Introduction to Integrating the Healthcare Enterprise (IHE) Making Interoperability and Health Information Exchange Real - Today

What’s the problem? The problem of interoperability requires implemented standards for cost effectiveness There are plenty of standards, but They are overlapping, disjointed or conflicting They are not consistently applied Real world uses require multiple standards in a coordinated manner Lack of a consistent end-to-end approach leads to implementation paralysis!

What is Needed Engage all the stakeholders Develop a consistent end-to-end workflow based on real world problems Select appropriate interoperability standards, and provide explicit guidance for use Establish a mechanism for testing and validating implementations Promote standards-based integration in the marketplace That’s “the IHE way!”

What is Integrating the Healthcare Enterprise? A 12-year old worldwide public-private collaboration Improves patient care and provider efficiency by harmonizing electronic health information exchange Creates implementable standards-based specifications for interoperability use cases Provides an implementation testing pathway to bring IHE-compliant products to market What is IHE? Optimal patient care requires efficient access to comprehensive electronic health records (EHRs). The Integrating the Healthcare Enterprise (IHE) initiative accelerates the adoption of the information standards needed to support EHRs. More than 200 vendors have implemented and tested products based on IHE. IHE improves patient care by harmonizing healthcare information exchange. IHE provides a common standards-based framework for seamlessly passing health information among care providers, enabling local, regional and national health information networks.

15 national, regional, and international deployment organizations Who is IHE? ~ 370 members: 55 healthcare professional organizations 15 government agencies; 7 standards organizations 45 provider, research and education organizations 250 HIT and consulting companies 12 technical domains Sponsored by professional organizations 15 national, regional, and international deployment organizations Ensure IHE is aligned with local interoperability projects

How does IHE work? Clinicians and HIT professionals work together to identify key clinical interoperability issues Jointly they define solutions called IHE profiles that harmonize the way standards are implemented in HIT products HIT vendors implement IHE profiles in their systems and test them at annual Connectathon HIT users specify IHE profiles in purchase tenders to achieve interoperability IHE: A forum for agreeing on how to implement standards and processes for making it happen Example #1: IHE provides a profile for information sharing Cross-Enterprise Document Sharing. This IHE Integration Profile facilitates the registration, distribution and access across health enterprises of patient electronic health records. Cross-Enterprise Document Sharing (XDS) is focused on providing a standards-based specification for managing the sharing of documents between any healthcare enterprise, ranging from a private physician office to a clinic to an acute care in-patient facility. In today’s paradigm of healthcare data is documented at each patient encounter whether it be in an ER, Outpatient clinic, physician’s office, or another venue and is faxed or mailed to another venue if time is taken to copy a personal physician etc. Example #2: IHE provides a profile for HIPAA compliance called Audit Trail and Node Authentication (ATNA) – you must comply with HIPAA regulations and must have audit trails to document compliance. Clinicians and IT professionals agree on the audit trails, the workflow, etc to enable them to maintain and document HIPAA compliance.

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

IHE Organizational Structure IHE International Board IHE Europe IHE North America France USA Canada IHE Asia-Oceania Japan Korea Taiwan Netherlands Spain Sweden United Kingdom Italy Germany Norway Regional Deployment China Switzerland Turkey Global Development Radiology Cardiology IT Infrastructure Patient Care Coordination Device Laboratory Anatomic Pathology Pharmacy Radiation Oncology Dental Endoscopy Eye Care ACC ACP HIMSS RSNA JAHIS JIRA JRS METI-MLHW MEDIS-DC JAMI GMSIH SFR SFIL ACCE SIRM BIR EuroRec COCIR EAR-ECR DRG ESC Professional Societies / Sponsors Contributing & Participating Vendors

National and Regional Projects Using IHE Profiles Netherland Amsterdam Lower Austria Italy (Conto Corrente Salute) UK CfH (Radiology WF) France DMP Denmark (Funen) Italy (Veneto) Spain (Aragon) Austria Quebec, Ontario, Alberta, British Columbia Canada Health Infoway VITL-Vermont Boston Medical Center - MA Philadelphia HIE CPHIC – Pennsylvania CareSpark – TN & VA South Africa Malaysia CHINA-MoH Lab results sharing JAPAN-Nagoya Imaging Info Sharing THINC- New York NCHICA – N. Carolina CHINA-Shanghai Imaging Info Sharing 9 9

IHE and “Meaningful Use” IHE is a formal partner in the “Standards and Interoperability Framework” Harmonization Project of the HHS Office of the National Coordinator for Health IT IHE Cross-Enterprise Document Sharing (XDS) profiles are the basis for Health Information Exchanges, and for the DIRECT Project (secure healthcare email) IHE Patient Care Coordination Profiles are key parts of the forthcoming 2013 and 2015 requirements IHE Request Form for Data Capture supports a standard approach to public health and quality reporting

Who benefits from IHE’s work? Patients Enhance care’s quality, safety, efficiency & effectiveness Clinicians Improve workflow & information reporting Fewer error opportunities; less repeated work Vendors and Consultants Satisfy customers’ interoperability demands Decreased cost & complexity of installation & management Standards Organizations Rapid feedback to address real-world issues Establishment of critical mass and widespread adoption Government Reduced costs of implementing HIEs Facilitates public health and quality measures Government – reducing the cost of implementing healthcare systems

As a User or Vendor Committee Member 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

www.ihe.net Resources Technical Frameworks Connectathon Results Product Registry Domain Information Member Organizations and more . . .

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