Transcript PPT1

http://www.ihe.net/Events/upload/IHE%20Support%20for%20RHIOs-V5-Charles.ppt
IHE support for RHIOs,
and community Health
Information Exchange
IHE 2006 Workshop, June 2006
Charles Parisot, GE Healthcare
IT Infrastructure co-chair Technical Committee
September, 2005
1
What IHE Delivers
1 - Distinguish “edge” HIT systems from
information exchange infrastructure
Edge HIT System
Edge HIT System
NHIN Subnetwork
Critical Boundary
Critical Boundary
Edge to Edge Communication
2
2 - Support multiple architectures
Centralized, distributed, federated, etc.
?
Registry Locator
Document Registry
Clinic
Hospital
Clinic
Centralized
Repository
Practice
Document Registry
Hospital
Practice
Different business models, cost, legacy systems, etc.
3
3 - Enrich Incrementally, no rip and replace
Has been the hallmark of IHE for many years
Think long-term, but specify & implement what is
needed today
Steal good ideas, learn form others’ mistakes
Listen and collaborate
Reuse, reuse previous Integration Profiles
If a clear use case cannot be specified in 6 months,
and implemented for testing in the next 6 month,
rethink.
4
Step-wise IHE RHIO strategy
1.
Start with “Document Sharing” with patient identifiers management
2005
2.
Establish basic security (pipe encryption and node authentication)
3.
Grow document sharing content to deliver multi-level interoperability
(enabling coded information) with medical summaries & imaging info
2006
What is introduced in 2006-2007 ?
2007
5
Step-wise IHE RHIO strategy
1.
Start with “Document Sharing” with patient identifiers management
2.
Establish basic security (pipe encryption and node authentication)
3.
Grow document sharing content to deliver multi-level interoperability
(enabling coded information) with medical summaries & imaging info
2005
2006
4.
Introduce point-point interchange by disfeaturing “document sharing” to
enable upward evolution
5.
Grown content to cover info exchange to support common care
coordination use cases, basic diagnostics/therapeutic information, and
simple patient input.
6.
Extend security by leveraging existing edge system security capabilities to
enable basic RHIO policies
2007
6
Step-wise IHE RHIO strategy
1.
Start with “Document Sharing” with patient identifiers management
2.
Establish basic security (pipe encryption and node authentication)
3.
Grow document sharing content to deliver multi-level interoperability
(enabling coded information) with medical summaries & imaging info
2005
2006
4.
Introduce point-point interchange by disfeaturing “document sharing” to
enable upward evolution
5.
Grown content to cover info exchange to support common care
coordination use cases, basic diagnostics/therapeutic information, and
simple patient input.
6.
Extend security by leveraging existing edge system security capabilities to
enable basic RHIO policies
2007
7.
Progressive introduction of consistent of coded terminologies…..
8.
Cross-enterprise workflows (e.g. lab & radiology orders …….
9.
Federation of XDS domains ……
10.
X-Enterprise User Authentication-Federated identity ……
7
Sharing, Sending, Interchanging and Transacting
Health Information Exchange or RHIO
XDS
Publish
Structured
objects
Pull
Pull
Send to
XDP
Write
Workflow
Mgr
Info
Requestor
Switch
Interchange
Media
Transactions
Query / Response
Send to
Read
Workflow
Mgr
Data
Repository
8
IHE Integration Profiles for Health Info Nets
What is available and has been added in 2005 and is for 2006
Clinical and PHR
Content
Emergency Referrals
PHR Extracts/Updates
Format of the Document Content
andReport
associated
coded vocabulary
ECG
Document
Format
of the Document
Content
and
associated
coded
vocabulary
Lab
Results Document
Format of the Document Content
Content
Scanned
Documents
and associated
coded vocabulary
Format of the Document Content
Imaging
and associated
coded vocabulary
Format
of theInformation
Document
Content
Medical Summary
Format of the Document Content
Allergies,
Pbs)
and(Meds,
associated
coded
vocabulary
Format of the Document Content
and associated coded vocabulary
Health Data Exchange
Cross-Enterprise
Document Sharing
Registration, distribution and access
across health enterprises of clinical
documents forming a patient
electronic health record
Cross-enterprise Document
Point-Point Interchange
Media-CD/USB & e-mail push
Security
Basic Patients Privacy
Consents
Establish Consents & Enable
Access Control
Document Digital
Signature
Patient Id Mgt
Patient Demographics
Query
Patient Identifier
Cross-referencing
Map patient identifiers across
independent identification
domains
Attesting “true-copy and origin
Audit Trail & Node
Authentication
Centralized privacy audit trail and node
to node authentication to create a
secured domain.
