1. 1 Welcome to the HIMSS09 Interoperability Showcase brought to you by IHE Sponsors and Committee Members

2. 22 IHE: A Framework for Interoperability A common framework for harmonizing and implementing multiple standards  Application-to-application  System-to-system  Setting-to-setting Enables seamless health information movement within and between enterprises, regions, nations Promotes unbiased selection and coordinated use of established healthcare and IT standards to address specific clinical needs

3. 3 Standards: Necessary…Not Sufficient Standards are  Foundational - interoperability and communications  Broad - varying interpretations and implementations  Narrow - may not consider relationships between standards domains  Plentiful - often redundant or disjointed  Focused - standards implementation guides typically focus on a single standard IHE provides a standard process for implementing multiple standards

4. 4 IHE: Connecting Standards to Care Coordinate implementation of standards to meet clinical and administrative needs  Clinicians and HIT professionals identify the key interoperability problems they face  Providers and industry work together to develop and make available standards-based solutions  Implementers are able to follow common guidelines in purchasing and integrating effective systems IHE: A forum for agreeing on how to implement standards and processes for making it happen

5. 55 IHE Sponsors 1997: Founded in Radiology (RSNA) and IT (HIMSS) Many professional societies (stakeholder representation)  American Academy of Ophthalmology (AAO)  American College of Physicians (ACP)  American College of Clinical Engineering (ACCE)  American College of Emergency Physicians (ACEP)  American Society for Therapeutic Radiation Oncology (ASTRO)  GMSIH (IT France), JAHIS (IT Japan), SFIL (laboratory)  Healthcare Information Management Systems Society (HIMSS)  National Quality Forum (NQF)  National Institute of Standards and Technology (NIST)  Radiological Society of North America (RSNA)  And many more….

6. 6 IHE Participants and Relationships Participants include:  Users - Clinicians, Staff, Administrators, CIOs, Governments  Vendors of Information Systems and Equipment  Consultants Relationship with Standards Development Organizations (SDOs):  HL7, DICOM, ISO, CDISC, ASTM, W3C, IEEE, IETF, and many others  Approved via ISO/TC 215 allowing for IHE profiles to be published as ISO deliverables National Adoption of Healthcare IT Standards  HITSP, Infoway, many others worldwide

7. 77 IHE Organizational Structure Contributing & Participating Vendors Regional Deployment IHE Europe IHE North America France USA Canada IHE Asia-Oceania Japan KoreaTaiwan Netherlands Spain Sweden UK Italy Germany Norway China Austria ACC ACCE ACEP JAHIS JIRA JRS METI-MLHW MEDIS-DC JAMI RSNA SFR SFIL SIRM BIR EuroRec COCIR EAR-ECR DRG ESC Professional Societies / Sponsors ACP GMSI HIMSS Global Development Radiology Cardiology IT Infrastructure Patient Care Coordination Patient Care Devices Laboratory Pathology Eye CareRadiation Oncology Public Health, Quality and Research IHE International Board

8. 8 Established IHE as an International Organization (end of 2007) The IHE International Organization ~ 250+ Member Organizations  Healthcare Professional Associations  Healthcare Provider Organizations  Healthcare Education / Research Orgs  Trade Associations  Healthcare IT Companies  Government Agencies  Standards Organizations (SDOs)  Health Information Exchanges (HIEs)

9. 9 11 Years of Steady Evolution 1998 – 2009 The IHE Development Domains Laying the Groundwork 1998 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

10. 1010 International Growth of IHE France - Local Deployment - National Extensions - Promotional & Live Demonstration Events - Funding USAGermanyItalyJapanUKCanadaKoreaTaiwanNorway Netherlands Spain ChinaAustria Pragmatic global standards harmonization + best practices sharing Australia 1999 2000 2001200220032004 200520062007 2008 2009

11. 1111 National and Regional Projects Using IHE Profiles Quebec, Ontario, Alberta, British Columbia Canada Health Infoway Denmark (Funen) Italy (Veneto) Spain (Aragon) THINC- New York NCHICA – N. Carolina Italy (Conto Corrente Salute) Boston Medical Center - MA France DMP UK CfH (Radiology WF) Philadelphia HIE CHINA-MoH Lab results sharing CPHIC – Pennsylvania CHINA-Shanghai Imaging Info Sharing JAPAN-Nagoya Imaging Info Sharing South Africa Malaysia VITL-Vermont CareSpark – TN & VA Netherland Amsterdam Lower Austria

