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

2. IHE: A Framework for Interoperability A common framework for harmonizing and implementing multiple standardsA common framework for harmonizing and implementing multiple standards Enables seamless health information movement within and between enterprises, regions, nationsEnables 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 needsPromotes unbiased selection and coordinated use of established healthcare and IT standards to address specific clinical needs

3. Standards: Necessary…Not Sufficient Standards areStandards are –Foundational - to 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 focus only on a single standard IHE provides a standard process for implementing multiple standards

4. IHE: Connecting Standards to Care Healthcare professionals work with industryHealthcare professionals work with industry Coordinate implementation of standards to meet clinical and administrative needsCoordinate 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 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. IHE Implementation Strategy Leverage established standards to allow rapid deployment and plan for future Pragmatic, Ease of EvolutionLeverage established standards to allow rapid deployment and plan for future Pragmatic, Ease of Evolution Enable architectural freedom (patient vs. provider centric, centralized vs. decentralized, scalable [from office to enterprise to IDN to RHIO]) Configuration flexibilityEnable architectural freedom (patient vs. provider centric, centralized vs. decentralized, scalable [from office to enterprise to IDN to RHIO]) Configuration flexibility Support priority use cases: variety of care settings, care coordination, public health, PHR, EHR Interoperability for broad constituenciesSupport priority use cases: variety of care settings, care coordination, public health, PHR, EHR Interoperability for broad constituencies IHE: Offers consistent, standards-based record sharing for EHRs and other information systems

6. Integrating the Healthcare Enterprise “Achieving Interoperability through Implementation of Standards” 1997: Founded in Radiology (RSNA) and IT (HIMSS) Many professional societies (stakeholder representation)Many professional societies (stakeholder representation) –American Academy of Ophthalmology (AAO) –American College of Cardiology (ACC) –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) –Radiological Society of North America (RSNA) –And many more….

7. IHE Participants and Relationships Participants include:Participants include: –Users - Clinicians, Staff, Administrators, CIOs, Governments (e.g. NIST, VA). –Vendors - Information Systems and Equipment e.g., imaging, cardiology, devicese.g., imaging, cardiology, devices –Consultants Relationship with Standards Development Organizations (SDOs):Relationship with Standards Development Organizations (SDOs): –HL7, DICOM, ISO, CDISC, ASTM, W3C, IEEE, IETF, and many others Approved by ISO/TC 215 allowing for IHE profiles to be published as ISO deliverablesApproved by ISO/TC 215 allowing for IHE profiles to be published as ISO deliverables

8. IHE Organizational Structure ACC ACP HIMSS RSNA JAHIS JIRA JRS METI-MLHW MEDIS-DC JAMI GMSIH SFR SFIL ACCE SIRM BIR EuroRec COCIR EAR-ECR DRG ESC Professional Societies / Sponsors Contributing & Participating Vendors IHE (International) Strategic Development Committee Global Development Radiology Cardiology IT Infrastructure Patient Care Coordination Patient Care Devices Laboratory Pathology Pharmacy / Medication Admin Radiation Oncology IHE Europe IHE North America France USA Canada IHE Asia-Oceania Japan KoreaTaiwan Netherlands Spain Sweden UK Italy Germany Norway Regional Deployment China

9. International Adoption of IHE France  Local Deployment  National Extensions (Local Adaptions)  Promotional & Live Demonstration Events  Funding USAGermanyItalyJapanUKCanadaKoreaTaiwan Norway HollandSpainChina Year 1 (1999) Year 2 (2000) Year 3 (2001) Year 4 (2002) Year 5 (2003) Year 6 (2004) Year 7 (2005) Year 8 (2006) Pragmatic global standards harmonization + best practices sharing

10. IHE based Regional and National EHR Projects (Operational and Planned) Toronto, Quebec, Alberta, BC Canada Infoway Austria THINC- New York NCHICA – N. Carolina Italy (Conto Corrente Salute) MA-Share – MA France DMP Philadelphia HIE CHINA-MoH Lab results sharing New York HIE

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

12. Stakeholder Benefits Healthcare providers and support staffHealthcare providers and support staff –Improved workflows –Information whenever and wherever needed –Fewer opportunities for errors –Fewer tedious tasks/repeated work –Improved report turnaround time VendorsVendors –Align product interoperability with industry consensus –Decreased cost and complexity of interface installation and management –Focus competition on functionality/service space not information transport space SDOsSDOs –Rapid feedback to adjust standards to real-world –Establishment of critical mass and widespread adoption

