Didi Davis, HIMSS Didi Davis, HIMSS Senior Director, Informatics/IHE InternationalSenior Director, Informatics/IHE International

Introduction to Introduction to Integrating the Healthcare Enterprise (IHE)Integrating the Healthcare Enterprise (IHE)

and IHE’s contribution to standards and IHE’s contribution to standards harmonization for the Nationwide Health harmonization for the Nationwide Health

Information NetworkInformation Network

22

What is Standards Harmonization?

• Healthcare is a complex multi-specialty multi-stakeholder Healthcare is a complex multi-specialty multi-stakeholder system. Multiple standard development organizations are system. Multiple standard development organizations are necessary.necessary.

• Challenge is to achieve “interoperability” while implementing Challenge is to achieve “interoperability” while implementing multiple standards to meet a broad range of information multiple standards to meet a broad range of information exchange needs:exchange needs:– Application-to-application– System-to-system– Setting-to-setting

• Coordinate adoption of standards to meet clinical and Coordinate adoption of standards to meet clinical and administrative Use Casesadministrative Use Cases– Identify the key interoperability problems they faceIdentify the key interoperability problems they face– Providers and industry work together to develop and make Providers and industry work together to develop and make

available standards-based solutionavailable standards-based solution

Standards: Necessary…Not Sufficient

• Standards areStandards are– Foundational - interoperability and communicationsFoundational - interoperability and communications– Broad - varying interpretations and Broad - varying interpretations and

implementationsimplementations– Narrow - may not consider relationships between Narrow - may not consider relationships between

standards domainsstandards domains– Plentiful - often redundant or disjointedPlentiful - often redundant or disjointed– Focused - standards implementation guides Focused - standards implementation guides

typically focus on a single standardtypically focus on a single standard

Need a standard process for implementing Need a standard process for implementing multiple standardsmultiple standards

What is “Integrating the Healthcare Enterprise”?

• A 9-year public-private initiative • Driven by end-users, 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• The IHE Global Standards Adoption process as

approved by the International Standards Organization (ISO) as a Technical Report 28380 in August 2007

How does IHE work?

• Clinicians and IT professionals identify key Clinicians and IT professionals identify key clinical and business workflow problemsclinical and business workflow problems

• Clinicians, IT professionals, consultants, and Clinicians, IT professionals, consultants, and vendors jointly solve those problems by vendors jointly solve those problems by standardizing the way existing standards are standardizing the way existing standards are implemented in HIT productsimplemented in HIT products

• IT professionals follow the IHE guidelines in IT professionals follow the IHE guidelines in purchasing and integrating effective systemspurchasing and integrating effective systems

Who’s involved in IHE?

• Users - Clinicians, Staff, Administrators, CIOs, Users - Clinicians, Staff, Administrators, CIOs, Gov’t agencies (e.g. NIST, VA, DoD, CDC, CMS)Gov’t agencies (e.g. NIST, VA, DoD, CDC, CMS)

• Professional Societies representing 270,000 Professional Societies representing 270,000 individual members:individual members:– HIMSS, RSNA, ACC, ACP, AAO, ACCE, ASTRO, etcHIMSS, RSNA, ACC, ACP, AAO, ACCE, ASTRO, etc

• Standards Development Orgs (SDOs):Standards Development Orgs (SDOs):– HL7, DICOM, ISO, CDISC, ASTM, W3C, IEEE, HL7, DICOM, ISO, CDISC, ASTM, W3C, IEEE,

IETF, etcIETF, etc

• Vendors & consultants (e.g., imaging, EHRs, Vendors & consultants (e.g., imaging, EHRs, cardiology, medical devices)cardiology, medical devices)

Integrating the Healthcare Enterprise

““Achieving Interoperability through Implementation of Standards”Achieving Interoperability through Implementation of Standards”

