1. An Overview of IHE IT Infrastructure Profiles and their relationship with other Domains IHE Educational Workshop 2007 June 12 th, 2007

2. This morning’s program… 8:30 – 9:00am Overview of IT Infrastructure8:30 – 9:00am Overview of IT Infrastructure 9:00 – 9:30am Basic Patient Privacy Consents9:00 – 9:30am Basic Patient Privacy Consents 9:30 – 9:45am Break9:30 – 9:45am Break 9:45 – 10:15am XDS Content Profiles9:45 – 10:15am XDS Content Profiles 10:15 – 10:45am Web Services and HL7v310:15 – 10:45am Web Services and HL7v3 10:45 – 11:00am Retrieve Form for Data Capture10:45 – 11:00am Retrieve Form for Data Capture Breakouts by domainBreakouts by domain

3. An Overview of the IHE IT Infrastructure Domain IHE Educational Workshop 2007 IT Infrastructure Domain Michael Nusbaum, FHIMSS Co-Chair, ITI Planning Committee

4. Agenda What is IHE IT Infrastructure?What is IHE IT Infrastructure? ITI’s role as a domain to support the other domainsITI’s role as a domain to support the other domains ITI long-range visionITI long-range vision ITI work to date, including this year’s activities and roadmap itemsITI work to date, including this year’s activities and roadmap items Of what value is IHE IT Infrastructure?Of what value is IHE IT Infrastructure? How do you get IHE IT Infrastructure?How do you get IHE IT Infrastructure? ITI profiles that we’d like to see featured at the upcoming Connectathon/Showcase cycleITI profiles that we’d like to see featured at the upcoming Connectathon/Showcase cycle How do you add to IHE IT Infrastructure?How do you add to IHE IT Infrastructure? Opportunities to grow ITI, and how to participateOpportunities to grow ITI, and how to participate What comes next?What comes next?

5. An Infrastructure Component… Represents a common IT function or service that is used as a building block for a variety of use casesRepresents a common IT function or service that is used as a building block for a variety of use cases May be imbedded in an application, but is often deployed as a shared resource within a RHIO or Health Information ExchangeMay be imbedded in an application, but is often deployed as a shared resource within a RHIO or Health Information Exchange Is a necessary ingredient, but is rarely visible to the end userIs a necessary ingredient, but is rarely visible to the end user

6. What is IHE IT Infrastructure? IT that enables computer applicationsIT that enables computer applications Operating platformsOperating platforms Computer languagesComputer languages Computing hardwareComputing hardware NetworksNetworks IT that serves multiple applicationsIT that serves multiple applications SecuritySecurity Data storage and retrievalData storage and retrieval InterfacesInterfaces Infrastructure applicationapplicationapplicationapplication

7. 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) Currently: 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-wide Testing at “Connectathons” world-wide Demonstrations at major conferences world-wide Demonstrations at major conferences world-wide

8. What is IHE IT Infrastructure? IHE IT Infrastructure domain produces...IHE IT Infrastructure domain produces... Profiles that serve the purposes of clinical workflows, regardless of IHE clinical domainProfiles that serve the purposes of clinical workflows, regardless of IHE clinical domain Examples: Security, Records Storage, Patient Identifiers Basic implementation-specification foundations to be extended by other IHE clinical domainsBasic implementation-specification foundations to be extended by other IHE clinical domains Examples: Retrieve Forms for Data Capture; Cross- Enterprise Document Sharing White Papers for current work itemsWhite Papers for current work items Examples: HIE Security and Privacy; Health Data Re-use Infrastructure; Risk Management

9. IT Infrastructure Domain Committees Domain Sponsor Develops long-term goalsDevelops long-term goals Maintain ITI RoadmapMaintain ITI Roadmap Identify interoperability problems and prioritiesIdentify interoperability problems and priorities Gather and review proposals for new profilesGather and review proposals for new profiles Select and approve proposals for technical review and developmentSelect and approve proposals for technical review and development Develop educational materialsDevelop educational materials Develop ITI White PapersDevelop ITI White Papers Assess feasibility and effort required for selected profile proposalsAssess feasibility and effort required for selected profile proposals Builds consensus on appropriate standards-based solutionsBuilds consensus on appropriate standards-based solutions Develop integration profilesDevelop integration profiles Develop ITI White PapersDevelop ITI White Papers Maintain ITI Technical FrameworkMaintain ITI Technical Framework

10. ITI Provides Foundation for Document Exchange Doc Exchange Integration Profiles Doc Content Profiles Doc Sharing XDS Media Interchange XDM Pt-Pt Doc Interchange XDR Scanned Doc XDS-SDConsentBPPCEmergencyEDR Pre Surgery PPHPLaboratoryXD*-Lab PHR Exchange XPHR Discharge & Referrals XDS-MS ImagingXDS-I

