September, 2005 What IHE Delivers

Chris Lindop, Chris Lindop, GE healthcareGE healthcare

IHE Co-chair radiology PC,IHE Co-chair radiology PC,

IHE Australia-Asia/Pacific liaison IHE Australia-Asia/Pacific liaison

HIMSS Asia Pac 2008, Hong KongHIMSS Asia Pac 2008, Hong Kong

IHE AustraliaIHE Australia

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Presentation ObjectivesPresentation Objectives

IHE Australia, OverviewIHE Australia, Overview

HistoryHistory

2008 plans2008 plans

How to participateHow to participate

33

International Adoption of IHEInternational Adoption of IHE

France

Local Deployment National Extensions (Local Adaptions) Promotional & Live Demonstration Events Conformance Testing

USA

Germany

Italy

JapanUK

Canada

Korea

Taiwan

Norway

Holland

SpainChina

Yea

r 1

(199

9)

Yea

r 2

(200

0)

Yea

r 3

(200

1)

Yea

r 4

(200

2)

Yea

r 5

(200

3)

Yea

r 6

(200

4)

Yea

r 7

(200

5)

Yea

r 8

(200

6)

Yea

r 9

(200

7)

Yea

r 10

(2

008)

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

Australia

44

IHE Organizational StructureIHE Organizational Structure

ACCACPHIMSSRSNA

JAHISJIRAJRS

METI-MLHWMEDIS-DCJAMI

GMSIHSFRSFIL

SIRMBIREuroRec

COCIREAR-ECRDRG

ESC

Professional Societies / Sponsors Contributing &Participating

Vendors

Global Development

Radiology

Cardiology

ITInfrastructure

Patient CareCoordination

Patient CareDevices

Laboratory

Pathology

Eye care, Quality, etc.

RadiationOncology

IHE Pacific Australia

IHE International

IHE Europe

IHE North America

France

USACanada

IHE Asia

Japan

Korea Taiwan

Netherlands

Spain Sweden UK

ItalyGermany

Norway

Regional Deployment

China

The IHE Adoption ProcessThe IHE Adoption Process

Document UseDocument Use Case Requirements Case RequirementsDocument UseDocument Use Case Requirements Case Requirements

Identify available Identify available standards (standards (e.g. HL7, e.g. HL7, DICOM, IETF, OASIS)DICOM, IETF, OASIS)

Identify available Identify available standards (standards (e.g. HL7, e.g. HL7, DICOM, IETF, OASIS)DICOM, IETF, OASIS)

Develop Develop technical technical

specificationsspecifications

Develop Develop technical technical

specificationsspecifications

Testing at Testing at ConnectathonsConnectathonsTesting at Testing at ConnectathonsConnectathons IHE IHE

DemonstrationsDemonstrationsIHE IHE DemonstrationsDemonstrations

Products Products with IHEwith IHEProducts Products with IHEwith IHE

Timely access to Timely access to informationinformationTimely access to Timely access to informationinformation Easy to integrate Easy to integrate

productsproductsEasy to integrate Easy to integrate productsproducts

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Deployment – National InitiativesDeployment – National Initiatives

IHE National Initiatives are responsible, within their geographical region, for promotion and deployment of IHE.

The primary activities of IHE National Initiatives are: Selecting which Integration Profiles are appropriate for promotion in

their locale/region. Recruiting local/regional vendors and encouraging them to participate Organizing local/regional demonstrations & Connectathons Educating the local/regional healthcare community about IHE

77

IHE AustraliaIHE AustraliaScope: Promoting IHE deployment with education, recruitment and organization in

Australia Incorporating other regional countries: NZ, Malaysia as they form to create a

sub-regional group IHE Asia-PacificKey Profile Deployment: PDI, SWF, XDS profiles

Supporting Events: IHE Participation and Educational Workshop, June 12-13 IHE Australia/Asia-Pacific Connectathon 2008, July 27-Aug 1 Interoperability Showcase, HIC 2008, Aug 31-Sept 3

Established in 2007 – undergoing IHE recognition process

Sponsors & Supporters: Health Informatics Society Australia (HISA) HL7 Australia Medical Software Industry Association (MSIA) Royal Australian and New Zealand College of Radiologists (RANZCR)

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Interoperability Australia

Showcase @ Med-Info 2007

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IHE Conference – Dec 10-12, 2007IHE Conference – Dec 10-12, 2007

