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

2. Pharmacy within IHE landscape
Pharmacy Since 2009
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
Quelle: IHE International
since 2008 2

3. IHE Pharmacy overview Pharmacy (PHARM) Since 2009
“IHE Pharmacy addresses information sharing, workflow and patient care in both community and hospital pharmacies.”
1 whitepaper, 5 profiles
Sponsors & Supporters
EAHP
NICTIZ
Réseau Phast

4. Our needs in community
Cover the overall process from prescription at the GP to dispense at the Pharmacy

5. Our needs in hospital
Cover the overall medication workflow from prescription via validation and dispense to administration to the patient

6. How to participate in Pharmacy …
Participate IHE’s Profile Cycle
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 (join !)

7. Our approach Create a common data model for pharmacy domain
Profile existing standards:
Hospital pharmacy: HL7v2.x standard (Message-based)
Community pharmacy: HL7v3 CDA standard (Document-based)
Technical Framework describes the details of each Integration Profile (data model, messages)
Connectathons (first at Pisa, April 2011) to validate implementations of the IHE Pharmacy Integration Profiles
Welcome additional members (users, vendors)

8. What has been done? IHE White Paper
Final version (integration of comments collected after having been put for public comments last year)
70 pages
Community Pharmacy use cases
Hospital Pharmacy use cases
Harmonization of actors definitions
ftp://ftp.ihe.net/Pharmacy/White%20Paper/IHE_Eur_Pharmacy_White_Paper_Final_Text_1.2.pdf

9. 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

10. IHE Pharmacy – Key process

11. Common Data Model
Data Model describe the data elements and their relations
Common for hospital pharmacy and community pharmacy
Derived from the model: HL7v2 messages and CDA documents
HL7v3 CDA
Pharmacy CMETs

12. cycle
CMPD
PRE
PADV
DIS
HMW

13. Community Pharmacy profiles
Existing Profiles with High Uptake
CMPD (Community Medication Prescription and Dispense)
Basic use case
GP prescribes
Someone 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

14. CMPD actor diagram

15. CMPD Workflow scenario
Prescription Placer
Pharmaceutical Adviser
Medication Dispenser
Ordering
Next task:
„Validation“
Validation
Next task:
„Dispensing“
Dispensing
Condition: Always
Condition: if PADV exists with
statusCode=completed
AND
code=OK or CHANGE
Next task:
„Ordering“
Condition: if PADV exists with
statusCode=completed
AND
code=REFUSE
Stop
Condition: if PADV exists with
statusCode=completed
AND
code=CANCEL
PHARM-1, Query: FindPrescriptionsForValidation
PHARM-1 , Query:
FindPrescriptionsForDispense
Prescription document contains at least one Prescription Item ready to be validated.
A Prescription Item is ready to validate if there exists no Pharmaceutical Advice Item related to it which has statusCode set to “completed”.
Prescription document contains at least one Prescription Item ready to be dispensed.
A Prescription Item is ready to dispense if there exists a Pharmaceutical Advice Item related to it which has statusCode set to “completed” and code=OK or CHANGE.

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

17. Hospital Pharmacy profiles
Existing Profiles with High Uptake
HMW
Basic use case:
Hospital physician prescribe in a ward
Hospital pharmacist review orders
Pharmacy technician dispense
Nurse administers drugs to the patient
Systems it would impact:
Prescription placer
Pharmaceutical advisor
Medication dispenser
Medication administration informer
Based on HL7 v2.x:
Message based to fit into hospital environment
4/19/2017 17

18. HMW actor diagram

19. HMW Interoperability Model

20. Becoming real … European Union: epSOS
Definition of prescription and dispense document aligned
Austria / Europe: e-Medication project
Adoption of PRE und DIS specifications in pilot
Full adoption for rollout
Italy / Europe: DOGE project
Venice region (5 million inhabitants)

21. Roadmap Current work-items Upcoming work-items Medication record
Aka „Medication documentation“ / „Medication treatment plan“
Cross-domain work with other IHE domains and HL7
Exceptional cases
Extension of use-cases in CMPD and HMW
Whitepaper: Supply chain in Hospital Pharmacy
Whitepaper: Transition „Community – Hospital“
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
Supply is part of the demo!!
Wording: „This topic is part of the demo, which shows interoperability exchanges in a hospital environment. For completeness the showcase currently uses common HL7 messages, however IHE Pharmacy have taken upon themselves to create a formal profile to cover this area“.

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

23. Thank you Jürgen Brandstätter IHE Pharmacy co-chair
IHE Austria Mitgliederversammlung 2008
IHE Austria
Thank you
Jürgen Brandstätter
IHE Pharmacy co-chair
CodeWerk Software Services and Development GmbH
IHE Austria, Schiffamtsgasse 15, 1020 Wien
IHE Austria, Schiffamtsgasse 15, 1020 Wien 23 23