1. Sept 13-15, 2004IHE Interoperability Workshop 1 Integrating the Healthcare Enterprise Overview of IHE IT Infrastructure Patient Synchronized Applications (PSA) Integration Profile Didi Davis, Director Eclipsys Corporation Co-chair - IHE IT Infrastructure Planning Committee

2. Sept 13-15, 2004IHE Interoperability Workshop 2 IHE IT Infrastructure 2004-2005 Enterprise User Authentication Provide users a single name and centralized authentication process across all systems Retrieve Information for Display Access a patient’s clinical information and documents in a format ready to be presented to the requesting user Retrieve Information for Display Access a patient’s clinical information and documents in a format ready to be presented to the requesting user Patient Identifier Cross-referencing for MPI Map patient identifiers across independent identification domains Patient Identifier Cross-referencing for MPI Map patient identifiers across independent identification domains Synchronize multiple applications on a desktop to the same patient Patient Synchronized Applications 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. New Patient Demographics Query New Personnel White Page Access to workforce contact information New Cross-Enterprise Document Sharing Registration, distribution and access across health enterprises of clinical documents forming a patient electronic health record New

3. Sept 13-15, 2004IHE Interoperability Workshop 3 IHE IT Infrastructure 2004-2005 Enterprise User Authentication Provide users a single name and centralized authentication process across all systems Retrieve Information for Display Access a patient’s clinical information and documents in a format ready to be presented to the requesting user Retrieve Information for Display Access a patient’s clinical information and documents in a format ready to be presented to the requesting user Patient Identifier Cross-referencing for MPI Map patient identifiers across independent identification domains Patient Identifier Cross-referencing for MPI Map patient identifiers across independent identification domains Synchronize multiple applications on a desktop to the same patient Patient Synchronized Applications 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. New Patient Demographics Query New Personnel White Page Access to workforce contact information New Cross-Enterprise Document Sharing Registration, distribution and access across health enterprises of clinical documents forming a patient electronic health record New Synchronize multiple applications on a desktop to the same patient Patient Synchronized Applications

4. Sept 13-15, 2004IHE Interoperability Workshop 4 Abstract / Scope Patient Synchronization of Multiple Disparate Applications Single Patient Selection When combined with PIX Profile, allows patient synchronization across patient identifier domains When combined with EUA Profile, provides user Single Sign-on (SSO) Patient Synchronized Applications

5. Sept 13-15, 2004IHE Interoperability Workshop 5 Value Proposition: User Convenience:  Eliminates the repetitive task of selecting the patient in each application  Permits the user to select the patient in the application for which they are most familiar and / or appropriate to the clinical workflow Patient Safety:  Ensures all data being viewed across applications is for the same patient Leverage Single Development Effort:  Allows vendors to leverage single CCOW enablement effort to support multiple actors: Patient Context Participant (PSA) User Context Participant (EUA) Patient Synchronized Applications

6. Sept 13-15, 2004IHE Interoperability Workshop 6 Context Manager Patient Context Participant Actor Context Manager Actor

7. Sept 13-15, 2004IHE Interoperability Workshop 7 Key Technical Properties: Standards Used:  HL7 Context Management “CCOW” Standard, Version 1.4  Support for both Windows and Web Technology  Support of “Patient Subject” IHE Constraints:  Specifies use of Patient.Id.IdList item Ensures maximum interoperability with PIX Profile Protects against future deprecation of patient identifier items Patient Synchronized Applications

8. Sept 13-15, 2004IHE Interoperability Workshop 8 Transaction Diagram Patient Synchronized Applications

9. Sept 13-15, 2004IHE Interoperability Workshop 9 Patient Synchronized Applications

10. Sept 13-15, 2004IHE Interoperability Workshop 10 Patient Synchronized Applications Synergies with Demonstration Scenarios Need Scenario to further define…ellicit input from group.

11. Sept 13-15, 2004IHE Interoperability Workshop 11 Bridging Diverse Technologies Web Client/Server Legacy WE NEED A CUSTOMER QUOTE IF POSSIBLE….ANY IDEAS WHO IF ANYONE HAS IMPLEMENTED? “The primary barrier preventing successful implementation of Web-based technologies is integration with existing, already-diverse healthcare IT infrastructures. Context management—founded on the HL7 CCOW standard—is the most effective, practical way to eliminate this barrier.” Landen Bain, CIO Duke University Medical Center

12. Sept 13-15, 2004IHE Interoperability Workshop 12 Enabling EMPI with IHE Questions?

13. Sept 13-15, 2004IHE Interoperability Workshop 13 CONTEXT MANGEMENT Enable caregivers to access synchronized patient information from diverse applications Dramatically enhance workflow for caregivers’ throughout the enterprise Improve caregiver satisfaction and productivity Increase patient safety and minimize risk through “single patient selection” Enable Different Applications from Different Vendors to Work As One

14. Sept 13-15, 2004IHE Interoperability Workshop 14 More information…. IHE Web sites: http://www.himss.org/IHE http://www.rsna.org/IHE http://www.acc.org/quality/ihe.htmhttp://www.acc.org/quality/ihe.htm. Technical Frameworks: ITI V1.0, RAD V5.5, LAB V1.0 Technical Framework Supplements - Trial Implementation May 2004: Radiology August 2004: Cardiology, IT Infrastructure Non-Technical Brochures : Calls for Participation IHE Fact Sheet and FAQ IHE Integration Profiles: Guidelines for Buyers IHE Connect-a-thon Results Vendor Products Integration Statements