11. IHE IT Infrastructure Composable Integration Profiles Doc Exchange Integration Profiles Doc Sharing XDS Media Interchange XDM Pt-Pt Doc Interchange XDR Patient Demographics Query Patient Identifier Cross-referencing Map patient identifiers across independent identification domains Notice of Document Availability Know about new information Patient Administration Management Patient Synchronized Applications Retrieve Information for Display Cross-Enterprise User Assertion User Attributes for Access Cntrl Cross-Community Access Querying and Retrieving Documents across multiple communities Remotely Manage Information Capture Request Form for Data Capture Scanned Doc XDS-SD 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. Document Digital Signature Attesting “true-copy and origin Personal White Pages Enterprise User Authentication (Intra-Enterprise only) * * * * * * Adopted by HITSP

12. IT Infrastructure work underway… Supplements to the Technical FrameworkSupplements to the Technical Framework Web Services for IHE transactions (Appendix V)Web Services for IHE transactions (Appendix V) [RFD] Retrieve Form for Data Capture[RFD] Retrieve Form for Data Capture [XUA] Cross-Enterprise User Assertion[XUA] Cross-Enterprise User Assertion [XDS.b] Cross-Enterprise Document Sharing (WS)[XDS.b] Cross-Enterprise Document Sharing (WS) [XCA] Cross-Community Access[XCA] Cross-Community Access XDS Patient Identity MergeXDS Patient Identity Merge White PapersWhite Papers XDS Affinity Domain ChecklistXDS Affinity Domain Checklist Risk ManagementRisk Management SOA and Web Services IHE RoadmapSOA and Web Services IHE Roadmap Health Data Reuse InfrastructureHealth Data Reuse Infrastructure HIE Security and PrivacyHIE Security and Privacy Public Comment June 13 – July 13

13. IT Infrastructure Roadmap 2008-09 Candidates2008-09 Candidates 2009-10 Candidates2009-10 Candidates Additional candidates to be brought forward for consideration this FallAdditional candidates to be brought forward for consideration this Fall

14. Of what value is the IHE IT Infrastructure? StakeholdersStakeholders Healthcare Consumers – People and EmployersHealthcare Consumers – People and Employers Healthcare Providers – Institutions and CliniciansHealthcare Providers – Institutions and Clinicians Healthcare payersHealthcare payers Public health agenciesPublic health agencies Safety net providersSafety net providers Clinical and health-services researchersClinical and health-services researchers VendorsVendors

15. Of what value is the IHE IT Infrastructure? Benefits for vendorsBenefits for vendors World-Class shared expertise amongst colleaguesWorld-Class shared expertise amongst colleagues Reduced development effortReduced development effort Quicker time-to-marketQuicker time-to-market Reduced implementation effort and negotiationReduced implementation effort and negotiation Greater collaboration amongst all stakeholdersGreater collaboration amongst all stakeholders Exposure in HIMSS Interoperability Showcase and other venuesExposure in HIMSS Interoperability Showcase and other venues Simplified RFP responsesSimplified RFP responses Better sales results when standards are importantBetter sales results when standards are important Satisfied customersSatisfied customers

16. Of what value is the IHE IT Infrastructure? Benefits for PurchasersBenefits for Purchasers Quicker realization of IT benefitsQuicker realization of IT benefits Fewer implementation fumblesFewer implementation fumbles Fewer multi-vendor coordination headachesFewer multi-vendor coordination headaches Lower implementation costLower implementation cost Benefits for ConsumersBenefits for Consumers Less user time spent fumbling with infrastructureLess user time spent fumbling with infrastructure More time for clinical IT use  Better outcomesMore time for clinical IT use  Better outcomes Potentially more funding for care-specific ITPotentially more funding for care-specific IT

17. Of what value is the IHE IT Infrastructure? Benefits for PayersBenefits for Payers Less overhead in care-provision and interfacesLess overhead in care-provision and interfaces Benefits for Public HealthBenefits for Public Health Better data collection  better population healthBetter data collection  better population health Benefits for Safety Net ProvidersBenefits for Safety Net Providers E asier access to patient data  less expenseE asier access to patient data  less expense Benefits for ResearchersBenefits for Researchers Simpler data collection  less expenseSimpler data collection  less expense

18. How do you get the IHE IT Infrastructure? Study: Technical FrameworkStudy: Technical Framework www.ihe.net/Technical_Framework/index.cfmwww.ihe.net/Technical_Framework/index.cfm Volume 1 – ProfilesVolume 1 – Profiles Volume 2 – TransactionsVolume 2 – Transactions www.ihe.net – New profiles and transactionswww.ihe.net – New profiles and transactions Practice: Connectathon TestingPractice: Connectathon Testing www.ihe.net and www.connectathon.netwww.ihe.net and www.connectathon.net Buy it:Buy it: Healthcare IT vendors are infrastructure- specialistsHealthcare IT vendors are infrastructure- specialists