1997: Founded in Radiology (RSNA) and IT (HIMSS)1997: Founded in Radiology (RSNA) and IT (HIMSS)• Many professional societies (stakeholder Many professional societies (stakeholder

representation)representation)– American Academy of Ophthalmology (AAO)American Academy of Ophthalmology (AAO)– American College of Cardiology (ACC)American College of Cardiology (ACC)– American College of Physicians (ACP)American College of Physicians (ACP)– American College of Clinical Engineering (ACCE) American College of Clinical Engineering (ACCE) – American College of Emergency Physicians (ACEP) American College of Emergency Physicians (ACEP) – American Society for Therapeutic Radiation Oncology (ASTRO)American Society for Therapeutic Radiation Oncology (ASTRO)– GMSIH (IT France), JAHIS (IT Japan), SFIL (laboratory)GMSIH (IT France), JAHIS (IT Japan), SFIL (laboratory)– Healthcare Information Management Systems Society (HIMSS)Healthcare Information Management Systems Society (HIMSS)– Radiological Society of North America (RSNA)Radiological Society of North America (RSNA)– And many more….And many more….

Who benefits from IHE’s work?

• Patients– Enhance care’s quality, safety, efficiency & effectiveness

• Clinicians– Improve workflow & information reporting– Fewer error opportunities; Less repeated work

• Vendors & Consultants– Satisfy customers’ interoperability demands– Decreased cost & complexity of installation & mgt

• SDOs– Rapid feedback to address real-world issues– Establishment of critical mass and widespread adoption

• Government– Reduced costs of implementing EHR systems– Increased patient information interoperability

IHE Organizational Structure

ACCACPHIMSSRSNA

JAHISJIRAJRS

METI-MLHWMEDIS-DCJAMI

GMSIHSFRSFILACCE

SIRMBIREuroRec

COCIREAR-ECRDRG

ESC

Professional Societies / Sponsors Contributing &Participating

Vendors

IHE International Board

IHE Europe

IHE North America

France

USA

Canada

IHE Asia-Oceania

Japan

Korea Taiwan

Netherlands

Spain Sweden UK

ItalyGermany

Norway

Regional Deployment

China

Global Development

Radiology

Cardiology

ITInfrastructure

Patient CareCoordination

Patient CareDevices

Laboratory

Pathology

Eye CareRadiationOncology

Public Health, Quality and Research

1010

International Growth of IHE

France

Local Deployment National Extensions Promotional & Live Demonstration Events Funding

USA

Germany

Italy

JapanUK

Canada

Korea

Taiwan

Norway

Netherlands

SpainChina

Austria

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

88

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

Australia

Proven Standards Adoption Process

Document Use Case RequirementsDocument Use 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 technical specifications

Develop technical specifications

Testing at ConnectathonsTesting at Connectathons

IHEDemonstrationsIHEDemonstrations

Products with IHEProducts with IHE

Timely access to informationTimely access to information

Easy to integrate productsEasy to integrate products

1212

National and Regional Projects Using IHE Profiles

Quebec, Ontario,Alberta, British ColumbiaCanada Health Infoway

Denmark (Funen)Italy (Veneto)Spain (Aragon)

THINC- New YorkNCHICA – N. Carolina

Italy (Conto Corrente

Salute)

Boston Medical

Center - MA

FranceDMP

UK CfH(Radiology WF)

Philadelphia HIE

CHINA-MoHLab results sharing

CPHIC – Pennsylvani

a

CHINA-ShanghaiImaging Info Sharing

JAPAN-NagoyaImaging Info Sharing

South Africa

Malaysia

VITL-Vermont

CareSpark – TN & VA

NetherlandAmsterdam

LowerAustria

Austria

Growth in IHE Domains

Radiology (18 profiles)

IT Infrastructure for Healthcare (20 profiles)

Cardiology (7 profiles)

Laboratory (6 profiles)

Radiation Oncology (3 profiles)

Patient Care Coord. (5 profiles)

Patient Care Devices (3 profiles)

Pathology

Eye Care (4 profiles)

19

99

• Over 200 vendors involved world-wideOver 200 vendors involved world-wide• 8 Technical Frameworks8 Technical Frameworks• 64 Integration Profiles64 Integration Profiles

