Transcript PPT3

Integrating the Healthcare Enterprise
IHE Update
Charles Parisot, GE Healthcare
IHE IT Infrastructure Technical Committee Co-chair
http://medical.nema.org/Dicom/minutes/Committee/2005/2005-03-31/Reports/IHE-Update.ppt
March 30, 2005
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IHE Update
IHE IT Infrastructure 2004-2005
New
Cross-Enterprise
Document Sharing
Registration, distribution and
access across health
enterprises of clinical
documents forming a patient
electronic health record
New
Retrieve
Retrieve Information
Information
for
Display
for Display
Access
Accessa apatient’s
patient’sclinical
clinical
information
and
documents
in in
a
information and documents
formataready
be presented
formattoready
to be
to the requesting
presented user
to the requesting user
New
Audit Trail & Node
Authentication
Patient Identifier
Patient Identifier
Cross-referencing
for
Cross-referencing
MPI
for MPI
Map patient identifiers
Map patient
identifiers
across
independent
across
independent
identification domains
identification domains
March 30, 2005
Centralized privacy audit trail
and node to node authentication
to create a secured domain.
Consistent Time
Coordinate time across
networked systems
2
Personnel White Page
Access to workforce
contact information
Patient Demographics
Query
New
Patient Synchronized
Applications
Synchronize multiple
applications on a desktop to the
same patient
Enterprise User
Enterprise
User
Authentication
Authentication
Provide users a single name
and centralized authentication
process
across all systems
IHE Update
Sharing and accessing Documents
EHR-LR:
Longitudinal Record
as used
across-encounters
Documents Registry
Long Term Care
Acute Care
(Inpatient)
Document
Repository
Other Specialized Care
or Diagnostics Services
PCPs and Clinics
(Ambulatory)
EHR-CR: Care Record systems
supporting care delivery
Submission of Document References
Retrieve of selected Documents
March 30, 2005
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IHE Update
Standards selection for IHE XDS
No single standard can address
Cross-enterprise Document Sharing
Electronic Business
Standards
ebXML Registry, SOAP, etc.
Internet Standards
HTML, HTTP,
ISO, PDF, JPEG, etc.
Healthcare
Content Standards
HL7 CDA, CEN EHRcom
ASTM CCR
DICOM, etc.
Marriage of healthcare standards facilitates
implementation and leverages complementary
technologies (e.g. security & privacy).
March 30, 2005
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IHE Update
HIMSS 2005 Interoperability Showcases
HIMSS leverages its sponsorship of IHE to demonstrate
practical interoperability in two large Showcase Exhibits:
cross-enterprise sharing of health information in the acute
care (18 vendors) and ambulatory (14 vendors).
HIMSS Showcase exhibits linked with vendor booths (10
vendors) show-wide.
Show-wide interactive environment demonstrating
attendees “patient” record in a “HIMSS RHIO”. Uses IHE
Cross-enterprise Document Sharing:

