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1September, 2005 What IHE Delivers
IHE Patient Care IHE Patient Care Coordination Domain Coordination Domain
Update Update HIMSS Interoperability Showcase February 2008HIMSS Interoperability Showcase February 2008Keith W. BooneKeith W. BooneInteroperability Architect, GE HealthcareInteroperability Architect, GE Healthcare
Co-chair, IHE PCCCo-chair, IHE PCCCo-chair, HL7 Structured DocumentsCo-chair, HL7 Structured DocumentsConvener, HITSP Care Management and Health Records Domain TCConvener, HITSP Care Management and Health Records Domain TC
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Patient Care CoordinationPatient Care Coordination
Established in 2005Established in 2005
ScopeScope
Integration issues that cross providers, patient problems or Integration issues that cross providers, patient problems or time. time.
General clinical care aspects such as General clinical care aspects such as • document exchange, document exchange,
• order processing, order processing,
• coordination with other specialty domains. coordination with other specialty domains.
Address workflows and the integration needs of specialty Address workflows and the integration needs of specialty areas without a separate domain within IHEareas without a separate domain within IHE
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Sponsors and Professional SocietiesSponsors and Professional Societies
SponsorsSponsors
Health Information Management Systems SocietyHealth Information Management Systems Society
American College of PhysiciansAmerican College of Physicians
Professional SocietiesProfessional Societies
American College of Obstetricians and GynecologistsAmerican College of Obstetricians and Gynecologists
American College of Emergency PhysiciansAmerican College of Emergency Physicians
93 Organizational Members of IHE93 Organizational Members of IHE
http://www.ihe.net/governance/member_organizations.cfmhttp://www.ihe.net/governance/member_organizations.cfm
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PCC Activities for 2008-2009PCC Activities for 2008-2009
Care ManagementCare Management Chronic Disease ManagementChronic Disease Management Immunization RegistriesImmunization Registries Cancer RegistriesCancer Registries
Clinical TrialsClinical Trials
Antepartum RecordAntepartum Record
Medical HomeMedical Home
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IHE PCC Nursing SubcommitteeIHE PCC Nursing Subcommittee
PCC Approved the formation of a Nursing PCC Approved the formation of a Nursing Subcommittee in November 2008Subcommittee in November 2008 Membership open to any IHE MemberMembership open to any IHE Member
• See See www.ihe.net/governancewww.ihe.net/governance Call for Co-chair Nominations occurring soonCall for Co-chair Nominations occurring soon
Initial FocusInitial Focus Review of ALL IHE Activities involving NursingReview of ALL IHE Activities involving Nursing Leading development of Nursing specific profilesLeading development of Nursing specific profiles Liason with other IHE DomainLiason with other IHE Domain
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Categories of Healthcare Communication ServicesCategories of Healthcare Communication Services
Security
DocumentSharing
Patient and Provider ID Mgt
DynamicInformation
Access
WorkflowManagement
Source persisted and attested health
records
Specific info snapshot
provided on demand
2 or more entitiessynchronize
a task
e.g. access to last 6 months historical
labs and encounter summaries
e.g. order a lab test, track status and receive results
e.g. get a current list of allergies or med list from a source
HospitalsHIEs and RHIOs
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Combining IHE ProfilesCombining IHE ProfilesDocument Content & Modes of Document ExchangeDocument Content & Modes of Document Exchange
Document Exchange Integration ProfilesDocument Exchange Integration Profiles
DocumentDocument SharingSharing
XDSXDS
MediaMediaInterchangeInterchange
XDMXDM
Reliable Pt-PtReliable Pt-PtInterchangeInterchange
XDRXDR
Doc Content Profiles Doc Content Profiles (Semantics content)(Semantics content)
Scanned DocScanned Doc
XDS-SDXDS-SD
Discharge &Discharge &ReferralsReferrals
XDS-MSXDS-MS
ImagingImaging
XDS-IXDS-I
ConsentConsent
BPPCBPPCEmergencyEmergency
EDREDRED EncounterED Encounter
SummarySummary
EDESEDES
Functional Status Functional Status AssessmentAssessment
FSAFSA
LaboratoryLaboratory
XD*-LabXD*-LabPHR PHR
ExchangeExchange
XPHRXPHR
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Use of a shared XDS InfrastructureUse of a shared XDS Infrastructure
HospitalHospital
Ambulatory or Ambulatory or Specialty CenterSpecialty CenterHomeHome
Between Providers and :Between Providers and :• SSpecialistspecialists• PatientsPatients
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Community Community Network ANetwork A
Document Registry
PracticePracticePractice
ClinicClinicClinicClinic
HospitalsHospitalsHospitalsHospital
Diag Test
Other
PracticePractice HospitalHospital
Community Community Network CNetwork C
Document Registry
PracticePractice
Clinic
Hospitals
Hospitals
HIMSS NHIN: Network of networksHIMSS NHIN: Network of networksThe largest multi-vendor HIE Prototype ever built !The largest multi-vendor HIE Prototype ever built !
