Clinical Document Sharing and Integrating the Healthcare Enterprise (IHE) Dr Nick Brown IHE-UK Steering Committee User Co-chair Mark Simmons IHE-UK Steering Committee Supplier Co-chair Use of slides supplied by IHE-Europe and Ed Conley, Cardiff

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Clinical Document Sharing and Integrating the
Healthcare Enterprise (IHE) Dr Nick BrownIHE-UK
Steering Committee User Co-chair Mark
SimmonsIHE-UK Steering Committee Supplier
Co-chair Use of slides supplied by IHE-Europe
and Ed Conley, Cardiff University, is
acknowledged Handouts sponsored by British
Computer Society IHE-UK IT Infrastructure
Technical CommitteeBritish Institute of
Radiology IHE-UK Medical Imaging and Radiation
Oncology TC
HL7 Roadshow 2009 London
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An IHE cross enterprise document sharing task
scenario
Data
document(s) descriptive search keywords
Pull
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An IHE cross enterprise document sharing task
scenario
Notify
Data
document(s) descriptive search keywords
Pull
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Why do we need need Integrating the Healthcare
Enterprise (IHE) ?

• Healthcare data communication standards are
  written to support a wide range of healthcare
  situations and include many optional features.
• Different suppliers implement different features
  hence interoperability problems
• IHE is a not-for-profit organisation that enables
  healthcare IT system users and IT suppliers to
  work together to obtain clinical interoperability
  by selecting existing standard features to fit
  the IT requirements for specific clinical tasks
• The home of IHE-UK is the British Computer
  Society)

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Who is IHE?
IHE North America
IHE Europe
IHE Domain-related Planning and Technical
Committees
IHE Asia/Oceania
Global DevelopmentIT Infrastructure,Radiology,
Cardiology,Lab, etc.
Regional NationalDeployment
Delegates
contribute
Participants
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Standards Adoption Process
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• Connectathon Barcelona 2006
• 300 participants, 120 systems
• 60 systems developers
• 2800 monitored test cases

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IHE integration profiles

• An IHE integration profile includes definitions
  of
• A specific clinical task (use case)
• Which data items in existing standards are to be
  used to exchange essential task information -
  overriding optionality
• Essential application entity task processes
• Supplier web sites show products that support IHE
  profiles
• Purchasers can buy products from different
  suppliers that will work properly as specified by
  IHE profiles

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Evolution of IHE Domains
Pharmacy
Pathology (1)
Patient Care Devices (1)
Patient Care Coordination (5)
Radiation Oncology (1)
Laboratory (6)
Cardiology (7)
IT Infrastructure for Healthcare (17)
Radiology (18)
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IHE-EUR countries and participants

• Denmark
• France
• Germany
• Israel
• Italy

• Netherlands
• Norway
• Spain
• Sweden
• United Kingdom

Users, HC Authorities, Vendors 40 single
country vendors60 multi-countries vendors
Example IHE-Netherlands
Users Vendors Vendors Government /Associations
Amphia Antonius Mesos Amsterdam MC AZ Maastricht Ned. Ver. Radiologie Ned. VerLeeuwarden UMC Nijmegen UMC Groningen . Kl. Chemie Ned. Ver. Microbiologie MC Vumc Agfa Forcare Chipsoft DA Medical GE Healthcare Getronics H2W IBM ICT Healthcare Initiate Systems iSOFT Leones Medical Phit Nucletron Oldelft Benelux Philips RVC Sectra Siemens Verdonk, Klooster Associates Welch Allyn Cardio Control APC Platform NICTIZ HL7 Nederland OIZ TNO
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IHE Regional and National EHR Projects Today
FranceDMP
Austria NÖmedWAN
Canada Infoway
MA-Share MA IHIE IN Mendicino - CA
Denmark (Funen) Italy (Veneto) Spain (Aragon)
HITSP Interoperability Specifications
Italy (Conto CorrenteSalute)
THINC- New York NCHICA N. Carolina
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IHE-XDS components
Community or sub-network (Affinity domain)
Local documentrepository
Centralizeddocument repository
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IHE Document sharing

• IHE Clinical document sharing
• Any format PDF, JPEG (Images), DICOM Images, CDA,
  etc
• Proven specifications
• Multiple suppliers
• Support for multiple patient identifiers
• Email notification of availability of documents
• Security metadata item
• Registry can point to hardcopy and/or electronic
  documents

REPOSITORY
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IHE-UK Current Key Projects

• Support for Humber XDS project Multi
  Disciplinary Team support in planning stage
• XDS UK search data spec for Doc Class and
  Sub-class
• XDS UK user guides
• Support for image sharing between
  institutionsIHE XDS-I, ISO WADO-WS, ISO WARM
• Work with ProRec UK on step by step
  implementation of improved EHRs

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IHE Benefits to users

• Users benefit because they can know exactly what
  functionality will be implemented in purchased
  products for which conformance to IHE
  specifications is stated
• Easy resolution of any interoperability
  problems that do arise at commissioning
• Easy replacement of systems
• Easy extension of networked systems
• Future proofing of investment

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IHE Benefits to suppliers 1

• Clear requirement specifications from users
• Easy implementation of systems that interoperate
• Connectathon testing their software with a
  number of different suppliers. They can learn
  more in one week at the connectathon than several
  months at base
• Reduced costs of commissioning on site
• If IHE is specified then you know what to do to
  get paid
• IHE specifications can shorten product
  development time

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IHE Benefits to suppliers 2

• Work with users and other suppliers to create
  applications that work well in the real world
• Support development
• IHE-UK Specific extensions to the core IHE
  Integration Profiles
• IHE-UK Guidance notes regarding use of IHER specs
  in the UK
• Collaborate with other suppliers in creating
  solutions for large multi enterprise (or
  multi-department) facilities
• Obtain a deep understanding of the benefits of
  the IHE methodology

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