Lisa Spellman, MBA, CPHIMS HIMSS, Senior Director Informatics, Staff Liaison to IHE

1. Integrating the Healthcare Enterprise (IHE)The Healthcare Information and Management Systems Society (HIMSS) Lisa Spellman, MBA, CPHIMS HIMSS, Senior Director Informatics, Staff Liaison to IHE Floyd P. Eisenberg, MD, MPH, FACP Senior Vice President, Health Information Technology, National Quality Forum QRPH Technical Co-chair

2. Webinar Overview Part I: Lisa Spellman IHE Overview Brief - IHE overview & relevance to their work Audiences that IHE attracts & serves Special welcome to Lori F & Patty C Get involved: Opportunities for public health leaders & your HIT vendors IHE Domains & Committees Review Public Comment documents Interop Showcases & testing Other opportunities HIMSS: HIE: Pam Mathews will speak with them next month Other SIGs & committees Resources Part II: Floyd Eisenberg Retrieve Protocol for Execution Profile Clinical Research Data Capture Profile (change proposal) Maternal Child Health Profile Drug Safety Content Profile Performance Quality Report Profile Newborn Screening White Paper Chronic Disease Management White Paper Knowledge Representation in Diabetes Care Management White Paper Next Steps

3. What is “Integrating the Healthcare Enterprise”? • A 10-year public-private global initiative driven by end-users worldwide • Clinicians • Non-profit organizations • USA: OASIS, CORE • State & Federal agencies & related entities • State Depts Public Health • Governments: • France: GIP-DMP - French Ministry of Health • USA: American Heart Association • Worldwide: HIMSS, RSNA • Professional Societies • Representing 270,000+ individual members: • HIMSS, RSNA, PHIN, ACC, ACP, AAO, ACCE, ASTRO, etc • Standards Development Orgs (SDOs): • HL7, DICOM, CDISC, W3C, IEEE, Etc. • Vendors & consultants (imaging, EHRs, Cardio, devices, etc)

4. IHE Mission • IHE improves patient care by harmonizing electronic health information exchange • Enables approved standards to seamlessly pass health information among care providers on a local, regional and national level • IHE Frameworks are freely available to all • Ok, now translate – what does that really mean?

5. Big concept = package approved standards into usable “tool kit or package” Package standards in usable packages (called profiles) • Standards are a great thing to have, but how to best assemble and use them? Example: Child car seats • Standard = All children younger than certain age had to be in a car seat • Location: Not prescribed • Front seat - OK • New standard packaged the concept • Child in car seat + strapped in + facing backwards + better sizing

6. 10 IHE Development Domains - Helping Public Health More Directly Note: The Public Health Data Standards Consortium helped HIMSS & RSNA start QRPH Domain QRPH leverages “packages” (profiles) from multiple domains Radiologysince 1998 PharmacyNEW 2009 Cardiologysince 2004 Pathologysince 2006 Laboratorysince 2004 Eye Caresince 2006 (Healthcare)IT Infrastructuresince 2003 QualityResearch & Public Healthsince 2006 Radiation Oncologysince 2004 Patient Care Devicessince 2005 Patient Care Coordinationsince 2004 11 Years of Steady Evolution 1998 – 2009

7. Why Public Health professionals & your vendors should get involved • If as a PH professional you are involved in evaluating and/or selecting IT products and consultants - you and/or your consultants & vendors can & should: • Use IHE Integration Profiles to develop interoperability strategy • Use Connectathon Results and Integration Statements to evaluate vendors • Demand IHE Integration Profile compliance in RFPs

8. IHE Vendor Integration Statements

9. Many ways to become involved • As a User, Committee Member or Interested Observer • Contribute your knowledge & expertise • Join a Domain Planning or Technical Committee • Provide Public Comments on Technical Framework Supplements and IHE White Papers • June 1, 2009: IHE opened round of Public Comment • www.ihe.net/Technical_Framework/public_comment.cfm • Attend Demonstrations, Educational Events and Workshops

10. See for yourself – Interoperability Demonstrations • PHIN: August 2009 - Atlanta • RSNA: November 2009 – Chicago • HIMSS10: March 2010 – Atlanta

11. QRPH White Papers Section 3001 of ARRA that requires the National Coordinator for Health Information Technology (HIT) to develop a nationwide health information technology infrastructure that will allow for the electronic use and exchange of information to improve health care quality, reduce medical errors, reduce health care disparities, and advance the delivery of patient-centered medical care… • Patient-Level Export of Quality Data • Identifies a set if IT Infrastructure and Patient Care Coordination profiles that can be used to retrieve quality data from multiple systems for quality reporting and aggregation. This framework can be extended to research and public health purposes • White Paper: Performance Measurement Data Element Structured for EHR Extraction • Intended to identify a standard mechanism to enable extraction of quality measures from Electronic Health Record Systems

12. Cancer Registry Pathology ReportValue Proposition • ~ 2 Million cancers diagnosed each year in the US • ~ 95% of these cancers have one or more pathology reports • The US federally mandates reporting • serves as the foundation to reduce illness and death from cancer • Making use of the EHR and IHE methodology • reduce time and resources required to meet federal mandates • improve the timeliness of reporting • Being proposed to IHE Pathology for a New Directions Demonstration 12

