June 2006What IHE Delivers 1 IHE Workshop Changing the Way Healthcare Connects Flora Lum, M.D. Director, Quality of Care and Knowledge Base Development American Academy of Ophthalmology Jim Riggi, CTO Medflow, Inc. Co-Chair IHE Eye Care Technical Committee IHE Eye Care Process and Timeline

June Standards are critical but alone are not enough Standards offer generality, ambiguity and alternatives Standard implementation guides are focused on a single standard Increasing complexity IHE provides a standard process for implementing multiple standards!

June Connecting Standards to Care Care providers work with vendors to coordinate implementation of standards to meet their needs  Care providers identify key interoperability problems they face  Drive industry to develop and make available standards- based solutions  Implementers follow common guidelines in purchasing and integrating systems that deliver these solutions What is the effective way to establish those “standards” for how to implement standards?

June What is Integrating the Healthcare Enterprise? IHE provides a common framework for passing health information seamlessly:  within the healthcare enterprise  across multiple healthcare enterprises  for local, regional & national health information networks. IHE is sponsored by healthcare professional associations. IHE drives standards adoption to address specific clinical needs.

June Why is AAO sponsoring IHE Eye Care? Strong belief in the benefits of standard setting and interoperability  Enhance quality of patient care  Increase efficiencies for eye care practices  Reduce costs to developers and ultimately users  Accelerate usability of electronic health record systems AAO provides neutral forum to bring vendors and users together

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

June Driving healthcare standards-based integration IHE Integration Profile: A well-defined and tested solution to a specific information exchange problem

June IHE organizational Structure Multi-Domain & Multi-National Participants contribute Global Development: Radiology, IT Infrastructure, Cardiology, Lab, Eye Care, etc. Delegates IHE Europe IHE North America IHE Asia/Oceania Regional & National Deployment supervises reports IHE (International) Strategic Development Committee Sponsors Co-Chairs Global Interoperability IHE Domain-related Planning Committee and Technical Committee National Extensions

June IHE Contributors & Participants Societies Representing Healthcare Segments  RSNA, HIMSS, ACC, ACCE, AAO  Any Healthcare Stakeholder Organization Users  Clinicians, Medical Staff, Administrators, CIOs, … Information Systems & Equipment Vendors  Electronic health record systems, practice management systems, image management systems, manufacturers of medical devices and instruments In addition, active liaison with Standards Development Organizations (SDOs)  HL7, DICOM, NCCLS, ASTM, ISO, others

June Achievements and expanding scope 15 Active national chapters on 4 continents, 5 Technical Frameworks 42 Integration Profiles, Testing at yearly Connectathons, Demonstrations at major exhibitions world-wide 3 Integration Profiles

June A Proven Standards Adoption Process IHE Integration Profiles B IHE Integration Profile A Easy to Integrate Products IHE Connect-a-thon Product With IHE IHE Demonstration User Site RFP Standards (e.g. ASTM-CCR HL7 CDA) Product IHE Integration Statement IHE Connect-a-thon Results 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 with continuous improvements Requirements

June IHE Connectathon Open invitation to vendor community Use of advanced testing tools (MESA) Testing organized and supervised by project management team Thousands of cross-vendor tests performed Results recorded and published Excellent opportunity for vendors to test their products with other vendors

June IHE Connectathons Vendors do not pass… until IHE Technical Project Manager attests it ! Massive yearly events : vendors engineers Over 100 systems ….integrated in 5 days

June Integration Statements

June **HIMSS web-based survey in data collection in November 2004 – 163 participants 2005 IHE Survey Results

June IHE Eye Care Process Open invitation to vendor community to participate in process – October 2005 Open process to create the Technical Framework – January ~ May 2006 Open public comment period – April 2006 Comments reviewed and suggestions incorporated – April ~ May 2006 Profile for trial implementation released – June 2006

June IHE Eye Care Process Requirement for Modality Vendors  Dr. David Clunie has offered to check DICOM images for correctness, such as Ophthalmic Photography.  This is also for other kinds of DICOM objects, like DICOM Encapsulated PDFs.  Every vendor should make use of this opportunity.  the images to David or put them on an FTP or web site and send him link, or upload to his FTP:

June IHE Eye Care Process Vendors can start testing right now Tools are already available cover 90% of the IHE Technical Framework specifications (based on existing IHE radiology technical specifications) tribution.html tribution.html A project manager will be handling:  Development of testing tools (MESA)  Planning and operations of Connectathon  Testing before and during Connectathon  Results and feedback to vendors

June IHE Eye Care Process Development of MESA testing tools for the exceptions (10% that is different from existing specifications) – June ~ August Vendors implement profiles – July ~ Sept Organizational meeting for Connectathon and MESA tools made available – August 10 th Vendors submit MESA test results – Sept 15 th Test results and issues provided to each vendor – Sept 27 th

June IHE Eye Care Connectathon Open invitation to vendor community Week of October 9 th RSNA headquarters, Chicago Prerequisite to participate in the AAO Annual Meeting Interoperability Showcase Cost to participate for Connectathon: $6,000 (costs for facilities, IT network, project manager) Application: Contact Flora Lum, (415)

June IHE Eye Care Showcase 50x50 booth space on show floor for vendors to demonstrate interoperability Marketing and publicity to members through AAO website, mailed brochures, on-site advertising, Eyenet magazine, on-site brochure, booth signage Presentations at the Technology Pavilion Cost to participate for Showcase: $5,000 (furniture, IT/electrical, equipment, marketing, etc.) Application: Contact Flora Lum, (415)

June