Other
Request Form
for Data Capture
External form with custom
import/export scripting
Consistent Time
Coordinate time across networked
systems
Notification of
Document Availability
Notification of a remote
provider/ health enterprise
9
Health Information Exchanges Interoperability:
Cross-enterprise Document Sharing
Cross-Enterprise Document Sharing minimizes
clinical/admin data management by the infrastructure.
Transparency = Ease of Evolution
Patients/consumers have guaranteed portability and
providers may share information without concerns of
aggregation errors.
Digital Documents = Patients and providers empowerment
Supports both centralized and decentralized repository
architectures. Ease of federation nationally. Flexible
privacy, Flexibility of configurations
Has received major support world-wide:
National & regional projects, NHIN contractors, US EHR
Vendor Assoc., complements Connecting for Health RLS.
10
Exchange of EHR & PHR Content,
Array of document content with many common modules
XDS-MS
Medical
Documents
History and
Physical
Preprocedure
History and
Physical
PPHP
Medical
Summaries
Consent
BCCP
Lab Report
PHR
Extract
PHR Extract
PHR Update
Referral
Discharge
Summary
Emergency
Department
Referral
EDR
PHR Update
XPHR
XDS-LAB
XPHR
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e.g. Exchange of PHR Content
The Exchange of Personal Health Record
Content (XPHR) provides a standards-based
specification for enabling interoperability of
core personal health information between:
 a Personal Health Record and
 either an EHR or another PHR System
Supports interchange of PHR Information:
 Demographics
 Insurance Information
 Medications, Problems, Allergies
 Health History
 Other Information
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PHR Systems another edge system
Needs sharing records/documents: IHE-XDS
Community
Health Payer
Record
Hospital Record
Specialist Record
Repository of
Documents
Shared
Repository of
Documents
Reference
to records
4 - Health data
presented to
Patient
3-Records
Returned
Internet
Index of patients records
(Document-level)
Sharing System
Aggregate
Patient Info
PHR System
2-Reference
to Records
for Inquiry
21
IHE Integration Statements
Explicit claim by the implementor/vendor,
for a specific product version
Lists IHE Integration Profiles, Actors & Options
Short (1 page) & Sweet
Compare apples with apples.
http://www.ihe.net/resources/
ihe_integration_statements.cfm
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Building a RHIO with IHE
Leverage a large body of international contributions
and experiences. Submit your gaps.
Suggested Approach
 Define Use Cases of interest
 Match against existing IHE Integration Profiles
 For each use case selected, develop a “RHIO interoperability
specification” that builds by reference upon the selected set of IHE
Integration Profiles. Include in RFP.
 Request vendors (infrastructure and edge systems) to submit
proposed product IHE Integration Statements
 Verify vendor participation in IHE Connectathon
25
IHE Integration Profiles for Health Info Nets
What is available and has been added in 2005 and is for 2006
Clinical and PHR
Content
Emergency Referrals
PHR Extracts/Updates
Format of the Document Content
andReport
associated
coded vocabulary
ECG
Document
Format
of the Document
Content
and
associated
coded
vocabulary
Lab
Results Document
Format of the Document Content
Content
Scanned
Documents
and associated
coded vocabulary
Format of the Document Content
Imaging
and associated
coded vocabulary
Format
of theInformation
Document
Content
Medical Summary
Format of the Document Content
Allergies,
Pbs)
and(Meds,
associated
coded
vocabulary
Format of the Document Content
and associated coded vocabulary
Health Data Exchange
Cross-Enterprise
Document Sharing
Registration, distribution and access
across health enterprises of clinical
documents forming a patient
electronic health record
Cross-enterprise Document
Point-Point Interchange
Media-CD/USB & e-mail push
Security
Basic Patients Privacy
Consents
Establish Consents & Enable
Access Control
Document Digital
Signature
Patient Id Mgt
Patient Demographics
Query
Patient Identifier
Cross-referencing
Map patient identifiers across
independent identification
domains
Attesting “true-copy and origin
Audit Trail & Node
Authentication
Centralized privacy audit trail and node
to node authentication to create a
secured domain.
Other
Request Form
for Data Capture
External form with custom
import/export scripting
Consistent Time
Coordinate time across networked
systems
Notification of
Document Availability
Notification of a remote
provider/ health enterprise
26
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