Integrating the Healthcare Enterprise Applying the IHE Process to Cardiology Joyce Sensmeier MS, RN, BC, CPHIMS Director of Professional Services, HIMSS Christopher Carr Director of Informatics, RSNA

12/08/03IHE Cardiology Workshop IHE Process: Organizational Overview Goal: – Stimulate integration of healthcare information resources to improve clinical care – Develop and publish detailed frameworks for implementing established data standards – Support testing, demonstration and education to promote deployment

12/08/03IHE Cardiology Workshop Development International, Domain Specific Deployment Regional and National Lab Tech Cmte Lab Plan Cmte Cardiology Tech Cmte Cardiology Plan Cmte IT Infrastructure Tech Cmte IT Infrastructure Planning Cmte Radiology Planning Cmte Radiology Technical Cmte Sponsors: GMSIH, SFIL, JAHIS Sponsor: ACCSponsor: HIMSSSponsor: RSNA Strategic Development Committee Local/Domain Review Committees IHE-Europe IHE -UK IHE- Italy IHE- Denm ark IHE- Franc e IHE-Asia Oceania IHE- China IHE- Korea IHE- Japan IHE-North America Local/Domain Review Committees IHE- Canada IHE-USA Domain Committees/Domain Sponsors and Cooperating Organizations National/Regional Deployment Initiatives/Sponsoring Organizations Organization Overview

12/08/03IHE Cardiology Workshop Two principal activities Development – The work process that leads to publication of the IHE Technical Framework Deployment – Testing and demonstrations – Promotional and educational efforts

12/08/03IHE Cardiology Workshop Development Activities Domain specific and Global in scope Defines and documents standards- based solutions to address specific clinical and operational integration needs  Integration Profiles Detailed in the Technical Framework

12/08/03IHE Cardiology Workshop IHE Technical Framework Based on a consensus selection of established standards Carefully constrains implementation of these standards Makes the attainment of functional systems integration more efficient and less expensive

12/08/03IHE Cardiology Workshop IHE Technical Framework

12/08/03IHE Cardiology Workshop Strategic Development Committee Evolving to international in scope Broadest oversight body Define and publish the goals of IHE and guidelines for activities Oversee adherence to goals/guidelines Communication and coordination among domain committees and regional/national initiatives

12/08/03IHE Cardiology Workshop Strategic Development Committee Domain expansion activities Recruitment and liaison with related industry organizations Composition – Selected members/staff of sponsoring organizations – Current/past co-chairs of Domain Planning/Technical Committees – Invited reps of national/regional initiatives – Invited domain experts and reps of targeted expansion domains

12/08/03IHE Cardiology Workshop Review Committee Executive staff and senior membership of sponsors Mediate issues that may have implications for commercial competition Final authority on planning and execution of deployment activities in their nation or region

12/08/03IHE Cardiology Workshop Domain-specific Planning and Technical Committees International in scope Perform the work of selecting appropriate standards to address identified integration issues Define constrained implementations of these standards Document these implementations in the IHE Technical Framework

12/08/03IHE Cardiology Workshop Annual Cycle Scope planning Technical Framework publication and review Coordination with deployment activities

12/08/03IHE Cardiology Workshop Date Event JulyPlanning and Technical Committees: Initial annual organizational meeting Planning Committee: Initial Integration Profile development proposals August - September Planning Cmte: Development and review of Integration Profile proposals OctoberPlanning Cmte: Selection of Integration Profiles for development as sections of Technical Framework November - January Technical Committee: Development of Technical Framework Supplements to support new Integration Profiles and other changes FebruaryTech Cmte: Publication of Expanded Technical Framework for public review MarchPublic Review period for expanded Technical Framework AprilTech Cmte: Resolve public comments on extensions to Technical Framework and publish draft for Trial Implementation. NovemberTech Cmte: Resolve comments on Technical Framework and publish final stable version. IHE Radiology Timeline

12/08/03IHE Cardiology Workshop Date Event JulyPlanning and Technical Committees: Initial annual organizational meeting Planning Committee: Initial Integration Profile development proposals August - September Planning Cmte: Development and review of Integration Profile proposals DecemberPlanning Cmte: Selection of Integration Profiles for development as sections of Technical Framework January-MayTechnical Committee: Development of Technical Framework Supplements to support new Integration Profiles and other changes JuneTech Cmte: Publication of Expanded Technical Framework for public review JulyPublic Review period for expanded Technical Framework AugustTech Cmte: Resolve public comments on Technical Framework and publish draft for Trial Implementation FebruaryTech Cmte: Resolve comments on Technical Framework and publish stable yearly version. IHE IT Infrastructure Timeline

12/08/03IHE Cardiology Workshop Planning Committee Develop and review Integration Profile proposals Determine scope development priorities within their domain Communicate and coordinate development activities across domains

12/08/03IHE Cardiology Workshop Technical Committee Assess feasibility of scope development priorities Develop detailed documentation of approved Integration Profiles for inclusion of IHE Technical Framework

12/08/03IHE Cardiology Workshop Committee Representation Includes representatives from organizations whose systems and software are used within the given domain Domain experts provide guidance and oversight to development activities – Identify key clinical integration priorities – Review the work product to ensure that it addresses these priorities. Staff liaison(s) from sponsoring organization

12/08/03IHE Cardiology Workshop Committee Responsibility Participation is open and voluntary General invitation at start of annual cycle Responsibilities – Attendance at committee meetings – Attendance in teleconferences – Performing committee assignments

