IHE USA Presents the North American IHE Connectathon January, 2011 Chicago The first formal activity of the newly incorporated non-profit IHE USA, the official IHE International National Deployment Committee for the United States! Please set your cell phones on stun!

Elliot B. Sloane, PhD, CCE, FHIMSS Drexel University, Health Systems Engineering Director Founder, Center for Healthcare Information Research and Policy Board of Directors, IHE-USA Co-Chair, IHE International Board of Directors, Delaware Valley HIMSS Past Chair, HIMSS Security and Privacy Steering Committee Sponsor, IEEE Medical Informatics Standards Interoperability, Health Information Security, and Medical Devices,

IHE USA Incorporated in 2010 as an independent non-profit agency in the state of Illinois, and is filing with the IRS as a 501(c)(3) educational foundation Legally independent, and separate Board of Directors, from HIMSS, RSNA, and IHE International Receives donations, tuition, membership and Connectathon fees, and grant funding Provides educational, teaching, and research grants and scholarships, and Pays for the development and dissemination of critical Open Source, free testing and implementation tools for hospitals, government agencies, and manufacturers The first IHE USA membership drive is just starting! –Small and large institutions, plus individuals

IHE International oversees the creation of detailed guidelines that use multiple standards to build interoperable health IT systems. IHE International also coordinates the activities of national and regional deployment committees worldwide, such as IHE USA. IHE USA is recognized by IHE International as the national deployment committee for the United States. IHE USA's role is to serve as the voice for US health IT interests and foster national adoption of information standards to enable interoperability

IHE USA supports HHS & ONC IHE USA exists to serve Americas healthcare needs. It does its very best to discover and support synergies and efficiencies in HIT standards development and deployment, and to eliminate waste, redundancy, and unnecessary and wasteful conflict.

IHE USA is NOT the same as IHE Europe or IHE Oceania-Asia The US healthcare market uses different coding standards, is based on a privatized business and insurance models, has very different clinical delivery processes, and has its own unique legal and regulatory framework. e.g., IHE USA still supports ICD-9 coding because that is stipulated in the HIPAA 4010 standards. US laws and practices drive IHE USA, not IHE International or other National Domains

IHE USA adapts well developed global standards to solve US challenges where efficient and appropriate e.g., DICOM, IEEE 11073, HL-7, ICD-9, ICD-10 are all well-recognized international standards. CPT, LOINC, SNOMED, and UMLS are US-centric Though many countries have national patient identifiers, but IHE USA supports the US patient- matching model using multi-factor patient identification

IHE USA leverages well-tested modular core IHE services to meet US needs e.g., IHEs Consistent Time Integration Profile assures that all records in and from all computer systems inside and outside of the hospital can synchronize the timestamps each clinical and business document IHEs XDS (Cross Enterprise Document Sharing) Integration Profile allows documents to be reliably and securely shared anywhere in the healthcare enterprise.

9 Our testing results are public and IHE-Profile-specificwww.ihe.net/Connectathon

Examples of Integration Profiles that were tested and verified in the 2010 Connectathon

Companies that tested the IHE Integration Profiles in the 2010 Connectathon

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 Pharmacy Since 2009 Dentistry Since 2010 ALL IHE clinical domains share the 50+ integration profiles! IHE: Ever-growing since 1998.

13 12-yr International Growth of IHE France Local Deployment, National Extensions Promotional & Live Demonstration Events The IHE Integration Profiles may be extended for local requirements USA Germany Italy Japan UK Canada Taiwan Netherlands Spain Austria Pragmatic global standards harmonization + best practices sharing 2008 Australia 2010 China Turkey Malaysia Switzerland USA Most of the 55+ Integration Profiles are re-used around the globe!

Document Exchange Integration Profiles Document Sharing XDS / XCA Sharing XDS / XCA Media Interchange XDM Reliable Pt-Pt Interchange XDR Doc Content Profiles (HL7 CDA, DICOM Semantics content) Scanned Doc XDS-SD LaboratoryXD*-Lab PHR Exchange XPHR Discharge & Referrals XDS-MS ImagingXDS-I ConsentBPPC EmergencyEDR Pre- Surgery PPHP Functional Status Assessment FSA

15 How real is IHE XDS ? Stable specification, tested by 100 vendorsStable specification, tested by 100 vendors First implementation in clinical use in region of Genoa - Italy) since early 2006.First implementation in clinical use in region of Genoa - Italy) since early Several since: Three Austria regions, Applications in Vermont, Pennsylvania, Nagoya city, South Africa region, Italian & Dutch regions, France, etc.Several since: Three Austria regions, Applications in Vermont, Pennsylvania, Nagoya city, South Africa region, Italian & Dutch regions, France, etc. Adopted by several national programs world-wideAdopted by several national programs world-wide 4 open source toolkits available, numerous product implementations in EMRs and Infrastructure offerings.4 open source toolkits available, numerous product implementations in EMRs and Infrastructure offerings.

