1. Interoperability Shining Across a Connected Nation HL7-IHE Demonstration HIMSS 2004

2. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 Brought to you by… Health Level Seven –Model-based standards for healthcare Integrating the Healthcare Enterprise –Integration Profiles for healthcare

3. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 Participants Members of HL7 & IHE participants fielding technical applications

4. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 Partners Supporting organizations providing expertise, technology and guidance

5. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 Sponsors Members of HL7 & IHE providing financial support

6. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 What is it? A laboratory and a test-bed for standards development and implementation An opportunity to deploy and debug new and emerging standards-based solutions A vehicle to communicate to industry how standards have evolved, what problems they solve and what work remains to be done

7. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 How is the demo created? Open participation –Membership in HL7 &/or IHE required –Supported by participation fees and host organizations Design criteria –Participants choose what to put into play –Must utilize an HL7 standard, draft standard or IHE Integration Profile

8. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 How is it all put together? Virtual healthcare IT community by the numbers: –10k+ conference call minutes –100+ Email listserver –5-day January 2004 Connectathon –4-member Demo Executive Committee from HL7 & IHE –2-day September 2003 workshop –1 very patient Technical Manager –1/2 overworked Project Director

9. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 What is there to see? Standards & Profiles in support of: –Continuity of Care –Patient Safety –Public Health –Clinical Trials Each of these illustrated in a scenario based on actual case or protocol

10. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 How are the scenarios developed? Careful planning –Written by physicians drawing from actual cases –Participants volunteer to support aspects of one or more scenarios plus… Spontaneous combustion –brokered claims attachments –third party document discovery, retrieval Incendiary actions –hyperlinking documents and PACS images –distributed repositories, central registry

11. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 The Scenarios Continuity of Care Clinical Trials Patient Safety Public Health

12. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 Continuity of Care Follows a patient from primary care through surgery and back again Traces outpatient, inpatient and consulting radiologists’ reports, the surgeon’s note and the pathologist’s report Path report becomes a cancer registry tumor report

13. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 Clinical Trials Patients enrolled in an ECG clinical trial are monitored wherever they receive care Data collected at multiple sites –heterogeneous applications –annotated onsite or –submitted for annotation at the core lab –sponsor monitoring for adverse events gets background information on blinded study subjects through a third-party broker

14. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 Patient Safety Adverse drug-drug interaction caught using online guidelines Reported to the FDA –contraindication can be published on the product insert and –incorporated into decision support modules. Further harm averted when Web-based Medical Logic Modules incorporated into clinical systems Clinical systems coordinated by patient context management for continuity across ED and inpatient settings

15. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 Public Health Patient presents at ED with acute respiratory difficulty –Botulism suspected Physician observations and laboratory results trigger release of anti-toxin by state health officials Case is confirmed and reported to the Centers for Disease Control and Prevention

16. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 Highlights From liora’s press conference slides and/or press release copy

17. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3

18. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 Report Card tbs

19. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 Special thanks to Mallinckrodt Institute of Radiology –Patient Identifier Cross Referencing (PIX) server Fred Behlen, Laitek Technologies –DICOM SR to CDA transformation The SIMI Group –State Department of Health application Michael Palmer, Zurich Biotech –SAS to ODM conversion NorthEast Monitoring –Corelab software integrating aECGs CSS Informatics –FDA Patient Profile Viewer AMPS –FDA aECG Viewer Amnon Shabo, IBM Haifa –Sample CDA Botulism Case Report Data Conversion Labs –Sample Structured Product Labeling transformation

20. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 Participants logos

21. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 Invitation to Tour Guided Tours start on the quarter hour Self-guided Tours anytime –M–Maps available at Reception Complete a tour, win a prize –G–Get each location initialled by participant –G–Go to reception with completed map –E–Enter a business card to win HL7 Working Group Registration (drawing 1/day) HIMSS 2005 Registration (drawing 1/week)

22. GE RA600 Guided tours on the quarter hour; Self-guided tours any time Take A Tour, Win A Prize! Get a stamp at every stop on a tour Take stamped Tour Guide to receptionist Enter to win a Prize! -HL7 Registration or -HIMSS 2005 Registration Continuity of Care Tour Clinical Trials Tour Patient Safety Tour Public Health Tour aECG Annotated ECG (V3) 4, 16, 19, 20,21, 27 Arden Arden Syntax Medical Logic Modules 17, 19, 26 CCOW Clinical Context Object Workgroup 1,14, 15, 17, 18, 28, 29, 30 CDA Clinical Document Architecture (RIM) 2, 6, 7, 9, 10, 11, 12, 13, 20, 22, 23, 24, 25, 26, 32 CT Integration Profile for Consistent Time 1, 2, 18, 30 EUA Enterprise User Authentication (Kerberos) 1, 2, 14, 18, 28, 30 Integration Profiles: 1, 2, 3, 6, 8, 10, 11, 14, 15, 18, 28, 29, 30, 31 LDM Lab Data Model (V3, CDISC) 20 ODM Operational Data Model (CDISC) 20, 21 PIX Patient Identifier Cross Referencing (V2) 1, 11 PSA Patient Synchronized Application (CCOW) 1, 14, 18,28, 29, 30, RID Retrieve Information for Display 1,8, 10,11,15,18,29, 30 RIM Reference Information Model (V3) 2, 4,6, 7, 9, 10, 11, 12, 13, 16,19,20,21, 22, 23, 24, 25, 26, 27,32 SDS Submissions Data Standard (CDISC) 20, 21 SPL Structured Product Label (CDA) 19 SWF Scheduled Work Flow (V2, DICOM) 1,2,3,29,31 V2 Version 2 messaging 1,5,6, 8, 9,11,12,17,18,22,25,26,32 V3 Version 3 messaging 4,9,10,11,16,19,20,21,22,24,27,32 Start GE CWeb Kodak GE Solar Carefx/GE Mortara GE ED Eclipsys DigitalInfuzion DCRI CDC/ UCDavis Philips Adobe Epic GE CPortal Sentillion INFINITT Ximis Kryptiq CommerceNet MS InfoPath GE MUSE ACP/FDA NIST Start Berdy MS BTS Raining Data Dictaphone Soarian SNOMED Siemens OL 1 2 3 T H E A T E R C L A S S R O O M Misys 4 5 6 7 8 9 13 10 12 11 232425 2627 282930 31 32 21 22 14 15 1817 16 19 20 AISLE Tour Guide HL7-IHE Interoperability Demonstration Booth 4638

23. Adobe Berdy Carefx CommerceNet DCRI Dictaphone Digital Infuzion Eclipsys Epic GE Heartlab IBM INFINITT Kodak Kryptiq Microsoft Misys Mortara NIST Philips Raining Data Sentillion Siemens SNOMED XIMIS aECG Arden CCOW CDA CT EUA LDM ODM PIX PSA RID RIM SDM SPL SWF V2 V3 The theatre: Monday Welcome/Intro every half-hour 2:10 Virtual Tour: Clinical Trials Scenario 2:40 Commentary: Demo Highlights and Report Card 3:10 Virtual Tour: Patient Safety Scenario 3:40 Commentary: The HL7-IHE Demo as an Electronic Health Record Implementation, Ed Larsen, HIMSS 4:10 Virtual Tour: Continuity of Care Scenario 4:40 Commentary: Continuity of Care, a Physician’s Perspective, Dr. Thomas Sullivan, Massachusetts Medical Society 5:10 Virtual Tour: Public Health Scenario, Dr. Cecil Lynch, UC Davis 5:40 Commentary: Standards for Public Health Reporting, a CDC Perspective, Dr. Daniel Pollock