IHE IT Infrastructure Cross Enterprise Document Sharing XDS Integration Profile
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1 ,QWHJUDWLQJWKH+HDOWKFDUH(QWHUSULVH IHE IT Infrastructure Cross Enterprise Sharing XDS Integration Profile Charles Parisot,, GE Healthcare IHE IT Infrastructure co-chair chair G. Claeys,, Agfa Healthcare R&D Past Vendor Co-chair IHE Europe Amended by Nick Brown January
2 Introduction: EHR Cross-Enterprise Sharing )LUVWVWHSWRZDUGVWKH ORQJLWXGLQDOGLPHQVLRQRIWKH(+5 )RFXV 6XSSRUWGRFXPHQWVKDULQJEHWZHHQ (+5V LQGLIIHUHQWFDUHVHWWLQJVDQG RUJDQL]DWLRQV 2
3 7\SLFDOO\DSDWLHQWJRHVWKURXJK DVHTXHQFHRIHQFRXQWHUV LQGLIIHUHQW&DUH6HWWLQJV Long Term Care Acute Care (Inpatient) Other Specialized Care (incl. Diagnostics Services) GPs and Clinics (Ambulatory) Continuity of Care: Patient Longitudinal Record 3
4 Finding patient records tedious manual process community Hospital Record Laboratory Results Specialist Record Records Sent Clinical IT System The challenge: To easily find and obtain documents from other care providers in the community Clinical Encounter 4
5 Sharing records that have been published community Hospital Record Laboratory Results Specialist Record Reference to records 4-Patient data presented to Clinician 3-Selected Records Clinical Encounter Clinical IT System Temporary Aggregate Patient History 5 6KDULQJ6\VWHP 1-Patient Authorized Query Index of patients records (-level) 2-References to Records found
6 Building and accessing s EHR-LR: Longitudinal Record as used across-encounters s Registry Long Term Care Repository Acute Care (Inpatient) Other Specialized Care or Diagnostics Services PCPs and Clinics (Ambulatory) EHR-CR: Care Record systems supporting care delivery Submission of References Retrieve of selected s 6
7 Actors & Transactions of XDS Profile Patient Identity Feed Patient Identity Source Registry Query s Consumer Register Set Source Provide&Register Set Repository Retrieve 7
8 IHE-XDS = Flexibility centralised or distributed architecture Source Source Source Source Source Source Source Source Provide & Register Set Repository Repository Repository Repository Register Set Patient Identity Feed Patient Identity Source Registry Repository Query s Retrieve Consumer Consumer Consumer Consumer 8
9 Standards selection for IHE XDS No single standard can address Cross-enterprise Sharing Electronic Business Standards ebxml Registry, SOAP, etc. Healthcare Content Standards HL7 CDA, CEN EHRcom HL7, ASTM CCR DICOM, etc. Internet Standards HTML, HTTP, ISO, PDF, JPEG, etc. 0DUULDJHRIKHDOWKFDUHVWDQGDUGVIDFLOLWDWHV LPSOHPHQWDWLRQDQGOHYHUDJHVFRPSOHPHQWDU\ WHFKQRORJLHVHJVHFXULW\ SULYDF\ 9
10 XDS Value Proposition )RXQGDWLRQIRU+HDOWK,7,QIUDVWUXFWXUHV 6KDUHG (OHFWURQLF+HDOWK5HFRUGLQDFRPPXQLW\UHJLRQHWF (IIHFWLYHPHDQVWRFRQWULEXWHDQGDFFHVV FOLQLFDO GRFXPHQWVDFURVVKHDOWKHQWHUSULVHV 6FDODEOHVKDULQJRIGRFXPHQWV EHWZHHQSULYDWH FOLQLFLDQVFOLQLFVORQJWHUPFDUHSKDUPDF\DFXWH FDUHZLWKGLIIHUHQWFOLQLFDO,7V\VWHPV (DV\DFFHVV &DUHSURYLGHUVDUHJLYHQWKHPHDQVWR TXHU\IRUDQGUHWULHYHFOLQLFDOGRFXPHQWVRILQWHUHVW 10
