Transcript Interoperability Workshop

INTEGRATING THE
HEALTHCARE
ENTERPISE (IHE)
Orientation Workshop (2)
International HL7 Interoperability Conference-10
Carlos Guilherme Costa, Product Manager, Alert, IHE US & Eu
Connectathon participant
Julio Carau, Director, Hospital de Clinicas "Dr. Manuel Quintela", Montevideo,
Uruguay
May, 2010
1
IHE Orientation-Rio de Janeiro
Agenda
Part 1: THE IHE STANDARDS ADOPTION PROCESS:
achieving practical interoperability
This Afternoon:
Part 2:
USERS AND VENDORS WORKING TOGETHER:
how can I contribute & benefit from IHE
HOW TO USE IHE RESOURCES: hands on experience
2
Understanding the IHE Initiative
IHE has a clear focus
IHE is a healthcare domain-based initiative
IHE creates synergies for interoperability testing
across domains
IHE addresses the standards adoption process
IHE is both regional and multi-national
IHE is both user lead and vendor driven
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Standards Adoption Process
Testing at
Connectathons
Develop
technical
specifications
Identify available
standards (e.g. HL7,
IHE
Demonstrations
Products
with IHE
DICOM, IETF, OASIS)
Timely access to
Document Use Case information
Requirements
Easy to integrate
products
4
IHE Organizational Structure
IHE International Board
Global Development
Regional Deployment
IHE America
Canada
IHE Asia-Oceania
China
USA
Japan
Radiology
IT
Infrastructure
Laboratory
Cardiology
Patient Care
Coordination
Pathology
Radiation
Oncology
Patient Care
Devices
Eye Care
Australia
Korea
Taiwan
IHE Europe & Middle East
Austria
Italy
France
Israel
Germany
Spain
Netherlands
Turkey
UK
Swiss
Sweden
Public Health, Quality
and Research
Professional Societies / Sponsors
ACC
ACCE
ACEP
ACP
GMSI
HIMSS
RSNA
SFR
SFIL
COCIR
SIRM
ESC
EAR-ECR BIR
DRG
EuroRec
JAHIS
JIRA
JRS
METI-MLHW
MEDIS-DC
JAMI
Contributing &
Participating
Vendors
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5
IHE Sponsors
Professional societies
 Healthcare Information Management Systems Society (HIMSS)
 Radiological Society of North America (RSNA)
 British Institute of Radiology (BIR), British Computer Society (BCS
 German Radiology Society (DRG)
 GMSIH (IT France), SFIL (laboratory), French National Project (DMP)
 European Society of Cardiology……Many other European Societies
 American College of Physicians (ACP), American College of
Emergency Physicians (ACEP) …Many other American healthcare
societies (ACCE), (AAO), (ASTRO), etc.
 JAHIS (IT Japan), JIRA, JRS….Many other Japanese Societies
 And many more….
Health Authorities
 NICTIZ (Netherlands), ASIP (F), ELGA (Austria), Infoway (Canada), etc.
6
IHE Participants and Relationships
Participants include:
 Users - Clinicians, Staff, Administrators, CIOs, Governments
 Vendors of Information Systems and Equipment
 Consultants
Relationship with Standards Development Organizations
(SDOs):
 HL7, DICOM, ISO, CDISC, IEEE and many others
 Adoption process approved via ISO/TC 215, IHE profiles to be published
as ISO Technical Reports
 Other Profiling Organizations such as Continua (Consumer Devices)
National Adoption of IHE Profiles
 DMP(France), ELGA(Austria), HITSP (USA), Infoway (Canada), many
others worldwide…..
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IHE International Governance - Membership
Membership: www.ihe.net/governance
 Members are Organizations–Sign Governance & IP once.
 Three Organizational Categories: User, Developer, General
Interest
 Member designates a primary/alternate representatives to
one of more Committees (Domains, Test& Tools, MarCom).
 Elect Committee co-chairs. One User & one vendor
recommended for Planning Committees
 Regional and National IHE Committee members required to
become members of IHE International.
 Over 300 Member organizations. About half users/half
Vendors
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IHE International Governance – Others Committees
IHE Regional or National Deployment Committees are
independent entities with their own governance but close
collaborative relationship with IHE International.
IHE International Board empowers “Regional and
National Committee”. 3 year commitment, renewable.
Oversees Testing and Tools Committee
 Coordinates the various Regional and National Committees.
Oversees Marketing & Communication Committee
 Consistency of communication among Domains within IHE
International and various Regional and National Committees.
