September, 2005What IHE Delivers 1 IHE Patient Care Coordination Domain Update HIMSS Interoperability Showcase February 2008 Keith W. Boone Interoperability Architect, GE Healthcare Co-chair, IHE PCC Co-chair, HL7 Structured Documents Convener, HITSP Care Management and Health Records Domain TC

2 Patient Care Coordination Established in 2005 Scope  Integration issues that cross providers, patient problems or time.  General clinical care aspects such as document exchange, document exchange, order processing, order processing, coordination with other specialty domains. coordination with other specialty domains.  Address workflows and the integration needs of specialty areas without a separate domain within IHE

3 Sponsors and Professional Societies Sponsors  Health Information Management Systems Society  American College of Physicians Professional Societies  American College of Obstetricians and Gynecologists  American College of Emergency Physicians 93 Organizational Members of IHE 

4 PCC Activities to Date

5 PCC Activities for Care Management  Chronic Disease Management  Immunization Registries  Cancer Registries Clinical Trials Antepartum Record Medical Home

6 IHE PCC Nursing Subcommittee PCC Approved the formation of a Nursing Subcommittee in November 2008  Membership open to any IHE Member See See  Call for Co-chair Nominations occurring soon Initial Focus  Review of ALL IHE Activities involving Nursing  Leading development of Nursing specific profiles  Liason with other IHE Domain

7 Categories of Healthcare Communication Services Security Document Sharing Patient and Provider ID Mgt Dynamic Information Access Workflow Management Source persisted and attested health records Specific info snapshot provided on demand 2 or more entities synchronize a task e.g. access to last 6 months historical labs and encounter summaries e.g. order a lab test, track status and receive results e.g. get a current list of allergies or med list from a source Hospitals HIEs and RHIOs

8 Combining IHE Profiles Document Content & Modes of Document Exchange Document Exchange Integration Profiles Document Sharing XDS Sharing XDS Media Interchange XDM Reliable Pt-Pt Interchange XDR Doc Content Profiles (Semantics content) Scanned Doc XDS-SD Discharge & Referrals XDS-MS ImagingXDS-I ConsentBPPC EmergencyEDR ED Encounter SummaryEDES Functional Status Assessment FSA LaboratoryXD*-Lab PHR Exchange XPHR

9 Use of a shared XDS Infrastructure Hospital Ambulatory or Specialty Center Home Between Providers and : Between Providers and : S pecialistsS pecialists PatientsPatients

10 Community Network A Document Registry Practice Clinic Hospitals Hospital Diag Test Other Practice Hospital Community Network C Document Registry Practice Clinic Hospitals HIMSS NHIN: Network of networks The largest multi-vendor HIE Prototype ever built ! 3 infrastructure 7 local systems 3 infrastructure systems Community Network B Document Registry Practice Clinic Hospitals Diag Test Community Network D Document Registry Practice Clinic Hospitals 6 infrastructure 9 local systems 3 infrastructure 9 local systems 2 infrastructure 4 local systems

HIMSS Interoperability Showcase

12 IHE, global standards-based profiles adopted by several national & regional projects Quebec, Toronto, Alberta, British Columbia Canada Infoway Denmark (Funen) Italy (Veneto) Spain (Aragon) THINC- New York NCHICA – N. Carolina Italy (Conto Corrente Salute) Boston Medical Center - MA France DMP UK CfH (Radiology WF) Philadelphia HIE CHINA-MoH Lab results sharing CPHIC – Pennsylvania CHINA-Shanghai Imaging Info Sharing JAPAN-Nagaya Imaging Info Sharing South Africa Malaysia VITL-Vermont CareSpark – TN & VA Netherland Amsterdam Lower Austria

13 NHIN-2 Projects CareSpark – Tricities region of Eastern Tennessee and Southwestern Virginia Delaware Health Information Network Indiana University Long Beach Network for Health Lovelace Clinic Foundation – New Mexico MedVirginia New York eHealth Collaborative North Carolina Healthcare Information and Communications Alliance, Inc. (NCHICA) West Virginia Health Information Network

14 The PCC Technical Framework enable both semantic interoperability and simple viewing ! S S t t r r u u c c t t u u r r e e d d C C o o n n t t e e n n t t w w i i t t h h c c o o d d e e d d s s e e c c t t i i o o n n s s : :  Reason for Referral     Vital Signs     M M e e d d i i c c a a t t i i o o n n  Studies     A A l l l l e e r r g g i i e e s s  Social History     P P r r o o b b l l e e m m s s  Care Plan PCC Technical Framework HL7 Clinical Document Architecture (CDA) Release 2 and ASTM/HL7 Continuity of Care Structured and Coded Header Patient, Author, Authenticator, Institution, Time of Service, etc. Header always structured and coded Title-coded sections with non-structured nor coded content (text, lists, tables).  Simple Viewing (XML Style sheet) Level 1 Level 2 Text Structure Entry Text Structure Entry Med, Problems and Allergies as highly structured text.  Text easy to import/parse Text Structure Entry Level 3 CCHIT 08 Med Problems and Allergies have a fine-grain structure with optional coding. Coding Scheme explicitly identified. Coded Section Entry Coded Section Entry Coded Section Entry Level 3 CCHIT 09

1515 IHE Profiles are consistent with HHS Accepted Standards (HITSP Interoperability Specifications)

16 As a Provider or Vendor Contributor Offer Clinical Use Case Input to Drive IHE Profile Development Become a member of relevant domain’s Planning or Technical Committees Become a member of relevant Regional/National Committees Help to shape IHE’s future direction As a Vendor Participant Respond to Public Comments of Domain Supplements Attend the June Educational Workshop Participate in Connect-a-thons and Demonstrations As a Provider/Consultant Participant Respond to Public Comments of Domain Supplements Attend the June Educational Workshop Attend Demonstrations and include IHE Integration Profiles in your RFPs and Integration Projects. How can I participate?

17 What can you do? Attend the IHE Domain specific sessions in these Theaters during HIMSS 2007 (Orange sessions) Learn about IHE, Insist on relevant IHE profiles compliance in your RFPs and contract documents:  Select Integration Profiles, and Appropriate Actor(s)  Ask vendors for their products “IHE Integration Statements”. Need more interoperability ?  Contribute to IHE Committees

18 IHE Web site: Frequently Asked Questions Integration Profiles in Technical Frameworks: See Volume 1 of each TF for Use cases  Cardiology  Eye Care  IT Infrastructure  Laboratory  Patient Care Coordination  Patient Care Devices  Pathology  Quality  Radiation Oncology  Radiology Connectathon Result: Vendor Products Integration Statements

19 ANSI/HITSP Call for Participation Care Management and Health Records Domain TC  Health Information Management Professionals  Architects and Implementers of EHR Systems  Experts in Clinical Vocabularies LOINC LOINC SNOMED SNOMED RxNORM RxNORM  Architects and Implementers of Clinical Decision Support Systems  HL7 CDA R2 knowledge and implementation experience

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