IHE USAPresents the North American

IHE Connectathon17-21 January, 2011 Chicago

The first formal activity of the newly incorporated non-profit IHE USA, the official IHE International National Deployment Committee for the United

States!

Please set your cell phones on “stun!”

Elliot B. Sloane, PhD, CCE, FHIMSS Drexel University, Health Systems Engineering Director Founder, Center for Healthcare Information Research and Policy Board of Directors, IHE-USA Co-Chair, IHE International Board of Directors, Delaware Valley HIMSS Past Chair, HIMSS Security and Privacy Steering Committee Sponsor, IEEE 11073 Medical Informatics Standards

Interoperability,Health Information Security,

and Medical Devices,

IHE USA• Incorporated in 2010 as an independent non-profit

agency in the state of Illinois, and is filing with the IRS as a 501(c)(3) educational foundation

• Legally independent, and separate Board of Directors, from HIMSS, RSNA, and IHE International

• Receives donations, tuition, membership and Connectathon fees, and grant funding

• Provides educational, teaching, and research grants and scholarships, and

• Pays for the development and dissemination of critical Open Source, free testing and implementation tools for hospitals, government agencies, and manufacturers

• The first IHE USA membership drive is just starting!– Small and large institutions, plus individuals

IHE International oversees the creation of detailed guidelines that use multiple standards to build interoperable health IT systems.

IHE International also coordinates the activities of national and regional deployment committees worldwide, such as IHE USA.

IHE USA is recognized by IHE International as the national deployment committee for the United States.

IHE USA's role is to serve as the voice for US health IT interests and foster national adoption of information standards to enable interoperability

IHE USA supports HHS & ONC

IHE USA exists to serve America’s healthcare needs.

It does its very best to discover and support synergies and efficiencies in HIT standards

development and deployment, and to eliminate waste, redundancy, and unnecessary and

wasteful conflict.

IHE USA is NOT the same as IHE Europe or IHE Oceania-Asia

The US healthcare market uses different coding standards, is based on a privatized business and insurance models, has very different clinical delivery processes, and has its own unique legal and regulatory

framework.e.g., IHE USA still supports ICD-9 coding because that

is stipulated in the HIPAA 4010 standards.

US laws and practices drive IHE USA, not IHE International or other National Domains

IHE USA adapts well developed global standards to solve US

challenges where efficient and appropriate

• e.g., DICOM, IEEE 11073, HL-7, ICD-9, ICD-10 are all well-recognized international standards.

• CPT, LOINC, SNOMED, and UMLS are US-centric• Though many countries have national patient

identifiers, but IHE USA supports the US patient-matching model using multi-factor patient identification

IHE USA leverages well-tested modular core IHE services to meet US needs

• e.g., IHE’s “Consistent Time” Integration Profile assures that all records in and from all computer systems inside and outside of the hospital can synchronize the timestamps each clinical and business document

• IHE’s XDS (Cross Enterprise Document Sharing) Integration Profile allows documents to be reliably and securely shared anywhere in the healthcare enterprise.

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Our testing results are public and Our testing results are public and IHE-Profile-specificIHE-Profile-specific

www.ihe.net/Connectathonwww.ihe.net/Connectathon

Examples of Integration Profiles that were tested and verified in the 2010 Connectathon

Companies that tested the IHE Integration Profiles in the 2010 Connectathon

Pathologysince 2006

Radiation Oncologysince 2004

Radiologysince 1998

Cardiologysince 2004

Patient Care Devicessince 2005

Patient Care Coordinationsince 2004

Eye Caresince 2006

QualityResearch & Public Health

since 2006

Laboratorysince 2004

(Healthcare)IT Infrastructure

since 2003

PharmacySince 2009

DentistrySince 2010

ALL IHE clinical domains share the 50+ integration profiles!

IHE: Ever-growing since 1998.

