1. Sept 13-15, 2004IHE Interoperability Workshop 1 Integrating the Healthcare Enterprise Overview of IHE IT Infrastructure Patient Synchronized Applications (PSA) Integration Profile Didi Davis Eclipsys Corporation Co-chair - IHE IT Infrastructure Planning Committee

2. Sept 13-15, 2004IHE Interoperability Workshop 2 IHE IT Infrastructure 2004-2005 Enterprise User Authentication Provide users a single name and centralized authentication process across all systems Retrieve Information for Display Access a patient’s clinical information and documents in a format ready to be presented to the requesting user Retrieve Information for Display Access a patient’s clinical information and documents in a format ready to be presented to the requesting user Patient Identifier Cross-referencing for MPI Map patient identifiers across independent identification domains Patient Identifier Cross-referencing for MPI Map patient identifiers across independent identification domains Synchronize multiple applications on a desktop to the same patient Patient Synchronized Applications 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. New Patient Demographics Query New Personnel White Page Access to workforce contact information New Cross-Enterprise Document Sharing Registration, distribution and access across health enterprises of clinical documents forming a patient electronic health record New

3. Sept 13-15, 2004IHE Interoperability Workshop 3 IHE IT Infrastructure 2004-2005 Enterprise User Authentication Provide users a single name and centralized authentication process across all systems Retrieve Information for Display Access a patient’s clinical information and documents in a format ready to be presented to the requesting user Retrieve Information for Display Access a patient’s clinical information and documents in a format ready to be presented to the requesting user Patient Identifier Cross-referencing for MPI Map patient identifiers across independent identification domains Patient Identifier Cross-referencing for MPI Map patient identifiers across independent identification domains Synchronize multiple applications on a desktop to the same patient Patient Synchronized Applications 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. New Patient Demographics Query New Personnel White Page Access to workforce contact information New Cross-Enterprise Document Sharing Registration, distribution and access across health enterprises of clinical documents forming a patient electronic health record New Synchronize multiple applications on a desktop to the same patient Patient Synchronized Applications

4. Sept 13-15, 2004IHE Interoperability Workshop 4 Abstract / Scope Patient Synchronization of Multiple Disparate Applications Single Patient Selection When combined with PIX Profile, allows patient synchronization across patient identifier domains When combined with EUA Profile, provides user Single Sign-on (SSO) Patient Synchronized Applications

5. Sept 13-15, 2004IHE Interoperability Workshop 5 Value Proposition User Convenience:  Eliminates the repetitive task of selecting the patient in each application  Permits the user to select the patient in the application for which they are most familiar and / or appropriate to the clinical workflow Patient Safety:  Ensures all data being viewed across applications is for the same patient Leverage Single Development Effort:  Allows vendors to leverage single CCOW enablement effort to support multiple actors: Patient Context Participant (PSA) User Context Participant (EUA) Patient Synchronized Applications

6. Sept 13-15, 2004IHE Interoperability Workshop 6 Patient Synchronized Applications Actors Context Manager Actor The IHE Context Manager Actor may encompass more than a CCOW context manager function. It may include a number of other components such as the context management registry and patient mapping agent. Patient Context Participant Actor The Patient Context Participant Actor shall respond to all patient context changes. This actor shall set the patient context provided the application has patient selection capability.

7. Sept 13-15, 2004IHE Interoperability Workshop 7 IHE Actor Concept Patient Context Participant Actor Context Manager Actor

8. Sept 13-15, 2004IHE Interoperability Workshop 8 Transactions Diagram Patient Synchronized Applications These transactions are required by both Actors to claim compliance

9. Sept 13-15, 2004IHE Interoperability Workshop 9 Simple Patient Switching Process

10. Sept 13-15, 2004IHE Interoperability Workshop 10 Key Technical Properties Standards Used:  HL7 Context Management “CCOW” Standard, Version 1.4  Support for both Windows and Web Technology  Support of “Patient Subject” IHE Constraints:  Specifies use of Patient.Id.IdList item Ensures maximum interoperability with PIX Profile Protects against future deprecation of patient identifier items (HL7 2.3.1, 2.4, 2.5, CCOW). Patient Synchronized Applications

11. Sept 13-15, 2004IHE Interoperability Workshop 11 Synergy between IHE IT Int. Profiles Apps with PSA, EUA & PIX Application A Client Authentication Agent Time ClientKerberos Authentication Server Time Server Patient Identity Consumer Patient Identity X-ref Manager Context Manager Application B Context participant Example of support of multiple actors/profiles 11

12. Sept 13-15, 2004IHE Interoperability Workshop 12 Bridging Diverse Technologies with Sentillion HIMSS 2003

13. Sept 13-15, 2004IHE Interoperability Workshop 13 Bridging Diverse Technologies with CareFX HIMSS 2004

14. Sept 13-15, 2004IHE Interoperability Workshop 14 Enabling EMPI with IHE Questions?

15. Sept 13-15, 2004IHE Interoperability Workshop 15 CONTEXT MANGEMENT Enable caregivers to access synchronized patient information from diverse applications Dramatically enhance workflow for caregivers’ throughout the enterprise Improve caregiver satisfaction and productivity Increase patient safety and minimize risk through “single patient selection” Enable Different Applications from Different Vendors to Work As One

16. Sept 13-15, 2004IHE Interoperability Workshop 16 More information…. IHE Web sites: http://www.himss.org/IHE http://www.rsna.org/IHE http://www.acc.org/quality/ihe.htmhttp://www.acc.org/quality/ihe.htm. Technical Frameworks: ITI V1.0, RAD V5.5, LAB V1.0 Technical Framework Supplements - Trial Implementation May 2004: Radiology August 2004: Cardiology, IT Infrastructure Non-Technical Brochures : Calls for Participation IHE Fact Sheet and FAQ IHE Integration Profiles: Guidelines for Buyers IHE Connect-a-thon Results Vendor Products Integration Statements