IHE's contribution to standards harmonization for the National Health Information Network

1. IHE's contribution to standards harmonization for the National Health Information Network • Joyce Sensmeier, HIMSS • Glen Marshall, Siemens Healthcare • Charles Parisot, GE Healthcare

2. What is Harmonizing Standards ? Healthcare is a complex multi-specialty multi-stakeholder system. Multiple standard development organizations are necessary. Challenge is to achieve “interoperability” while implementing multiple standards to meet a broad range of information exchange needs: Application-to-application System-to-system Setting-to-setting Coordinate adoption of standards to meet clinical and administrative Use Cases Identify the key interoperability problems they face Providers and industry work together to develop and make available standards-based solution 2

3. Standards: Necessary…Not Sufficient • Standards are • Foundational - interoperability and communications • Broad - varying interpretations and implementations • Narrow - may not consider relationships between standards domains • Plentiful - often redundant or disjointed • Focused - standards implementation guides typically focus on a single standard Need a standard process for implementing multiple standards

4. US Federal Initiative for Health IT and National Health Information Network • The US health system is managed both at the federal level and the state-level. • Over 200 Health Information Exchanges projects in the USA at the state level or communities within the states. • At the federal level, HHS has set-up a policy-level setting board (AHIC), a coordination office (ONC) and 4 supporting initiatives for standards harmonization, certification, privacy and implementation prototyping. • IHE-USA has been engaged in the organization of one of these supporting initiatives: HITSP. IHE and IHE sponsors (e.g. HIMSS, RSNA, ACCE, etc.) and participants contribute to those initiatives.

5. The Certification Commission for Health Information Technology (CCHIT) Health Information Technology Standards Panel (HITSP) American Health Information Community (AHIC) The Health Information Security and Privacy Collaboration (HISPC) National Health Information Network (NHIN) Architecture Projects The Community is the hub that drives opportunities for increasing nation-wide health information interoperability • AHIC, chaired by HHS Secretary is strategic coordination. • CCHIT focuses on developing a mechanism for certification of health care IT products • HITSP brings together all relevant stakeholders to identify & harmonize appropriate standards • HISPC addresses variations in business policy and state law that affect privacy and security • NHIN is focused on interoperability pilots and implementation

6. HITSP delivers interoperability specs to AHIC • The Health Information Technology Standards Panel (HITSP) has addressed 7 business use cases for interoperability. • HITSP has over 300 members representing all US stakeholders in healthcare and Standards Development Organizations (incl. X12, DICOM, HL7, etc.). • HITSP in its standards-based interoperability specifications, has decided to leverage standard-based implementation guides such as those from Integrating the Healthcare Enterprise (IHE). • The IHE Connectathon and HIMSS Interoperability Showcase play a visible role demonstrating the HITSP/IHE synergy.

7. From Standards to solving a Use Case Business Use Case • AHIC/ONC • HITSP Interoperability Specifications + Constructs Standards Adoption/Profiling Technical Use Case Driven • IHE • HL7, NCPDP, • X12, DICOM, ISO, etc… Base Standards Foundations

8. 18 IHE Profiles used by HITSP Interoperability Specifications

9. IHE Profiles/HITSP Constructs reused across ISs for consistency

10. Conformance Testing & Certification • IHE Conformance Testing • CCHIT Certification Interoperability Specifications + Constructs Standards Adoption/Profiling Technical Use Case Driven Base Standards Foundations

11. HITSP GOALS and IHE • HITSP goals with respect to testing activities • Ensure 'fitness for use' of HITSP Interoperability Specifications • Has relationship with IHE that developed/maintain stds/profiles used in HITSP ISs to help overall collaborative testing activities • HITSP collaboration with IHE • 18 IHE Profiles are contained as constructs in HITSP ISs • IHE profiles provide to HITSP globally accepted standards • IHE Connectathon/HIMSS Showcase provide opportunity for collaboration to meet mutual goals • To access HITSP Interoperability Specifications: www.HITSP.org

12. 2008 HIMSS Interoperability Showcase40 out of 51 implementers demonstrated HITSP