19. How do you add to IHE IT Infrastructure? Implement the profilesImplement the profiles Your experience adds to the shared knowledge.Your experience adds to the shared knowledge. Based on experience, you can make Change Proposals to update the framework.Based on experience, you can make Change Proposals to update the framework. Your participation in the Connectathon adds to the collective IHE experienceYour participation in the Connectathon adds to the collective IHE experience Comment on the new profilesComment on the new profiles Your knowledge and perceptions adds to the quality of the Technical Framework.Your knowledge and perceptions adds to the quality of the Technical Framework. It is better to discover and correct problems in the design phase than in the coding phase.It is better to discover and correct problems in the design phase than in the coding phase. Your good ideas will be folded-into the final work.Your good ideas will be folded-into the final work.

20. How do you add to IHE IT Infrastructure? Help author the profiles (Technical Committee)Help author the profiles (Technical Committee) Your technical expertise contributes to – and is honed by – the collaborative experienceYour technical expertise contributes to – and is honed by – the collaborative experience Your ideas will be consolidated and improved-upon by working with expert peers.Your ideas will be consolidated and improved-upon by working with expert peers. “Many hands make light work.”“Many hands make light work.” Help plan the profiles (Planning Committee)Help plan the profiles (Planning Committee) Your market expertise contributes to – and is honed by – the collaborative experienceYour market expertise contributes to – and is honed by – the collaborative experience Your ideas will be consolidated and improved-upon by working with expert peers.Your ideas will be consolidated and improved-upon by working with expert peers. “Many hands make light work.”“Many hands make light work.”

21. What comes next? Current cycle Education at this conferenceEducation at this conference Comments for the new IT Infrastructure profiles – due by July 13, 2007Comments for the new IT Infrastructure profiles – due by July 13, 2007 Publication of the new IT Infrastructure profiles for trial implementation – early August, 2007Publication of the new IT Infrastructure profiles for trial implementation – early August, 2007 Publication of IHE IT Infrastructure Roadmap update – early August, 2007Publication of IHE IT Infrastructure Roadmap update – early August, 2007 Sign-up for the 2008 Connectathon and HIMSS Interoperability Showcase – September 15 th, 2008Sign-up for the 2008 Connectathon and HIMSS Interoperability Showcase – September 15 th, 2008 Implement and test for 2008 Connectathon, per scheduleImplement and test for 2008 Connectathon, per schedule Connectathon – January 28 – February 1, 2008, Chicago (Hyatt)Connectathon – January 28 – February 1, 2008, Chicago (Hyatt) HIMSS Interoperability Showcase – February 24-28, 2008, OrlandoHIMSS Interoperability Showcase – February 24-28, 2008, Orlando

22. What comes next? 2007-2008 Development Cycle Brief proposals submitted to ITI Planning Committee – October 9-10, 2007Brief proposals submitted to ITI Planning Committee – October 9-10, 2007 ITI Planning Committee selects “short list”, hands off to ITI Technical Committee – November, 2007ITI Planning Committee selects “short list”, hands off to ITI Technical Committee – November, 2007 ITI Technical Committee selects scopes final profiles, white papers – January, 2008ITI Technical Committee selects scopes final profiles, white papers – January, 2008 Profile development complete, supplements published for public comment – June, 2008Profile development complete, supplements published for public comment – June, 2008

23. IHE Web Site - http://www.ihe.netIHE Web Site - http://www.ihe.net Technical FrameworksTechnical Frameworks Technical Framework Supplements – Trial ImplementationTechnical Framework Supplements – Trial Implementation Calls for ParticipationCalls for Participation IHE Fact Sheet and FAQIHE Fact Sheet and FAQ IHE Integration Profiles: Guidelines for BuyersIHE Integration Profiles: Guidelines for Buyers IHE Connectathon ResultsIHE Connectathon Results Vendors’ Product Integration StatementsVendors’ Product Integration Statements Sponsors’ IHE sitesSponsors’ IHE sites http://www.himss.org/IHEhttp://www.himss.org/IHE http://www.rsna.org/IHEhttp://www.rsna.org/IHE http://www.acc.org/quality/ihe.htmhttp://www.acc.org/quality/ihe.htm More Information

24. For further info, contact: Michael Nusbaum Co-Chair, IT Infrastructure Planning Committee,Co-Chair, IT Infrastructure Planning Committee, IHE Strategic Development CommitteeIHE Strategic Development Committee Interoperability Showcase Planning CommitteeInteroperability Showcase Planning Committeemichael@mhnusbaum.com250-384-0001