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Integrating the Healthcare Enterprise

Integrating the Healthcare Enterprise. IHE, beyond cardiology and radiology An interoperability strategy for the enterprise. Charles Parisot, GE Healthcare IHE IT Infrastructure Co-chair. IHE 2004 achievements and expanding scope. Over 80 vendors involved world-wide, 4 Technical Frameworks

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Integrating the Healthcare Enterprise

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  1. Integrating the Healthcare Enterprise IHE, beyond cardiology and radiology An interoperability strategy for the enterprise Charles Parisot, GE Healthcare IHE IT Infrastructure Co-chair IHE European Cardiology

  2. IHE 2004 achievements and expanding scope Over 80 vendors involved world-wide, 4 Technical Frameworks 31 Integration Profiles, Testing at yearly Connectathons, Demonstrations at major exhibitions world-wide Provider-Vendor cooperation to accelerate standards adoption IHE European Cardiology

  3. IHE: A stepwise approach Patient Management Order Management Patient Identifier Linkage, Registries, Security Electronic Health Record Enterprise Scheduling Labora- tory Pharmacy,….. Radiology Cardiology IHE European Cardiology

  4. Key IHE Concepts • Generalized Systems -> Actors • Interactions between Actors -> Transactions • Problem/Solution Scenarios -> IntegrationProfiles • For each Integration Profile: • the context is described (which real-world problem) • the actors are defined (what systems are involved) • the transactions are defined (what must they do) IHE European Cardiology

  5. IHE Radiology Integration profiles Scheduled Workflow Charge Posting Presentation of Grouped Procedures Reporting Workflow Post-Processing Workflow Patient Information Reconciliation Consistent Presentation of Images Simple Image and Numeric Reports Evidence Documents Key Image Notes Access to Radiology Information Basic Security - IHE European Cardiology

  6. IHE Penetration in Radiology • Now entering Year 6 !! • 50+ vendors worldwide • 100+ systems in annual Connectathons • Geographic spread • U.S., France, Germany, Japan, Italy, Korea, Taiwan, U.K, Norway, Netherlands, Spain, etc. • Well over 100 commercial products available IHE European Cardiology

  7. IHE IT Infrastructure 2004-2005 Personnel White Page New Access to workforcecontact information New Retrieve Information for Display Retrieve Information for Display Cross-Enterprise Document Sharing Access a patient’s clinical information and documents in a format ready to be presentedto the requesting user Access a patient’s clinical information and documents in a format ready to be presentedto the requesting user Registration, distribution and access across health enterprises of clinical documents forming a patient electronic health record Patient Demographics Query New Audit Trail & Node Authentication New Centralized privacy audit trail and node to node authentication to create a secured domain. Enterprise User Authentication Enterprise User Authentication Consistent Time Provide users a single nameand centralized authentication processacross all systems Coordinate time across networked systems Patient Synchronized Applications Synchronize multiple applications on a desktop to the same patient Patient Identifier Cross-referencing for MPI Patient Identifier Cross-referencing for MPI Map patient identifiers across independent identification domains Map patient identifiers across independent identification domains IHE European Cardiology

  8. IHE Penetration in IT Infrastructure and Laboratory • Has just completed Year 1 !! • About 20 vendors worldwide • 40+ systems in annual Connectathons • Geographic spread • U.S., France, Italy, Japan, Germany, etc. • Commercial products appearing IHE European Cardiology

  9. IHE Laboratory Integration Profiles Laboratory Scheduled Workflow (LSWF) done in 2003 Laboratory Point Of Care Testing (LPOCT) year 2004 Tests performed by a laboratory for an identified inpatient or outpatient Tests performed on point of care or patient’s bedside Laboratory Patient Information Reconciliation (LPIR) year 2004 Laboratory Device Automation (LDA) year 2004 Pre-analytic process, analysis and post-analytical treatment Tests performed on an unidentified or misidentified patient Laboratory Code Set Distribution (LCSD) year 2004 Sharing the batteries and tests code sets throughout the enterprise IHE European Cardiology

