IHE Eye Care Process and Timeline

1. IHE Eye CareProcess and Timeline IHE Workshop 2006 - Changing the Way Healthcare Connects Flora Lum, M.D.Director, Quality of Care and Knowledge Base DevelopmentAmerican Academy of Ophthalmology Jim Riggi, CTO Medflow, Inc. Co-Chair IHE Eye Care Technical Committee

2. Standards are critical but alone are not enough • Standards offer generality, ambiguity and alternatives • Standard implementation guides are focused on a single standard • Increasing complexity IHE provides a standard process for implementing multiple standards!

3. Connecting Standards to Care • Care providers work with vendors to coordinate implementation of standards to meet their needs • Care providers identify key interoperability problems they face • Drive industry to develop and make available standards-based solutions • Implementers follow common guidelines in purchasing and integrating systems that deliver these solutions What is the effective way to establish those “standards” for how to implement standards?

4. What is Integrating the Healthcare Enterprise? • IHE provides a common framework for passing health information seamlessly: • within the healthcare enterprise • across multiple healthcare enterprises • for local, regional & national health information networks. • IHE is sponsored by healthcare professional associations. • IHE drives standards adoption to address specific clinical needs.

5. Why is AAO sponsoring IHE Eye Care? • Strong belief in the benefits of standard setting and interoperability • Enhance quality of patient care • Increase efficiencies for eye care practices • Reduce costs to developers and ultimately users • Accelerate usability of electronic health record systems • AAO provides neutral forum to bring vendors and users together

6. Testing at Connectathons IHE Demonstrations Develop technical specifications Products with IHE Identify available standards (e.g. HL7, DICOM, IETF, OASIS) Timely access to information Document Use Case Requirements Easy to integrate products Standards Adoption Process

7. Driving healthcare standards-based integration IHE Integration Profile:A well-defined and tested solution to a specific information exchange problem

8. IHE (International) Strategic Development Committee SponsorsCo-Chairs reports supervises Global IHE North America IHE Europe IHE Asia/Oceania Regional &NationalDeployment Interoperability Delegates National Extensions IHE organizational Structure Multi-Domain & Multi-National IHE Domain-related Planning Committee and Technical Committee Global Development:Radiology,IT Infrastructure,Cardiology,Lab, Eye Care, etc. contribute Participants

9. IHE Contributors & Participants • Societies Representing Healthcare Segments • RSNA, HIMSS, ACC, ACCE, AAO • Any Healthcare Stakeholder Organization • Users • Clinicians, Medical Staff, Administrators, CIOs, … • Information Systems & Equipment Vendors • Electronic health record systems, practice management systems, image management systems, manufacturers of medical devices and instruments • In addition, active liaison with Standards Development Organizations (SDOs) • HL7, DICOM, NCCLS, ASTM, ISO, others

10. Achievements and expanding scope 15 Active national chapters on 4 continents, 5 Technical Frameworks 42 Integration Profiles, Testing at yearly Connectathons, Demonstrations at major exhibitions world-wide 3 Integration Profiles

11. Product IHE IntegrationStatement Requirements IHEConnect-a-thon IHEDemonstration Product With IHE Easy to Integrate Products Standards (e.g. ASTM-CCR HL7 CDA) IHEIntegration Profiles B IHEIntegration Profile A RFP A Proven Standards Adoption Process IHE Connect-a-thonResults User Site IHE Integration Profiles at the heart of IHE : • Detailed selection of standards and options each solving a specific integration problem • A growing set of effective provider/vendor agreed solutions • Vendors can implement with ROI • Providers can deploy with stability • Process started in 1998 with continuous improvements

12. IHE Connectathon • Open invitation to vendor community • Use of advanced testing tools (MESA) • Testing organized and supervised by project management team • Thousands of cross-vendor tests performed • Results recorded and published • Excellent opportunity for vendors to test their products with other vendors

13. Vendors do not pass… until IHE Technical Project Manager attests it ! IHE Connectathons Massive yearly events : 60-70 vendors 120-160 engineers Over 100 systems ….integrated in 5 days

14. Integration Statements

15. 2005 IHE Survey Results **HIMSS web-based survey in data collection in November 2004 – 163 participants

16. IHE Eye Care Process • Open invitation to vendor community to participate in process – October 2005 • Open process to create the Technical Framework – January ~ May 2006 • Open public comment period – April 2006 • Comments reviewed and suggestions incorporated – April ~ May 2006 • Profile for trial implementation released – June 2006

17. IHE Eye Care Process • Requirement for Modality Vendors • Dr. David Clunie has offered to check DICOM images for correctness, such as Ophthalmic Photography. • This is also for other kinds of DICOM objects, like DICOM Encapsulated PDFs. • Every vendor should make use of this opportunity. • Email the images to David (dclunie@dclunie.com) or put them on an FTP or web site and send him link, or upload to his FTP:ftp://vatest:pinnacle@dclunie.com/incoming/

18. IHE Eye Care Process • Vendors can start testing right now • Tools are already available cover 90% of the IHE Technical Framework specifications (based on existing IHE radiology technical specifications) • http://wuerlim.wustl.edu/mesa/software/mesa_distribution.html • A project manager will be handling: • Development of testing tools (MESA) • Planning and operations of Connectathon • Testing before and during Connectathon • Results and feedback to vendors

19. IHE Eye Care Process • Development of MESA testing tools for the exceptions (10% that is different from existing specifications) – June ~ August • Vendors implement profiles – July ~ Sept • Organizational meeting for Connectathon and MESA tools made available – August 10th • Vendors submit MESA test results – Sept 15th • Test results and issues provided to each vendor – Sept 27th

20. IHE Eye Care Connectathon • Open invitation to vendor community • Week of October 9th • RSNA headquarters, Chicago • Prerequisite to participate in the AAO Annual Meeting Interoperability Showcase • Cost to participate for Connectathon: $6,000 (costs for facilities, IT network, project manager) • Application: Contact Flora Lum, flum@aao.org, (415) 561-8592

21. IHE Eye Care Showcase • 50x50 booth space on show floor for vendors to demonstrate interoperability • Marketing and publicity to members through AAO website, mailed brochures, on-site advertising, Eyenet magazine, on-site brochure, booth signage • Presentations at the Technology Pavilion • Cost to participate for Showcase: $5,000 (furniture, IT/electrical, equipment, marketing, etc.) • Application: Contact Flora Lum, flum@aao.org, (415) 561-8592