12/08/03IHE Cardiology Workshop Committee Sponsors Professional societies and trade associations representing relevant domains Share responsibility for logistics and expenses of committee activities Recruitment and organization of committee participants

12/08/03IHE Cardiology Workshop Committee Sponsors Scheduling and hosting meetings Secretarial duties Communication and publication of materials Coordinate educational/promotional efforts Designate staff and allocate resources

12/08/03IHE Cardiology Workshop Committee Sponsors Maintain and publish rosters and schedules of domain activities Document meeting minutes Maintain committee documents/work products Communicate with national IHE initiatives and others

12/08/03IHE Cardiology Workshop Committee Sponsors Designate individual members to provide advisory input, oversee and participate in domain-specific planning committees These representatives work through their organizations to gather the broadest domain expertise to determine strategic and scope development priorities

12/08/03IHE Cardiology Workshop IHE Development Domain Sponsors DomainOrganizational Sponsor IT Infrastructure Healthcare Information and Management Systems Society (HIMSS) RadiologyRadiological Society of North America (RSNA) LaboratoryGroupement pour la Modernisation du Système d'Information Hospitalier (GMSIH); Association Harmoniser et Promouvoir les Informatiques Medicales (H.PR.I.M) Japan Association of Healthcare Information Systems Industry (JAHIS) CardiologyAmerican College of Cardiology (ACC)

12/08/03IHE Cardiology Workshop Cooperating Organizations Do not undertake the financial and resource commitments Agree to be listed on IHE publications May designate a liaison to the appropriate domain planning committee – Communicate their strategic and scope priorities – Receive reports of committee activities Example: American College of Clinical Engineering (ACCE)

12/08/03IHE Cardiology Workshop Deployment Activities Domain specific and national or regional in scope Foster implementation of IHE Integration Profiles Process: – Interoperability testing – Demonstration – Education – Promotion

12/08/03IHE Cardiology Workshop National - Regional Initiatives Coordinate the deployment of the IHE Technical Framework and Integration Profiles Give input to their development relevant to local needs May rely on funding from other organizations (e.g. governmental bodies or foundations)

12/08/03IHE Cardiology Workshop National - Regional Initiatives Sponsored and overseen by relevant professional associations and local vendor representatives Responsible for – Organizing testing/implementation efforts – Public presentations – Education

12/08/03IHE Cardiology Workshop Deployment Activities Recruit national IHE initiative participants, sponsors and contributors Participate in regional IHE initiative planning activities & coordinate with national activities Communicate with other IHE regional and national initiatives Plan and support interoperability testing process, Connectathons, demonstrations and educational and promotional events

12/08/03IHE Cardiology Workshop Deployment Activities Retain a technical project manager/team to coordinate testing, Connectathons, and demonstrations Publish and disseminate educational/promotional materials Develop and proposed national extensions to the Technical Framework to address national policies/traditions of care

12/08/03IHE Cardiology Workshop Date Event AprilRSNA: Invitation to vendors to participate in testing and demonstration process; hold vendor workshop AprilSubmission of titles, abstracts and learning objectives for educational sessions at RSNA annual meeting JuneVendor applications due for participation in testing and demonstration process JulyParticipant meeting or Web conference AugustDevelopment and review of promotional materials SeptemberParticipant submission of MESA tools test results OctoberConnectathon testing event; results published in promotional materials DecemberEducational and promotional activities at RSNA annual meeting Domain Deployment Timeline: Radiology/North America

12/08/03IHE Cardiology Workshop Date Event May 28HL7-IHE Interoperability Demonstration Planning Committee June 15Call for participation announced August 15Final call for participation in HL7-IHE Interoperability Demonstration September 11-12HL7-IHE Interoperability Demonstration - Vendor workshop, Memphis, TN October 15Application due for HL7-IHE Interoperability Demonstration and Connectathon October 31, Nov. 30 Interim vendor progress reports due January 26-30, 2004 HL7-IHE Interoperability Demonstration - IT Infrastructure Connectathon – San Diego, CA February 22-26, 2004 HIMSS 2004 – HL7-IHE Interoperability Demonstration – Orlando, FL Domain Deployment Timeline: IT Infrastructure/North America

12/08/03IHE Cardiology Workshop IHE National and Regional Sponsors: North America Healthcare Information and Management Systems Society Radiological Society of North America American College of Cardiology (ACC)

12/08/03IHE Cardiology Workshop IHE National and Regional Sponsors: Europe European Association of Radiology (EAR) European Congress of Radiologists (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)

12/08/03IHE Cardiology Workshop IHE National and Regional Sponsors: Japan 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)

12/08/03IHE Cardiology Workshop Development International, Domain Specific Deployment Regional and National Lab Tech Cmte Lab Plan Cmte Cardiology Tech Cmte Cardiology Plan Cmte IT Infrastructure Tech Cmte IT Infrastructure Planning Cmte Radiology Planning Cmte Radiology Technical Cmte Sponsors: GMSIH, SFIL, JAHIS Sponsor: ACCSponsor: HIMSSSponsor: RSNA Strategic Development Committee Local/Domain Review Committees IHE-Europe IHE -UK IHE- Italy IHE- Denm ark IHE- Franc e IHE-Asia Oceania IHE- China IHE- Korea IHE- Japan IHE-North America Local/Domain Review Committees IHE- Canada IHE-USA Domain Committees/Domain Sponsors and Cooperating Organizations National/Regional Deployment Initiatives/Sponsoring Organizations Organization Overview