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September, 2005What IHE Delivers 1 IHE in regional and national Health Information Exchanges around the WORLD AsiaPac Interoperability Showcase April 2008.

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Presentation on theme: "September, 2005What IHE Delivers 1 IHE in regional and national Health Information Exchanges around the WORLD AsiaPac Interoperability Showcase April 2008."— Presentation transcript:

1 September, 2005What IHE Delivers 1 IHE in regional and national Health Information Exchanges around the WORLD AsiaPac Interoperability Showcase April 2008 Didi Davis, Sr. Director, IHE, HIMSS

2 22 International Growth of IHE France Local Deployment National Extensions Promotional & Live Demonstration Events Funding USAGermanyItalyJapanUKCanadaKoreaTaiwanNorway Netherlands Spain ChinaAustria 1999 2000 2001200220032004 200520062007 2088 Pragmatic global standards harmonization + best practices sharing Australia

3 33 IHE Organizational Structure Contributing & Participating Vendors IHE Europe IHE North America France USA Canada IHE Asia-Oceania Japan KoreaTaiwan Netherlands Spain Sweden UK Italy Germany Norway China Austria ACC ACCE ACEP JAHIS JIRA JRS METI-MLHW MEDIS-DC JAMI RSNA SFR SFIL SIRM BIR EuroRec COCIR EAR-ECR DRG ESC Professional Societies / Sponsors ACP GMSI HIMSS IHE International Board Regional Deployment Global Development Radiology Cardiology IT Infrastructure Patient Care Coordination Patient Care Devices Laboratory Pathology Eye CareRadiation Oncology Public Health, Quality and Research

4 4 National and Regional projects It is difficult to provide a simple summary view of these projects: These slides reflect information publicly available and current based on authors knowledge. IHE offers 24 Integration & Content profiles applicable in health information exchange for communities, regions or nations. Each project discussed here uses different subsets of these profiles (IHE Modularity). These projects are multi-year and projects with complex decision making processes.

5 5 Categories of Healthcare Communication Services Most HIEs in the World chose to start with Document Sharing 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

6 6 Sharing and Accessing Electronic Health Records IHE offers interoperability for local, regional, specific, or national health information exchange Goal is to enable exchange between providers clinical and administrative systems and ancillary IT systems (EHRs,Lab, Pharma, Payers, etc.) and personal health record systems. Objective is to empower the consumers in having shared EHR information between all of its potential healthcare providers (if authorized) and self. Objective is to empower the providers in choosing when and what information to share, and to trust the information they may use in the care of their patients.

7 7 Community or sub-network Clinical Encounter Clinical IT System Sharing System Clinic Record Specialist Record Hospital Record Introduced at HIMSS in 2005 : IHE-XDS 1-Reference to records Repository of Documents Index of patients records

8 8 Community or sub-network Clinical Encounter Clinical IT System Aggregate Patient Info 4-Patient data presented to Physician Sharing System Clinic Record Specialist Record Hospital Record 2-Reference to Records for Inquiry Introduced at HIMSS in 2005 : IHE-XDS 3-RecordsReturned 1-Reference to records Repository of Documents Index of patients records

9 9 IHE Integration Profiles for Health Info Nets What is available and has been added in 2007 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 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 Final Text Approved Trial Implementation-2007 – Final Txt 2008 Cross-Enterprise Document Sharing Registration, distribution and access across health enterprises of clinical documents forming a longitudinal record Cross-Enterprise Document Pt-Pt Reliable Interchange Cross-Enterprise Document Media Interchange Cross-Community Access Security & Privacy 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 origin Cross-Enterprise User Attestation User Attributes fro Access Control

10 10 IHE, global standards-based profiles adopted by several national & regional projects Quebec, Toronto, Alberta, British Columbia Canada Infoway Denmark (Funen) Italy (Veneto) Spain (Aragon) NCHICA – N. Carolina Italy (Conto Corrente Salute) Boston Medical Center - MA France DMP UK CfH (Radiology WF) Philadelphia HIE CHINA-MoH Lab results sharing KeyHIE – Pennsylvania CHINA-Shanghai Imaging Info Sharing JAPAN-Nagoya Imaging Info Sharing South Africa Malaysia Singapore VITL-Vermont CareSpark – TN & VA Netherland Amsterdam Lower Austria

11 11 Italy (Genoa Region)

12 12 Italy (Genoa Region) In service since January 2006. 4 Hospitals and 500 physician offices. EMRs import and export documents from their local records. All vendor products required to pass IHE-Europe connectathon in April 2005. Patients chose to join through one of their care provider Infrastructure includes: XDS Registry XDS Registry XDS Repository shared at the regional level XDS Repository shared at the regional level PIX for patient Id linking PIX for patient Id linking Doc content is CDA with PDF content. Plan in place to move to CDA rel 2 with structured data. IHE (XD*-Lab) CDA Lab primary candidate. Doc content is CDA with PDF content. Plan in place to move to CDA rel 2 with structured data. IHE (XD*-Lab) CDA Lab primary candidate.

