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IHE in North America

IHE in North America. Chris Carr Director of Informatics/Staff Liaison to IHE Radiological Society of North America. IHE North America. What?/Who? Organization Testing Implementation Learn more/Get involved. Regional Deployment Committee.

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IHE in North America

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  1. IHE in North America Chris Carr Director of Informatics/Staff Liaison to IHE Radiological Society of North America

  2. IHE North America • What?/Who? • Organization • Testing • Implementation • Learn more/Get involved HIMSS 2009

  3. Regional Deployment Committee • Multinational association assembled to oversee testing and implementation activities • Two national deployment committees: • IHE Canada • IHE USA HIMSS 2009

  4. IHE Canada – Established 2007 Part of Standards Collaborative HIMSS 2009

  5. IHE USA – Established 2008 • Initial sponsors and supporters: • HIMSS • RSNA • American Academy of Ophthalmology (AAO) • American College of Cardiology (ACC) • American College of Physicians (ACP) • American College of Clinical Engineering (ACCE) • American College of Emergency Physicians (ACEP) • American Society for Therapeutic Radiation Oncology (ASTRO) Preparing for incorporation in Q2 2009 HIMSS 2009

  6. Deployment Committee Responsibilities • Sponsor and oversee testing • Support development of test tools • Conduct demonstrations and education events • Establish relationships with national HIT agencies, EHR initiatives, etc. • Develop any national extensions to IHE Technical Frameworks HIMSS 2009

  7. Connectathon History: 1999-2009 • Continuous, steady expansion in scope and participation in Connectathon: • 1999: 15 companies, 24 systems • 2009: 77 companies, 126 systems HIMSS 2009

  8. Connectathon History • 1999: First IHE Connectathon • 1999 - present: Continual expansion of scope and participation • 2001: First IHE-Europe Connectathon • 2002: First IHE-Japan Connectathon • 2005: First multi-domain North American Connectathon: Cardio, IT, Radiology • 2008: Testing Coordinated with HITSP HIMSS 2009

  9. What is a Connectathon? • Face-to-face interoperability testing event • Tests implementation of Integration Profiles: integration capabilities defined in IHE Technical Frameworks • Testing structured and supervised by Technical Project Management Team • Successful results recorded and published by event sponsors • Used as preparation for IHE demonstrations events • Primary purpose: foster adoption of standards-based solutions in products HIMSS 2009

  10. Connectathon HIMSS 2009

  11. Connectathon Results • Tool contains Connectathon results from 2001 to present • Part of the testing management tool • Development underway to build a new PRODUCT REGISTRY including specific vendors product implementations of Integration Profiles HIMSS 2009

  12. Integration Statements HIMSS 2009

  13. Integration Statements on www.ihe.net HIMSS 2009

  14. Product Registry – coming soon! http://product-registry.ihe.net/ HIMSS 2009

  15. IHE and Canada Health Infoway • CHI has worked on development of IHE profiles, eg, XDS and XDS-I • CHI contractors have provided testing oversight at Connectathons • CHI contributed to development of testing tools • CHI has specified IHE profiles as “Pan-Canadian Standards” • Numerous implementation projects using IHE profiles HIMSS 2009

  16. Canada Health Infoway: Standards Used in Diagnostic Imaging EHRS Blueprint v2 Privacy & Security Privacy Legislation HealthcareContent, Messaging, Terminology HL7/CDA, DICOM SNOMED CT, LOINC, ICD-10CA, CCI Internet Standards XML, PDF, JPEG, JPIP, MIME, HTTP, FTP, UTF-8, … Electronic BusinessStandards ebXML, Web Services • No single standard addresses DI Requirements IHE Integration Profiles Rad: XDS-I, SWF, PIR, CPI, PGP, KIN, PDI IS: XDS, PIX, PDQ, ATNA, EUA , XUA, BPPC, CT HIMSS 2009 16

  17. DI Data Sharing in the EHR Environment Longitudinal Record Services Common Services Communication Bus SharedHealth Record DI Repository • XDS Document Registry • Registry entries • Metadata • XDS Document / DI Repository • Manifests • Document Sets • Images • Reports • Relevant images • Presentation states • Measurements • Other evidence docs EHR Data& Services Registries Data& Services XDS Doc Registry BusinessRules EHRIndex MessageStructures Terminology Services Security MgmtData Privacy Data Terminology HIAL EHR Viewer Physician/Provider • PACS • DI Studies • Presentation states • Measurements • RIS • Orders • Reports • Imaging Modalities • DI Studies • Presentation states PACS PACS HIS DI Repository RIS EMR/CPOE RIS XDS Document Repository US US MRI CT CT DI Clinics Hospitals DICOM HL7 Transactions: XDS INFOSTRUCTURE ClientRegistry ProviderRegistry LocationRegistry POS HIMSS 2009 17