13. Other Opportunities for Involvement

14. 2009 Webinar Schedule Overview • All sessions recorded & available at http://www.ihe.net/Events/webinars2009.cfm • Session 1-Thur June 11, 09: Overview 2009-2010 North American Connectathon & HIMSS10 US Interoperability Showcase • Why IHE & HITSP • What 2010 NA Connectathon Participants need to know: Connectathon Administrative & Logistics • Testing Cycle Requirements • How to Interpret the Technical Framework • 2009 NA Connectathon Registration • What HIMSS10 Interop Showcase Participants need to know: Administrative & Logistics • Special Session for Returning NA Connectathon & Interop Showcase Participants • Session 2: Radiology, Mammography & Nuclear Medicine - Tuesday, June 24 • QRPH, PCC, PCD, Etc… • And so on –there will be 12-15 sessions June – September 2009

15. Insert Transition Slide Thank you and now I’ll hand over to Dr. Floyd Eisenberg who will speak to current and planned activities for IHE but also about activities underway at HISTP, NQF and so on… Thank you and I can be reached at Lisa Spellman Senior Director, Informatics Staff Liaison, IHE lspellman@himss.org (703) 678-5795 www.himss.org www.ihe.net

16. QRPH 2009 Profiles / White Papers • Retrieve Protocol for Execution Profile • Clinical Research Data Capture Profile (change proposal) • Maternal Child Health Profile • Drug Safety Content Profile • Performance Quality Report Profile • Newborn Screening White Paper • Chronic Disease Management White Paper • Knowledge Representation in Diabetes Care Management White Paper

17. Retrieve Protocol for Execution The Retrieve Protocol for Execution Profile (RPE) provides an automated mechanism for an Electronic Health Record (EHR) to retrieve a complex set of clinical research instructions (Protocol Definition) from an Electronic Data Capture (EDC) system to execute within the EHR. EnterPatientRequest (2) PatientScreeningVisitsScheduled (3) RecordPatientScreeningVisit(4) EnrollPatientRequest(5) PatientStudyVisitsScheduled(6) RecordPatientStudyVisit(7) ReviewProtocolDef (1) Protocol Executor AmendProtocolDef (8) AlertProtocolState (9) ProtocolDefManager Protocol State Manager

18. Retrieve Protocol for Execution • Retrieve Protocol for Execution (RPE) ProtocolDefManager ProtocolExecutor ProtocolStateManager RetrieveProtocolDef [1] EnterPatientRequest [2] PatientScreeningVisitsScheduled [3] RecordPatientScreeningVisit [4] EnrollPatientRequest [5] PatientStudyVisitsScheduled [6] RecordPatientStudyVisit [7] AlertProtocolState [9] RetrieveProtocolDef [8]

19. Clinical Research Data Capture • Clinical Research Data Capture Retrieve Form [ITI-34] along with pre-population data Continuity of Care Document (CCD) Form Manager Form Filler Form Delivery of Form along with pre-population data bound to the form

20. Maternal Child Health • Content profile describes to automating data capture in vital records such as the birth certificate or early childhood health certificates. • Pre-populate certificate with data from the EHR • Submit certificate to interested organizations • Retrieve Form for Data Capture (RFD) • Uses transactions and content modules defined in other IHE profiles to provide interoperable data exchange.

21. Maternal Child Health

22. Drug Safety Profile Reference Implementation CCD Form Manager CCD E2B M XSLT Retrieve Form [ITI-34] along with pre-population data Continuity of Care Document (CCD) Form Manager Form Filler Form Delivery of Form along with pre-population data bound to form

23. Newborn Screening (White Paper) • Newborn Screening White Paper • Work processes and data information exchange needs for Newborn Screening programs administered by regulatory health authorities • Newborn bloodspot screening (NBS) • Metabolic, pulmonary, genetic, hematologic and other disorders identified by laboratory testing • Newborn hearing screening (NHS or Early Hearing Detection and Intervention – EHDI) • Permanent conductive or sensorineural hearing losses using physiologic testing technologies • Screening is conducted at the birthing facility within three days of birth, representing the first two information exchanges between clinical care and public health authorities in the life course of a child.

24. Additional QRPH Work • Performance Quality Report Profile – mid-June • Newborn Screening White Paper • Chronic Disease Management White Paper • Knowledge Representation in Diabetes Care Management White Paper

25. Thank you! Aligned Industry Efforts HITSP Quality Tiger Team – 16 inpatient measures, re-tooling requirements Data Architecture Tiger Team – Value set attributes, maintenance and storage Post Tiger Team – Maternal Child Health, Newborn Screening NQF HITEP Quality Data Set Data Flow Opportunities Align measurement and reporting around Quality Data Set Near term exemplars of reporting based on value sets Discussion….

26. Resources Lisa Spellman Senior Director, Informatics Staff Liaison, IHE lspellman@himss.org (703) 678-5795 www.himss.org & www.ihe.net Floyd Eisenberg, MD, MPH, FACP Senior VP, Health IT National Quality Forum feisenberg@qualityforum.org (202) 783-1300 x 167 www.ihe.net http://wiki.ihe.net www.himss.org IHE 2009 Webinar Series www.ihe.net www.interoperability.org www.hitsp.org/ www.qualityforum.org/ www.jointcommission.org/