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Integrating the Healthcare Enterprise. The Essentials. Courtesy of IHE Committees. Healthcare IT – Main Obstacles. IHE scope. Lack of financial funding : IT : 2.3% of hospital budget (in other industries : 2.8%) [Gartner] Lack of national/regional guidelines & incentives - PowerPoint PPT Presentation
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The Essentials
Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise
G. ClaeysAgfa Healthcare R&D, Technology Manager
Vendor co-chair
IHE Europe
Prof. Dr. med. B. WeinPraxisgemeinschaft im Kapuzinerkarree
User Co-chair
IHE Europe
Courtesy of IHE Committees
7 February 2005 IHE Europe Educational Event2
Healthcare IT – Main ObstaclesHealthcare IT – Main Obstacles
Lack of financial funding : IT : 2.3% of hospital budget (in other industries : 2.8%)
[Gartner]
Lack of national/regional guidelines & incentives
Lack of access to IT infrastructure
Lack of solutions that meet clinical needs
Lack of adequate healthcare IT standards and interoperability Integration cost : 20% of hospital IT budget
IHE scope
7 February 2005 IHE Europe Educational Event3
IHE MissionIHE Mission
Improve the quality and cost of healthcare by removing the interoperability barriers Access to Patient Information Clinical Workflow
Provide an open interoperability framework, based on existing standards
Enable cross-vendor environment (best-of-breed)
Leverage the interoperability solutions in multiple domains (radiology, cardiology, clinical lab, enterprise)
IHE = Integrating the Healthcare Enterprise
7 February 2005 IHE Europe Educational Event4
IHE
EHR- Longitudinal Record
IHE Cardiology
IHE Laboratory
IHE Radiology
IHE
Future Domain
IHE
Future Domain
IHE
IT Infrastructure Intra-Enterprise
Cross-Enterprise
17 Integration Profiles
3 Integration Profile
3 Integration Profiles
9 Integration Profiles
IHE Expanding Scope IHE Expanding Scope
7 February 2005 IHE Europe Educational Event5
IHE ApproachIHE ApproachSolve real-world integration problems
Close co-operation between users and vendors Users identify the integration problems Vendors provide technical solutions
Incremental development & deployment process with an annual heartbeat
Common technical framework, based on established standards (e.g. DICOM, HL7,..)
7 February 2005 IHE Europe Educational Event6
IHE Development & Deployment IHE Development & Deployment processprocess
Identify critical healthcare workflows and integration problems
Research & select existing standards to implement a solution
Write, review and publish IHE Technical Framework
Develop trial implementations
Perform cross-testing at “Connectathon”
Demonstrate at tradeshows (HIMSS/RSNA…)
IHE Domains Milestones – 20 month cycleIHE Domains Milestones – 20 month cycleDevelopmentDevelopment and and DeploymentDeploymentProposed Scope
Approved Scope
Public Comment Intgr-profile Sponsors announce Connectathon/Demos with set of
Implementation Profiles
Final Intgr-profile + 9 ---
- 10 ---
- 7 ---
- 2 ---
Trial Implementation Intgr-profile 0 ---Connectathon/Demo Vendor Participant Registered
+ 2 ---
Vendor Participant passed Connectathon
+ 5 ---
+ 6 --- Demo &Education Material
Vendors release products with IHE Integration
Statements---
7 February 2005 IHE Europe Educational Event8
IHE Building BlocksIHE Building Blocks
IHE Technical Framework
IHE Validation Process
IHE Integration Statements
7 February 2005 IHE Europe Educational Event9
IHE Technical FrameworkIHE Technical Framework
Describes the different integration solutions (domain specific) Radiology, IT Infrastructure, Cardiology, Lab
Key concepts are domain neutral Integration Profile Transactions Actors Data model
Country & Regional specialization Limited : max. 5%
Based on existing standards
IT
Standards
(http, ebxml)
Healthcare
Standards
(HL7, DICOM)
IHE
Integration Profiles
eHealth
Application
eHealth
Application
7 February 2005 IHE Europe Educational Event10
IHE Technical Frameworks – IHE Technical Frameworks – The booksThe books
One Technical Framework for each one of the IHE Domains:
Cardiology IT Infrastructure Lab Radiology
7 February 2005 IHE Europe Educational Event11
IHE Integration Profile - ScopeIHE Integration Profile - Scope
Integration solution for real-world problems
Coherent set of integration functionality
Allow users to focus on high-level integration
7 February 2005 IHE Europe Educational Event12
IHE Integration Profiles – ExamplesIHE Integration Profiles – Examples
Streamline the workflow sub-processes Patient ADT – Ordering – Data creation & processing– Reporting –
Treatment - Billing Cross referencing patient id’s among hospitals (MPI)
Access to clinical data from workstations and browsers Departmental reports (e.g.. Clinical lab, cardiology, radiology),
measurements, images
Quality control Consistent presentation of images on displays & printers
Security : authentication, auditing
Access to common longitudinal health record (EHR) Focus on sharing of health record among healthcare institutions
7 February 2005 IHE Europe Educational Event13
IHE Integration Profiles - ContentIHE Integration Profiles - Content
Set of Transactions among Actors
Actor = logical entity (e.g. modality, image manager, order filler)
Transaction = Sequence of messages among Actors
Messages : e.g. HL7, DICOM, ebXML,.
