1. Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth Initiatives Elliot B. Sloane, PhD, CCE, FHIMSS President, Center for Healthcare Information Research and Policy (CHIRP) & Co-Chair, IHE International Joint ITU-WHO Workshop on e-Health Standards and Interoperability (Geneva, Switzerland, 26-27 April 2012)

2. IHE International - www.IHE.net Created in 1997 to assure electronic health data interoperability Triggered by inability of products to reliably exchange DICOM images Worldwide initiative in > 24 countries Non-profit, volunteer driven, user- centric No cost for membership or documents Join or download at www.IHE.net Geneva, Switzerland, 26-27 April 20122

3. Main results to date Many hundreds of software and hardware products tested around the world using the IHE Profiles See http://connectathon-results.ihe.net/ 2012 product testing in North America, Asia-Oceania and Europe Embedded in national/state standards in Canada Gradually emerging in US and China Some products are IHE Natives Successful collaboration with Continua Geneva, Switzerland, 26-27 April 20123

4. 4 Korea International Growth of IHEFrance Local Deployment, National Extensions Promotional & Live Demonstration Events Over 400 Organizational Members (all stakeholders) USA Germany Italy Japan UK Canada Taiwan Netherlands Spain Austria 199920002001200220032004 2005200620072009 Pragmatic global standards harmonization + best practices sharing 2008 Australia 2010 China Turkey Malaysia Switzerland Early programs in Brazil, Dubai, Israel, and Saudi Arabia, too

5. 12 Years of Steady Evolution 1997 – 2010 The IHE Development Domains Pharmacy Since 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 since 2008 IHE has eHealth initiatives in many/most key clinical areas

6. Future activities Expanding to more products & nations Exploring smart phone tools, apps See also: www.CEITCollaboration.org www.ACCEnet.org www.IHE.netwww.IHE.net and www.IHE.net/PCDwww.IHE.net/PCD Large number of device, state, and national examples at http://www.iheusa.org/IHEUSA- Resources-Education-Conference- Archives2012.aspxhttp://www.iheusa.org/IHEUSA- Resources-Education-Conference- Archives2012.aspx See additional slides at end of this set! Geneva, Switzerland, 26-27 April 20126

7. Challenges, lessons learned Every new entrant wants to start with a fresh sheet of paper! Waste of great talent and precious time Never, ever really done Tomorrows innovations will require new adaptations Mobile technologies are coming quick How to share disciplines like security, standards with that enthusiastic crowd? Geneva, Switzerland, 26-27 April 20127

8. Conclusions and Recommendations Make standards, tools and toolsets visible to mHealth developers Sponsor Mobile Technology Connectathons that demonstrate IHE, IEEE, HL7, Rosetta use Grand prizes? Chronic disease smart phone apps that use IHE! Education needed on value of at rest and in-motion data encryption Free tools available! Personal health data MUST be protected! Geneva, Switzerland, 26-27 April 2012 8

9. Questions and enthusiastic ideas are WELCOME! Please feel free to contact me directly at ebsloane@gmail.com or ebsloane@chirp.us.orgebsloane@gmail.com ebsloane@chirp.us.org Elliot B. Sloane, PhD, CCE, FHIMSSS www.ebsloane.org Remember: it is all free: www.IHE.net www.IHE.net/PCD

10. This slide is intentionally empty Geneva, Switzerland, 26-27 April 201210

11. Geneva, Switzerland, 26-27 April 2012 Elliot B. Sloane, PhD, CCE, FHIMSS President, Center for Healthcare Information Research and Policy (CHIRP) & Co-Chair, IHE International Joint ITU-WHO Workshop on e-Health Standards and Interoperability (Geneva, Switzerland, 26-27 April 2012) FULL PRESENTATION & DETAILS Integrating the Healthcare Enterprise (IHE) - eHealth Initiatives

12. Some of the current FAQs: Elliot B. Sloane, PhD, CCE, FHIMSS President, Center for Healthcare Information Research and Policy HIMSS roles: Board of Directors, Delaware Valley HIMSS HIMSS Annual Conference Education Committee Past Chair, HIMSS Security and Privacy Steering Committee IHE roles: Co-Chair, IHE International Board of Directors Co-Founder IHE Patient Care Device Domain Board of Directors, IHE-USA Other professional roles: Sponsor, IEEE 11073 Medical Informatics Standards Past President, American College of Clinical Engineering Past Board of Directors, IEEE EMBS Past Board of Directors, ANSI/HITSP project www.ebsloane.orgwww.ebsloane.org & www.ebsloane.org/HealthSystemsEngineering/

13. 13 Korea International Growth of IHEFrance Local Deployment, National Extensions Promotional & Live Demonstration Events Over 400 Organizational Members (all stakeholders) USA Germany Italy Japan UK Canada Taiwan Netherlands Spain Austria 199920002001200220032004 2005200620072009 Pragmatic global standards harmonization + best practices sharing 2008 Australia 2010 China Turkey Malaysia Switzerland Early programs and projects in Brazil, Dubai, Israel, Mexico, and Saudi Arabia, too

