RSNA/HIMSS Integrating the Healthcare Enterprise IHE in an International Context Chris Carr Radiological Society of North America – Director of Informatics Staff Liaison to IHE

IHE Canada Introduction Process to encourage global adoption of standards Domain framework development National/regional deployment Mechanisms for accommodating national/regional differences Ideas for IHE Canada

IHE Canada Principles re: Intl’zation IHE’s mission: encourage adoption of standards-based solutions for integrating healthcare information systems in order to improve care Eliminate arbitrary divergence Be respectful of real diversity

IHE Canada Division of Labor IHE activities fall into two categories: – Development Writing and publishing the Technical Frameworks GLOBAL – Domain-specific – Deployment Testing, demonstrations, education NATIONAL/REGIONAL – Cross-domain

IHE Canada Global Technical Frameworks The foundation of IHE is the Technical Frameworks, a set of global standards- based technical specification.

IHE Canada Development Work Annual cycles of expansion, review and publication of Technical Frameworks Driven by vendor committees Guided by clinical domain experts from sponsoring organizations Currently active IHE domains: – Cardiology, IT Infrastructure, Laboratory, Radiology

IHE Canada Domain Sponsors Organize and support domain committee work – Recruit vendor participation – Organize meetings and communication – Publish Technical Frameworks Provide clinical expertise to help domain committees set priorities and review solutions – Dedicate volunteer representatives to be engaged with committee work

IHE Canada How to Be a Domain Sponsor Be an association representing clinical experts Get representatives from industry to work on domain committees Commit to sponsoring committee activities with goal of public demonstration or other event Tell the other domain sponsors who you are and agree to work together Be persistent

IHE Canada Current Domain Sponsors CardiologyAmerican College of Cardiology (ACC) IT Infrastructure - Healthcare Information and Management Systems Society (HIMSS) Radiology - Radiological Society of North America (RSNA) Laboratory - Groupement pour la Modernisation du Système d'Information Hospitalier (GMSIH);Société Française d'Informatique de Laboratoire (SFIL); Japan Association of Healthcare Information Systems Industry (JAHIS)

IHE Canada Deployment Work Recruit vendors to participate Organize testing process, including Connectathons – Joint multi-domain Connectathon planned for January 2005 Education and demonstrations at major medical meetings and other venues – User Success Stories – IHE Users Group – Disseminate tools for users

IHE Canada Deployment Sponsorship IHE National Initiatives – Medical associations, industry groups, government-supported organizations, others—band together and share work – Responsible for organizing testing, staging events, recruiting participants, hiring technical support, performing outreach, publishing educational materials, etc., etc.

IHE Canada How to Be a National Initiative Self-organize: bring together relevant associations, government groups, etc. Commit to IHE principles and process Plan one or more events: testing and education Communicate with the other national initiatives about your activities

IHE Canada National/ Regional Initiative Sponsors IHE North America (IHE- NA) Healthcare Information and Management Systems Society (HIMSS) Radiological Society of North America (RSNA) American College of Cardiology (ACC) IHE Europe (IHE-EUR)  European Association of Radiology (EAR) § European Congress of Radiology (ECR) § Coordination Committee of the Radiological and Electromedical Industries (COCIR) § Deutsche Röntgengesellschaft (DRG) § EuroPACS Association § Groupement pour la Modernisation du Système d'Information Hospitalier (GMSIH) § Société Francaise de Radiologie (SFR) § Società Italiana di Radiologia Medica (SIRM) § British Institute of Radiology (BIR) § College of Radiographers § Institute of Physics and Engineering in Medicine § NHS Information Authority § Royal College of Radiologists (RCR) IHE Japan (IHE-J)  Ministry of Economy, Trade, and Industry (METI)  Ministry of Health, Labor, and Welfare § MEDIS-DC § Japan Industries Association of Radiological Systems (JIRA) § Japan Association of Healthcare Information Systems Industry (JAHIS) § Japan Radiological Society (JRS) § Japan Society of Radiological Technology (JSRT) § Japan Association of Medical Informatics (JAMI)