Around a central document registry

Distributed document repositories

17 EHR that publish/share documents (CCR, CDA, HL7-lab, PDF)
March 30, 2005
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IHE Update
HIMSS 2005 Interoperability Showcases
HIMSS sponsors the testing and demonstration of IHE
interoperability in two large Showcase Exhibits:
cross-enterprise sharing of health information in the
acute care, 18 vendors:
Cedara
Dictaphone
Eastman Kodak
Eclipsys
Emageon
EPIC
GE Healthcare
IDX
InterSystems
Infinitt Technology
Kryptiq
MedCommons
Mortara Instruments
NIST
Novell
Open Text
Sentillion
Siemens
ambulatory sharing of health information, 14 vendors:
Allscripts
CapMed/SanDisk
Cerner
Eclipsys
ETIAM
March 30, 2005
GE Healthcare
Healthramp
IDX
Krytiq
MediNotes
6
MidMark
Misys
NextGen
WebMD
IHE Update
HIMSS Highlights
March 30, 2005
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IHE Update
HIMSS IHE Highlights
HIMSS: 700 Exhibitors - 23,000 Attendees
Over 2000 visited the IHE Booth.
49 participants in IHE Interoperability booth
15 vendors participated in XDS from their booth
732 Attendees registered for their own EHR
7,772 Documents registered in XDS Registry
40,984 Queries to XDS Registry
US National IT Coordinator (Dr Brailer) held his press
conference in IHE Booth and thanked IHE. 50 members
of press toured.
March 30, 2005
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IHE Update
HIMSS 2005 – Show-Wide Interoperability
Vendor System
Cross-enterprise Showcase Booth
Radiology
IT
Infrastructure
& Lab
Vendor Booth
Vendor Booth
Allscripts
In-Patient/Out-patient
Eclipsys
GE Healthcare
Vendor Booth
Healthramp
Cardiology
IDX
Radiology
Vendor Booth
HIMSS “RHIO” with
Infinitt
Cross-enterprise
InterSystems
Vendor Booth
doc sharing
MedCommons
PCP
Novell
OpenText
Vendor Booth
Diag Center
Siemens
Home
Multispecialty
Clinic
Vendor Booth
Ambulatory Showcase Booth
March 30, 2005
Vendor Booth
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IHE Update
IHE Profiles for a “Regional Health Info Organization”
What are the gaps to be filled in 2005 ?
Patient Demographics
Query
Imaging Information
SimpleContent
Document
Format of the Document Content
Content
and
associated
coded vocabulary
For
Display
Document
Format
of the Document
Content
Content
and associated
coded vocabulary
Lab
Results Document
Format of the Document Content
Content
Continuity
of Care
Format of the Document Content
Document
Content
and
associated coded
vocabulary
Cross-Enterprise
Notification
Notification of a remote
provider/ health enterprise
Map patient identifiers across
independent identification
domains
Audit Trail & Node
Authentication
Personnel White Page
Format of the Document Content
and associated coded vocabulary
Cross-Enterprise Document
Sharing
Registration, distribution and access
across health enterprises of clinical
documents forming a patient
electronic health record
Centralized privacy audit trail
and node to node authentication
to create a secured domain.
Consistent Time
Coordinate time across
networked systems
March 30, 2005
Patient Identifier
Cross-referencing
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Access to workforce
contact information
User Identity,
Authentication and
Permissions
Enable Basic Access
Control
IHE Update
Infrastructure and Interoperability
Cross-Enterprise Document Sharing (XDS) minimizes
clinical data management by the infrastructure.
Transparency = Ease of Evolution, increase efficiencies.
XDS needs other IHE Integration Profiles:
 Audit Trail and Node Authentication (ATNA)
 Patient Id Cross-referencing (PIX)
 Patient Demographics Query (PDQ)
In 2005, IHE plans to complement a set of integration
profiles to build a RHIO, candidates:




Security: Identity Management + Info for Access Control
Content Profiles: Core CCR, HL7-CDA, HL7-Lab, PDF (legacy)
Provider Notification (with doc reference) and Point-to-point Transfer
Dynamic Clinical Data Mgt (Allergy lists, Problem Lists)
 Prioritization of Candidate Integration Profiles
November-December 2004. Technical
development
January-July
2005.
Open
to
all.
March 30, 2005
IHE
Update
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IHE Radiology Integration Profiles
Charge
Posting
Extensions
Scheduled Workflow
-
Patient
Info.
Reconciliation
Presentation
of Grouped
Procedures
PostProcessing
Workflow
Reporting
Workflow
New
NM
Image
Consistent
Presentation of
Images
Evidence
Docs
Key
Image
Notes
Simple
Image &
Numeric
Reports
Access to Radiology Information
New
Portable Data for Imaging
Basic Security
March 30, 2005
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IHE Update
Laboratory IHE Integration Profiles
In Dev.
Laboratory Scheduled
Workflow (LSWF)
Laboratory Point Of
Care Testing (LPOCT)
Completed in 2003
In Process –TI Nov 2004
Tests performed by a
laboratory for an identified
inpatient or outpatient
Tests performed on point of
care or patient’s bedside
In Dev.
Laboratory Patient Information
Reconciliation (LPIR) In Process
Tests performed on an unidentified or
misidentified patient
Laboratory Device
Automation (LDA)
In Process –TI Nov 2004
Laboratory Code Set Distribution
(LCSD) In Process
In Dev.
Sharing the batteries and tests code sets
throughout the enterprise
March 30, 2005
In Dev.
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Pre-analytic process, analysis
and post-analytical treatment
IHE Update
IHE Cardiology 2004-2005
New
Retrieve ECG for Display
Provide high-quality ECG and related reports
to the enterprise and outside in a ready-to-display format
New
Retrieve Information
EchoCardiography
for Display
Worklflow
Cardiac Catheterization
Workflow
Access a patient’s clinical information and
Admit, order, schedule, acquire
documents in a format ready to be
images, notify
of completed steps,
presented
on fixed
and
mobile user
stress echo
to the
requesting
Scheduled & unscheduled
acquisition and management of
cathlab information, notification
of completed steps.
March 30, 2005
New
modalities.
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IHE Update
ACC 2005 IHE Demonstration
ACC sponsors the testing and demonstration of IHE
interoperability in their exhibit – March 2005
11 vendors:
Agfa
Camtronics
Cerner
Emageon
GE Healthcare
Heartlab
IDX
Medcon
Schiller
Philips
Toshiba
Scenario:

Emergency Cath, Change of Lab mid-procedure

Scheduled Echo+Mobile Modality, Stress Echo
Echo demo planned for ASE (Boston June 2005)
Full demonstration planned for ESC (August 2005)
March 30, 2005
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IHE Update