14. 12 Years of Steady Evolution 1997 – 2010 The IHE Development Domains Pharmacy Since 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 since 2008 IHE has eHealth initiatives in many/most key clinical areas

15. eHealth Broad umbrella Health data needs to be in electronic form so it can be liberated/visible/usable by MANY stakeholders Patients Caregivers/family/supporting persons/agencies Physicians, nurses, hospitals, clinics, public health Must be affordable, portable, & durable GIGO: Garbage In = Garbage Out Health data must be correct, complete, timely, coordinated, AND, of course, secure Geneva, Switzerland, 26-27 April 201215

16. Technology convergence Mobile technologies like cell phones, smart phones, tablets, etc offer low cost mobile access to data (text, numbers, and images) On the one hand its all the same, in that all computers manage the same binary coded data Mobile devices can do Geneva, Switzerland, 26-27 April 201216

17. There is a new breed of crossover products smart phone devices … (many/most w/FDA 510k clearance) that show what is possible! Here is a quick tour…

18. From: http://www.imedicalapps.comhttp://www.imedicalapps.com

20. FREE!

21. Well, those are secondary use devices for radiologists or other physicians. How about real devices used for diagnosis or treatment?

27. Coming soon??? An entire large and growing conference has emerged, called the mHealth Summit, and a community has formed at mHIMSS.org WHO led sessions there last December More and more relevant products and services seem to emerge each week. Some examples follow…

30. Only the Continua WAN devices offer IHE interoperabiity! Wide spectrum, from Personal Health Devices to regulated Medical Devices

31. IHE can handle all of these types of devices: clinical measurements of all sorts! Geneva, Switzerland, 26-27 April 201231 In a real sense, IHE does not care if the device is a smartphone or not! i.e., systolic blood pressure is still the same!

32. IHE is vendor and modality neutral. e.g., Rosetta Project maps ALL vendor clinical coding to each other via IEEE 11073 Extensible: IHEs Rosetta Project harmonizes vendors to ISO/IEEE 11073 to SNOMED to ???

33. 25% of HIMSS 11 Interoperability Showcase vendors featured medical devices! IHEs Steady Growth! Partners from software, hardware, pharmaceuticals, telecom, and more

34. IHE PCD facilitates -- and is inspiring -- innovation and competition! One vendor from China has designed, built, and is selling IHE-PCD-native anesthesia and monitoring products to US and global markets already!

35. 35 Results are public and profile specific www.ihe.net/Connectathon

36. (c) 2011, Elliot B. Sloane, All rights reserved. The IHE-PCD, Continua-WAN, and IHE EMR interfaces were shown in the HIMSS Interoperability Showcase for the past couple of years.

37. Implementation Tools Open source implementations are available for XDS, XCA, XCPD, PIX, PDQ, ATNA, CT, and more: Microsoft under codeplex http://ihe.codeplex.com/ http://ihe.codeplex.com/ NIST under Source Forge http://sourceforge.net/projects/iheos / http://sourceforge.net/projects/iheos / HIE-OS under Source Forge http://sourceforge.net/projects/hieos/ http://sourceforge.net/projects/hieos/ FHA CONNECT http://www.connectopensource.org http://www.connectopensource.org OHT – IHE Profiles Charter https://iheprofiles.projects.openhealthtools.org https://iheprofiles.projects.openhealthtools.org OHT – Open Exchange Forge https://openexchange.projects.openhealthtools.org https://openexchange.projects.openhealthtools.org OHT – Model Driven Health Tools-Charter https://mdht.projects.openhealthtools.org https://mdht.projects.openhealthtools.org 37

38. Barriers to successful eHealth innovation? 13-20,000 new medical apps expected in the coming year Apple, Droid, Window phones& tablets NO apparent standardization, even though it would be so, so easy Frankly, no awareness of a larger picture to share health data with each other and/or various providers Follow/leverage the Continua example? Geneva, Switzerland, 26-27 April 201238

39. Conclusions and Recommendations Make standards, tools and toolsets visible to mHealth developers Sponsor Mobile Technology Connectathons that demonstrate IHE, IEEE, HL7, Rosetta use Grand prizes? Chronic disease smart phone apps that use IHE! Education needed on value of at rest and in-motion data encryption Free tools available! Personal health data MUST be protected! Geneva, Switzerland, 26-27 April 2012 39

40. Questions and enthusiastic ideas are WELCOME! Please feel free to contact me directly at ebsloane@gmail.com or ebsloane@chirp.us.orgebsloane@gmail.com ebsloane@chirp.us.org Elliot B. Sloane, PhD, CCE, FHIMSSS www.ebsloane.org Remember: it is all free: www.IHE.net www.IHE.net/PCD