September, 2005What IHE Delivers Chris Lindop, GE healthcare IHE Co-chair radiology PC, IHE Australia-Asia/Pacific liaison HIMSS Asia Pac 2008, Hong Kong IHE Australia

1 Presentation Objectives IHE Australia, Overview History 2008 plans How to participate

2 International Adoption of IHE France   Local Deployment   National Extensions (Local Adaptions)   Promotional & Live Demonstration Events   Conformance Testing USAGermanyItalyJapanUKCanadaKoreaTaiwan Norway HollandSpainChina Year 1 (1999) Year 2 (2000) Year 3 (2001) Year 4 (2002) Year 5 (2003) Year 6 (2004) Year 7 (2005) Year 8 (2006) Year 9 (2007) Year 10 (2008) Pragmatic global standards harmonization + best practices sharing Australia

3 IHE Organizational Structure ACC ACP HIMSS RSNA JAHIS JIRA JRS METI-MLHW MEDIS-DC JAMI GMSIH SFR SFIL SIRM BIR EuroRec COCIR EAR-ECR DRG ESC Professional Societies / Sponsors Contributing & Participating Vendors Global Development Radiology Cardiology IT Infrastructure Patient Care Coordination Patient Care Devices Laboratory Pathology Eye care, Quality, etc. Radiation Oncology IHE Pacific Australia IHE International IHE Europe IHE North America France USA Canada IHE Asia Japan KoreaTaiwan Netherlands Spain Sweden UK Italy Germany Norway Regional Deployment China

The IHE 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

5 Deployment – National Initiatives IHE National Initiatives are responsible, within their geographical region, for promotion and deployment of IHE. The primary activities of IHE National Initiatives are:  Selecting which Integration Profiles are appropriate for promotion in their locale/region.  Recruiting local/regional vendors and encouraging them to participate  Organizing local/regional demonstrations & Connectathons  Educating the local/regional healthcare community about IHE

6 IHE Australia Scope:  Promoting IHE deployment with education, recruitment and organization in Australia  Incorporating other regional countries: NZ, Malaysia as they form to create a sub-regional group IHE Asia-Pacific Key Profile Deployment:  PDI, SWF, XDS profiles Supporting Events:  IHE Participation and Educational Workshop, June  IHE Australia/Asia-Pacific Connectathon 2008, July 27-Aug 1  Interoperability Showcase, HIC 2008, Aug 31-Sept 3 Established in 2007 – undergoing IHE recognition process Sponsors & Supporters:  Health Informatics Society Australia (HISA)  HL7 Australia  Medical Software Industry Association (MSIA)  Royal Australian and New Zealand College of Radiologists (RANZCR)

7 Interoperability Australia Med-Info 2007

8 IHE Conference – Dec 10-12, day meeting (NICTA)  Day 1 – Overview, more in depth discussion of use cases, profiles, infrastructure and organisation, applicability to Australia, use of Australian standards & HL7 CDA  Day 2 - IHE Radiology profile and XDS profiles  Day 3 – IHE Portable Data Imaging (CD)

Activities Connectathon Showcase Radiology Conference – CD Challenge Contact: Peter MacIsaac: Klaus Veil: Brendan Lovelock:

10 Local implementation problems: Local implementation problems: Portable Data for imaging  1 st level film-less interoperability provided to referrer Scheduled Workflow  Top profile implemented by radiology vendors with over 200 Integration statements XDS/XDS-I  The emerging technology worldwide for Health information exchange Deployment of HL7 v2 – lab, radiology orders and results using Australian Standard AS &.7  Rigid adherence to local standards/implementation guide  Appropriate use of message and application acknowledgements Key IHE Profiles for Australia

11 PDI -The Problems In the film world, looking at prior studies was easy. In the digital world, this has been complicated  Can I read the CD?  Can I read the Digital Images?  Can I process the Digital Images I receive?  How do I handle Studies from other Institutions?