  18. VA IHE Success Story • All VA DICOM image acquisition uses IHE Radiology Transactions to interface modalities to PACS:  • #5 - Modality Worklist Provided - download patient and study • #8 - Modality Images Stored - send images to the PACS • 200 different models of radiology instruments interfaced • Exactly the same IHE DICOM interface to Consults for ophthalmology (eye care), dentistry, endoscopy, pathology, and cardiology. • The VA will not purchase a new modality unless it supports both of these capabilities. HIMSS 2009

  19. IHE: Supporting HHS/ONC Goals Certification Commission for Healthcare Information Technology (CCHIT) Healthcare Information Technology Standards Panel (HITSP) American Health Information Community National eHealth Collaborative Standards harmonization and adoption Interoperability testing Health Information Security and Privacy Collaboration (HISPC) Nationwide Health Information Network Architecture Projects(NHIN) Specifications for standards-based EHR functionality to support RHIOs Security and privacy standards HIMSS 2009

  20. HITSP Recommended Standards • Biosurveillance • ICD-9CM – International Classification of Diseases v. 9 Clinical Modifications • ICD-10 CM – Diagnoses and Procedures • IHE-XDS – Integrating the Healthcare Enterprise (IHE) Cross-Enterprise Document Sharing • IHE-XDS Lab – IHE Laboratory Report Document Sharing • IHE-RFD – IHE Retrieve Form for Data Capture • IHE-PIX – IHE Patient Identification Cross-Referencing • IHE-RAD – XDS-I – IHE Cross-Enterprise Sharing of Images • IHE-NAV – IHE Notification of Document Availability • IHE-XDS-MS – IHE Medical Summary Document Sharing • ISO/TC215 -DTS 25237 - Health Informatics Pseudonymisation • LOINC – Logical Observation Identifiers Names and Codes • NCCLS – National Committee for Clinical Laboratory Standards • RxNorm – National Library of Medicine RxNorm HIMSS 2009

  21. HITSP Recommended Standards • Consumer Empowerment • IHE-XDS – Integrating the Healthcare Enterprise (IHE) Cross-Enterprise Document Sharing • IHE-PIX – IHE Patient Identification Cross-Referencing • IHE-PDQ – IHE Patient Demographics Query • Health Level Seven (HL7) CDA R2 – HL7 Clinical Document Architecture Release 2 • HL7 CCD – HL7 Continuity of Care Document with mappings from ASTM E 2369-05 Continuity of Care Record (CCR), X12 N 270/271 and NCPDP Script 8.1. • HL7 EHR Systems Functional Model Draft Standard for Trial Use (DSTU) • Logical Observation Identifiers Names and Codes (LOINC) HIMSS 2009

  22. HITSP Recommended Standards • Electronic Health Record Exchange • IHE-XDS Lab – IHE Laboratory Report Document Sharing • IHE-PIX – IHE Patient Identification Cross-Referencing • IHE-PDQ – IHE Patient Demographics Query • Health Level Seven (HL7) CDA R2 – HL7 Clinical Document Architecture Release 2 • HL7 v. 2.5 • Clinical Laboratory Improvement Amendments (CLIA) • Logical Observation Identifiers Names and Codes (LOINC) • Health Insurance Portability and Accountability Act (HIPAA) • Systematized Nomenclature of Medicine – Clinical Terms (SNOMED – CT) • Unified Code for Units of Measure (UCUM) IHE contributes to HITSP’s success HIMSS 2009

  23. HITSP and Federal Procurement • Former HHS Secretary Leavitt “recognized” the work product of HITSP, meaning that it will be used in for federal purchasing specifications for all affected health IT systems as of Jan. 1, 2009. HIMSS 2009

  24. Testing – HITSP, CCHIT and NHIN • HITSP interoperability pilot testing performed at IHE Connectathon • CCHIT, NIST and IHE have agreement to collaborate on testing tools • NIST and IHE collaborated to provide testing services for first NHIN testing event in August 2008 HIMSS 2009

  25. IHE Testing Tools • 11 years experience automating HIT interoperability testing • Test management tool evolving to support remote testing • Close partnership with National Institute of Standards and Technology HIMSS 2009

  26. IHE Testing Tools: Project Gazelle Demographic Service Gazelle Control System Database External Validation Services External Validation Services Actor Simulators Configuration Info External Validation Services Gazelle Test Engine Actor Simulators External Validation Services Control Actor Simulators Actor Simulators Feedback Actor Simulators System Under Test System Under Test System Under Test System Under Test Tests Scenario Proxy Network HIMSS 2009 22/05/08 Projet IHE-Dev Inria Rennes

  27. More Resources -www.ihe.net • Integration Profiles/Technical Frameworks • Connectathon Results • Product Registry – coming soon! • Webinar and presentation materials • Committee/domain activities • Governance and Membership Materials HIMSS 2009

  28. Providers and Vendors Working Together to Deliver Interoperable Health Information Systems in the Enterprise and Across Care Settings http://www.ihe.net HIMSS 2009

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