3 day meeting (NICTA) Day 1 – Overview, more in depth discussion of

use cases, profiles, infrastructure and organisation, applicability to Australia, use of Australian standards & HL7 CDA

Day 2 - IHE Radiology profile and XDS profiles Day 3 – IHE Portable Data Imaging (CD)

1010

2008 Activities2008 Activities

Connectathon

Showcase

Radiology Conference – CD Challenge

Contact:

Peter MacIsaac: peter@macisaacinformatics.org

Klaus Veil: klaus@veil.net.au

Brendan Lovelock: brendan.lovelock@hisa.org.au

1111

Local implementation problems:Local implementation problems:

Portable Data for imaging 1st level film-less interoperability provided to referrer

Scheduled Workflow Top profile implemented by radiology vendors with over 200

Integration statements

XDS/XDS-I The emerging technology worldwide for Health information exchange

Deployment of HL7 v2 – lab, radiology orders and results using Australian Standard AS4700.2 & .7 Rigid adherence to local standards/implementation guide Appropriate use of message and application acknowledgements

Key IHE Profiles for AustraliaKey IHE Profiles for Australia

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PDI -The ProblemsPDI -The Problems

In the film world, looking at prior studies was easy. In the digital world, this has been complicated Can I read the CD? Can I read the Digital

Images? Can I process the Digital

Images I receive? How do I handle Studies from

other Institutions?

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PDI – Actors and TransactionsPDI – Actors and Transactions

Portable MediaCreator

Print Composer

Report Reader

Image Display

Display

Distribute ImagingInformation on Media

Media Importer

1414

Import Reconciliation WorkflowImport Reconciliation WorkflowScheduled Import Transaction DiagramScheduled Import Transaction Diagram

Imported Objects Stored [RAD-61]

Storage Commitment [RAD-10]

Query Modality Worklist [RAD-5]

Performed Procedure

Step Manager

Import PS in Progress [RAD-59] Import PS Completed [RAD-60]

Import PS in Progress [RAD-59] Import PS Completed [RAD-60]

Import PS in Progress [RAD-59] Import PS Completed [RAD-60]

Importer

Image Manager

Image Archive

DSS/Order Filler

DICOM Transactions

Modality Worklist (MWL)

Modality Performed Procedure Step (MPPS)

Object Storage

Storage Commitment

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Import Reconciliation WorkflowImport Reconciliation WorkflowUnscheduled Import Transaction DiagramUnscheduled Import Transaction Diagram

HL7 Transactions

Patient Demographics Query (QBP^22)

DICOM Transactions

Modality Performed Procedure Step (MPPS)

Object Storage

Storage Commitment

1616

imagesstored

patientinformation

RIS

examination orders

imagesretrieved

HIS

PACS

procedurescheduled

Prefetch any relevantprior studies

modalityworklist

report

report

Radiology Scheduled Workflow: Use CaseRadiology Scheduled Workflow: Use Case

Registration

Orders Placed

Orders Filled

Film

FilmFolder

Image Manager& Archive

FilmLightbox

report ReportRepository

DiagnosticWorkstation

Modality

acquisitionacquisitionin-progressin-progressacquisitioncompleted

acquisitioncompleted

imagesprinted

AcquisitionModality

1717

IHE Integration Profiles for Health Info Nets What is available and has been added in 2006/07

Cross-Enterprise Document Sharing

Registration, distribution and access across health enterprises of clinical

documents forming a patient

electronic health record

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 ContentImaging Information

Format of the Document Content and associated coded vocabulary

Medical Summary (Meds, Allergies, Pbs)

Format of the Document Contentand associated coded vocabulary

Consistent TimeCoordinate 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

SecuritySecurityClinical and PHR ContentClinical and PHR Content

Health Data ExchangeHealth 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 Formfor Data Capture

External form with custom import/export scripting

Patient ID MgmtPatient ID Mgmt

OtherOther

Cross-Enterprise Document Pt-Pt Reliable Interchange

Final Text ApprovedFinal Text Approved

Trial Implementation-2006 Trial Implementation-2006 –– Final Txt 2007Final Txt 2007

Cross-Enterprise Document Media Interchange

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DocumentDocumentSourceSource

DocumentDocumentSourceSource

Document Registry/Repository Model:Document Registry/Repository Model:

