Presentation to the CDC PHIN Partner Group June 3, 2009 Integrating the Healthcare Enterprise (IHE) The Healthcare Information and Management Systems Society (HIMSS) Lisa Spellman, MBA, CPHIMS HIMSS, Senior Director Informatics, Staff Liaison to IHE Floyd P. Eisenberg, MD, MPH, FACP Senior Vice President, Health Information Technology, National Quality Forum QRPH Technical Co-chair

Copyright IHE International Webinar Overview Part I: Lisa Spellman IHE Overview  Brief - IHE overview & relevance to their work  Audiences that IHE attracts & serves  Special welcome to Lori F & Patty C Get involved: Opportunities for public health leaders & your HIT vendors  IHE Domains & Committees  Review Public Comment documents  Interop Showcases & testing Other opportunities  HIMSS: HIE: Pam Mathews will speak with them next month Other SIGs & committees Resources Part II: Floyd Eisenberg Retrieve Protocol for Execution Profile Clinical Research Data Capture Profile (change proposal) Maternal Child Health Profile Drug Safety Content Profile Performance Quality Report Profile Newborn Screening White Paper Chronic Disease Management White Paper Knowledge Representation in Diabetes Care Management White Paper Next Steps

Copyright IHE International What is “Integrating the Healthcare Enterprise”? A 10-year public-private global initiative driven by end-users worldwide Clinicians Non-profit organizations USA: OASIS, CORE State & Federal agencies & related entities State Depts Public Health Governments: France: GIP-DMP - French Ministry of Health USA: American Heart Association Worldwide: HIMSS, RSNA Professional Societies  Representing 270,000+ individual members:  HIMSS, RSNA, PHIN, ACC, ACP, AAO, ACCE, ASTRO, etc Standards Development Orgs (SDOs):  HL7, DICOM, CDISC, W3C, IEEE, Etc. Vendors & consultants (imaging, EHRs, Cardio, devices, etc)

Copyright IHE International IHE Mission IHE improves patient care by harmonizing electronic health information exchange Enables approved standards to seamlessly pass health information among care providers on a local, regional and national level IHE Frameworks are freely available to all Ok, now translate – what does that really mean?

Copyright IHE International Big concept = package approved standards into usable “tool kit or package” Package standards in usable packages (called profiles) Standards are a great thing to have, but how to best assemble and use them? Example: Child car seats  Standard = All children younger than certain age had to be in a car seat  Location: Not prescribed  Front seat - OK  New standard packaged the concept  Child in car seat + strapped in + facing backwards + better sizing

Copyright IHE International IHE Development Domains - Helping Public Health More Directly Note: The Public Health Data Standards Consortium helped HIMSS & RSNA start QRPH Domain QRPH leverages “packages” (profiles) from multiple domains 11 Years of Steady Evolution 1998 – 2009 Pharmacy NEW 2009 Pathology since 2006 Radiation Oncology since 2004 Radiology since 1998 Cardiology since 2004 Patient Care Devices since 2005 Patient Care Coordination since 2004 Eye Care since 2006 Quality Research & Public Health since 2006 Laboratory since 2004 (Healthcare) IT Infrastructure since 2003

Copyright IHE International Why Public Health professionals & your vendors should get involved If as a PH professional you are involved in evaluating and/or selecting IT products and consultants - you and/or your consultants & vendors can & should:  Use IHE Integration Profiles to develop interoperability strategy  Use Connectathon Results and Integration Statements to evaluate vendors  Demand IHE Integration Profile compliance in RFPs

Copyright IHE International IHE Vendor Integration Statements

Copyright IHE International Many ways to become involved As a User, Committee Member or Interested Observer  Contribute your knowledge & expertise Join a Domain Planning or Technical Committee Provide Public Comments on Technical Framework Supplements and IHE White Papers June 1, 2009: IHE opened round of Public Comment  Attend Demonstrations, Educational Events and Workshops

Copyright IHE International See for yourself – Interoperability Demonstrations PHIN: August Atlanta RSNA: November 2009 – Chicago HIMSS10: March 2010 – Atlanta

Copyright IHE International QRPH White Papers Patient-Level Export of Quality Data  Identifies a set if IT Infrastructure and Patient Care Coordination profiles that can be used to retrieve quality data from multiple systems for quality reporting and aggregation. This framework can be extended to research and public health purposes White Paper: Performance Measurement Data Element Structured for EHR Extraction  Intended to identify a standard mechanism to enable extraction of quality measures from Electronic Health Record Systems Section 3001 of ARRA that requires the National Coordinator for Health Information Technology (HIT) to develop a nationwide health information technology infrastructure that will allow for the electronic use and exchange of information to improve health care quality, reduce medical errors, reduce health care disparities, and advance the delivery of patient-centered medical care…

Copyright IHE International Cancer Registry Pathology Report Value Proposition 12 ~ 2 Million cancers diagnosed each year in the US  ~ 95% of these cancers have one or more pathology reports The US federally mandates reporting  serves as the foundation to reduce illness and death from cancer Making use of the EHR and IHE methodology  reduce time and resources required to meet federal mandates  improve the timeliness of reporting Being proposed to IHE Pathology for a New Directions Demonstration