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12-yr International Growth of IHE12-yr International Growth of IHE

FranceFrance

Local Deployment, National Extensions Promotional & Live Demonstration Events The IHE Integration Profiles may be extended for

local requirements

USAUSA

GermanyGermany

ItalyItaly

JapanJapanUKUK

CanadaCanadaTaiwanTaiwan

NetherlandsNetherlandsSpainSpain

AustriaAustria

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99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

09

Pragmatic global standards harmonization + best practices sharing Pragmatic global standards harmonization + best practices sharing

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AustraliaAustralia

20

10

ChinaChina

TurkeyTurkey

MalaysiaMalaysia

SwitzerlandSwitzerland

USAUSA

Most of the 55+ IntegrationProfiles are re-used around the globe!

Document Exchange Integration ProfilesDocument Exchange Integration Profiles

DocumentDocument SharingSharing

XDS / XCAXDS / XCA

MediaMediaInterchangeInterchange

XDMXDM

Reliable Pt-PtReliable Pt-PtInterchangeInterchange

XDRXDR

Doc Content Profiles Doc Content Profiles (HL7 CDA, DICOM Semantics content)(HL7 CDA, DICOM Semantics content)Scanned DocScanned Doc

XDS-SDXDS-SD

LaboratoryLaboratory

XD*-LabXD*-LabPHR PHR

ExchangeExchange

XPHRXPHR

Discharge &Discharge &ReferralsReferrals

XDS-MSXDS-MS

ImagingImaging

XDS-IXDS-I

ConsentConsent

BPPCBPPCEmergencyEmergency

EDREDRPre-Pre-

SurgerySurgery

PPHPPPHP

Functional Status Functional Status AssessmentAssessment

FSAFSA

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How real is IHE XDS ?How real is IHE XDS ?• Stable specification, tested by 100 vendorsStable specification, tested by 100 vendors• First implementation in clinical use in region of Genoa - First implementation in clinical use in region of Genoa -

Italy) since early 2006.Italy) since early 2006.• Several since: Three Austria regions, Applications in Several since: Three Austria regions, Applications in

Vermont, Pennsylvania, Nagoya city, South Africa region, Vermont, Pennsylvania, Nagoya city, South Africa region, Italian & Dutch regions, France, etc.Italian & Dutch regions, France, etc.

• Adopted by several national programs world-wideAdopted by several national programs world-wide• 4 open source toolkits available, numerous product 4 open source toolkits available, numerous product

implementations in EMRs and Infrastructure offerings.implementations in EMRs and Infrastructure offerings.

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IHE, Global Standards-Based Profiles IHE, Global Standards-Based Profiles Adopted in National & Regional Projects (sample)Adopted in National & Regional Projects (sample)

Quebec, Toronto,Alberta, British ColumbiaCanada Infoway

THINC- New YorkNCHICA – N. Carolina

Italy Conto CorrenteVenetto - Friuli

Boston Medical

Center - MA

CHINA-MoHLab results sharing

CHINA-ShanghaiImaging Info Sharing

JAPAN-NagoyaImaging Info Sharing,

Nationwide PDI guideline

South Africa

VITL-Vermont

CareSpark – TN & VA

NETHERLANDSFriesland

Natn’l Mamography

LowerAustria

Austria

FranceDMPWales

Imaging

BelgiumFlemish-Leuven

SuisseSt GallenLausane

Providence Health

System - OR

GeisingerKeyHIE

Pennsylvania

SHARP CA

France Imaging

IDF

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For more complete list see:For more complete list see: tinyurl.com/wwXDS tinyurl.com/wwXDS

At IHE, progress for patient care never stops!

Connecting Medical Devices to the Electronic Health Record is my personal passion

• IHE-PCD: IHE Patient Care Device Domain Committee• Have spent almost a decade developing integration

profiles that allow medical and personal health devices to send vital signs data automatically, accurately, and securely in a medical record that can be read and stored in any EMR that can interpret an XML HL-7 v2.6 document

In 2010, the IHE-PCD and Continua-WAN specifications were finally aligned, and a SINGLE data standard is now used by ALL devices to load clinical data directly from any device

into the EMR

The IHE-PCD, Continua-WAN, and IHE EMR interfaces will be proven here this

week for the first time!