16 IHE, Global Standards-Based Profiles Adopted in National & Regional Projects (sample) Quebec, Toronto, Alberta, British Columbia Canada Infoway THINC- New York NCHICA – N. Carolina Italy Conto Corrente Venetto - Friuli Boston Medical Center - MA CHINA-MoH Lab results sharing CHINA-Shanghai Imaging Info Sharing JAPAN-Nagoya Imaging Info Sharing, Nationwide PDI guideline South Africa VITL-Vermont CareSpark – TN & VA NETHERLANDS Friesland Natnl Mamography Lower Austria France DMP Wales Imaging Belgium Flemish-Leuven Suisse St Gallen Lausane Providence Health System - OR Geisinger KeyHIE Pennsylvania SHARP CA France Imaging IDF 16 For more complete list see: tinyurl.com/wwXDS

At IHE, progress for patient care never stops!

Connecting Medical Devices to the Electronic Health Record is my personal passion IHE-PCD: IHE Patient Care Device Domain Committee Have spent almost a decade developing integration profiles that allow medical and personal health devices to send vital signs data automatically, accurately, and securely in a medical record that can be read and stored in any EMR that can interpret an XML HL-7 v2.6 document In 2010, the IHE-PCD and Continua-WAN specifications were finally aligned, and a SINGLE data standard is now used by ALL devices to load clinical data directly from any device into the EMR

The IHE-PCD, Continua-WAN, and IHE EMR interfaces will be proven here this week for the first time! Hospitals Dr. Office Nursing Homes | FDA-regulated Medical Devices | Home Care Personal Health Devices | Home Care

Finally, a cross-enterprise labor-, error-, and delay-saving breakthrough for patient monitoring! The new IHE-PCD and Continua-WAN compatible interface allows flexible home monitoring, hospital monitoring, EMS monitoring, and alternate-site care monitoring with interchangeable, interoperable devices that can ALL load clinical data DIRECTLY to the EMR. We have ONC and Dr. John Halamka to thank: they asked for a single solution in 2008, so we developed one!

We are pleased to have Dr. Doug Fridsma with us today Gives us the opportunity to expand the discussion about how IHE USA can best support him and his colleagues at ONC. e.g., how can IHEs resources best support Meaningful Use Phases 1, 2, and 3? e.g., how can IHEs resources best support the newly emerging S&I Framework?

IHE USA supports the new ONC Standards and Infrastructure (S&I) Lifecycle. IHE Connectathon & Showcases (late fall and winter) IHE Testing & Tools Development (late spring and summer) IHE Domain Committee draft profile (winter and spring) IHE Domain Committee & workgroup meetings (early Fall) IHE Domain Committee new work product proposal reviews (late summer) e.g., Can IHE align its process and priorities to better support ONC?

IHE supports the new ONC IEPD artifacts: can some of IHEs artifacts be useful? Information Exchange Package Documention

Can IHE USA work together with ONC to accommodate the National Information Exchange Model (NIEM)?

IHE is Powered by Volunteers The nation salutes Dr. King each year with a Day of Service. IHEs Volunteers donate tens of thousands of hours, day by day, year by year, to one shared dream: to create a world that will improve patient care by ensuring health data is secure, interoperable, complete, and readily available at the point and moment of care, regardless of location. Thank you to ALL of our volunteers! The Connectathon monitors you will meet today are all volunteers.

Rich Set of FREE Open Source Tools and Resources! 1 Implementation Guidance 2 Implementation Tools 2.1 Development Tools IHE Integration Profiles OHT IHE Profiles 2.2 Test Tools MESA Laika Gazelle Test Management Tool Patient Care Device Testing Tools HL7 V2 Toolkit EVS Message Validation Toolkit XDS Toolkit XDS-I and PIX/PDQv3 Testing Tools DICOMScope Visualization Tools (MESA Consistent Image Presentation) Portable Data for Imaging Disk Validator IHE-RO Test Tools 2.3 Test Tools by Profile and Actor 3 Sample Files/Objects/Messages/Data

FREE Open Source medical device IHE-ready XML test tools from the US Government - NIST NIST has developed an Implementation Conformance Statement (ICS) generator tool called ICSGenerator to facilitate creation of vendor conformance statements that would be applicable to testing a particular ISO/IEEE (X73) device. Additionally, NIST has completed initial development of a ValidatePDU tool, a tool that provides basic syntax and structure check and low level semantic checks for one or more captured messages. Both tools utilize the electronic representation of the X73 standard's information model implemented by NIST researchers in the form of an XML schema.. Medical device test message generation is also possible to enable future manager/agent conformance test scenarios.an XML schema

Large Library of Free IHE Educational Webinars Each month since 2008 were – and are – presented on topics including IHE, Interoperability, the IHE North America Connectathon, the HIMSS Interoperability Showcase, and a detailed review of profile supplements developed this year in IHE's twelve active domains! The Webinar schedule and links to free registration for upcoming sessions are below. Copies of slides are provided for sessions already presented. Video recordings of the sessions will be made available shortly. Additional Webinar sessions will be posted throughout the summer as dates are confirmed. Past IHE Webinar Series

We are IHE USA, and were here to serve. Welcome to the IHE Connectathon, and welcome to the ongoing conversation with our vibrant IHE USA professional community. Devoted to changing the way the healthcare world connects!