13. Growth in IHE Domains Radiology (18) IT Infrastructure for Healthcare (17) Cardiology (7) Laboratory (6) Radiation Oncology (1) Patient Care Coordination (5) Patient Care Devices (1) Quality Eye Care (3) Veterinary Endoscopy Pathology Pharmacy Year 1 (1999) Year 2 (2000) Year 3 (2001) Year 4 (2002) Year 5 (2003) Year 6 (2004) Year 7 (2005) Year 8 (2006) Year 9 (2007) Over 100 vendors involved world-wide Over 100 vendors involved world-wide 8 Technical Frameworks 8 Technical Frameworks 48 Integration Profiles 48 Integration Profiles Testing at “Connectathons” world-wideTesting at “Connectathons” world-wide Demonstrations at major conferences world-wide Demonstrations at major conferences world-wide

14. IHE Integration Profiles for Health Info Nets What is available and has been added in 2006/07 Cross-Enterprise Document Sharing Registration, distribution and access across health enterprises of clinical documents forming a patient electronic health record 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 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 originSecurity Clinical and PHR Content 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 Pt-Pt Reliable Interchange Final Text Approved Trial Implementation-2006 – Final Txt 2007 Cross-Enterprise Document Media Interchange

15. HITSP Interoperability Specs and CCHIT Roadmap Compliance with US National Health Info Net HITSP Interoperability Specs and CCHIT Roadmap Patient Demographics Query Patient Identifier Cross-referencing Map patient identifiers across independent identification domains Cross-Enterprise Document Sharing Registration, distribution and access across health enterprises of clinical documents forming a patient electronic health record Cross-Enterprise Document Media Interchange 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 Patient ID Mgmt 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 Security Clinical and PHR Content Health Data Exchange Notification of Document Availability Notification of a remote provider/ health enterprise Request Form for Data Capture External form with custom import/export scripting Other Cross-Enterprise Document Reliable Interchange Accepted by HITSP&CCHIT in 2006 Candidates for HITSP&CCHIT in 2007

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

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

19. Brought to you by…

21. This year in the Showcase… Secured Health Information Exchange with broad contentSecured Health Information Exchange with broad content New Directions Focus (Life Sciences [Bio-Pharma], PIX/PDQ v3.0, ELINCS Lab)New Directions Focus (Life Sciences [Bio-Pharma], PIX/PDQ v3.0, ELINCS Lab) HITSP Interoperability SpecificationsHITSP Interoperability Specifications Clinical data exchange amongst patient care devicesClinical data exchange amongst patient care devices 20072006 Vendors Connected 5135 Supporters1614 Other participants 912 Total7661 Personal health record solutionsPersonal health record solutions Financial and administrative systems for billing and claims attachments (CAQH/CORE)Financial and administrative systems for billing and claims attachments (CAQH/CORE) Clinical scenarios focusing on clinician and patient access, and information sharing across the full continuum of careClinical scenarios focusing on clinician and patient access, and information sharing across the full continuum of care A Growing Cast

22. Community Network C Document Registry Practice Clinic Hospitals HIMSS RHIO: Network of networks The largest multi-vendor RHIO Prototype ever built ! IHE Transactions Patient Locator service Federation Query Service Federation 18 edge systems 5 infrastructure systems 5 edge systems 5 infrastructure systems 13 edge systems 5 infrastructure systems 2 infrastructure systems Federation Query Service Hospital Community Network A Document Registry Practice Clinic Hospitals Diag Test Community Network B Document Registry Practice Clinic Hospitals Hospital Diag Test Other Practice Hospital Practice

23. HIMSS RHIO: Network of networks The largest multi-vendor RHIO Prototype ever built ! Community Network C Document Registry Practice Clinic Hospitals IHE Transactions Patient Locator service Federation Query Service Federation 18 edge systems 5 infrastructure systems 5 edge systems 5 infrastructure systems 13 edge systems 5 infrastructure systems 2 infrastructure systems Federation Query Service Hospital Community Network A Document Registry Practice Clinic Hospitals Diag Test Community Network B Document Registry Practice Clinic Hospitals Hospital Diag Test Other Practice Hospital Practice

25. G Your Guide to the Showcase Theatre

26. supported by: Infrastructure Patient Identity ManagementPatient Identity Management –incl. New Directions – using HL7v3 XDS Document RegistriesXDS Document Registries XDS Document RepositoriesXDS Document Repositories Audit RepositoryAudit Repository

27. …and also starring HITSP Theater (M)HITSP Theater (M) –Showcasing breakthrough use cases ELINCS Theater (N)ELINCS Theater (N) –Interoperability between EHR & Lab CAQH Theatre (M)CAQH Theatre (M) –Interoperability between Provider & Health Plan Life Sciences (L)Life Sciences (L) –New Directions bridging research/surveillance and EHR’s

28. What happens next? Docents will guide you to a story/act/cast, each demonstrating interoperabilityDocents will guide you to a story/act/cast, each demonstrating interoperabilityOR A presentation begins immediately in this theatreA presentation begins immediately in this theatre

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