HospitalsDr. Office

Nursing Homes|

FDA-regulated Medical Devices

|Home Care

Personal Health

Devices|

Home Care

Finally, a cross-enterprise labor-, error-, and delay-saving breakthrough for patient

monitoring!The new IHE-PCD and Continua-WAN compatible interface

allows flexible home monitoring, hospital monitoring, EMS monitoring, and alternate-site care monitoring

with interchangeable, interoperable devices that can ALL load clinical data DIRECTLY to the EMR.

We have ONC and Dr. John Halamka to thank: they asked for a single solution in 2008, so

we developed one!

We are pleased to have Dr. Doug Fridsma with us today

• Gives us the opportunity to expand the discussion about how IHE USA can best support him and his colleagues at ONC.

• e.g., how can IHE’s resources best support Meaningful Use Phases 1, 2, and 3?

• e.g., how can IHE’s resources best support the newly emerging S&I Framework?

IHE USA supports the new ONC Standards and Infrastructure (S&I) Lifecycle.

IHE Connectathon & Showcases (late fall and winter)

IHE Testing & Tools Development (late spring and summer)

IHE Domain Committee draft profile (winter and spring)

IHE Domain Committee & workgroup meetings (early Fall)

IHE Domain Committee new work product proposal reviews (late summer)

e.g., Can IHE align its process and priorities to better support ONC?

IHE supports the new ONC IEPD artifacts: can some of IHE’s artifacts be useful?

Information Exchange Package Documention

Can IHE USA work together with ONC to accommodate the National Information Exchange Model (NIEM)?

IHE is Powered by VolunteersThe nation salutes Dr. King each

year with a Day of Service.IHE’s Volunteers donate tens of

thousands of hours, day by day, year by year, to one shared dream: to create a world that will improve patient care by ensuring health data is secure, interoperable, complete, and readily available at the point and moment of care, regardless of location.

Thank you to ALL of our volunteers!

The Connectathon monitors you will meet today are all volunteers.

Rich Set of FREE Open Source Tools and Resources!1 Implementation Guidance 2 Implementation Tools

2.1 Development Tools 2.1.1 IHE Integration Profiles 2.1.2 OHT IHE Profiles

2.2 Test Tools 2.2.1 MESA 2.2.2 Laika 2.2.3 Gazelle Test Management Tool 2.2.4 Patient Care Device Testing Tools 2.2.5 HL7 V2 Toolkit 2.2.6 EVS Message Validation Toolkit 2.2.7 XDS Toolkit 2.2.8 XDS-I and PIX/PDQv3 Testing Tools 2.2.9 DICOMScope Visualization Tools (MESA Consistent Image Presentation) 2.2.10 Portable Data for Imaging Disk Validator 2.2.11 IHE-RO Test Tools

2.3 Test Tools by Profile and Actor3 Sample Files/Objects/Messages/Data

http://wiki.ihe.net/index.php?title=Implementation

FREE Open Source medical device IHE-ready XML test tools from the US Government - NIST

NIST has developed an Implementation Conformance Statement (ICS) generator tool called ICSGenerator to facilitate creation of vendor conformance statements that would be applicable to testing a particular ISO/IEEE 11073 (X73) device. Additionally, NIST has completed initial development of a ValidatePDU tool, a tool that provides basic syntax and structure check and low level semantic checks for one or more captured messages. Both tools utilize the electronic representation of the X73 standard's information model implemented by NIST researchers in the form of an XML schema.. Medical device test message generation is also possible to enable future manager/agent conformance test scenarios.

http://xw2k.nist.gov/medicaldevices/testtools.html

Large Library of Free IHE Educational Webinars

Each month since 2008 were – and are – presented on topics including IHE, Interoperability, the IHE North America Connectathon, the HIMSS Interoperability Showcase, and a detailed review of profile supplements developed this year in

IHE's twelve active domains!

The Webinar schedule and links to free registration for upcoming sessions are below. Copies of slides are provided for sessions already presented. Video

recordings of the sessions will be made available shortly. Additional Webinar sessions will be posted throughout the summer as dates are confirmed. Past IHE

Webinar Series

http://www.ihe.net/Events/webinars2010.cfm

We are IHE USA, and we’re here to serve.

Welcome to the IHE Connectathon, and welcome to the ongoing conversation with our vibrant

IHE USA professional community.

Devoted to changing the way the healthcare world connects!