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

world-wideworld-wide

VeterinaryEndoscopyPharmacy

Public Health, Quality and Research

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

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

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

OtherOtherCross-Enterprise Document Sharing

Registration, distribution and access across health enterprises of clinical

documents forming a longitudinal record

Cross-Enterprise Document Pt-Pt Reliable InterchangeCross-Enterprise Document

Media InterchangeCross-Community Access

Security & PrivacySecurity & Privacy

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

Cross-Enterprise User Attestation

User Attributes fro Access Control

IHE Integration Profiles for Health Info Nets What is available and has been added this cycle

Clinical and PHR ContentClinical and PHR Content

The Community is the Hub that Drives Interoperability

• AHIC, chaired by HHS Secretary provides strategic coordination.

• CCHIT focuses on developing a mechanism for certification of health care IT products

• HITSP brings together all relevant stakeholders to identify & harmonize appropriate standards

• HISPC addresses variations in business policy and state law that affect privacy and security

• NHIN is focused on interoperability pilots and implementation

Healthcare Information Technology

Standards Panel (HITSP)

Nationwide Health Information

Network (NHIN) Architecture

Projects

The Health Information Security and

Privacy Collaboration

(HISPC)

The Certification Commission for

Healthcare Information Technology

(CCHIT)

American Health Information

Community (AHIC)

Standards Harmonization

HITSP (Healthcare Information Standards Panel)

US Federal Initiative for Health IT and Nationwide Health Information Network

• The U.S. healthcare system is managed both at the federal level and the state-level.

• Over 200 Health Information Exchange projects in the U.S. at the state level or regional communities within the states.

• At the federal level, HHS has set-up a policy-level setting board (AHIC), a coordination office (ONC) and 4 supporting initiatives for standards harmonization, certification, privacy and implementation prototyping.

• IHE-USA has been engaged in the organization of one of these supporting initiatives: HITSP. IHE and its sponsors (e.g. HIMSS, RSNA, ACCE, etc.) and participants contribute to those initiatives.

HITSP Delivers Interoperability Specs to AHIC

• The Healthcare Information Technology Standards Panel (HITSP) has addressed 7 business use cases for interoperability.

• HITSP has nearly 400 member organizations representing all U.S. stakeholders including Standards Development Organizations (incl. X12, DICOM, HL7, etc.).

• HITSP, through its standards-based interoperability specifications, is leveraging standard-based implementation guides such as those from Integrating the Healthcare Enterprise (IHE).

• The IHE Connectathon and the HIMSS Interoperability Showcase play a visible role demonstrating the HITSP/IHE synergy.

From Standards to Solving a Use Case

• AHIC/ONC

• HITSPInteroperability Specifications

+ Constructs

Standards Adoption/Profiling

Technical Use Case Driven

Base StandardsFoundations

• IHE

• HL7, NCPDP, • X12, DICOM,

ISO, etc…

Business Use Case

2020

IHE contributes to

HITSP’s success

IHE contributes to

HITSP’s success18 IHE Profiles adopted

byHITSP Interoperability

Specifications

Conformance Testing & Certification

• IHE Conformance Testing

• CCHIT Certification

Interoperability Specifications+ Constructs

Standards Adoption/ProfilingTechnical Use Case Driven

Base StandardsFoundations

HITSP GOALS and IHE

• HITSP goals with respect to testing activities– Ensure 'fitness for use' of HITSP Interoperability Specifications– Has leveraged the IHE testing process to support overall

collaborative testing activities

• HITSP collaboration with IHE– 18 IHE Profiles are used as constructs in HITSP ISs– IHE Profiles provide globally accepted standards to HITSP – IHE Connectathon/HIMSS Showcase provide opportunity for

collaboration to meet mutual goals

• To access HITSP Interoperability Specifications:www.HITSP.org

HIMSS08 Interoperability Showcase40 out of 51 implementers demonstrated HITSP

Requirements for an open RHIO/HIE(1)• Bring trust and ease of use for healthcare professionals:

– Care delivery organizations choose information to share:• Based on patient situation

• When they see fit (discharge, end of encounter, etc.)