Profiling existing communication standards Map data models, message content “Restrict the options” Clarify the semantics : accession nr
ADT PatientRegistration
OrderPlacer
DeptScheduler
ImageManager/Archive
Modality
7 February 2005 IHE Europe Educational Event14
IHE Integration Profile - ExampleIHE Integration Profile - Example
7 February 2005 IHE Europe Educational Event16
The IHE The IHE WWorld….orld….
IHE ActorIHE Actor
ActorActorActorActor
ActorActor
IHEIHETransactionTransactionIHEIHE
TransactionTransaction
IHEIHETransactionTransaction
IHE ActorIHE Actor
7 February 2005 IHE Europe Educational Event17
The Product World…..The Product World…..
Product XYZfrom Vendor T
7 February 2005 IHE Europe Educational Event18
Mapping IHE to ProductsMapping IHE to Products
IHE ActorIHE Actor
ActorActorActorActor
ActorActor
IHEIHETransactionTransactionIHEIHE
TransactionTransaction
IHEIHETransactionTransaction
IHE ActorIHE Actor
Poduct XYZfrom Vendor T
7 February 2005 IHE Europe Educational Event19
IHE Validation ProcessIHE Validation Process
Goal : Validate implementations of IHE TF in products
Approach IHE is not a certification authority IHE stimulates auto-validation
• Vendors are responsible for validating and documenting IHE implementations
• IHE provide tools and infrastructure
IHE Validation tools Mesa toolkit Connectathon IHE Integration statement
7 February 2005 IHE Europe Educational Event20
MESA Test ToolkitMESA Test Toolkit
Software library
Emulate the various actors in the different implementation profiles
Supports single product, single vendor testing
Pre-requisite for connectathon participation Implementers submit test logs prior to connectathon
7 February 2005 IHE Europe Educational Event21
Connectathon Connectathon Connectathon = connectivity marathon
Validate the Integration Profiles for a particular IHE demo Pre-requisite for participating at IHE demos
1 week validation session in Europe, USA and Japan End-to-end scenario testing Multi-product; multi-vendor; multi-domain
Multi-vendor, multi products 2004 : 50 companies, 100 systems 2005 : 77 companies, 118 systems
Multi-domain Integration Profiles Rad, ITI, Lab, Cardio
European connectathon’s : Paris (2002), Aachen (2003), Padua (2004) Noordwijkerhout (April 2005)
Results are published on www.ihe-europe.org
7 February 2005 IHE Europe Educational Event24
Connectathon results (simple)Connectathon results (simple)
7 February 2005 IHE Europe Educational Event25
Connectathon results (simple)Connectathon results (simple)
7 February 2005 IHE Europe Educational Event26
Connectathon results (advanced)Connectathon results (advanced)
7 February 2005 IHE Europe Educational Event27
IHE Integration StatementsIHE Integration Statements
Vendors Document the IHE implementation
per product Content :
• List of supported actors• List of supported integration
profiles (per actor) “contractual” commitment
Buyers Uniform mechanism to compare
product integration capabilities Enables validation on paper
7 February 2005 IHE Europe Educational Event28
IHE Integration Statement
Vendor Product Name Version Date
Huge Imaging Medical Systems IntegrateRAD V2.3 12 Oct 2002
