IHE (Integrating the Healthcare Enterprise): A solution for
Payer-Provider Interoperability? An Introduction to the Plumbing
Mike Nusbaum, BASc, MHSA, FHIMSS President MH Nusbaum &
Associates Ltd.
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Todays Agenda Introduce IHE, its products & processes How
can IHE serve the Payer community? Opportunities Q&A 2
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The Case for Standards 3
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Why do we need IHE? IHE Profiles address real-world problems
IHE Profiles make standards implementable Compliance to IHE
Profiles maximizes opportunity for plug-compatible interoperability
IHE can accelerate adoption and implementation of standards The IHE
Process ensures rigor and robustness: reliance on established
standards extensive engagement with stakeholders, incl. public
comment profile maintenance conformance testing in a real-world
environment attestation (not yet certification) 44
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Base Standards eHealth Projects Interoperability: Highest Cause
of Health IT project failures IHTSDO IETF 5
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Profile Development Base Standards eHealth Projects From a
problem to a solution Profiling Organizations Have Emerged IHTSDO
IETF Specific Extensions 6
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Standards: Necessary but not sufficient Standards are
Foundational - to interoperability and communications Broad -
varying interpretations and implementations Narrow - may not
consider relationships between standards domains Plentiful - often
redundant or disjointed Focused - standards implementation guides
focus only on a single standard IHE provides a standard process for
implementing multiple standards 7
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Connecting Standards to Care Healthcare professionals work with
industry Coordinate implementation of standards to meet clinical
and administrative needs Clinicians and HIT professionals identify
the key interoperability problems they face Providers and industry
work together to develop and make available standards- based
solutions Implementers follow common guidelines in purchasing and
integrating effective systems IHE: A forum for agreeing on how to
implement standards and processes for making it happen 8
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IHE: A Framework for Interoperability A common technical
framework for harmonizing and implementing multiple standards
Application-to-application System-to-system Setting-to-setting
Enables seamless health information movement within and between
enterprises, regions, nations Promotes unbiased selection and
coordinated use of established healthcare and IT standards to
address specific clinical needs 9
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Is IHE a novel idea? Has IHE been adopted? 10 What are the
alternatives ? Ignore the issue Pick key standards, and hope for
the best Rely on robust standards harmonization ISO Health
Informatics: TR28380 Global Standards Adoption IHE Process,
Profiles and Implementation Widespread adoption of IHE Profiles by
National and Regional Projects around the world: USA, Canada,
Europe, Asia Home Health: CONTINUA and IHE work together. 12
Country European epSOS Project (IHE-Europe hosting Industry Team).
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1111 IHE International Organizational Structure Contributing
& Participating Vendors Example Deployment Committees IHE
Europe IHE North America France USA Canada IHE Asia-Oceania Japan
KoreaAustralia Netherlands Spain Sweden UK Italy Germany Norway
China Austria Professional Societies / Sponsors IHE International
Board Global Development Domains Radiology Cardiology IT
Infrastructure Patient Care Coordination Patient Care Devices
Laboratory Pathology Eye CareRadiation Oncology Public Health,
Quality and Research Pharmacy Endoscopy Dentistry 11
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12 15 Years of Steady Evolution 1998 2012 The IHE Development
Domains Pathology since 2006 Radiation Oncology since 2004
Radiology since 1998 Cardiology since 2004 Patient Care Devices
since 2005 Patient Care Coordination since 2004 Eye Care since 2006
Quality Research & Public Health since 2006 Laboratory since
2004 (Healthcare) IT Infrastructure since 2003 Endoscopy since 2010
Dentistry since 2010 Pharmacy since 2009 12
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13 France Local Deployment National Extensions Promotional
& Live Demonstration Events Funding
USAGermanyItalyJapanUKCanadaKoreaTaiwanNorway Netherlands Spain
ChinaAustria 199920002001200220032004 2005200620072009 Pragmatic
global standards harmonization + best practices sharing 2008
Australia International Participation in IHE 13
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IHE Sponsors Professional societies: Healthcare Information
Management Systems Society (HIMSS) American College of Physicians
(ACP), American College of Emergency Physicians (ACEP) American
College of Obstetricians and Gynecologists (ACOG) Many other
American Professional Societies (ACCE), (AAO), (ASTRO), etc.
British Institute of Radiology (BIR), British Computer Society
(BCS) German Radiology Society (DRG) ASIP (IT France), SFIL
(laboratory), French National Project (DMP), European Society of
Cardiology Radiological Society of North America (RSNA) JAHIS (IT
Japan), JIRA, JRS, And many more Government Agencies: French
National Project (ASIP-Sant) Dutch National Project (NICTIZ)
Austrian National Project (ELGA) Canada Health Infoway (CHI)
Regional projects (Italy, USA, Japan) and many more.. 14
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Document Use Case Requirements Identify available standards (
e.g. HL7, DICOM, IETF, OASIS) Develop technical specifications
Testing at Connectathons Products declare IHE Timely access to
information Easy to integrate products RFPs with IHE reqts IHE
Standards Adoption Process 15 IHE Demonstrations
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What is a Connectathon? Cross-vendor, live, supervised,
structured testing event All participating vendors products tested
together in the same place/time Experts from each vendor available
for immediate problem resolution fixes are done in minutes, not
months!! Each vendor tests with multiple trading partners (actual
product to actual product) Testing of real-world clinical scenarios
using IHE Integration Profiles 16
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IHE Product Registry A website to search IHE Integration
Statements published by vendors Helps users find products that
match their needs Product Registry maintains a database of
actors/profiles in vendors integration statements Product Registry
points to Integration Statement on vendors web site 17
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18 Registering IHE Integration Statements
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Product Registry Usage 19 Approximately 410 Integration
Statements in the database Over 100 companies registered Average
280 visits per month
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IHE Integration Statement 20
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Product Registry Links 21 IHE Integration Statement template
http://tinyurl.com/62ymvtc Link to Product Registry :
http://product-registry.ihe.net Documentation :
http://gazelle.ihe.net/content/product -registry Support
http://gazelle.ihe.net/jira/PR
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HIMSS Interoperability Showcase 22
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Where in the World is XDS and CDA Link 23
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Of interest to payers XD* family of IT infrastructure profiles
XDS, XDR, XDM, XDS-SD XCA Content profiles that leverage the XD*
family XDS-MS, XD-LAB, XDS-I CDA (C-CDA) harmonized templates that
carry clinical data exchanged amongst healthcare stakeholders
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Opportunities Is there an interest in setting up a domain to
address payer needs? International or US-realm? Implications
Approach Next steps 25
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Thank you!!! Questions? Find out more at ihe.net 26