3 infrastructure3 infrastructure7 local systems7 local systems
3 infrastructure3 infrastructuresystemssystems
Community Community Network BNetwork B
Document Registry
PracticePracticePracticePracticePractice
ClinicClinicClinicClinic
HospitalsHospitalsHospitals
Diag Test
Community Community Network DNetwork D
Document Registry
PracticePractice
Clinic
Hospitals
Hospitals
6 infrastructure6 infrastructure9 local systems9 local systems
3 infrastructure3 infrastructure9 local systems9 local systems 2 infrastructure2 infrastructure
4 local systems4 local systems
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IHE, global standards-based profiles adopted by IHE, global standards-based profiles adopted by several national & regional projectsseveral national & regional projects
Quebec, Toronto,Alberta, British Columbia
Canada Infoway
Denmark (Funen)Italy (Veneto)Spain (Aragon)
THINC- New YorkNCHICA – N. Carolina
Italy (Conto Corrente
Salute)
Boston Medical
Center - MA
FranceDMP
UK CfH(Radiology WF)
Philadelphia HIE
CHINA-MoHLab results sharing
CPHIC – Pennsylvani
a
CHINA-ShanghaiImaging Info Sharing
JAPAN-NagayaImaging Info Sharing
South Africa
Malaysia
VITL-Vermont
CareSpark – TN & VA
NetherlandAmsterdam
LowerAustria
Austria
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NHIN-2 ProjectsNHIN-2 Projects
CareSpark – Tricities region CareSpark – Tricities region of Eastern Tennessee and of Eastern Tennessee and Southwestern VirginiaSouthwestern Virginia
Delaware Health Information Delaware Health Information NetworkNetwork
Indiana UniversityIndiana University
Long Beach Network for Long Beach Network for HealthHealth
Lovelace Clinic Foundation Lovelace Clinic Foundation – New Mexico– New Mexico
MedVirginiaMedVirginia
New York eHealth CollaborativeNew York eHealth Collaborative
North Carolina Healthcare North Carolina Healthcare Information and Communications Information and Communications Alliance, Inc. (NCHICA)Alliance, Inc. (NCHICA)
West Virginia Health Information West Virginia Health Information NetworkNetwork
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The PCC Technical Framework The PCC Technical Framework enable both semantic enable both semantic
interoperability and simple viewing !interoperability and simple viewing !
SSttrruuccttuurreedd CCoonntteenntt wwii tthh ccooddeedd sseecctt iioonnss::
Reason for Referral Vital Signs
MMeeddiiccaattiioonn
Studies AAlllleerrggiieess
Social History PPrroobblleemmss
Care Plan
PCC PCC TechnicalTechnical Framework FrameworkHL7 HL7 ClinicalClinical Document Architecture (CDA) Release 2 Document Architecture (CDA) Release 2
and ASTM/HL7 and ASTM/HL7 ContinuityContinuity of Care of Care
Structured and Coded Header Patient, Author, Authenticator, Institution, Time of Service, etc.