• What information to share (pick relevant types of documents, and content elements).

– Care delivery organizations access patient information through:• their own EMR (if they have one), or

• through a shared portal otherwise.

– When accessing patient info:• Find quickly if relevant information is available or not (single query).

• May select among relevant documents, which ones to see (may be done in background)

• Among those of interest, chose to import in whole or part in its own EMR Chart (responsibility).

Requirements for an open RHIO/HIE(2)

• Bring trust and privacy to patients:– Only authorized organizations and authenticated healthcare providers

may transact in the HIE:• Each node or IT system interfaced is strongly authenticated

• Each user shall be authenticated on the edge system (where context is best known)

• All traffic trough the infrastructure is encrypted

– Patient consent needs multiple choices or levels• Unless opt-in, no data about a specific patient may be shared

• Several data sharing policies offered to the patient consent

• Each shared document is assigned to specific policies (or not shared) at encounter time.

• Healthcare providers may only access documents compatible with their role.

– Shared Document Registry does not contain patient clinical data only generic information (minimum metadata + repository reference)

Categories of Healthcare Communication Services

Security

DocumentSharing

Patient and Provider ID Mgt

DynamicInformation

Access

WorkflowManagement

Source persisted and attested health

records

Specific info snapshot

provided on demand

2 or more entitiessynchronize

a task

e.g. access to last 6 months historical

labs and encounter summaries

e.g. order a lab test, track status and receive results

e.g. get a current list of allergies or med list from a source

HospitalsHIEs and RHIOs

IT Infrastructure

What is IHE IT Infrastructure?

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

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

– Basic implementation-specification foundations to be extended by other IHE clinical domains

Examples: Retrieve Forms for Data Capture; Cross-Enterprise Document Sharing

– White Papers for current work itemsExamples: HIE Security and Privacy; Health Data Re-use

Infrastructure; Risk Management

Community orsub-network

Clinical Encounter

Clinical IT System Index of patients records(Document-level)

Aggregate Patient Info

4-Patient data 4-Patient data presented to presented to

PhysicianPhysician

Sharing SystemSharing System

Clinic Record Specialist Record

Hospital Record

2-Reference2-Referenceto Records to Records for Inquiryfor Inquiry

Introduced at HIMSS in 2005 : IHE-XDSIntroduced at HIMSS in 2005 : IHE-XDS

3-Records3-RecordsReturnedReturned

ReferenceReferenceto recordsto records Repository of

Documents

Repository ofDocuments

IHE-XDS Infrastructure Components

• Audit Record Repository (ATNA) – Receive audit records from other actors and securely store for audit purposes. ATNA also authenticates peer-nodes and encrypt communications.

• Time Server (CT) – Provides consistent definition of date/time enabling time synchronization across multiple systems. Enables events associated with patients to be sorted reliably in chronological order.

• Document Registry (XDS) – Queryable index of metadata and references to all documents shared within a connected community (XDS Affinity Domain)

• Document Repository (XDS) – Supports storage and retrieval of clinical information (as documents). May be centralized or distributed.

• Patient Identifier Cross Reference Manager (PIX) – Reconciles information on patients from multiple domains to a single, cross referenced set of ids for each given patient.

• Patient Demographics Supplier (PDQ) – Returns demographic information and identifiers for patients based on specified demographic criteria.

