An Overview of

IHE IT Infrastructure Profilesand their relationship with

other Domains

IHE Educational Workshop 2007IHE Educational Workshop 2007June 12June 12thth, 2007, 2007

This morning’s program…

• 8:30 – 9:00am8:30 – 9:00am Overview of IT InfrastructureOverview of IT Infrastructure• 9:00 – 9:30am9:00 – 9:30am Basic Patient Privacy ConsentsBasic Patient Privacy Consents• 9:30 – 9:45am9:30 – 9:45am BreakBreak• 9:45 – 10:15am9:45 – 10:15am XDS Content ProfilesXDS Content Profiles• 10:15 – 10:45am10:15 – 10:45am Web Services and HL7v3Web Services and HL7v3• 10:45 – 11:00am10:45 – 11:00am Retrieve Form for Data CaptureRetrieve Form for Data Capture

• Breakouts by domainBreakouts by domain

An Overview of the

IHE IT Infrastructure Domain

IHE Educational Workshop 2007IHE Educational Workshop 2007IT Infrastructure DomainIT Infrastructure DomainMichael Nusbaum, FHIMSSMichael Nusbaum, FHIMSS

Co-Chair, ITI Planning CommitteeCo-Chair, ITI Planning Committee

Agenda

• What is IHE IT Infrastructure?What is IHE IT Infrastructure?• ITI’s role as a domain to support the other domains ITI’s role as a domain to support the other domains • ITI long-range visionITI long-range vision• ITI work to date, including this year’s activities and roadmap ITI work to date, including this year’s activities and roadmap

items items

• Of what value is IHE IT Infrastructure?Of what value is IHE IT Infrastructure?• How do you get IHE IT Infrastructure?How do you get IHE IT Infrastructure?

• ITI profiles that we’d like to see featured at the upcoming ITI profiles that we’d like to see featured at the upcoming Connectathon/Showcase cycleConnectathon/Showcase cycle

• How do you add to IHE IT Infrastructure?How do you add to IHE IT Infrastructure?• Opportunities to grow ITI, and how to participateOpportunities to grow ITI, and how to participate

• What comes next?What comes next?

An Infrastructure Component…

• Represents a common IT function or Represents a common IT function or service that is used as a building block for service that is used as a building block for a variety of use casesa variety of use cases

• May be imbedded in an application, but is May be imbedded in an application, but is often deployed as a shared resource within often deployed as a shared resource within a RHIO or Health Information Exchange a RHIO or Health Information Exchange

• Is a necessary ingredient, but is rarely Is a necessary ingredient, but is rarely visible to the end uservisible to the end user

What is IHE IT Infrastructure?

• IT that enables computer applicationsIT that enables computer applications• Operating platformsOperating platforms• Computer languagesComputer languages• Computing hardwareComputing hardware• NetworksNetworks

• IT that serves multiple applications IT that serves multiple applications • SecuritySecurity• Data storage and retrievalData storage and retrieval• InterfacesInterfaces

Infrastructure

applicationapplication

applicationapplication

applicationapplication

applicationapplication

Growth in IHE Domains

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)

VeterinaryEndoscopyPathologyPharmacy

Ye

ar

1

(19

99

)

Ye

ar

2

(20

00

)

Ye

ar

3

(20

01

)

Ye

ar

4

(20

02

)

Ye

ar

5

(20

03

)

Ye

ar

6

(20

04

)

Ye

ar

7

(20

05

)

Ye

ar

8

(20

06

)

Ye

ar

9

(20

07

)

Currently:Currently: • Over 100 vendors involved world-wideOver 100 vendors involved world-wide• 8 Technical Frameworks8 Technical Frameworks• 48 Integration Profiles48 Integration Profiles

• Testing at “Connectathons” world-wideTesting at “Connectathons” world-wide• Demonstrations at major conferences world-wideDemonstrations at major conferences world-wide

What is IHE IT Infrastructure?

