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Integrating the Healthcare Enterprise

Gain insights into IHE Integration Profiles, detailing their role, selection of standards, and implementation benefits for providers and vendors, fostering stable healthcare deployments.

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Integrating the Healthcare Enterprise

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  1. Integrating the Healthcare Enterprise IHE Integration Profiles:Structure and Function • Charles Parisot, GE Healthcare • IHE IT Infrastructure Technical Committee Co-chair IHE Interoperability Workshop

  2. A Proven Standards Adoption Process IHE Connect-a-thonResults Product IHE IntegrationStatement IHEConnect-a-thon IHEDemonstration Product With IHE Easy to Integrate Products Standards IHEIntegration Profiles B IHEIntegration Profile A RFP IHETechnicalFramework 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 IHE Interoperability Workshop

  3. A Proven Standards Adoption Process 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 Return On Investment • Providers can deploy with stability IHE Interoperability Workshop

  4. Key IHE Concepts • Generalized Systems -> Actors • Interactions between Actors -> Transactions • Problem/Solution Scenarios -> IntegrationProfiles • For each Integration Profile: • the context is described (which real-world problem) • the actors are defined (what systems are involved) • the transactions are defined (what must they do) IHE Interoperability Workshop

  5. 1st key concept: Actor • Represents a set of application roles and responsibilities performed by a system • Always supported by a real-world system • A real-world system may support several IHE Actors Examples: • Order Placer • Order Filler • Patient Admission, Discharge and Transfer (ADT) • Laboratory Automation Manager • Point Of Care Analyzer IHE leaves the definition of products to users and vendors IHE Interoperability Workshop

  6. 2nd key concept: Transaction Order Placer Order Filler New order Order accepted Battery replaced → Placer order management [LAB-1] Acknowledgement Status change Order Placer Order Filler Acknowledgement Example: Transaction LAB-1 « Placer order management » • A set of interactions or messages defined between two Actors for a specific task. • Defines unambiguously how the Actors must cooperate to achieve this task. • Using existing standards such as HL7, DICOM, NCCLS etc. IHE defines transactions at a user-level workflow IHE Interoperability Workshop

  7. 3rd key concept: Integration Profile Integration Profile … Actor Actor Actor … … … Transaction Transaction Transaction Transaction Transaction Referenced standard (HL7) Detailed messaging info -------------------------- Roles • Solves an Integration Problem: • A collection of real world information exchange capabilities supported by a set of specific Actors using Standards-based Transactions Examples:  • Enterprise User Authentication • Retrieve Information for Display • Laboratory Scheduled Workflow • Echo Laboratory Workflow • Cross-Enterprise Document Sharing IHE Interoperability Workshop

  8. The Product World….. Product XYZfrom Vendor T IHE Interoperability Workshop

  9. The IHE World…. Actor Actor Actor IHETransaction IHETransaction IHE Actor IHE Actor IHETransaction IHE Interoperability Workshop

  10. Mapping IHE to Products Actor Actor Actor Product XYZfrom Vendor T IHETransaction IHETransaction IHE Actor IHE Actor IHETransaction IHE Interoperability Workshop

  11. The IHE Technical Approach • Identify the transactions required to integrate a specific information flow between several information systems/devices • For each transaction, select a single standard (e.g.HL7 messages, RFC) for use in implementing the transaction • Specify in detail the use of the standard(s) in implementing the transaction IHE Interoperability Workshop

  12. IHE : An Integration ProfileA Solution to an Integration Problem Actorscooperating throughTransactionsto perform a specifictask Report Creator 24: Report Submission Structured Report Export: 28  Report Manager Enterprise Report Repository 25: Report Issuing Report Repository External Report Repository Access 26: Query Reports 27: Retrieve Reports Report Reader IHE Interoperability Workshop

  13. IHE Integration Profilesat 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 Return On Investment • Providers can deploy with stability IHE Interoperability Workshop

  14. IHE Integration Profilesat the heart of IHE • A well-defined integration problem • A complete specification for the solution by reference to selected standard(s) and options. • Testing will be performed on the basis of a complete and unambiguous specification. • Interoperability between complementary actors of the same Integration Profile will be maximized. IHE Interoperability Workshop

  15. IHE Technical Frameworks One Technical Framework for each one of the IHE Domains: • Cardiology • IT Infrastructure • Lab • Radiology IHE Interoperability Workshop

  16. Organization of TFs(1) • Volume 1: Integration Profiles • Describes scope and clinical need • Identifies the actors • Identifies the required/optional transactions • Defines profiles dependencies • Describes process flow (time sequences) for typical use cases IHE Interoperability Workshop

  17. Organization of TFs(2) • Volume 2+: Transactions • Provides implementation specification for each transaction. • Pay attention to the HL7 and DICOM profiling conventions. • Transaction described using: • Trigger, Message semantics, Expected Action • Dependencies with other transactions • Transactions sometimes broken down in separate messages. • Each message includes base-standard references, options selection. IHE Interoperability Workshop

  18. IHE Interoperability Methodology • Actors, Transactions are higher workflow-level concepts than the development methodologies of healthcare standards (HL7 V2-V3, DICOM, etc.) • Powerful but simple methodology. Proven by 5 years of experience by vendors and users. • Suitable for integration and mix use of a broad variety of healthcare Standards as well as IT Standards. • Compatible with HL7 message profiles (lower level). Healthcare interoperability require integrationof tens of standards. IHE offers a generic and pragmatic methodology IHE Interoperability Workshop

  19. 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 MilestonesDevelopment and Deployment - 10 --- Approved Supplement Scope - 7 --- Public Comment Intgr-profile - 2 --- Sponsors announce Connectathon/Demos with set of Implementation Profiles Proposed Supplement Scope IHE Interoperability Workshop

  20. Development Process • TF Final Text Vx.y • Stable Integration Profiles specifications ready for operational/clinical use. • Available for Product implementation and inclusion in product Integration Statements by vendors • TF Trial Implementation Supplements • Integration Profiles (or extensions) that are frozen for trial implementation (Connectathon). Change Proposals may be submitted based on implementation or testing experience. • All Change Proposals approved by IHE Technical Committees are folded in the Final Text publication. • Only fixes and clarification are expected. • All Final Text Integration Profiles of an IHE cycle are folded into the next version of IHE TF Volume 1 and 2. IHE Interoperability Workshop

  21. Organization of TFs(3) • Volume 4 defines regional extensions • Translation of terms from English to regional language • Extensions (forbidden options/fields, specific vocabularies, etc.) • No incompatibilities introduced. IHE Interoperability Workshop

  22. IHE Technical Frameworks • Technical Frameworks Final Text: • ITI V1.0 • RAD V5.5 • LAB V1.0 • Technical Framework Supplements - Trial Implementation • May 2004: Radiology • August 2004: IT Infrastructure • August 2004: Cardiology • IHE Web sites: http://www.himss.org/IHE http://www.rsna.org/IHE http://www.acc.org/quality/ihe.htm. IHE Interoperability Workshop

  23. More information…. • IHE Web sites: http://www.himss.org/IHE http://www.rsna.org/IHE http://www.acc.org/quality/ihe.htm. • Technical Frameworks: • ITI V1.0, RAD V5.5, LAB V1.0 • Technical Framework Supplements - Trial Implementation • May 2004: Radiology • August 2004: Cardiology, IT Infrastructure • Non-Technical Brochures : • Calls for Participation • IHE Fact Sheet and FAQ • IHE Integration Profiles: Guidelines for Buyers • IHE Connect-a-thon Results • Vendor Products Integration Statements IHE Interoperability Workshop

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