Integrating the HealthEnterprise IHE Australia 900 plus organisational members across more than 40 countries

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  • What IHE Delivers

    Integrating the

    HealthEnterprise

    IHE Australia

    Introduction to IHE

    Dr Vincent McCauley Chair, IHE Australia

    Chief Medical Officer, Emerging Systems

    HIC 2016

  • 22

    IHE Organizational Structure

    Contributing &

    Participating

    Vendors

    IHE North America

    USA

    Canada

    IHE Asia

    Japan

    Korea Taiwan

    China

    ACC

    ACCE

    ACEP

    HISA

    JAHIS

    JIRA

    JRS

    ADIA

    METI-MLHW

    MEDIS-DC

    JAMI

    RSNA

    SFR

    SFIL

    MSIA

    SIRM

    BIR

    EuroRec

    RACS

    COCIR

    EAR-ECR

    DRG

    RANZCR

    ESC

    Professional Societies / Sponsors

    ACP

    GMSIHIM

    SS

    HL7 AUS

    IHE International Board

    Global Development

    Radiology

    Cardiology

    IT

    Infrastructure

    Patient Care

    Coordination

    Patient Care

    Devices

    Laboratory

    Pathology

    Eye CareRadiation

    Oncology

    Public Health, Quality

    and Research

    IHE Asia-Pacific

    New ZealandAustralia Malaysia

    IHE Europe

    France Netherlands

    Spain Sweden UKItaly

    Germany

    Norway

    Austria

    Regional Deployment

    Dental

  • IHE International

    900 plus organisational members across more than 40

    countries

    USA, Canada, USA, UK, 23 European nations, China,

    Japan, Korea

    Standards Development Organisation (SDO) 2012

    Liaison A status ISO TC215 Health Informatics

    MOU with HL7 International to ballot profiles at HL7

    Joint Working group (WG) with HL7 International –

    Healthcare Standards Integration (HSI)

    Member ISO TC215 Joint International Council (JIC)

  • IHE Australia

    IHE Australia Sponsors

    - Health Informatics Society of Australia (HISA)

    - Health Level Seven (HL7) Australia

    - Medical Software Industry Association (MSIA)

    - Royal Australasian College of Radiologists (RANZCR)

    Some Australian supporting members

    - Health Information Management Association (HIMAA)

    - Royal Australian College of Surgeons (RACS)

    - Australian Diagnostic Imaging Association (ADIA)

  • International

    Organisation for

    Standardization

    (ISO) TC215

    National

    Representative

    Bodies

    International SDOs

    GS1 – Identification standards

    DICOM – Imaging standards

    IHE – Interoperability profiles &

    testing

    HL7 - Clinical interoperability

    standards and process models

    IEC – Medical devices standards

    CDISC – Health research

    IHTSDO – Terminologies

    CEN251 – EEC standards

    IEEE – Device standards

    Joint

    Initiative

    Council

    (JIC)

    International

    National

    Coordinates

    development

    between SDOs

    Integration point

    for all SDOs

    …have specific

    responsibilities to

    ISO

    Standards

    Australia

    IT-014 Technical Subcommittees

    IT-014Comprises stakeholder representatives

    Comprises independent,

    content expert volunteers

    HL7

    Australia

    IHE

    Australia

    GS1

    Australia

    License agreement

    (to publish HL7 localisations with

    conditions)

    Health Informatics Standards Development

    Environment

    IHE Global Standards Context

  • IHE Domains Radiology – mammography, nuclear medicine

    Cardiology

    Radiation Oncology

    IT Infrastructure

    Patient Care Coordination

    Patient Care devices

    Laboratory, Pathology, Eye Care, Dental

    Pharmacy

    Quality Research and Public Health

  • IHE Value Proposition

    • IHE Solutions are Driven by Strategic Healthcare Lead Users that collaborate with Healthcare Vendors

    • IHE Solutions are Generic, Reusable and Interoperable based on Healthcare Standards: DICOM, HL7, RFC

    • IHE Solutions Optimize the Clinical Workflows

    • IHE Deployment process – Connectathon, Integration Statements and Users Success Stories information helps to refine the product “Business Case”