12 PDI – Actors and Transactions Portable Media Creator Print Composer Report Reader Image Display Display Distribute Imaging Information on Media Media Importer

13 Import Reconciliation Workflow Scheduled Import Transaction Diagram DICOM Transactions Modality Worklist (MWL) Modality Performed Procedure Step (MPPS) Object Storage Storage Commitment

14 Import Reconciliation Workflow Unscheduled Import Transaction Diagram HL7 Transactions Patient Demographics Query (QBP^22) DICOM Transactions Modality Performed Procedure Step (MPPS) Object Storage Storage Commitment

15 Radiology Scheduled Workflow: Use Case Registration Orders Placed Orders Filled Film Folder Image Manager & Archive Film Lightbox report Report Repository Diagnostic Workstation Modality acquisition in-progress acquisition completed images printed Acquisition Modality

16 IHE Integration Profiles for Health Info Nets What is available and has been added in 2006/07 Cross-Enterprise Document Sharing Registration, distribution and access across health enterprises of clinical documents forming a patient electronic health record Emergency Referrals Format of the Document Content and associated coded vocabulary PHR Extracts/Updates Format of the Document Content and associated coded vocabulary ECG Report Document Format of the Document Content and associated coded vocabulary Lab Results Document Content Format of the Document Content and associated coded vocabulary Scanned Documents Format of the Document Content Imaging Information Format of the Document Content and associated coded vocabulary Medical Summary ( Meds, Allergies, Pbs) Format of the Document Content and associated coded vocabulary Consistent Time Coordinate time across networked systems Audit Trail & Node Authentication Centralized privacy audit trail and node to node authentication to create a secured domain. Basic Patients Privacy Consents Establish Consents & Enable Access Control Document Digital Signature Attesting “true-copy and originSecurity Clinical and PHR Content Health Data Exchange Patient Demographics Query Patient Identifier Cross-referencing Map patient identifiers across independent identification domains Notification of Document Availability Notification of a remote provider/ health enterprise Request Form for Data Capture External form with custom import/export scripting Patient ID Mgmt Other Cross-Enterprise Document Pt-Pt Reliable Interchange Final Text Approved Trial Implementation-2006 – Final Txt 2007 Cross-Enterprise Document Media Interchange

17 DocumentSource DocumentSource Document Registry/Repository Model: Document Repository Submit Doc Meta-data + References Submit Documents Document Repository Submit Doc Meta-data + ReferencesDocumentRegistry Retrieve Documents Query for Docs References DocumentConsumer Retrieve Documents

18 Example: Providing Access to Prior Health Information Acute Care (Inpatient) PCPs and Clinics (Ambulatory) Long Term Care Other Specialized Care or Diagnostics Services Shared Document Repository Longitudinal Record as used across-encounters Encounter Medical Summary (med-prescribed & dispensed, allergies, pbs, etc) Lab Report (structured & coded tests results) Radiology Report and Images Links EKG Report Public Health

19 To find IHE Profiles: /technical_frameworks Radiology (18) IT Infrastructure for Healthcare (17) Cardiology (7) Laboratory (6) Radiation Oncology (1) Patient Care Coordination (5) Patient Care Devices (1) Quality Eye Care (3) Veterinary Endoscopy Pharmacy IHE Global Developments Over 60 Integration and content Profiles (# X) Solutions to Real-World Interoperability Needs & Problems:  Within Clinical Departments e.g.:  Radiology  Cardiology  Lab ...  Across Departmental & Institutional Boundaries – XDS  RHIOs (Regional Healthcare Information Organizations)  EHR Enablers Year 1 (1999)Year 2 (2000)Year 3 (2001) Year 4 (2002) Year 5 (2003)Year 6 (2004) Year 7 (2005) Year 8 (2006)Year 9 (2007) Pathology (1)

20 How to Participate As a Committee Member Become a member of relevant Domains Planning or Technical Committees As as Interested Observer Provide Public Comments on Technical Framework Supplements Attend Demonstrations, Educational Events and Workshops

21 How to Use IHE As a Vendor Implementer Implement IHE Integration Profiles Test systems through Connectathon process Publish an IHE Integration Statement for products As a User Implementer or Consultant Use IHE Integration Profiles to develop interoperability strategy Use Connectathon Results and Integration Statements to evaluate vendors Demand IHE Integration Profile compliance in RFPs

22 Stakeholders Working Together to Deliver Interoperable Health Information Systems in the Enterprise and Across Care Settings

23 More Resources Integration Profiles in Technical Frameworks:  Cardiology  IT Infrastructure  Laboratory  Patient Care Coordination  Patient Care Devices  Radiation Oncology  Radiology Connectathon Results – world-wide Vendor Products Integration Statements Participation in Domain Committees Participation in IHE Australia   Connectathon   Interoperability showcase

September, 2005What IHE Delivers