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How can I participate?
All Participants:
Become a member of relevant domain’s Planning or Technical
Committees
Become a member of relevant Regional/National Committees
Help to shape IHE’s future direction
Offer Clinical Use Case Input to Drive IHE Profile Development
Respond to Public Comments of Domain Supplements
Attend Educational Workshops/Webminars
As a Vendor Participant
Participate in Connect-a-thons and Demonstrations
As a Provider/Consultant Participant
Attend Demonstrations and include IHE Integration Profiles in your
RFPs and Integration Projects.
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What can you do?
Learn about IHE, www.ihe.net
Insist on relevant IHE profiles compliance in
your RFPs and contract documents:
 Select Integration Profiles, and Appropriate
Actor(s)
 Ask vendors for their products “IHE
Integration Statements”
Need more interoperability ?
 Contribute to IHE Committees
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Agenda
Part 2:
USERS AND VENDORS WORKING TOGETHER:
how can I contribute & benefit from IHE
HOW TO USE IHE RESOURCES:
hands on experience
12
Agenda
From IHE Profiles to conformance testing,
closing the implementation gap
Helping the implementers, testing tools,
connectathons
How to use other IHE resources: hands on
experience
Technical Frameworks: navigating, Q&A
Test tools: finding, using, configuring
Participating in the testing process
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Connectathon
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Connectathon
Started in 1998 in the USA
Europe started in 2001
Japan in 2003
China and Australia have now joined
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Purpose
Test implementation of the IHE
integration and content profiles within
product/open source
 Verify that the vendors did a good job
Verify that what the committees specified
is clear !
 Verify that the Technical Frameworks are not
ambiguous
 Verify that that the Technical Committee did
not miss anything
Build a community of computer geeks who
loves local brewed beers and have fun working together to
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From the vendor perspective
Unique Opportunity for vendors to test their
implementations of the IHE integration profiles
Controlled environment
 Customer is not present !
 Not in a clinical production environment
Specialists available
 From SDO
 From the peer companies
Bugs are identified and most of the time fixed !!!!
Connectathon Results
 http://www.ihe.net/Connectathon/index.cfm
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From the user perspective
Unique Opportunity to engage potential vendors
and user own implementation tested for
conformance to IHE integration and content profiles
Controlled environment
 User community in IHE designate the Connectathon Monitors !
 Not in a clinical production environment
Specialists available
 From SDO
 From the vendor companies
Bugs are identified and most of the time fixed,
before the product is installed !!!!
Connectathon Results
 http://www.ihe.net/Connectathon/index.cfm
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But…
Testing in interoperability is (always) suboptimal
 Only a part of all the possible tests are
performed
 A system successful at the connectathon is
not guaranteed to be error free !!!!
 But, …. it is the most thorough
interoperability conformance widely available
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From the IHE perspective
Feedback from the vendor
community
 Did the profile development committee do
a good job ?
 Did the developed integration or content
profile responds to the expectations of the
vendors and meets the intended user
need ?
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Maturity of IHE Connectathons
We have reached now our cruising speed
NA and EU Connectathon are very alike.
Japanese Connectathon is now mature.
Connectathon also used as an IHE
promoting tool
 Workshop in parallel to the Connectathon
 VIP visits
 Visitors are truly impressed !!
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The IHE testing process
Users
Testing Results
Deployed
Systems
Testing Tools
Sponsors:
Project
Management
Team
Develop
Testing Tools
Vendors/
Implementers
Implement
Profile Actors
Users
Demonstrations
Approves
Test Logs
Connectathon
In-House
Testing
Product +
Integration
Statement
Demonstration
IHE Technical Framework (Profiles Specification)
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Unit Testing & Peer Testing
Vendor B
Vendor A
Implementation A
Peer Testing
Implementation B
Unit testing
Specifications/Standards
22/05/08
Projet IHE-Dev Inria Rennes
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Both Unit Testing & Peer Testing
Need to have unit testing in the IHE Testing
process
Important to perform unit testing in advance
of the peer testing
Peer testing takes place during the testing
event (connectathon).
Need to perform unit testing as well during
the connectathon.
