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IHE Concrete Implementation

IHE Concrete Implementation. June, 2010. Motivation for IHE implementation. We are a group of organizations who have already implemented IHE profiles We recognized the user stories – IHE already addresses them We could leverage existing products and toolkits – it wasn’t scary

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IHE Concrete Implementation

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  1. IHE Concrete Implementation June, 2010

  2. Motivation for IHE implementation • We are a group of organizations who have already implemented IHE profiles • We recognized the user stories – IHE already addresses them • We could leverage existing products and toolkits – it wasn’t scary • We can get this done fast

  3. Our IHE Approach • XDR backbone • Step up and down to edges UDDI Directory Source Systems Destination Systems SMTP SMTP Source HISP Destination HISP Step up to XDR REST Step up to XDR REST Step down from XDR Step up to XDR XMPP XMPP XDR, XDM Optional HISP hops XDR, XDM Provide and Register

  4. Demonstration Scenarios • EMR to EMR • EMR to email • Email to PHR • Web app to email

  5. Scenario 1: EMR to EMR • From: harry.winston@goodhealthclinic.org • To: edward.stukel@epic.ehr.nhin.org • Source: Allscripts • Source HISP: MedAllies • Destination/ Destination HISP: Epic User stories: 1, 2, 3, 4, 6

  6. Scenario 2: EMR to Email • From: harry.winston@goodhealthclinic.org • To: john.smith@happyvalleyclinic.nhindirect.org • Source/Source HISP: Epic • Destination HISP: MedAllies • Destination: email client User stories: 1, 2, 3, 4, 6, 7, 8, 9, 10, 11

  7. Scenario 3: Email to PHR • From: harry.winston@goodhealthclinic.org • To: marlowephillips@lucy.phr.nhin.org • Source: email client • Source HISP: GE / MedAllies • Destination / Destination HISP Epic’s Lucy PHR User stories: 6, 7, 8, 9, 10, 11

  8. Scenario 4: Web app to email • From: harry.winston@goodhealthclinic.org • To: john.smith@happyvalleyclinic.nhindirect.org • Source: IBM web app • Source HISP: GE / Vangent • Destination HISP: MedAllies • Destination : email client User stories: 1, 2, 3, 4, 6, 7, 8, 9, 10, 11

  9. Other User Stories • 5: Laboratory sends lab results to ordering provider Laboratory may not have a patient ID. If they do, they would likely use XDR on the sending edge. If not: A: Use order number as pseudo patient identifier B: Relax XDR metadata requirements • 12: Primary care provider sends patient immunization data to public health Several initiatives within CMS already use XDR on the receiving edge, so this may just be scenario 1.

  10. Strengths of the IHE Approach • Straightforward integration with NHIN Exchange • One metadata model supports both minimal and extended metadata • Developed, maintained, and enhanced through a formal and open process • Can work across the continuum of care settings, from small practices to integrated delivery networks

  11. Weaknesses of the IHE Approach • Supports point-to-point encryption; doesn’t currently support non-trusted intermediaries • Intended recipient metadata integrated into content container metadata • ebXML can look daunting • SOAP looks hard

  12. Why the IHE Approach is Best • EHRA support • NHIN Direct can make it to the real world faster with IHE • Maturity of the approach: small changes to XDR are much preferable to inventing something new • This is a profile, not just a protocol • It’s simple, scalable, and sustainable

  13. Q&A

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