13 13 Austria (Lower Austria and National) Lower Austria Region (around Vienna) Deployed in 2007 - Operational. 1.5 Million patients on-line. 11 hospitals connected. Use IHE profiles: XDS, PIX, XDS-SD, ATNA, XUA, BPPC. National project launched in 2007 (ELGA). Given the success to deploy the first region is about one year. Roll-out includes: Ministry backing of IHE conformance (IHE-Eu Connectathon) Ministry backing of IHE conformance (IHE-Eu Connectathon) Extending to Ambulatory Physicians in 2008 Extending to Ambulatory Physicians in 2008 Step-wise introduction of structured and coded content with HL7 CDA based IHE Content Profiles. Step-wise introduction of structured and coded content with HL7 CDA based IHE Content Profiles. Lower Austria

14 14 USA (Philapdelphia Region) Philadelphia Health Info Exchange in service since 2005. Focused on images and reports sharing. 5 Hospitals + Imaging Center + Public Health The Hospital of the University of Pennsylvania The Hospital of the University of Pennsylvania Thomas Jefferson University Hospital Thomas Jefferson University Hospital Childrens Hospital of Philadelphia Childrens Hospital of Philadelphia Presbyterian Medical Center Presbyterian Medical Center Pennsylvania Hospital Pennsylvania Hospital UPHS Community Radiology UPHS Community Radiology Philadelphia Department of Public Health Philadelphia Department of Public Health Migration to XDS, ATNA, PIX and XDS-I completed in 2007. Demonstrated live at RSNA-Chicago Nov 2007

15 15 USA (Other) HITSP (HHS sponsored) accepted 8 IHE Integration profiles for: Lab results distribution and sharing, Registration and Medication History for Consumers, Biosurveillance. 2 NHIN-1 Pilots (CSC and IBM) leveraged IHE profiles (Med Summaries and Lab). South Shore, MA: Operational (Inpatient and Emergency Dept) NHIN-2 Trial Implementations (NCHICA, Virginia & CareSpark HIEs) Several HIEs projects are actively planning the use of IHE Vermont State Vermont State KeyHIE (PA) KeyHIE (PA) eHealthConnecticut eHealthConnecticut Boston Medical Center and affiliated clinics Boston Medical Center and affiliated clinics

16 16 Canada Canada Health Infoway: national Commitment to XDS/XDS- I for imaging sharing 3 infrastructure tenders awarded in 2007 and 1 more to come early 2008 resulting in over 1/3 of Canadian patients covered: Toronto East Network - Ontario Toronto East Network - Ontario Montreal McGill - Quebec Montreal McGill - Quebec Alberta Alberta British Columbia British Columbia Includes XDS, ATNA, PIX and XDS-I. Planned to become live 2008 in Quebec, Ontario, Alberta, British Columbia.

17 17 France (National DMP) Prototype RFP call for tender mid-2005. Confirmed requirement to use to IHE profiles: XDS, ATNA, XUA, BPPC, etc. Encourage vendors to submit their products to the IHE- Europe Connectathon (April 2007-Berlin). Implementation plan under revision. Infrastructure to include: XUA from User Authentication Portal and BPPC for privacy XUA from User Authentication Portal and BPPC for privacy XDS Registry/XDS Repositories XDS Registry/XDS Repositories ATNA for audit trail and node authentication. ATNA for audit trail and node authentication. Doc content to be: CDA rel 2 patient summary (close to XDS-MS), Hprim with migration to IHE XD*-Lab for Lab, Scanned Doc (PDF) and imaging (XDS-I). Doc content to be: CDA rel 2 patient summary (close to XDS-MS), Hprim with migration to IHE XD*-Lab for Lab, Scanned Doc (PDF) and imaging (XDS-I).

18 18 Other Commitments China MoH selected XDS and XD*-Lab (CDA) for lab info sharing. MoH selected XDS and XD*-Lab (CDA) for lab info sharing. XDS-I in Shanghai. XDS-I in Shanghai. Israel, Jordan, Palestinian Authority Public Health Info Affinity Domain (XDS, ATNA, XD*Lab) Public Health Info Affinity Domain (XDS, ATNA, XD*Lab) Middle east Consortium for infectious Disease Surveillance Middle east Consortium for infectious Disease SurveillanceNetherlands Amsterdam region network project launched 2007. XDS-I. Amsterdam region network project launched 2007. XDS-I.Japan Nagoya region network project operational late 2007. XDS, XDS-I Nagoya region network project operational late 2007. XDS, XDS-I Kobe with imaging info sharing Kobe with imaging info sharing South Africa National project launched in 2007. Tender awarded. Operational in 2008. National project launched in 2007. Tender awarded. Operational in 2008.

19 19 IHE, global standards-based profiles adopted by several national & regional projects Quebec, Toronto, Alberta, British Columbia Canada Infoway Denmark (Funen) Italy (Veneto) Spain (Aragon) NCHICA – N. Carolina Italy (Conto Corrente Salute) Boston Medical Center - MA France DMP UK CfH (Radiology WF) Philadelphia HIE CHINA-MoH Lab results sharing KeyHIE – Pennsylvania CHINA-Shanghai Imaging Info Sharing JAPAN-Nagoya Imaging Info Sharing South Africa Malaysia Singapore VITL-Vermont CareSpark – TN & VA Netherland Amsterdam Lower Austria

20 September, 2005What IHE Delivers 20


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