• IHE IT Infrastructure domain produces...IHE IT Infrastructure domain produces...• ProfilesProfiles that serve the purposes of clinical that serve the purposes of clinical

workflows, regardless of IHE clinical domainworkflows, regardless of IHE clinical domainExamples: Security, Records Storage, Patient IdentifiersExamples: Security, Records Storage, Patient Identifiers

• Basic implementation-specification Basic implementation-specification foundationsfoundations to to be extended by other IHE clinical domainsbe extended by other IHE clinical domainsExamples: Retrieve Forms for Data Capture; Cross-Examples: Retrieve Forms for Data Capture; Cross-

Enterprise Document SharingEnterprise Document Sharing

• White PapersWhite Papers for current work items for current work itemsExamples: HIE Security and Privacy; Health Data Re-use Examples: HIE Security and Privacy; Health Data Re-use

Infrastructure; Risk ManagementInfrastructure; Risk Management

IT Infrastructure Domain Committees

Domain SponsorDomain Sponsor

• Develops long-term goalsDevelops long-term goals• Maintain ITI RoadmapMaintain ITI Roadmap• Identify interoperability Identify interoperability

problems and prioritiesproblems and priorities• Gather and review proposals Gather and review proposals

for new profilesfor new profiles• Select and approve Select and approve

proposals for technical proposals for technical review and developmentreview and development

• Develop educational Develop educational materialsmaterials

• Develop ITI White PapersDevelop ITI White Papers

• Assess feasibility and effort Assess feasibility and effort required for selected profile required for selected profile proposalsproposals

• Builds consensus on Builds consensus on appropriate standards-based appropriate standards-based solutionssolutions

• Develop integration profilesDevelop integration profiles• Develop ITI White PapersDevelop ITI White Papers• Maintain ITI Technical Maintain ITI Technical

FrameworkFramework

ITI Provides Foundation for Document Exchange

Doc Exchange Integration ProfilesDoc Exchange Integration Profiles

Doc Content ProfilesDoc Content Profiles

Doc SharingDoc Sharing

XDSXDS

MediaMediaInterchangeInterchange

XDMXDM

Pt-Pt DocPt-Pt DocInterchangeInterchange

XDRXDR

Scanned DocScanned Doc

XDS-SDXDS-SDConsentConsent

BPPCBPPCEmergencyEmergency

EDREDRPrePre

SurgerySurgery

PPHPPPHP

LaboratoryLaboratory

XD*-LabXD*-LabPHR PHR

ExchangeExchange

XPHRXPHR

Discharge &Discharge &ReferralsReferrals

XDS-MSXDS-MS

ImagingImaging

XDS-IXDS-I

IHE IT InfrastructureComposable Integration Profiles

Doc Exchange Integration ProfilesDoc Exchange Integration Profiles

Doc SharingDoc Sharing

XDS

MediaInterchange

XDM

Pt-Pt DocInterchange

XDR

Patient Demographics Query

Patient Identifier Cross-referencing

Map patient identifiers across independent identification

domains

Notice of Document Availability

Know about new information

Patient Administration Management

Patient Synchronized Applications

Retrieve Information for Display

Cross-Enterprise User Assertion

User Attributes for Access Cntrl

Cross-Community AccessQuerying and Retrieving Documents across

multiple communities Remotely Manage Information

Capture

Request Form for Data Capture

Scanned Doc

XDS-SD

Consistent TimeCoordinate time across

networked systems

Audit Trail & Node Authentication

Centralized privacy audit trail and node to node

authentication to create a secured domain.

Document Digital Signature

Attesting “true-copy and origin

Personal White Pages

Enterprise User Authentication

(Intra-Enterprise only)(Intra-Enterprise only)

**

**

****

**

** Adopted by HITSPAdopted by HITSP

IT Infrastructure work underway…

• Supplements to the Technical FrameworkSupplements to the Technical Framework• Web Services for IHE transactions (Appendix V)Web Services for IHE transactions (Appendix V)• [RFD] Retrieve Form for Data Capture[RFD] Retrieve Form for Data Capture• [XUA] Cross-Enterprise User Assertion[XUA] Cross-Enterprise User Assertion• [XDS.b] Cross-Enterprise Document Sharing (WS)[XDS.b] Cross-Enterprise Document Sharing (WS)• [XCA] Cross-Community Access[XCA] Cross-Community Access• XDS Patient Identity MergeXDS Patient Identity Merge