Integration Profiles Implemented
Actors Implemented Options Implemented
Scheduled Workflow Image Manager/Archivee none
Image Display Performed Procedure Step
Order Filler PPS Exception Management
Simple Image and Numeric Report
Report Creator none
Link to vendor IHE page www.HImedicalsystems.fake/ihe
Links to Standards Conformance Statements of the Implementation
HL7 www.HImedicalsystems.fake/hl7
DICOM www.HImedicalsystems.fake/dicom/integrateRAD.pdf
IHE Integration Statements - ExampleIHE Integration Statements - Example
7 February 2005 IHE Europe Educational Event29
IHE Integration Statements - ResourcesIHE Integration Statements - Resources
7 February 2005 IHE Europe Educational Event30
IHE Integration Statements - ListIHE Integration Statements - List
7 February 2005 IHE Europe Educational Event31
IHE Market AdoptionIHE Market Adoption
40+ companies / 100+ Products with IHE Integration Statements www.ihe-europe.org -> Product IS www.rsna.org/IHE/integration_statements
IHE support is requested in RFPs
IHE User Success Stories in North American and Europe
7 February 2005 IHE Europe Educational Event32
IHE User Success Stories – Submitted since 2002
IHE measures success on:
Compliant products availability
Provider deployed integrated systems
IHE Becomes realityIHE Becomes reality
7 February 2005 IHE Europe Educational Event34
IHE OrganizationIHE Organization
Global Structure
Why IHE Europe
7 February 2005 IHE Europe Educational Event35
IHE Europe
IHE North America
France
USA Canada
IHE Asia-Ocenia
Japan
KoreaTaiwan
Netherland Spain Sweeden
UKItalyGermany
Norway
Regional Deployment
RadiologyPlanning Committee
RadiologyTechnical Committee
IT InfrastructurePlanning Committee
IT InfrastructureTechnical Committee
Pharmacy ExporatorySub-Committee
Global Development
CardiologyPlanning Committee
CardiologyTechnical Committee
LaboratoryPlanning and technical
Committee
IHE Strategic Development Committee
ACCHIMSSRSNA
JAHISJIRAJRS
METIMEDIS-DCJAMI
GMSIHSFRSFIL
SIRMBIREuroRec
COCIREAR-ECRDRG
ESCProfessional Societies / SponsorsProfessional Societies / Sponsors Contributing and participatingContributing and participating
VendorsVendors
IHE Organizational StructureIHE Organizational Structure
7 February 2005 IHE Europe Educational Event36
IHE Members IHE Members
Users Clinicians, Medical Staff, Administrators, CIOs, …
Vendors Information Systems & Imaging Equipment (80 vendors)
Societies Representing Healthcare Segments EAR, ESC, Other Professional Societies…
Governmental agencies e.g. GMSIH
Active liaison with Standards Development Organizations (SDOs) HL7, DICOM, ASTM, others …
Stakeholders of healthcare interoperability solution
7 February 2005 IHE Europe Educational Event37
AGFA Healthcare
AISoftw@re Medical Solutions
Algotec
ARES SA
aycan Digitalsysteme
ConVis
DEDALUS
Dianoema
Eastman Kodak Company
Ebit Sanita
EDL
ELFIN s.r.l.
Engineering Sanità Enti Locali
ESAOTE
ETIAM
Ferrania
Fujifilm
GE Healthcare
GMD
GIE Convergence-Profils
Rogan-Delft
Sago spa
Sectra Imtec AB
Siemens Medical Solutions
Soluzioni Informatiche srl
Stentor Inc.
Swissray Medical AG
Symphonie On Line
Synapsis
TELEMIS S.A.