Copyright IHE International Other Opportunities for Involvement

Copyright IHE International Webinar Schedule Overview All sessions recorded & available at Session 1-Thur June 11, 09: Overview North American Connectathon & HIMSS10 US Interoperability Showcase  Why IHE & HITSP  What 2010 NA Connectathon Participants need to know: Connectathon Administrative & Logistics  Testing Cycle Requirements  How to Interpret the Technical Framework  2009 NA Connectathon Registration  What HIMSS10 Interop Showcase Participants need to know: Administrative & Logistics  Special Session for Returning NA Connectathon & Interop Showcase Participants Session 2: Radiology, Mammography & Nuclear Medicine - Tuesday, June 24 QRPH, PCC, PCD, Etc… And so on –there will be sessions June – September 2009

Copyright IHE International Insert Transition Slide Thank you and now I’ll hand over to Dr. Floyd Eisenberg who will speak to current and planned activities for IHE but also about activities underway at HISTP, NQF and so on… Thank you and I can be reached at Lisa Spellman Senior Director, Informatics Staff Liaison, IHE (703)

Copyright IHE International QRPH 2009 Profiles / White Papers Retrieve Protocol for Execution Profile Clinical Research Data Capture Profile (change proposal) Maternal Child Health Profile Drug Safety Content Profile Performance Quality Report Profile Newborn Screening White Paper Chronic Disease Management White Paper Knowledge Representation in Diabetes Care Management White Paper

Copyright IHE International Retrieve Protocol for Execution ProtocolDefManager Protocol Executor Protocol State Manager AmendProtocolDef (8) AlertProtocolState (9) ReviewProtocolDef (1) EnterPatientRequest (2) PatientScreeningVisitsScheduled (3) RecordPatientScreeningVisit(4) EnrollPatientRequest(5) PatientStudyVisitsScheduled(6) RecordPatientStudyVisit(7) The Retrieve Protocol for Execution Profile (RPE) provides an automated mechanism for an Electronic Health Record (EHR) to retrieve a complex set of clinical research instructions (Protocol Definition) from an Electronic Data Capture (EDC) system to execute within the EHR.

Copyright IHE International Retrieve Protocol for Execution Retrieve Protocol for Execution (RPE) ProtocolDefManagerProtocolExecutorProtocolStateManager RetrieveProtocolDef [1] EnterPatientRequest [2] PatientScreeningVisitsScheduled [3] RecordPatientScreeningVisit [4] EnrollPatientRequest [5] PatientStudyVisitsScheduled [6] RecordPatientStudyVisit [7] AlertProtocolState [9] RetrieveProtocolDef [8]

Copyright IHE International Clinical Research Data Capture Form Filler Form Manager Retrieve Form [ITI-34] along with pre-population data Continuity of Care Document (CCD) Form Delivery of Form along with pre- population data bound to the form

Copyright IHE International Maternal Child Health Content profile describes to automating data capture in vital records such as the birth certificate or early childhood health certificates. Pre-populate certificate with data from the EHR Submit certificate to interested organizations  Retrieve Form for Data Capture (RFD)  Uses transactions and content modules defined in other IHE profiles to provide interoperable data exchange.

Copyright IHE International Maternal Child Health

Copyright IHE International Drug Safety Profile Form Filler Form Manager Retrieve Form [ITI-34] along with pre-population data Continuity of Care Document (CCD) Form Delivery of Form along with pre- population data bound to form CCDE2B M XSLT Reference Implementation CCD Form Manager

Copyright IHE International Newborn Screening (White Paper) Newborn Screening White Paper  Work processes and data information exchange needs for Newborn Screening programs administered by regulatory health authorities  Newborn bloodspot screening (NBS) Metabolic, pulmonary, genetic, hematologic and other disorders identified by laboratory testing  Newborn hearing screening (NHS or Early Hearing Detection and Intervention – EHDI) Permanent conductive or sensorineural hearing losses using physiologic testing technologies  Screening is conducted at the birthing facility within three days of birth, representing the first two information exchanges between clinical care and public health authorities in the life course of a child.

Copyright IHE International Additional QRPH Work Performance Quality Report Profile – mid-June Newborn Screening White Paper Chronic Disease Management White Paper Knowledge Representation in Diabetes Care Management White Paper

Copyright IHE International Thank you! Aligned Industry Efforts HITSP Quality Tiger Team – 16 inpatient measures, re- tooling requirements Data Architecture Tiger Team – Value set attributes, maintenance and storage Post Tiger Team – Maternal Child Health, Newborn Screening NQF HITEP Quality Data Set Data Flow Opportunities Align measurement and reporting around Quality Data Set Near term exemplars of reporting based on value sets Discussion….

Copyright IHE International Resources Lisa Spellman Senior Director, Informatics Staff Liaison, IHE (703) & Floyd Eisenberg, MD, MPH, FACP Senior VP, Health IT National Quality Forum (202) x IHE 2009 Webinar Series  

Copyright IHE International