• White PapersWhite Papers• XDS Affinity Domain ChecklistXDS Affinity Domain Checklist• Risk ManagementRisk Management• SOA and Web Services IHE RoadmapSOA and Web Services IHE Roadmap• Health Data Reuse InfrastructureHealth Data Reuse Infrastructure• HIE Security and PrivacyHIE Security and Privacy

Public CommentPublic CommentJune 13 – July 13June 13 – July 13

IT Infrastructure Roadmap

• 2008-09 Candidates2008-09 Candidates• 2009-10 Candidates2009-10 Candidates

• Additional candidates to be brought forward Additional candidates to be brought forward for consideration this Fallfor consideration this Fall

Of what value is the IHE IT Infrastructure?

• StakeholdersStakeholders• Healthcare Consumers – People and Employers Healthcare Consumers – People and Employers • Healthcare Providers – Institutions and CliniciansHealthcare Providers – Institutions and Clinicians• Healthcare payersHealthcare payers• Public health agenciesPublic health agencies• Safety net providersSafety net providers• Clinical and health-services researchersClinical and health-services researchers• VendorsVendors

Of what value is the IHE IT Infrastructure?

• Benefits for vendorsBenefits for vendors• World-ClassWorld-Class shared expertise amongst colleagues shared expertise amongst colleagues• Reduced development effortReduced development effort• Quicker time-to-marketQuicker time-to-market• Reduced implementation effort and negotiationReduced implementation effort and negotiation• Greater collaboration amongst all stakeholdersGreater collaboration amongst all stakeholders• Exposure in HIMSS Interoperability Showcase and Exposure in HIMSS Interoperability Showcase and

other venuesother venues• Simplified RFP responsesSimplified RFP responses• Better sales results when standards are importantBetter sales results when standards are important• Satisfied customersSatisfied customers

Of what value is the IHE IT Infrastructure?

• Benefits for PurchasersBenefits for Purchasers• Quicker realization of IT benefitsQuicker realization of IT benefits• Fewer implementation fumblesFewer implementation fumbles• Fewer multi-vendor coordination headachesFewer multi-vendor coordination headaches• Lower implementation costLower implementation cost

• Benefits for ConsumersBenefits for Consumers• Less user time spent fumbling with infrastructureLess user time spent fumbling with infrastructure• More time for clinical IT use More time for clinical IT use Better outcomes Better outcomes• Potentially more funding for care-specific ITPotentially more funding for care-specific IT

Of what value is the IHE IT Infrastructure?

• Benefits for PayersBenefits for Payers• Less overhead in care-provision and interfacesLess overhead in care-provision and interfaces

• Benefits for Public HealthBenefits for Public Health• Better data collection Better data collection better population health better population health

• Benefits for Benefits for Safety Net ProvidersSafety Net Providers• EEasier access to patient data asier access to patient data less expense less expense

• Benefits for Benefits for ResearchersResearchers• Simpler data collection Simpler data collection less expense less expense

How do you get the IHE IT Infrastructure?

• Study: Technical Framework Study: Technical Framework • www.ihe.net/Technical_Framework/index.cfmwww.ihe.net/Technical_Framework/index.cfm

• Volume 1 – ProfilesVolume 1 – Profiles• Volume 2 – TransactionsVolume 2 – Transactions

• www.ihe.net – New profiles and transactionswww.ihe.net – New profiles and transactions• Practice: Connectathon TestingPractice: Connectathon Testing

• www.ihe.net www.ihe.net and and www.connectathon.net www.connectathon.net• Buy it:Buy it:

• Healthcare IT vendors are infrastructure-Healthcare IT vendors are infrastructure-specialistsspecialists

How do you add to IHE IT Infrastructure?

• Implement the profilesImplement the profiles• Your experience adds to the shared knowledge.Your experience adds to the shared knowledge.• Based on experience, you can make Change Based on experience, you can make Change

Proposals to update the framework.Proposals to update the framework.• Your participation in the Connectathon adds to the Your participation in the Connectathon adds to the

collective IHE experiencecollective IHE experience

• Comment on the new profilesComment on the new profiles• Your knowledge and perceptions adds to the quality of Your knowledge and perceptions adds to the quality of

the Technical Framework.the Technical Framework.• It is better to discover and correct problems in the It is better to discover and correct problems in the

design phase than in the coding phase.design phase than in the coding phase.• Your good ideas will be folded-into the final work.Your good ideas will be folded-into the final work.