IHE IT InfrastructureComposable Integration Profiles

Doc Exchange Integration ProfilesDoc Exchange Integration Profiles

Doc SharingDoc Sharing

XDSXDS

MediaMediaInterchangeInterchange

XDMXDM

Pt-Pt DocPt-Pt DocInterchangeInterchange

XDRXDR

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 DocScanned Doc

XDS-SDXDS-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

Community Clinic

Lab Info. System

PACS

Teaching Hospital

PACS

ED Application

EHR System

Physician Office

EHR System

XDS Scenario + use of ATNA & CT

PMS

Retrieve DocumentRetrieve Document

Register DocumentRegister DocumentQuery DocumentQuery Document

XDS Document Registry

ATNA Audit record repository CT Time server

Record AuditRecord AuditEventEvent

MaintainMaintainTimeTime

MaintainMaintainTimeTimeRecord AuditRecord Audit

EventEvent

Maintain TimeMaintain TimeProvide & Register Docs

Record AuditRecord AuditEventEvent

XDS Document Repository

XDSDocumen

t Reposito

rySecured MessagingSecured Messaging

Community Clinic

Lab Info. System

PACS

Teaching Hospital

PACS

ED Application

EHR System

Physician Office

EHR System

XDS Scenario + use of PIX & PDQ

A87631

PACS

L-716

Affinity Domain Patient Identity Source

M8354673993

Retrieve Document Provide & Register Docs

Register (using Pt ID)Query Document (using Pt Id)

Patient Identity Feed

Document Registry

14355M8354673993

L-716

A87631

Patient Identity Feed

PIX Query

PIX Query

Patient Identity Feed

Patient Identity XRef MgrPatient Identity FeedPDQ Query to Acquire Affinity Domain Patient ID

M8354673993

A87631L-716

M8354673993

XDS Document Repository

XDSDocument

Repository

ATNA Audit record repository CT Time server

Patient Care Coordination

A content profile is…

• A sharable information component that can be exchanged…– within an HIE or RHIO (XDS)– via Media or USB Device (XDM)– via Reliable Messages (XDR)

• Document content using standards– CDA Release 2.0– HL7 Care Record Summary– ASTM/HL7 Continuity of Care Document

• Library of Reusable Parts

XDS-MS and XPHR enable both semantic XDS-MS and XPHR enable both semantic interoperability & simple viewing !interoperability & simple viewing !

SSttrruuccttuurreedd CCoonntteenntt wwii tthh ccooddeedd sseecctt iioonnss::

Reason for Referral Vital Signs

MMeeddiiccaattiioonn

Studies AAlllleerrggiieess

Social History PPrroobblleemmss

Care Plan

XDS-MS Medical Summary or PHR Extract ExchangeProfile based on HL7 CDA Rel 2 and ASTM/HL7 CCD

Structured and Coded Header Patient, Author, Authenticator, Institution, Time of Service, etc.

Header always structured and coded

Title-coded sections with non-structured nor coded content (text, lists, tables). Simple Viewing (XML Style sheet)

Level 1Level 1

Level 2Level 2

Text StructureEntry

Text Structure Entry

Med, Problems and Allergies as highly structured text. Text easy to import/parse

Text StructureEntry

Level 3Level 3

CC

HIT

08C

CH

IT 08

Med Problems and Allergies have afine-grain structure with optional coding. Coding Scheme explicitly identified.

Coded Section Entry

Coded Section Entry

Coded Section Entry

Level 3Level 3

CC

HIT

09C

CH

IT 09

PCC Profiles

Medical Summaries

ED Referral

ExchangingPHR

Content

AntepartumCare

Summary

EmergencyDepartmentEncounter

Record

PreprocedureHistory and

Physical

BasicPatientPrivacyConsent

LabReport

FunctionalStatus

Assessments

2005-062005-062006-072006-072007-082007-08In

teg

rati

on

Co

nte

nt

Query for Existing Data

- Among 30 Consensus Standards Recommended by HITSP and accepted by HHS Secretary Leavitt.