Header always structured and coded
Title-coded sections with non-structured nor coded content (text, lists, tables). Simple Viewing (XML Style sheet)
Level 1Level 1
Level 2Level 2
Text StructureEntry
Text Structure Entry
Med, Problems and Allergies as highly structured text. Text easy to import/parse
Text StructureEntry
Level 3Level 3
CC
HIT
08C
CH
IT 08
Med Problems and Allergies have afine-grain structure with optional coding. Coding Scheme explicitly identified.
Coded Section Entry
Coded Section Entry
Coded Section Entry
Level 3Level 3
CC
HIT
09C
CH
IT 09
151515
IHE Profiles are IHE Profiles are consistent with HHS consistent with HHS Accepted StandardsAccepted Standards(HITSP Interoperability (HITSP Interoperability
Specifications)Specifications)
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As a Provider or Vendor ContributorAs a Provider or Vendor Contributor
Offer Clinical Use Case Input to Drive IHE Profile DevelopmentOffer Clinical Use Case Input to Drive IHE Profile Development
Become a member of relevant domain’s Planning or Technical Become a member of relevant domain’s Planning or Technical CommitteesCommittees
Become a member of relevant Regional/National CommitteesBecome a member of relevant Regional/National Committees
Help to shape IHE’s future directionHelp to shape IHE’s future direction
As a Vendor ParticipantAs a Vendor Participant
Respond to Public Comments of Domain SupplementsRespond to Public Comments of Domain Supplements
Attend the June Educational WorkshopAttend the June Educational Workshop
Participate in Connect-a-thons and DemonstrationsParticipate in Connect-a-thons and Demonstrations
As a Provider/Consultant ParticipantAs a Provider/Consultant Participant
Respond to Public Comments of Domain SupplementsRespond to Public Comments of Domain Supplements
Attend the June Educational Workshop Attend the June Educational Workshop
Attend Demonstrations and include IHE Integration Profiles in your RFPs Attend Demonstrations and include IHE Integration Profiles in your RFPs and Integration Projects.and Integration Projects.
How can I participate?How can I participate?
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What can you do?What can you do?
Attend the IHE Domain specific sessions in these Attend the IHE Domain specific sessions in these Theaters during HIMSS 2007 (Orange sessions)Theaters during HIMSS 2007 (Orange sessions)
Learn about IHE, Learn about IHE, www.ihe.netwww.ihe.net
Insist on relevant IHE profiles compliance in your Insist on relevant IHE profiles compliance in your RFPs and contract documents:RFPs and contract documents:
Select Integration Profiles, and Appropriate Actor(s) Select Integration Profiles, and Appropriate Actor(s)
Ask vendors for their products “IHE Integration Ask vendors for their products “IHE Integration Statements”.Statements”.
Need more interoperability ? Need more interoperability ?
Contribute to IHE CommitteesContribute to IHE Committees
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IHE Web site:IHE Web site: www.IHE .netwww.IHE .net Frequently AskedFrequently Asked QuestionsQuestions
Integration Profiles in Technical Frameworks: Integration Profiles in Technical Frameworks: See Volume 1 of each TF for Use casesSee Volume 1 of each TF for Use cases
CardiologyCardiology Eye CareEye Care IT InfrastructureIT Infrastructure LaboratoryLaboratory Patient Care CoordinationPatient Care Coordination Patient Care DevicesPatient Care Devices PathologyPathology QualityQuality Radiation Oncology Radiation Oncology RadiologyRadiology
Connectathon Result: Connectathon Result: www.ihe.net/Events/connectathon_results.cfmwww.ihe.net/Events/connectathon_results.cfm
Vendor Products Integration StatementsVendor Products Integration Statements
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ANSI/HITSP Call for ANSI/HITSP Call for ParticipationParticipation
Care Management and Health Records Domain TCCare Management and Health Records Domain TC Health Information Management ProfessionalsHealth Information Management Professionals Architects and Implementers of EHR SystemsArchitects and Implementers of EHR Systems Experts in Clinical Vocabularies Experts in Clinical Vocabularies
• LOINCLOINC• SNOMEDSNOMED• RxNORMRxNORM
Architects and Implementers of Clinical Decision Support SystemsArchitects and Implementers of Clinical Decision Support Systems HL7 CDA R2 knowledge and implementation experienceHL7 CDA R2 knowledge and implementation experience