DocumentDocumentRepositoryRepository Submit

Doc Meta-data+ References

SubmitDocuments

DocumentDocumentRepositoryRepository

SubmitDoc Meta-data+ References

DocumentDocumentRegistryRegistry

RetrieveDocuments

Query for DocsReferences

DocumentDocumentConsumerConsumer

RetrieveDocuments

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Example: Example: Providing Access to Prior Health InformationProviding Access to Prior Health Information

Acute Care (Inpatient)

PCPs and Clinics (Ambulatory)

Long Term Care

Other Specialized Careor Diagnostics Services

Shared DocumentRepository

Longitudinal Record as usedacross-encounters

Encounter Medical Summary (med-prescribed & dispensed, allergies, pbs, etc)Lab Report (structured & coded tests results)

Radiology Report and Images Links

EKG Report

PublicHealth

2020

To find IHE Profiles:To find IHE Profiles:www.ihe.net /technical_frameworkswww.ihe.net /technical_frameworks

Radiology (18)

IT Infrastructure for Healthcare (17)

Cardiology (7)

Laboratory (6)

Radiation Oncology (1)

Patient Care Coordination (5)

Patient Care Devices (1)

Quality

Eye Care (3)

Veterinary

EndoscopyPharmacy

IHE Global DevelopmentsIHE Global DevelopmentsOver 60 Integration and content Profiles (# X)Over 60 Integration and content Profiles (# X)Solutions to Real-World Interoperability Solutions to Real-World Interoperability

Needs & Problems:Needs & Problems:

Within Clinical Departments e.g.:Within Clinical Departments e.g.: RadiologyRadiology CardiologyCardiology LabLab ......

Across Departmental &Across Departmental &Institutional Boundaries – XDSInstitutional Boundaries – XDS

RHIOsRHIOs (Regional Healthcare Information Organizations) (Regional Healthcare Information Organizations)

EHR EnablersEHR Enablers

Yea

r 1

(199

9)

Yea

r 2

(200

0)

Yea

r 3

(200

1)

Yea

r 4

(200

2)

Yea

r 5

(200

3)

Yea

r 6

(200

4)

Yea

r 7

(200

5)

Yea

r 8

(200

6)

Yea

r 9

(200

7)

Pathology (1)

2121

How to ParticipateHow to Participate

As a Committee MemberAs a Committee Member

Become a member of relevant Domains Planning or Become a member of relevant Domains Planning or Technical CommitteesTechnical Committees

As as Interested ObserverAs as Interested Observer

Provide Public Comments on Technical Framework Provide Public Comments on Technical Framework SupplementsSupplements

Attend Demonstrations, Educational Events and WorkshopsAttend Demonstrations, Educational Events and Workshops

2222

How to Use IHEHow to Use IHE

As a Vendor ImplementerAs a Vendor ImplementerImplement IHE Integration ProfilesImplement IHE Integration Profiles

Test systems through Connectathon processTest systems through Connectathon process

Publish an IHE Integration Statement for productsPublish an IHE Integration Statement for products

As a User Implementer or ConsultantAs a User Implementer or ConsultantUse IHE Integration Profiles to develop interoperability strategyUse IHE Integration Profiles to develop interoperability strategy

Use Connectathon Results and Integration Statements to Use Connectathon Results and Integration Statements to evaluate vendorsevaluate vendors

Demand IHE Integration Profile compliance in RFPsDemand IHE Integration Profile compliance in RFPs

2323

StakeholdersStakeholders

Working Together to DeliverWorking Together to Deliver

Interoperable Health Information SystemsInteroperable Health Information Systems

in the Enterprisein the Enterprise

and Across Care Settingsand Across Care Settings

http://www.ihe.net

http://www.ihe.net.au

2424

More Resources - More Resources - www.ihe.netwww.ihe.net Integration Profiles in Technical Frameworks:Integration Profiles in Technical Frameworks:

CardiologyCardiology IT InfrastructureIT Infrastructure LaboratoryLaboratory Patient Care CoordinationPatient Care Coordination Patient Care DevicesPatient Care Devices Radiation OncologyRadiation Oncology RadiologyRadiology

Connectathon Results – world-wideConnectathon Results – world-wide

Vendor Products Integration StatementsVendor Products Integration Statements

Participation in Domain CommitteesParticipation in Domain Committees

Participation in IHE Australia Participation in IHE Australia www.ihe.net.auwww.ihe.net.au

Connectathon Interoperability showcase

September, 2005 What IHE Delivers