TIANI MEDGRAPH AG
TOREX GAP Medical
Toshiba Medical Systems
TSI groupe europMedica
VEPRO AG
VISUS Technology Transfer
WAID
XR PARTNER
GWI Research
IASI Srl
IdeoPass
Image Device-Cerner Company
INFINITT
INOVIT
McKesson
MED2RAD
MEDASYS SA
Medavis
Medigration GmbH
MEDIMON Ltd.
MEDOS AG
Merge eFilm
METAFORA
Minolta Europe
Omnilab
Philips Medical Systems
Rasna Imaging Systems
RAYPAX INC.
In yellow, companies with IHE Committees Chairs (Summer 2004)
Participating and Contributing Vendors (Europe)Participating and Contributing Vendors (Europe)
7 February 2005 IHE Europe Educational Event38
IHE in Europe - WhyIHE in Europe - Why
Similar integration problems ask for similar (IHE) solutions
Provide European vendors (RIS/HIS) with a platform to develop and test world-class interoperability
Address European specific requirements :
Multi-language aspect Limited acceptance of HL7 Country specific RIS vendors Country specific congresses & exhibitions
Represent European needs in the different global IHE Development committees
7 February 2005 IHE Europe Educational Event39
IHE Netherlands IHE Netherlands CommitteeCommittee
IHE Germany IHE Germany CommitteeCommittee
IHE xxx IHE xxx CommitteeCommittee
Demonstrations
Education
National TF extensions
Vendor Participation
IHE Europe IHE Europe CommitteeCommittee
Strategic Development
Connectathon
New Integration Profiles
Education and promotion
IHEInter-
national
IHE Europe vs. NIHE Europe vs. National IHEational IHE
7 February 2005 IHE Europe Educational Event40
IHE-Europe – Deployment ActivitiesIHE-Europe – Deployment Activities
National IHE Committees (8) 2001 : France, Germany 2002 : Italy, UK 2003 : Norway, Denmark, Netherlands 2004 : Spain
Demos : Radiology centric demos : JFR, DRK,
SIRM, UKRC, ECR Hospital centric demos : Hopital Expo,
Medica, HCC
400 visitors/demo (average)
40% local vendors; 60% international vendors
7 February 2005 IHE Europe Educational Event41
IHE Europe Development ActivitiesIHE Europe Development Activities
Participate in global IHE Development activities National extensions of Technical Framework
Champion of IHE Clinical Lab : Joint effort of IHE France and IHE Japan Other countries join : USA, Germany
Assess new IHE initiatives in Pathology & Surgery
IHE test tool development: Extensions of MESA Test tools for clinical lab Web based test management tool
7 February 2005 IHE Europe Educational Event42
IHE Europe – Activities 2005IHE Europe – Activities 2005
IHE Connectathon Noordwijkerhout, 25-29 April 2005 All IHE domains : Radiology, IT Infrastructure,
Cardiology, Clinical Lab
IHE Demos : Radiology : UK, ECR, France, Germany Cardiology : ESC congress (Stockholm) Lab : France, Italy Enterprise : Italy, France
7 February 2005 IHE Europe Educational Event43
How to participate to IHE?How to participate to IHE?
As a VendorImplement IHE profiles in your products
Participate to Connect-a-thons and Demonstrations
Respond to Public Comments of Domain Supplements
Participate in IHE development / deployment committee
As a User/ConsultantInclude IHE Integration Profiles in your RFPs and Integration Projects
Respond to Public Comments of Domain Supplements
Attend Demonstrations.
Participate in IHE development / deployment committee
7 February 2005 IHE Europe Educational Event44
IHE, IHE, the effective bridge the effective bridge
betweenbetweeninformation exchange standards information exchange standards
and and their practical use in healthcaretheir practical use in healthcare
7 February 2005 IHE Europe Educational Event45
More information….More information….
IHE Web sites: • http://ihe-europe.org• http://www.rsna.org/IHE• http://www.acc.org/quality/ihe.htm• http://ihe-nl.org
Technical Frameworks:• ITI V1.0, RAD V5.5, LAB V1.0, CARDIO V1.0
Non-Technical Brochures :• IHE Europe Business Case• IHE Fact Sheet and FAQ• IHE Integration Profiles: Guidelines for Buyers• IHE Connectathon Results• Vendor Products Integration Statements