11 XDS - Value Proposition 'LVWULEXWHG (DFK&DUHGHOLYHU\RUJDQL]DWLRQ³SXEOLVKHV FOLQLFDO LQIRUPDWLRQIRURWKHUV$FWXDOGRFXPHQWVPD\UHPDLQLQWKH VRXUFH(+5&5 &URVV(QWHUSULVH $5HJLVWU\SURYLGHVDQLQGH[RIVXEPLWWHG GRFXPHQWVDYDLODEOHWRDXWKRUL]HGFDUHGHOLYHU\RUJDQL]DWLRQV EHORQJLQJWRWKHVDPHFOLQLFDODIILQLW\GRPDLQJURXSRI HQWHUSULVHVZKLFKKDYHDJUHHGWRVKDUHGRFXPHQWV 'RFXPHQW&HQWULF 3XEOLVKHGFOLQLFDOGDWDLVRUJDQL]HGLQWR ³FOLQLFDOGRFXPHQWV XVLQJDJUHHGVWDQGDUGGRFXPHQWW\SHV +/&'$$670&&53')',&20HWF 'RFXPHQW&RQWHQW1HXWUDO 'RFXPHQWFRQWHQWLVSURFHVVHGRQO\ E\VRXUFHDQGFRQVXPHU,7V\VWHPV 6WDQGDUGL]HG5HJLVWU\$WWULEXWHV Queries based on meaningful attributes ensure deterministic document searches. 11
![HQWHUSULVHVZKLFKKDYHDJUHHGWRVKDUHGRFXPHQWV 'RFXPHQW&HQWULF 3XEOLVKHGFOLQLFDOGDWDLVRUJDQL]HGLQWR ³FOLQLFDOGRFXPHQWV XVLQJDJUHHGVWDQGDUGGRFXPHQWW\SHV](/docs-images/43/9850957/images/page_11.jpg "+/&'$$670&&53')',&20HWF 'RFXPHQW&RQWHQW1HXWUDO 'RFXPHQWFRQWHQWLVSURFHVVHGRQO\ E\VRXUFHDQGFRQVXPHU,7V\VWHPV 6WDQGDUGL]HG5HJLVWU\$WWULEXWHV Queries based on meaningful")
12 How real is XDS? Specification work since Nov 2003 Public Comments June-July July 2004 ¾ ¾ 600 constructive comments received. Validity of XDS approach confirmed around the world. Stable specification IHE Technical Framework Published Aug 15 th, 2004 (TI Supplement) IHE Connectathon - January 2005 (USA)-17 vendors HIMSS Feb show-wide wide demonstration IHE Connectathon - April 2005 (Europe)-22 vendors Several Implementation Projects by health authorities in
13 HIMSS 2005 Interoperability Showcase 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 (15 vendors) show-wide. Show-wide interactive environment demonstrating attendees patient record in a HIMSS RHIO. Uses IHE Cross-enterprise Sharing: ¾ ¾ ¾ Around a central document registry Distributed document repositories 17 EHR that publish/share documents (CCR, CDA, HL7-lab, PDF) 13
14 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, 20 vendors: Cedara Gusrada/Care Science NIST Dictaphone IDX Novell Eastman Kodak InterSystems Open Text Eclipsys Infinitt Sentillion Emageon Kryptiq Siemens Epic MedCommons Univ. Of Washington GE Healthcare Mortara Instruments ambulatory sharing of health information, 13 vendors: Allscripts GE Healthcare MidMark CapMed/SanDisk IDX NextGen Cerner Krytiq WebMD Eclipsys MedcomSoft ETIAM MediNotes 14
15 IHE XDS Integration Profile: Key Concepts ;'6'RFXPHQW ;'66XEPLVVLRQ6HW ;'6)ROGHU 16
16 Repository and Registry Example of Submission Request Registry Submission Request Submission Set 1 Folder A Entry Entry Repositories 17
17 IHE XDS Integration Profile: Key Concepts ;'6'RFXPHQW $VHWRIDWWHVWHGFOLQLFDOLQIRUPDWLRQVWUXFWXUHGRUQRWZKLFK IRUPDQHOHPHQWRIDSDWLHQWUHFRUGWREHVKDUHG,WPD\ DOUHDG\H[LVWZLWKLQWKHVRXUFH,7V\VWHP ;'66XEPLVVLRQ6HW $VHWRIGRFXPHQWVUHODWHGWRDSDWLHQWWKDWDWHDPRI FOLQLFLDQVLQWKHVDPHVRXUFHV\VWHPKDYHGHFLGHGWRPDNH DYDLODEOHWRSRWHQWLDOFRQVXPHUV ;'6)ROGHU $PHDQVWRJURXSGRFXPHQWVIRUDQXPEHURIRWKHUUHDVRQV 7HDPZRUNDFURVVVHYHUDOSK\VLFLDQV (SLVRGHRIFDUH (PHUJHQF\LQIRUPDWLRQIRUDSDWLHQWHWF ;'6OHDYHVRSHQWKHXVHRIIROGHUVWRDIILQLW\GRPDLQFOLQLFLDQV 18
18 More about XDS Meeting: Delivering the results of diagnostic medicine. 31 st January 2006 British Institute of Radiology, London Main speaker in the afternoon is Charles Parisot IHE XDS project leader for details and application form look under events 19
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