11. Summary Data Reports Standards IHE Dynamic Document Sharing (2010 profile)