Device and EMR interoperability (IDCO)

Implantable Cardiac Device Information is Collected At Implant … During In Clinic Follow-ups … And in the Home Healthcare Environment.

Vendor #2Vendor #1 Moving this Information Collected from Multiple Vendor Products into Clinic Information Systems Vendor #N Supporting Multiple Vendor Integrations is Complicated and Expensive Supporting Multiple Vendor Integrations is Complicated and Expensive Is Required for Workflow Efficiency and Quality Outcomes in the Clinic.

Vendor #2Vendor #1 Standardizing the Way Vendor Devices Interoperate with Clinical Information Systems Vendor #N Integration Standards Simplify Interoperability Integration Standards Simplify Interoperability Simplifying Integrations Saves - Time, Money and Improves Quality Simplifying Integrations Saves - Time, Money and Improves Quality

Vendor Participation in the Implantable Cardiac Device Standards Process Good news! Multiple device and EMR vendors have been participating in the standards development process. Implantable Cardiac Device Vendors EMR Vendors

IDCO encompasses Three Standards Semantics –A nomenclature or set of terminology that defines the information being shared Syntax –The structural arrangement of the information Profiles –The specifications for how an integration will be accomplished for a specific use case

Standards used for Semantics The device vendors and a HRS committee has been working with CEN/ISO/IEEE/11073 to define a nomenclature for implantable cardiac device domain. The standards specify usage constraints for semantic meaning, data type, unit of measure, and enumerated values using a set of normative text and numeric code identifiers for labeling implantable cardiac device data. The IDCO standard is now in ballot and should be ratified before year end.

Standard used Structure Health Level Seven International (HL7) is the global authority on standards for interoperability of health information technology. The device and EMR vendors have adopted a standard HL7 version 2 message structure called an Unsolicited Orders and Observations Message to facilitate data integration. A HL7 version 3 message for the implantable cardiac device domain has also been defined and passed ballot in support of future initiatives. Health Level Seven International

Profiling Use of the Standards Integrating the Healthcare Enterprise (IHE) is an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information. IHE promotes the coordinated use of established standards such as HL7 and DICOM to address specific clinical need in support of optimal patient care. 1.Clinical experts define critical use cases for information sharing. 2.Technical experts create detailed specifications for communication among systems to address these use cases, selecting and optimizing established standards. 3.Industry implements these specifications (called IHE Profiles) in HIT systems. 4.IHE tests vendors’ systems at carefully planned and supervised events called Connectathons. IHE’s 4 Step Process

IHE Domains IHE Planning and Technical committees follow the four step annual process to address interoperability in a variety of clinical domains: –Anatomic Pathology –Cardiology –Eye Care –IT Infrastructure –Laboratory –Patient Care Coordination –Patient Care Devices –Quality, Research and Public Health –Radiation Oncology –Radiology IDCO crosses these two domains ACC and HRS physicians on the Planning Committee define use cases and data requirements Vendors on Technical Committee author the profile Vendors then implement profile specification in their product and participate in the Connectathon

IHE Connectathon The Connectathon is a large scale interoperability event held every year where vendors demonstrate connectivity using the IHE profiles.

Implantable Cardiac Device Observations Profile (IDCO) IDCO profiles in-clinic and home healthcare device interrogation use cases Based on IEEE IDC nomenclature and HL7 standards Device and EMR vendors successfully tested the IDCO Profile at the 2010 and 2011 Connectathons

Why is IDCO compliance important? Allows device data to be captured in EMR systems automatically which reduces workflow complexity EMR implementation costs are reduced for those systems that comply with IDCO Ensures quality of care by conforming data to standard data format and terminology

What’s Planned for 2011? Complete the balloting of the IDC Nomenclature Begin expanding the IEEE IDC Nomenclature with prioritization from the HRS working group to include detailed data, waveforms and alerts Refine the IDCO Profile to improve usability and ease of implementation Plan support for the evolving HL7 v3 standard

How Can You Get Involved or Provide Comments? As a physician … Contact Del Conyers at the HRS – Del Conyers, MPH, HRS Director of Quality Improvement at As a vendor … Contact info Technical Committee

Questions?