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Integrating the Healthcare Enterprise

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

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Integrating the Healthcare Enterprise

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  1. Integrating the Healthcare Enterprise The Essentials Courtesy of IHE Committees

  2. 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 • 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 Europe Educational Event

  3. IHE Mission IHE = Integrating the Healthcare Enterprise • 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 Europe Educational Event

  4. IHE Expanding Scope IHE Europe Educational Event

  5. IHE Approach • Solve 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,..) IHE Europe Educational Event

  6. IHE Development & Deployment process 20 Months • 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 Europe Educational Event

  7. Trial Implementation Intgr-profile 0 --- Connectathon/Demo Vendor Participant Registered + 2 --- Vendor Participant passed Connectathon + 5 --- Demo &Education Material + 6 --- Final Intgr-profile + 9 --- Vendors release products with IHE Integration Statements --- IHE Domains Milestones – 20 month cycleDevelopment and Deployment - 10 --- Approved Scope - 7 --- Public Comment Intgr-profile - 2 --- Sponsors announce Connectathon/Demos with set of Implementation Profiles Proposed Scope

  8. IHE Building Blocks • IHE Technical Framework • IHE Validation Process • IHE Integration Statements IHE Europe Educational Event

  9. IHE 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 eHealth Application eHealth Application IHE Integration Profiles IT Standards (http, ebxml) Healthcare Standards (HL7, DICOM) IHE Europe Educational Event

  10. IHE Technical Frameworks – The books One Technical Framework for each one of the IHE Domains: • Cardiology • IT Infrastructure • Lab • Radiology IHE Europe Educational Event

  11. IHE Integration Profile - Scope • Integration solution for real-world problems • Coherent set of integration functionality • Allow users to focus on high-level integration IHE Europe Educational Event

  12. IHE 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 IHE Europe Educational Event

  13. IHE Integration Profiles - Content ADT Patient Registration Order Placer Dept Scheduler Image Manager/Archive Modality • 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 IHE Europe Educational Event

  14. IHE Integration Profile - Example IHE Europe Educational Event

  15. IHE Transactions - Example IHE Europe Educational Event

  16. The IHE World…. Actor Actor Actor IHETransaction IHETransaction IHE Actor IHE Actor IHETransaction IHE Europe Educational Event

  17. The Product World….. Product XYZfrom Vendor T IHE Europe Educational Event

  18. Mapping IHE to Products Actor Actor Actor Poduct XYZfrom Vendor T IHETransaction IHETransaction IHE Actor IHE Actor IHETransaction IHE Europe Educational Event

  19. IHE 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 IHE Europe Educational Event

  20. MESA 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 IHE Europe Educational Event

  21. 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 IHE Europe Educational Event

  22. Connectathon at work 2003 Aachen IHE Europe Educational Event

  23. Connectathon results IHE Europe Educational Event

  24. Connectathon results (simple) IHE Europe Educational Event

  25. Connectathon results (simple) IHE Europe Educational Event

  26. Connectathon results (advanced) IHE Europe Educational Event

  27. IHE 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 IHE Europe Educational Event

  28. IHE Integration Statement IHE Integration Statements - Example Vendor Product Name Version Date HugeImaging Medical Systems IntegrateRAD V2.3 12 Oct 2002 Integration Profiles Implemented Actors Implemented Options Implemented Scheduled Workflow ImageManager/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 Europe Educational Event

  29. IHE Integration Statements - Resources IHE Europe Educational Event

  30. IHE Integration Statements - List IHE Europe Educational Event

  31. IHE 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 IHE Europe Educational Event

  32. IHE Becomes reality • IHE User Success Stories – Submitted since 2002 • IHE measures success on: • Compliant products availability • Provider deployed integrated systems IHE Europe Educational Event

  33. IHE Europe Success Stories IHE Europe Educational Event

  34. IHE Organization • Global Structure • Why IHE Europe IHE Europe Educational Event

  35. IHE Organizational Structure IHE Strategic Development Committee Global Development Regional Deployment IHE North America IHE Asia-Ocenia RadiologyPlanning Committee IT Infrastructure Planning Committee Japan CardiologyPlanning Committee USA Canada Taiwan Korea IT Infrastructure Technical Committee Radiology Technical Committee Cardiology Technical Committee IHE Europe LaboratoryPlanning and technicalCommittee Pharmacy Exporatory Sub-Committee France Germany Italy UK Netherland Spain Sweeden Norway Professional Societies / Sponsors Contributing and participatingVendors ACCHIMSSRSNA GMSIH SFRSFIL COCIR EAR-ECR DRG SIRM BIR EuroRec ESC JAHISJIRAJRS METIMEDIS-DCJAMI IHE Europe Educational Event

  36. IHE Members Stakeholders of healthcare interoperability solution • 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 … IHE Europe Educational Event

  37. Participating and Contributing Vendors (Europe) 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 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. 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 In yellow, companies with IHE Committees Chairs (Summer 2004) IHE Europe Educational Event

  38. IHE 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 IHE Europe Educational Event

  39. IHE Europe vs. National IHE Connectathon IHE Europe Committee Education and promotion IHEInter-national Strategic Development New Integration Profiles Vendor Participation National TF extensions IHE Netherlands Committee IHE Germany Committee IHE xxx Committee Demonstrations Education IHE Europe Educational Event

  40. IHE-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 IHE Europe Educational Event

  41. IHE 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 IHE Europe Educational Event

  42. IHE 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 IHE Europe Educational Event

  43. How to participate to IHE? As a Vendor • Implement 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/Consultant • Include IHE Integration Profiles in your RFPs and Integration Projects • Respond to Public Comments of Domain Supplements • Attend Demonstrations. • Participate in IHE development / deployment committee IHE Europe Educational Event

  44. IHE, the effective bridge betweeninformation exchange standards and their practical use in healthcare IHE Europe Educational Event

  45. 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 IHE Europe Educational Event

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