How do you add to IHE IT Infrastructure?

• Help author the profiles (Technical Committee)Help author the profiles (Technical Committee)• Your Your technical technical expertise contributes to – and is honed by – expertise contributes to – and is honed by –

the collaborative experiencethe collaborative experience• Your ideas will be consolidated and improved-upon by Your ideas will be consolidated and improved-upon by

working with expert peers.working with expert peers.• ““Many hands make light work.”Many hands make light work.”

• Help plan the profiles (Planning Committee)Help plan the profiles (Planning Committee)• Your Your marketmarket expertise contributes to – and is honed by – expertise contributes to – and is honed by –

the collaborative experiencethe collaborative experience• Your ideas will be consolidated and improved-upon by Your ideas will be consolidated and improved-upon by

working with expert peers.working with expert peers.• ““Many hands make light work.”Many hands make light work.”

What comes next?Current cycle

• Education at this conferenceEducation at this conference• Comments for the new IT Infrastructure profiles – due by Comments for the new IT Infrastructure profiles – due by

July 13, 2007July 13, 2007• Publication of the new IT Infrastructure profiles for trial Publication of the new IT Infrastructure profiles for trial

implementation – implementation – early August, 2007early August, 2007• Publication of IHE IT Infrastructure Roadmap update – Publication of IHE IT Infrastructure Roadmap update –

early August, 2007early August, 2007• Sign-up for the 2008 Connectathon and HIMSS Sign-up for the 2008 Connectathon and HIMSS

Interoperability Showcase – Interoperability Showcase – September 15September 15thth, 2008, 2008• Implement and test for 2008 Connectathon, per scheduleImplement and test for 2008 Connectathon, per schedule• Connectathon – Connectathon – January 28 – February 1, 2008January 28 – February 1, 2008, Chicago , Chicago

(Hyatt)(Hyatt)• HIMSS Interoperability Showcase – HIMSS Interoperability Showcase – February 24-28, February 24-28,

20082008, Orlando, Orlando

What comes next?2007-2008 Development Cycle

• Brief proposals submitted to ITI Planning Brief proposals submitted to ITI Planning Committee – Committee – October 9-10, 2007October 9-10, 2007

• ITI Planning Committee selects “short list”, hands ITI Planning Committee selects “short list”, hands off to ITI Technical Committee – off to ITI Technical Committee – November, 2007November, 2007

• ITI Technical Committee selects scopes final ITI Technical Committee selects scopes final profiles, white papers – profiles, white papers – January, 2008January, 2008

• Profile development complete, supplements Profile development complete, supplements published for public comment – published for public comment – June, 2008June, 2008

• IHE Web Site - http://www.ihe.netIHE Web Site - http://www.ihe.net• Technical FrameworksTechnical Frameworks• Technical Framework Supplements – Trial ImplementationTechnical Framework Supplements – Trial Implementation• Calls for ParticipationCalls for Participation• IHE Fact Sheet and FAQIHE Fact Sheet and FAQ• IHE Integration Profiles: Guidelines for BuyersIHE Integration Profiles: Guidelines for Buyers• IHE Connectathon ResultsIHE Connectathon Results• Vendors’ Product Integration StatementsVendors’ Product Integration Statements

• Sponsors’ IHE sitesSponsors’ IHE sites• http://www.himss.org/IHE http://www.himss.org/IHE • http://www.rsna.org/IHEhttp://www.rsna.org/IHE• http://www.acc.org/quality/ihe.htmhttp://www.acc.org/quality/ihe.htm

More Information

For further info, contact:For further info, contact:

Michael NusbaumMichael Nusbaum• Co-Chair, IT Infrastructure Planning Committee,Co-Chair, IT Infrastructure Planning Committee,• IHE Strategic Development CommitteeIHE Strategic Development Committee• Interoperability Showcase Planning CommitteeInteroperability Showcase Planning Committee

michael@mhnusbaum.commichael@mhnusbaum.com

250-384-0001250-384-0001