Jonathan L. Elion MD, FACC Co-Chair, IHE Cardiology Planning Committee The Basics of IHE: Concepts and Process

June 28-29, 2005IHE Interoperability Workshop1 Standards-Based Integration

June 28-29, 2005IHE Interoperability Workshop2 IHE Organizational Structure Multi-Domain & Multi-National IHE Organizational Structure Multi-Domain & Multi-National Participants contribute Global Development: Radiology, IT Infrastructure, Cardiology, Lab, etc. Delegates IHE Europe IHE North America IHE Asia/Oceania Regional & National Deployment supervises reports IHE (International) Strategic Development Committee Sponsor Co-Chairs Global Interoperability IHE Domain-related Planning and Technical Committees

June 28-29, 2005IHE Interoperability Workshop3 Achievements and expanding scope 15 Active national chapters on 4 continents 4 Technical Frameworks 39 Integration Profiles, Testing at yearly Connectathons, Demonstrations at major exhibitions world-wide Vendors claim compliance to IHE Integration Profiles by publishing an IHE Integration Statement for each product.

June 28-29, 2005IHE Interoperability Workshop4 Proven Standards Adoption Process IHE Integration Profiles B IHE Integration Profile A Easy to Integrate Products IHE Demonstration User Site RFP Standards IHE Technical Framework Product IHE Integration Statement IHE Integration Profiles at the heart of IHE : –Detailed selection of standards and options each solving a specific integration problem –A growing set of effective provider/vendor agreed solutions –Vendors can implement with ROI –Providers can deploy with stability –Process started in 1998; continuously improved IHE Connect-a-thon Product With IHE IHE Connect-a-thon Results

June 28-29, 2005IHE Interoperability Workshop5 Who is IHE? IHE is a joint initiative among: –American College of Cardiology (ACC) –Radiological Society of North America (RSNA) –Healthcare Information Management Systems Society (HIMSS) – GMSIH, HPRIM, JAHIS (laboratory) –American Society of Ophthalmology –And many more…. Began in 1997 in Radiology (RSNA) and IT (HIMSS) International effort: IHE- Europe and IHE-Japan Additional sponsors for Cardiology including ASE, ESC, ASNC, SCA&I, HRS and more

June 28-29, 2005IHE Interoperability Workshop6 IHE Deliverables Venue(s) for communication (committees) Integration Profiles (what needs to be done) Technical Framework (how to do it) Maintenance of Integration Profiles (sustainability) Connect-a-thon (actually do it!) Public Demonstrations (ACC ’05 for Cardiology) Tools for Acquiring Conformant Products (RFP’s)

June 28-29, 2005IHE Interoperability Workshop7 What is IHE NOT IHE is not a standard You conform to a standard You comply with IHE integration profile and actors IHE is not a standards development organization IHE is not a certifying authority IHE is not simply a demonstration project Demos are only one means to the end: Adoption Backed up by documentation, tools, testing, and publication of information IHE is not just for radiology and more!

June 28-29, 2005IHE Interoperability Workshop8 IHE Annual Cycle 1.Clinicians identify clinical problems to be addressed - “Integration Profiles” 2.Engineers from vendors collaborate to define technical specification (using existing standards such as DICOM and HL7) 3.Vendors implement the technical specification and participate in the “Connectathon” 4.Demonstrations at trade shows (ACC, HIMSS, etc.) 5.Vendors publish IHE Integration Statements 6.Customers reference IHE profiles in RFP’s

June 28-29, 2005IHE Interoperability Workshop9 Cardiology Example (Year 1) The Planning Committee identified three initial clinical problems to be addressed: 1.The ability to view an ECG from many locations - quickly and easily 2.Lab systems integration of patient, order, and procedure information in an Echo Lab, including mobile echo 3.Lab systems integration of patient, order, and procedure information in a Cath Lab, including angio, hemo, and IVUS ► “Retrieve ECG for Display” ► “Echocardiography Workflow” ► “Cardiac Catheterization Workflow”

June 28-29, 2005IHE Interoperability Workshop10 IHE Annual Cycle 1.Clinicians identify clinical problems to be addressed - “Integration Profiles” 2.Engineers from vendors collaborate to define technical specification (using existing standards such as DICOM and HL7) 3.Vendors implement the technical specification and participate in the “Connectathon” 4.Demonstrations at trade shows (ACC, HIMSS, etc.) 5.Vendors publish IHE Integration Statements 6.Customers reference IHE profiles in RFP’s

June 28-29, 2005IHE Interoperability Workshop11 IHE Technical Frameworks Detailed standards implementation guides –Cardiology –IT Infra –Lab –Radiology

