IHE Pharmacy domain Profiles for Community and Hospital Pharmacy Jürgen Brandstätter IHE Pharmacy co-chair

What is IHE? Use cases typically require „combinations“ of standards - but how to compose? eHealth Projects IHTSDO IETF Standards

What is IHE? eHealth Projects IHTSDO IETF Standards Profiling and Testing

IHE methodology Products ProductsProjects Use Case Identify available standards Products declare IHE Easy to integrate products RFPs with IHE reqs

Pathology since 2006 Radiation Oncology since 2004 Radiology since 1998 Cardiology since 2003 Patient Care Devices since 2005 Patient Care Coordination since 2005 Eye Care since 2006 Quality Research & Public Health since 2007 Laboratory since 2003 (Healthcare) IT Infrastructure since 2003 since 2008 Pharmacy within IHE landscape Pharmacy since 2008

IHE Pharmacy (PHARM)  “IHE Pharmacy addresses information sharing, workflow and patient care in both community and hospital pharmacies.”  Most actively involved … Many European countries USA/Canada Australia  1 whitepaper, 5 profiles  Whitepaper work on certain (rather complex) topics  Sponsors & Supporters EAHP NICTIZ Réseau Phast IHE Pharmacy overview

Liaisons ISO TC215 WG6 / CEN Global recognition ISO TC215 WG6 / CEN Global recognition HL7 Pharmacy Base Standards HL7 Pharmacy Base Standards IHE Pharmacy Profiling Layer Projects High-level Technical Profiles (Use Cases) HL7 Standards ISO Standards

Committee work follows the IHE Profile Cycle  Annual cycle Sep – Dec: Call for proposals Dec – Jun: Working on work-items Jun – Jul: Public comment Jul – Aug: Ballot & Release Opportunities for IHE members (and non-members) to participate in cycle Register at Meetings are F2F and TCons  Just join in! Participate IHE’s Profile Cycle How to participate in Pharmacy …

ftp://ftp.ihe.net/Pharmacy/White%20Paper/IHE_Eur_Pharmacy_White_Paper_Final_Text_1.2.pdf What has been done? IHE White Paper   Foundation of all current profiles Final version   Released in early pages   Community Pharmacy use cases   Hospital Pharmacy use cases   Harmonization of actors definitions

What has been done? 5 profiles for …  … Community Pharmacy CMPD Community Medication Prescription and Dispense PRE Content Profile: Medication Prescription PADV Content Profile: Pharmaceutical Advice DIS Content Profile: Medication Dispense  … Hospital Pharmacy HMW Hospital Medication Workflow

IHE Pharmacy – Key process Validation of the prescription (ICA check)

Existing Profiles with High Uptake CMPD (Community Medication Prescription and Dispense)  Basic use case GP prescribes Pharmacist validates the prescription Community pharmacist or pharmacy dispenses  Systems it would impact: Prescription placer module in GP systems Pharmaceutical validation software Pharmacy software  Based on IHE ITI XDS: Strong integration with existing CDA/XDS- based solutions + PRE Medication Prescription + PADV Pharmaceutical Advice + DIS Medication Dispense Community Pharmacy profiles

CMPD actor diagram

Content Profiles Content Profiles define „payload“ of CMPD system  PRE  PADV  DIS Based on HL7v3 CDA extended by HL7 Pharmacy CMETs

Existing Profiles with High Uptake HMW  Basic use case: Hospital physician prescribes in a ward Hospital pharmacist reviews orders Pharmacy technician dispenses Nurse administers drugs to the patient  Systems it would impact: Prescription placer nodules Validation software Medication dispensing systems Medication administration informer modules  Based on HL7 v2.5/v2.6: Message based to fit into hospital environment 6/27/ Hospital Pharmacy profiles

HMW Interoperability Model

Becoming real … European Union: epSOS  12 member states (extended in epSOS 2)  Definition of prescription and dispense document are (almost) in sync Italy / Europe: DOGE project  Venice region (5 million inhabitants)  21 Local Health Authorities, 2 Hospital Trusts, GPs, community pharmacies  Adoption of DIS profile Austria / Europe: e-Medication project  Full adoption of CMPD and content profiles (PRE, PADV, DIS) Other countries evaluating  Saudi Arabia, Switzerland

Future / Roadmap Current work-items  Pharmacy Medication List  Medication Management Aka „Medication record“ / „Medication treatment plan“ Cross-domain work with other IHE domains and HL7  Administration in Community Pharmacy domain  Supply chain in Hospital Pharmacy  Automatic administration by Infusion pumps Cross-domain work with IHE Patient Care Devices domain  Common Glossary Cross-domain work IHE and HL7 Upcoming work-items  HL7v3 messages  Prescription of non-medication products

Links Technical Frameworks  Pharmacy Wiki   Strategic planning page  Roadmap  Committees Google group 

Thank you Jürgen Brandstätter IHE Pharmacy co-chair, IHE International CodeWerk Software Services and Development GmbH