Integrating the Healthcare Enterprise

1. Integrating the Healthcare Enterprise Patient Identifier Cross-referencing for MPI (PIX) Profile Mike Henderson Eastern Informatics, Inc. Co-chair, IHE IT Infrastructure Technical Committee IHE Interoperability Workshop

2. IHE IT Infrastructure5 Integration Profiles Retrieve Information for Display Retrieve Information for Display Enterprise User Authentication Enterprise User Authentication Patient Synchronized Applications Patient Synchronized Applications Access a patient’s clinical information and documents in a format ready to be presentedto the requesting user Access a patient’s clinical information and documents in a format ready to be presentedto the requesting user Synchronize multiple applications on a desktop to the same patient Synchronize multiple applications on a desktop to the same patient Provide users a single nameandcentralized authentication processacross all systems Provide users a single nameandcentralized authentication processacross all systems Patient Identifier Cross-referencing for MPI Patient Identifier Cross-referencing for MPI Consistent Time Consistent Time Coordinate time across networked systems Coordinate time across networked systems Map patient identifiers across independent identification domains Map patient identifiers across independent identification domains IHE Interoperability Workshop

3. Patient Identifier Cross-referencing for MPIAbstract / Scope • Allow all enterprise participants to register the identifiers they use for patients in their domain • Participants retain control over their own domain’s patient index(es) • Support domain systems’ queries for other systems’ identifiers for their patients • Optionally, notify domain systems when other systems update identifiers for their patients IHE Interoperability Workshop

4. Patient Identifier Cross-referencing for MPIValue Proposition • Maintain all systems’ identifiers for a patient in a single location • Use any algorithms (encapsulated) to find matching patients across disparate identifier domains • Lower cost for synchronizing data across systems • No need to force identifier and format changes onto existing systems • Leverages standards and transactions already used within IHE IHE Interoperability Workshop

5. Patient Identifier Cross-referencing for MPITransaction Diagram IHE Interoperability Workshop

6. Patient Identifier Cross-referencing for MPIProcess Flow Showing ID Domains & Transactions IHE Interoperability Workshop

7. Patient Identifier Cross-referencing for MPI B:X456C: ? B:X456C: 2RT Patient Identity Cross References IHE Interoperability Workshop

8. Patient Identifier Cross-referencing for MPIStandards Used HL7 Version 2.5 • ADT Registration and Update Trigger Events • A01: inpatient admission • A04: outpatient registration • A05: pre-admission • A08: patient update • A40: merge patient • Queries for Corresponding Identifiers (ADT^Q23/K23) • Notification of Identifiers Lists Updates (ADT^A31) IHE Interoperability Workshop

9. Patient Identifier Cross-referencing for MPIActors Patient Identity Source • Definition • Assigns patient identities within its own domain • Notifies Patient Identifier Cross-reference Manager of all events related to patient identification (creation, merge, etc.) • Example: Registration (ADT) Actor in IHE Radiology Scheduled Workflow (SWF) Profile • Transaction Supported - Required • Patient Identity Feed [ITI-8] (as sender) IHE Interoperability Workshop

10. Patient Identifier Cross-referencing for MPIActors Patient Identifier Cross-reference Manager • Definition • Serves a well-defined set of Patient Identifier Domains • Receives patient identifier information from Patient Identity Source Actors • Manages cross-referencing of identifiers across domains • Transactions Supported - Required • Patient Identity Feed [ITI-8] (as receiver) • PIX Query [ITI-9] (as receiver) • PIX Update Notification [ITI-10] (as sender) IHE Interoperability Workshop

11. Patient Identifier Cross-referencing for MPIActors Patient Identifier Cross-reference Consumer • Definition • Requires information about patient identifiers in other domains • Requests patient identifier information from Patient Identifier Cross-reference Manager • Transaction Supported - Required • PIX Query [ITI-9] (as sender) • Transaction Supported - Optional • PIX Update Notification [ITI-10] (as receiver) IHE Interoperability Workshop

12. PIX Integration Profile & MPIThe typical view Master Patient Index Patient Identity Cross-reference Manager Master (A) PatientIdentity Source Patient Identification Domain A (Master Domain) Patient Identification Domain B Patient Identification Domain C IHE Interoperability Workshop

13. PIX Integration Profile & MPIThe Equivalent IHE Model Master Patient Index Patient Identity Cross-reference Manager Patient Identification Domain A (Master Domain) Master (A) PatientIdentity Source Patient Identification Domain B Patient Identification Domain C IHE Interoperability Workshop

14. 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