1. Sept 13-15, 2004IHE Interoperability Workshop 1 Integrating the Healthcare Enterprise Patient Identifier Cross-referencing Charles PARISOT GE Healthcare

2. Sept 13-15, 2004IHE Interoperability Workshop 2 IHE drives healthcare standards based-integration

3. Sept 13-15, 2004IHE Interoperability Workshop 3 IHE Organizational Structure Multi-Domain & Multi-National Participants contribute Global Development: Radiology, IT Infrastructure, Cardiology, Lab, etc. Delegates IHE Europe IHE North America IHE Asia/Oceania Regional & National Deployment supervises reports IHE (International) Strategic Development Committee Sponsor Co-Chairs Global Interoperability IHE Domain-related Planning and Technical Committees National Extensions

4. Sept 13-15, 2004IHE Interoperability Workshop 4 IHE 2004 achievements and expanding scope Over 80 vendors involved world-wide, 4 Technical Frameworks 31 Integration Profiles, Testing at yearly Connectathons, Demonstrations at major exhibitions world-wide Provider-Vendor cooperation to accelerate standards adoption

5. Sept 13-15, 2004IHE Interoperability Workshop 5 IHE Process Users and vendors work together to identify and design solutions for integration problems Intensive process with annual cycles:  Identify key healthcare workflows and integration problems  Research & select standards to specify a solution  Write, review and publish IHE Technical Framework  Perform cross-testing at “Connectathon”  Demonstrations at tradeshows (HIMSS/RSNA…)

6. Sept 13-15, 2004IHE Interoperability Workshop 6 A Proven Standards Adoption Process IHE Integration Profiles B IHE Integration Profile A Easy to Integrate Products IHE Connect-a-thon Product With IHE IHE Demonstration User Site RFP Standards IHE Technical Framework Product IHE Integration Statement IHE Connect-a-thon Results IHE Integration Profiles at the heart of IHE :  Detailed selection of standards and options each solving a specific integration problem  A growing set of effective provider/vendor agreed solutions  Vendors can implement with ROI  Providers can deploy with stability

7. Sept 13-15, 2004IHE Interoperability Workshop 7 More on IHE IT Infrastructure To learn more about IHE IT Infrastructure Integrating the Healthcare Enterprise: www.himss.org/ihe Read the IHE Brochure http://www.himss.org/content/files/IHE_newsletter_final.pdf

8. Sept 13-15, 2004IHE Interoperability Workshop 8 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

9. Sept 13-15, 2004IHE Interoperability Workshop 9 IHE IT Infrastructure 5 Integration Profiles Enterprise User Authentication Provide users a single name and centralized authentication process across all systems 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 Synchronize multiple applications on a desktop to the same patient Patient Synchronized Applications Synchronize multiple applications on a desktop to the same patient Patient Synchronized Applications Consistent Time Coordinate time across networked systems Consistent Time Coordinate time across networked systems 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

10. Sept 13-15, 2004IHE Interoperability Workshop 10 Patient Identifier Cross-referencing Abstract / Scope Allow all enterprise participants to register the identifiers they use for patients in their domain Support any systems (small and large) to query for other patients IDS in other patient identification domains Optionally, notify those systems when systems from other patient identification domains update identifiers for their patients

11. Sept 13-15, 2004IHE Interoperability Workshop 11 Patient Identifier Cross-referencing Value Proposition Provide to any systems a standard interface to map its patient IDs onto patient IDs of other Patient Identification domains. Maintain all systems’ identifiers for a patient in a single location Use any algorithms (encapsulated) to find matching patients across disparate identifier domains Lower cost for synchronizing data across systems  No need to force identifier and format changes onto existing systems

12. Sept 13-15, 2004IHE Interoperability Workshop 12 Patient Identifier Cross-referencing ID Domains & Transactions

13. Sept 13-15, 2004IHE Interoperability Workshop 13 Patient Identifier Cross-referencing Standards Used Standards Used  HL7 Version 2.3.1 and Version 2.5 ADT Registration and Update Trigger Events –A01: inpatient admission –A04: outpatient registration –A05: pre-admission –A08: patient update –A40: merge patient Queries for Corresponding Identifiers (ADT^Q23/K23) Notification of Identifiers Lists Updates (ADT^A31) Key Properties  ADTs remain in charge of their domains  No need for a master ID or MRN, but supported as another ID domain

14. Sept 13-15, 2004IHE Interoperability Workshop 14 Patient Identifier Cross-referencing B:X456 C: 2RT Identity Patient Cross References B:X456 C: ?

15. Sept 13-15, 2004IHE Interoperability Workshop 15 Patient Identifier Cross-referencing Key Benefits No need for a Master Patient Identifier (facilitates legal constraints). PIX Manager does not need to produce “consolidated demographics”. Any Patient Id Domain may be considered as providing “master patient ids” (see next slides). Patient Demographics is and remains a responsibility of ADTs Actors. In addition to Patient Registration distribution (e.g. Rad & Lab SWF), a Patient Demographics Query Int. Profile is planned

16. Sept 13-15, 2004IHE Interoperability Workshop 16 PIX Integration Profile & MPI The typical view Patient Identification Domain C Patient Identity Cross- reference Manager Patient Identification Domain A (Master Domain) Patient Identification Domain B Master (A) Patient Identity Source Master Patient Index

17. Sept 13-15, 2004IHE Interoperability Workshop 17 PIX Integration Profile & MPI The Equivalent IHE Model Patient Identification Domain C Patient Identity Cross- reference Manager Patient Identification Domain A (Master Domain) Patient Identification Domain B Master (A) Patient Identity Source Master Patient Index

18. Sept 13-15, 2004IHE Interoperability Workshop 18 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