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Preconnectathon
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Pre-connectathon
Registration
 Open to all, even non IHE members
 Choice of what can be tested  Actors for a Profile
Exchange of configuration parameters
 IP addresses
 Assigning authorities, Addresses, AE Title
 OID
 Certificates
 Affinity domain specification (e.g. XDS Meta-data)
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Pre-connectathon
Unit testing using Gazelle test tools
In-house testing for vendors to get ready
Vendors return Gazelle tool logs
Upon log return, and positive analysis,
participation to Connectathon event is
accepted by IHE Technical Project Mgr
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At connectathon
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Connectathon Testing
3 types of test to be performed
 “No-peer” tests
 “Peer to peer” tests
 “Workflow” tests (multi peers)
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5 days
Configured up and running by Monday
morning 11 am
 Set up time
Till Friday noon :
 Free “peer to peer” and “no peer” testing
From Wednesday till Friday noon :
 Directed “workflow” testing
Enough time to test 4-6 solid profiles and 1-2
new profiles per participating system
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Monitors
Report to IHE Technical Project Mgr
Volunteers, trained and screened
Independent from vendors. Selected by IHE
Countries users.
Standard knowledegeable
Verify tests
Act as moderator between vendors
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Results
To be successful
 Pre-connectathon test validated
 Each peer to peer test needs to be verified with at
least 3 peers
 A vendor may fail for an actor in a profile but pass
for the others
IHE does not report failure. Vendors have access to
their own detailed test results (track issues).
Vendors shall publish their products integration
statements  Market/Contractual sanction
32
Connect-a-thon Results
Browser
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Connectathon Results Browser
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Connectathon Results Browser
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What does it mean ?
The Company was successful at the
connectathon for an actor/integration profile
combination
Results express a company maturity and
willingness to collaborate. Does not guaranty
product conformity, but enables
market/contractual commitments by vendors to
their customers
Product conformity commitment: This is the
role of the « IHE integration statements »
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IHE Integration Statement
Product vendors take the next step
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Technical Frameworks
One per Domain
They are the reference, the tools are not !
Written and reviewed by Vendors and
Users
Freely available on http://www.ihe.net
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Organization of the TF
Volume 1
 Description of the Integration/content profiles and
actors
 Dependencies between actors and profiles
 Use cases
Volume 2 and followings
 Description of the transactions with reference to
used standards
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TF Life Cycle
Every year :
 New integration profiles
 Change Proposal
Integration Profile proposed as Supplements
 Public Comment
 Trial Implementation
 Final Text
Once in Final Text integration into the main document.
No concept of profile version (Corrections are
applied). Non backward changes result in a new
profile.
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IHE Wiki
http://wiki.ihe.net
 A lot of information. Used for supporting on-going
work by Committees
•
•
Committee planning / minutes /in development documents
General membership/Chairs
http://ihewiki.wustl.edu/
 Wiki for connectathon organization and management
 Code exchange
 XDS implementation page
 …
41
Gazelle
Objectives
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Objectives
Improve the overall quality of testing
 Conformance and Interoperability
Broaden the use of the application. Open Source
Licence (Apache).
Build a framework for Healthcare interoperability testing
Synchronous testing of multiple systems
Multilingual
Scalable
43
5 Context of Use
Connectathon
Virtual Connectathon
Company Internal Testing tool
Healthcare Enterprise Testing tool
Governmental/Certification organizations
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Gazelle
Architecture
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Gazelle Architecture
Gazelle Control System
External
External
Validation
External
Validation
Services
External
Validation
Services
Validation
Services
Services
Gazelle
Test Engine
Database
Configuration Info
Control
Feedback
Gazelle
Gazelle
Actor
Gazelle
Actor
(Simulators)
Gazelle
Actor
(Simulators)
Gazelle
Actor
(Simulators)
Actor
(Simulators)
(Simulators)
System Under Test
System Under Test
System Under Test
System
Under Test
Tests Scenario
Proxy
Network
22/05/08
Projet IHE-Dev Inria Rennes
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System under test
More than one system can be tested
at the same time
Management of System Under Test
 Web application to provide instructions
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Participants
3 IHE Regions
 North America : MIR
 Europe : INRIA
 Japan : Shizuoka University
DVTK
NIST
Tiani-Spirit
David Clunie
Offis
Open to more participants
48
Project Management
Testing and Tool Committee
 Overview of IHE testing activities
 Choice of the license
 Approve Connectathon Organizers
Testing Management Group
 Project Management
 Eric and Steve
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More Resources - www.ihe.net
Frequently Asked Questions
Integration Profiles in Technical Frameworks:






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Cardiology
IT Infrastructure
Laboratory
Patient Care Coordination
Patient Care Devices
Radiation Oncology
Radiology
Connectathon Results
Vendor Products Integration Statements
Participation in Committees and Connectathons
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May, 2010
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IHE Orientation-Rio de Janeiro