    • IHE Technical Framework specification describes the Global IHE solutions at a High Level for Planning & Marketing and in details for products Architects and Engineering development

  • IHE Benefits • Clinical Users

    • Greater access to consistent information

    • Fewer errors, fewer tedious tasks

    • Administrators

    • Increased throughput - Better scheduling

    • Reduce Cost

    • Buyers

    • Specify/purchase RFP’s integration capabilities easily and Freedom to acquire “Best of Breed” systems

    • IT Professionals

    • Faster, more predictable integration projects

    • Facilitate cooperation of competing vendors

  • IHE Profile Examples

    (XDS/XDS-I) Cross-Enterprise Document/Image Sharing

     Shares clinical documents, images, diagnostic reports and related information between healthcare enterprises

    (PIX) Patient ID Cross-referencing

     Cross-index patient IDs across multiple sites

    (PDQ) Patient Demographics Query

     Query and retrieve a patient’s demographic and visit information

    (ATNA) Audit Trail and Node Authentication

     Systems Authentication

     Audit events management

    (BPPC) Basic Patient Privacy and Consent

     Patient privacy consents & enforcement

    9

  • IHE Privacy and Security Toolkit

    • Accountability Controls – includes security audit logging,

    reporting, alerting and alarming

    • Identification and Authentication Controls - personal

    interactions, Digital Certificates, security assertions,

    Kerberos

    • Access Controls – Role Based Access Controls

    • Confidentiality Controls – encryption or access controls

    • Data Integrity Controls – digital signatures, secure hash

    algorithms, CRC, and checksum

    • Non-Repudiation Controls

    • Patient Privacy Controls

    • Availability Controls – backup, replication, fault tolerance,

    RAID, trusted recovery, uninterruptible power supplies, etc.

  • IHE reinforces need for basic security functionalities –

    through Audit Trail and Node Authentication

  • IHE Radiology Integration Profiles

    Patient

    Info.

    Recon-

    ciliation

    Access to Radiology Information

    Consistent

    Presentation

    of

    Images

    Audit Trail & Node Authentication - Radiology Option

    Evidence

    Docs

    Key

    Image

    Notes

    Simple

    Image &

    Numeric

    Reports

    Presentation

    of

    Grouped

    Procedures

    Post-

    Processing

    Workflow

    Reporting

    Workflow

    Charge

    Posting

    XDS for Imaging

    NM

    Image

    Scheduled Workflow

    Teaching

    Files &

    Clinical Trials

    Export

    Portable Data for Imaging

    NM

    Image

    Cardiac NM

    Option

    Image

    Fusion Image

    Fusion

  • A “simple” IHE Profile - Portable Data

    for Imaging

    Media

    Creator

    Printer

    [Media Reader]

    Image Display

    [Media Reader]

    PACS

    [Media Importer]

    CD

    John DoeDICOM Data

    Web Data

    (Optional)

    DICOM

    DICOM

    DICOM

    PC BrowserWeb Data

    Required to

    cleanup Patient

    ID, Acc#, etc.

  • 16

    images

    stored

    patient

    information

    RIS

    examination orders

    images

    retrieved

    HIS

    PACS

    procedure

    scheduled Prefetch any relevant

    prior studies

    modality

    worklist

    report

    report

    IHE Scheduled Workflow Profile

    Registration

    Orders Placed

    Orders Filled

    Film

    Film

    Folder Image Manager

    & Archive

    Film

    Lightbox

    report Report

    Repository

    Diagnostic

    Workstation

    Modality

    acquisition

    in-progress

    acquisition

    completed

    acquisition

    completed

    images

    printed

    Acquisition

    Modality

  • IHE Integration Profiles – supporting CDA

    Emergency Referrals

    Format of the Document Content

    and associated coded vocabulary

    PHR Extracts/Updates

    Format of the Document Content

    and associated coded vocabulary

    ECG Report Document

    Format of the Document Content

    and associated coded vocabulary

    Lab Results Document

    Content Format of the Document Content

    and associated coded vocabulary

    Scanned Documents Format of the Document ContentImaging Information

    Format of the Document Content

    and associated coded vocabulary

    Medical Summary

    (Meds, A