12. 12 Proven Standards Adoption Process Document Use Case Requirements Identify available standards (e.g. HL7, DICOM, IETF, OASIS) Develop technical specifications Testing at Connectathons Testing at Connectathons Products with IHE Timely access to information Easy to integrate products IHEDemonstrationsIHEDemonstrations

13. 13 Growth in IHE Domains Radiology (18 profiles) IT Infrastructure for Healthcare (20 profiles) Cardiology (7 profiles) Laboratory (6 profiles) Radiation Oncology (3 profiles) Patient Care Coord. (5 profiles) Patient Care Devices (3 profiles) Pathology Eye Care (4 profiles) 1999 Over 300 vendors involved world-wide 9 Technical Frameworks 64 Integration Profiles Testing at “Connectathons” world-wide Demonstrations at major conferences world-wide Veterinary Endoscopy Pharmacy Public Health, Quality and Research 200020012002200320042005200620072008

14. 14 Emergency Referrals Format of the Document Content and associated coded vocabulary PHR Extracts/Updates Format of the Document Content and associated coded vocabulary ECG Report Document Format of the Document Content and associated coded vocabulary Lab Results Document Content Format of the Document Content and associated coded vocabulary Scanned Documents Format of the Document Content Imaging Information Format of the Document Content and associated coded vocabulary Medical Summary ( Meds, Allergies, Pbs) Format of the Document Content and associated coded vocabulary Health Data Exchange Patient Demographics Query Patient Identifier Cross-referencing Map patient identifiers across independent identification domains Notification of Document Availability Notification of a remote provider/ health enterprise Request Form for Data Capture External form with custom import/export scripting Patient ID Mgmt Other Cross-Enterprise Document Sharing Registration, distribution and access across health enterprises of clinical documents forming a longitudinal record Cross-Enterprise Document Pt-Pt Reliable Interchange Cross-Enterprise Document Media Interchange Cross-Community Access Security & Privacy Consistent Time Coordinate time across networked systems Audit Trail & Node Authentication Centralized privacy audit trail and node to node authentication to create a secured domain. Basic Patients Privacy Consents Establish Consents & Enable Access Control Document Digital Signature Attesting “true-copy and origin Cross-Enterprise User Attestation User Attributes fro Access Control IHE Integration Profiles for Health Info Nets What is available and has been added this cycle Clinical and PHR Content

15. 15 IHE and US Healthcare IT Standards Harmonization Healthcare Information Technology Standards Panel (HITSP) Nationwide Health Information Network Architecture Projects (NHIN) The Health Information Security and Privacy Collaboration (HISPC) The Certification Commission for Healthcare Information Technology (CCHIT) American Health Information Community (AHIC)

16. 1616 IHE contributes to HITSP’s success 18 IHE Profiles adopted by HITSP Interoperability Specifications

17. 17 How to Participate As a User or Vendor Committee Member Become a member of a Domain’s Planning or Technical Committees As a User, Consultant or Vendor Interested Observer Provide Public Comments on Technical Framework Supplements Attend Demonstrations, Educational Events and Workshops

18. 18 How to Use IHE As a Vendor Implementer Implement IHE Integration Profiles Test systems through Connectathon process Publish an IHE Integration Statement for products As a User Implementer or Consultant Use IHE Integration Profiles to develop interoperability strategy Use Connectathon Results and Integration Statements to evaluate vendors Demand IHE Integration Profile compliance in RFPs

19. 19 2009 Interoperability Showcase Sponsors

20. 20 Featured this year in the Showcase… 76 connected applications, 32 IHE profiles Secured Health Information Exchange with broad content Clinical Scenarios, focusing on clinician and patient access and information sharing across the continuum of care Population Health, Quality and Research Privacy and Security HITSP Interoperability Specifications ConnectedEntities63 Supporters22 Total73 Health information exchange with patient care devices Personal health record solutions Financial and administrative systems for billing and claims attachments (CAQH/CORE) Expanded distributed demonstration in an HIE format showing connectivity with vendor booths The 2009 Cast:

21. 21 Sample Scenario Handout

22. 22 supported by: Infrastructure Patient Identity Management XDS Document Registries XDS Document Repositories Audit Repository

23. 23 The Distributed Demo… win an IPOD! Get your badge scanned, and be entered for a daily drawing! 3 Stickers enters you in the daily draw!!

24. 24 What happens next? Docents are standing by to guide you to through a clinical story demonstrating IHE interoperability OR A presentation begins immediately in this theatre

25. 25 Providers and Vendors Working Together to Deliver Interoperable Health Information Systems in the Enterprise and Across Care Settings http://www.ihe.net

26. 26