Wednesday Morning, 8AM…

1. Wednesday Morning, 8AM… • Special guest star… • China – Hospital Information System • Report back from Open Space • Policy Session – Mark Landry • Technical Session – Tom Hutton • Session 9 – Interoperability Specifics • Important concepts • Within the hospital/clinic • Reporting from the hospital/clinic • National level • Group Exercise on Interoperability

2. Session 9Interoperability Bill Lober, MD, University of Washington I-TECH Jan Flowers, University of Washington I-TECH Knut Staring, WHO/HMN, Geneva Kelvin Hui, GTI, Indonesia

3. Standards forInteroperability • Session 9 • Important concepts • Within the hospital/clinic (HL7) • Reporting from the hospital/clinic (SDMX-HD) • National level (semantics of data)

4. Important Concepts • Recent History • Types of Interoperability (Session 4)

6. Health Care Interoperability • Worldwide efforts • Canadian Health Infoway, Brazil, UK, SG, Rwanda… • US efforts • Office of National Coordinator, Healthcare Information Technology (ONC), 2004

7. Brailer DJ. Interoperability: The Key To The Future Health Care System. Health Affairs. 2005.

8. Session Theme Why Start With Interoperability? • Interoperability, Standards, and Architecture Architecture to Support Standards-based Interoperability Standards-based Interoperability Interoperability HL Lab Pharm HIV PMIS PMIS HIV VCT VCT HL7 messages SDMX-HD Provincial/District Reporting National Reporting Supply Chain/Stock Mgt Surveillance/Case Reporting National Patient Index Billing/Utilization/Insurance Commercial Ordering HL7 CDA HL7 X.12?EDIFACT? HL7 messaging Referral Summaries

9. 5 Types of Interoperability* • Priority areas for achieving interoperability • Unique person identifier - Jan • Meaning (semantics) - Kelvin • Structure/format (syntax) - Knut • Core data sets • Data quality and use *Hammond WE, Bailey C, Boucher P, Spohr M, Whitaker P. Connecting Information To Improve Health. Health Affairs. 2010;29(2):284 -288.

10. Assumptions AboutArchitecture • To develop scalable interoperability • All systems have to be well described, in functional requirements • The business processes that require data interactions should be well described in use cases • The standards used to support those data interactions, and the specific ways those standards are to be used, should be integrated with the use cases as interoperability profiles.

11. IHE • Activity • Technical process • Implementation Profiles • Organizational process • Annual development • Demonstration • Certification

12. Four Common Enterprise Architecture Layers or Domains

13. Standards forInteroperability • Session 9 • Important concepts • Within the hospital/clinic (HL7) • Reporting from the hospital/clinic (SDMX-HD) • National level (semantics of data)

14. Interoperability at the Hospital/Clinic • EMR-LIS • Development of a profile • EMR-Pharmacy (EDT) • Fingerprint identification & Patient Index • Enabling facility-level architecture

15. Standards forInteroperability • Session 9 • Important concepts • Within the hospital/clinic (HL7) • Reporting from the hospital/clinic (SDMX-HD) • National level (semantics of data)

16. Knut

17. Standards forInteroperability • Session 9 • Important concepts • Within the hospital/clinic (HL7) • Reporting from the hospital/clinic (SDMX-HD) • National level (semantics of data)

18. Kelvin