IHE Canada International IHE Initiatives IHE North America – IHE-USUSA – IHE-CCanada? IHE Europe – IHE-FFrance – IHE-DGermany – IHE-IItaly – IHE-UKUnited Kingdom – IHE-NNorway(Organizing) – IHE-DKDenmark(Organizing) – IHE-SSweden(Organizing) – IHE-NLNetherlands(Organizing) IHE Asia / Oceania – IHE-JJapan – IHE-PRCChina – IHE-KRKorea

IHE Canada IHE North America Connectathon – October 2003 – 37 vendors – 15 countries IHE Europe Connectathon – March 2004 – 45 vendors – 9 countries IHE Japan Connectathon for Asia & Oceania – February 2004 Testing and Verification by National IHE Initiatives

IHE Canada IHE Japan – Main events Connectathon in February 2004 Demonstration at JRC April in Yokohama Showing the IHE Radiology Integration Profiles: – Scheduled Workflow (SWF) – Patient Information Reconciliation (PIR) – Consistent Presentation of Images (CPI) – Simple Image & Numeric Reports (SINR) Analyze the Cardiology Workflow for Japan Analyze the Nuclear Medicine Workflow for Japan Develop IHE LAB National Extensions for Japan

IHE Canada IHE Europe – Main events Implemented the 1 st IHE LAB Integration Profile – Additional IHE Lab Integration Profiles Planned Implementing the IHE IT Infrastructure Integration Profiles: – Retrieve Information Display (RID) – Enterprise User Authentication (EUA) – Patient Identifier Cross-Reference (PIX) for MPI – Consistent Time (CT) IHE Europe Connectathon in Padova (Italy) in March 2004 Testing IHE RAD, ITI and LAB Profiles IHE Demonstrations in Europe in 2004: – IHE-FHôpital Expo – IHE-FJFR – IHE-DDRK – IHE-DMEDICA – IHE-ISIRM – IHE-UKHCC

IHE Canada IHE North America – Main events First multi-domain Connectathon (Oak Brook, IL?) – January 2005 Domain development work in – Cardiology – First four integration profiles – IT Infrastructure – Five existing profiles, three new – Radiology – Three new supplements to augment existing 12 Ongoing liaison with SDOs: HL7, DICOM, ASTM Distributed media demonstration at RSNA 2004 Broad interoperability demonstration at HIMSS 2005 First IHE Cardiology demonstration activities at ACC 2005

IHE Canada National Extensions Developed by national initiatives Meet specific local needs: – Language – Regulations – Traditions of care Reviewed and approved by domain Technical Committees Published in volume IV of Technical Framework

IHE Canada National Extensions Scope of National Extensions so far: – Character Set for National Languages – Translations of IHE Concepts and Data Fields into National Languages – Extension of Patient and Provider Information According to National Policies (Privacy, Confidentiality, …) Account of less than 2% of IHE requirements

IHE Canada IHE Organizational Structure Multi-Domain & Multi-National IHE Europe IHE North America IHE Asia / Oceania Participants supervises reports contribute Delegates IHE (International) Strategic Development Committee Global Development: Radiology, IT Infrastructure, Cardiology, Lab, etc. Regional & National Deployment IHE Domain-related Planning and Technical Committees Sponsor Co-Chairs Global Interoperability

IHE Canada Benefits of IHE International Leverage a global framework for implementing standards Engage clinical experts in determining development priorities Provide education on the potential of integrated systems to improve care Speed the development of international healthcare information infrastructure

IHE Canada Toward IHE Canada Identify a group of interested stakeholders – Start a network of communication – Plan roles and establish roster of committees Plan an event – Testing: joint North American Connectathon – Demonstration at Canadian meeting Identify liaisons to IHE domain committees and Strategic Development Committee Make your membership and plans known

IHE Canada More information…. Web sites: – IHE Rad Technical Framework 2003 – V5.5 – IHE IT Technical Framework 2004 – V 1.0 – IHE Laboratory Technical Framework 2004 – V 1.0 Non-Technical Brochures : – IHE Fact Sheet and IHE FAQ – IHE Integration Profiles: Guidelines for Buyers – IHE Connectathon Results