Combining IHE ProfilesDocument Content & Modes of Document Exchange

Document Exchange Integration ProfilesDocument Exchange Integration Profiles

DocumentDocument SharingSharing

XDSXDS

MediaMediaInterchangeInterchange

XDMXDM

Reliable Pt-PtReliable Pt-PtInterchangeInterchange

XDRXDR

Doc Content Profiles Doc Content Profiles (Semantics content)(Semantics content)

Scanned DocScanned Doc

XDS-SDXDS-SD

LaboratoryLaboratory

XD*-LabXD*-LabPHR PHR

ExchangeExchange

XPHRXPHR

Discharge &Discharge &ReferralsReferrals

XDS-MSXDS-MS

ImagingImaging

XDS-IXDS-I

ConsentConsent

BPPCBPPCEmergencyEmergency

EDREDRPre-Pre-

SurgerySurgery

PPHPPPHP

Functional Status Functional Status AssesmentAssesment

FSAFSA

Use of a shared XDS infrastructure to access Radiology Reports and Images (XDS-I)

HospitalHospital

Imaging CenterImaging CenterPhysician PracticePhysician Practice

Between Radiology and :Between Radiology and :• IImaging specialistsmaging specialists• Non-imaging cliniciansNon-imaging clinicians PACS Y

PACS Z

Radiology -to-Radiology -to-RadiologyRadiology

Radiology -to-Radiology -to-PhysiciansPhysicians

Same XDS InfrastructureSame XDS Infrastructure (Registry and Repositories) (Registry and Repositories)

for medical summaries and imaging information !for medical summaries and imaging information !

2008 HIMSS Interoperability Showcase

Featured this year in the Showcase…

• 76 connected applications, 32 IHE profiles76 connected applications, 32 IHE profiles• Secured Health Information Exchange with Secured Health Information Exchange with

broad contentbroad content• Clinical Scenarios, focusing on clinician and Clinical Scenarios, focusing on clinician and

patient access and information sharing patient access and information sharing across the continuum of careacross the continuum of care

• Population Health, Quality and ResearchPopulation Health, Quality and Research• Privacy and SecurityPrivacy and Security• HITSP Interoperability SpecificationsHITSP Interoperability Specifications

Vendors Vendors ConnectedConnected 5151

SupportersSupporters 2222

TotalTotal 7373

• Health information exchange with patient care devicesHealth information exchange with patient care devices• Personal health record solutionsPersonal health record solutions• Financial and administrative systems for billing and claims attachments Financial and administrative systems for billing and claims attachments

(CAQH/CORE)(CAQH/CORE)• Expanded distributed demonstration in an HIE format showing connectivity Expanded distributed demonstration in an HIE format showing connectivity

with vendor boothswith vendor booths

The 2008 Cast:The 2008 Cast:

Visit the Virtual Conference April 23 – 24, 2008

IHE: Proof of Concept – Promotion – Participation

Live Public Demonstrations Walk-Through healthcare scenarios Simulated multi-vendor clinical

settings USA: RSNA, HIMSS Europe: ECR, DRG, JFR, … Asia: JRC, …

Industry Participation

199

923 Vendors47 Systems

70 Organizations136 Systems

>389 Engineers

2008

Connectathons Proof of concept Annual multi-vendor interoperability tests North America, Europe, Asia

Health Information Exchanges Interoperability: Cross-enterprise Document Sharing

• Cross-Enterprise Document Sharing simplifies clinical data management by defining interoperable infrastructure.

Transparency = Ease of Evolution

• Patients have guaranteed portability and providers may share information without concerns of aggregation errors.Digital Documents = Patients and providers empowerment

• Supports both centralized and decentralized repository architectures. Ease of federation nationally. Flexible privacy, Flexibility of configurations

• Addresses the need for a longitudinal healthcare data (health records). Complements to interactive workflow or dynamic access to data.

How to Use IHE

As a Vendor ImplementerAs a Vendor Implementer• Participate and Implement IHE Integration ProfilesParticipate and Implement 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 Consultant• Use IHE Integration Profiles to develop Use IHE Integration Profiles to develop

interoperability strategyinteroperability strategy• Use Connectathon Results and Integration Use Connectathon Results and Integration

Statements to evaluate vendorsStatements to evaluate vendors• Require IHE Integration Profile compliance in RFPsRequire IHE Integration Profile compliance in RFPs

Providers and VendorsProviders and Vendors

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