  10. An Example ofIHE IT InfrastructureIntegration Profile IHE European Cardiology

  11. Introduction: EHR Cross-Enterprise Document Sharing First step towards the longitudinal dimension of the EHR Focus: Support document sharing between EHRs in different care settings and organizations IHE European Cardiology

  12. Typically, a patient goes through a sequence of encounters in different Care Settings Long Term Care Acute Care (Inpatient) Other Specialized Care(incl. Diagnostics Services) GPs and Clinics (Ambulatory) Continuity of Care: Patient Longitudinal Record IHE European Cardiology

  13. community Hospital Record Laboratory Results Specialist Record Records Sent Clinical Encounter Finding the records of a patient-Manual & tedious The challenge: Finding and accessing easily documents from other care providers In the community. Clinical IT System IHE European Cardiology

  14. Sharing records that have been published community Hospital Record Laboratory Results Reference to records Specialist Record 4-Patient data presented to Physician Temporary Aggregate Patient History Index of patients records (Document-level) 3-Records Returned Clinical IT System Sharing System 2-Reference to Records for Inquiry 1-Patient Authorized Inquiry Clinical Encounter IHE European Cardiology

  15. Building and accessing Documents DocumentRepository Submission of Document References Retrieve of selected Documents Documents Registry EHR-LR:Longitudinal Recordas usedacross-encounters Long Term Care Acute Care (Inpatient) Other Specialized Careor Diagnostics Services PCPs and Clinics (Ambulatory) EHR-CR: Care Record systemssupporting care delivery IHE European Cardiology

  16. XDS – Value Proposition • Foundation for Health IT Infrastructures: Shared Electronic Health Record, in a community, region, etc. • Effective means to contribute and access clinical documents across health enterprises. • Scalable sharing of documents between private physicians, clinics, long term care, pharmacy, acute care with different clinical IT systems. • Easy access: Care providers are offered means to query and retrieve clinical documents of interest. IHE European Cardiology

  17. XDS - Value Proposition • Distributed: Each Care delivery organization “publishes” clinical information for others. Actual documents may remain in the source EHR-CR. • Cross-Enterprise: A Registry provides an index for published information to authorized care delivery organizations belonging to the same clinical affinity domain (e.g. an LHII). • Document Centric: Published clinical data is organized into “clinical documents”. using agreed standard document types (HL7-CDA, ASTM-CCR, PDF, DICOM, etc.). • Document Content Neutral: Document content is processed only by source and consumer IT systems. • Standardized Registry Attributes: to ensure deterministic document searches. IHE European Cardiology

  18. XDS – Conclusion • Foundation for EHR & Health IT Infrastructures • Effective contribution and access to shared documents across all types of health enterprises • Scalable, Flexible and Easy access • XDS to be one of the major highlights of 2005 Annual HIMSS Conference & Exhibition. Dallas, Tex., Feb. 13-17: • used as a foundation for an on-site demonstration of interoperability in support of a National Health Information Networks. • Attendees at the conference will be able to create and share their own health records across vendor booths as well as in the ambulatory and acute care settings on the conference exhibit floor. IHE European Cardiology

  19. How real is XDS ? • Specification work since Nov 2003 • Under Public Comments June-July 2004 • 600 constructive comments received, • Stable specification IHE TF Aug 15th, 2004 • IHE Connectathon January 2005 (USA) • HIMSS Feb 2005 show-wide demonstration • IHE Connectathon April 2005 (Europe) IHE European Cardiology

  20. IHE, The practical solutions to the effective use of information exchange standards in healthcare IHE European Cardiology

  21. IHE Thank You ! IHE European Cardiology

  22. More information…. • IHE Web sites: http://www.ihe-europe.org http://www.himss.org/IHE http://www.rsna.org/IHE http://www.acc.org/quality/ihe.htm. • Technical Frameworks: • ITI V1.0, RAD V5.5, LAB V1.0, CARD V1.0 • Technical Framework Supplements - Trial Implementation • May 2004: Radiology • August 2004: Cardiology, IT Infrastructure • December 2004: Laboratory • Non-Technical Brochures : • IHE Fact Sheet and FAQ • IHE Integration Profiles: Guidelines for Buyers • IHE Connect-a-thon Results • Vendor Products Integration Statements IHE European Cardiology

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