June 28-29, 2005IHE Interoperability Workshop12 Organization of TFs Volume 1: Integration Profiles –Describes clinical need and use cases –Identifies the actors and transactions Volume 2+ of Technical Framework –Provides implementation specification for each transaction by specific reference to Standards

June 28-29, 2005IHE Interoperability Workshop13 Transactions & Actors: Displayable Reports Example Encapsulated Report Storage [CARD-9] Report Repository Report Manager Enterprise Report Repository Encapsulated Report Query [CARD-10] Encapsulated Report Retrieve [CARD-11] Report Reader Report Creator Encapsulated Report Submission [CARD-7] Storage Commitment [RAD-10] Encapsulated Report Submission [CARD-7] Display Retrieve Specific Info for Display [ITI-11] Retrieve Document for Display [ITI-12]        Information Source   Report Reference Submission [CARD-8] Retrieve Information for Display (RID) Profile

June 28-29, 2005IHE Interoperability Workshop14 IHE Annual Cycle 1.Clinicians identify clinical problems to be addressed - “Integration Profiles” 2.Engineers from vendors collaborate to define technical specification (using existing standards such as DICOM and HL7) 3.Vendors implement the technical specification and participate in the “Connectathon” 4.Demonstrations at trade shows (ACC, HIMSS, etc.) 5.Vendors publish IHE Integration Statements 6.Customers reference IHE profiles in RFP’s

June 28-29, 2005IHE Interoperability Workshop15 IHE Connectathon Open invitation to vendor community Advance testing tools (MESA) Testing organized and supervised by project management team Thousands of cross-vendor tests performed Results recorded and published

June 28-29, 2005IHE Interoperability Workshop16 IHE Connectathon, January participants, 110 systems (31 Cardiology) 43 vendors (14 Cardiology) 2800 monitored test cases

June 28-29, 2005IHE Interoperability Workshop17 IHE Annual Cycle 1.Clinicians identify clinical problems to be addressed - “Integration Profiles” 2.Engineers from vendors collaborate to define technical specification (using existing standards such as DICOM and HL7) 3.Vendors implement the technical specification and participate in the “Connectathon” 4.Demonstrations at trade shows (ACC, HIMSS, etc.) 5.Vendors publish IHE Integration Statements 6.Customers reference IHE profiles in RFP’s

June 28-29, 2005IHE Interoperability Workshop18 Total ACC’05 attendance was over 28,000.

June 28-29, 2005IHE Interoperability Workshop19 Over 1,000 visitors from 47 countries attended the IHE presentations and demonstrations.

June 28-29, 2005IHE Interoperability Workshop20 IHE Annual Cycle 1.Clinicians identify clinical problems to be addressed - “Integration Profiles” 2.Engineers from vendors collaborate to define technical specification (using existing standards such as DICOM and HL7) 3.Vendors implement the technical specification and participate in the “Connectathon” 4.Demonstrations at trade shows (ACC, HIMSS, etc.) 5.Vendors publish IHE Integration Statements 6.Customers reference IHE profiles in RFP’s

June 28-29, 2005IHE Interoperability Workshop21 IHE Integration Statement

June 28-29, 2005IHE Interoperability Workshop22 IHE Annual Cycle 1.Clinicians identify clinical problems to be addressed - “Integration Profiles” 2.Engineers from vendors collaborate to define technical specification (using existing standards such as DICOM and HL7) 3.Vendors implement the technical specification and participate in the “Connectathon” 4.Demonstrations at trade shows (ACC, HIMSS, etc.) 5.Vendors publish IHE Integration Statements 6.Customers reference IHE profiles in RFP’s

June 28-29, 2005IHE Interoperability Workshop23 Your Request for Proposals (RFPs) Incorporate IHE framework into RFP documents & product selection Much easier to specify an IHE Integration Profile than detailed technical specs –“Device must support IHE Echo Integration Profile, and vendor must supply an IHE Integration Statement.” Use IHE framework to evaluate your current workflow, even if not buying now Vendors build product functions that are requested by customers Ask for IHE Integration Loud & Often !!

June 28-29, 2005IHE Interoperability Workshop24 More information…. IHE Web site: Technical Frameworks Technical Framework Supplements – Trial Implementation Non-Technical Brochures : –Calls for Participation –IHE Fact Sheet and FAQ –IHE Integration Profiles: Guidelines for Buyers –IHE Connect-a-thon Results –Vendor Products Integration Statements Questions?

June 28-29, 2005IHE Interoperability Workshop25 W W W. I H E. N E T Providers and Vendors Working Together to Deliver Interoperable Health Information Systems in the Enterprise and Across Care Settings