Regionale uitwisseling van medische gegevens (IHE) Sessie B (10:50-11:50) Nieuwegein, 20 mei 2014
René Spronk Trainer / Senior Consultant Ringholm bv Haarlem, the Netherlands Tel. +31 (0)33 7 630 636 email: Rene.Spronk@Ringholm.com Web: http://www.ringholm.com HL7/IHE roles: Co-chair of the international HL7 AID User Group Co-chair of various Committees, HL7 Netherlands Contributor to the IHE Laboratory Technical Framework HL7 Fellow, 2011 2
Het zes-lagen model WET & REGELGEVING BELEID ZORGPROCES INFORMATIE APPLICATIES TECHNIEK Randvoorwaarden Richtlijnen Samenwerking Informatie-inhoud Softwarekoppeling Infrastructuur Informatiestandaarden in de zorg 3
Agenda Interoperabiliteit Wat is IHE en wat kun je ermee? Regionale uitwisseling XDS Voorbeelden regionale uitwisseling
Interoperability Hospital 1 Hospital 2 Policy Alignment organisations Use cases, care process Policy Alignment organisations Use cases, care process Information content and transactions Systems, Applications Information content and transactions Systems, Applications Technique, Infrastructure Technique, Infrastructure
What is IHE?
Intro IHE IHE = Integrating the Healthcare Enterprise Based on existing standards such as HL7 and DICOM IHE is not a standard; it is a constraint profile (a.k.a conformance profile). 7
IHE domains Pharmacy Since 2009 Radiology since 1998 Cardiology since 2004 Pathology since 2006 Eye Care since 2006 Quality Research & Public Health since 2006 (Healthcare) IT Infrastructure since 2003 Laboratory since 2004 Radiation Oncology since 2004 Patient Care Devices since 2005 Patient Care Coordination since 2004 8
Actors and Transactions Actor (HL7: Application Role, DICOM: Service Class) Functional grouping of the capability to exchange a specific set of Transactions in order to fulfill part of a workflow. Transaction (Functional) Information exchange Abstract concept, could be the equivalent of multiple message exchanges or service calls.
Affinity Domain; Identity Domain Affinity Domain A set of implementations of IHE Actors (i.e. applications) that share common policies when it comes to privacy, user authentication, auditing, use of code systems, Policy Alignment organisations WET & REGELGEVING BELEID
Document Sharing Affinity Domain Set of organizations/systems organized around a single Registry Agreed-upon sharing policies Common set of Codes Unified terminology Single Patient ID Domain Involves business and legal agreements Security & Access Control model/agreements
XDS profile Regionale uitwisseling: Cross-enterprise Document Sharing
Primary Care Physician Legacy - heterogeneous, disconnected silos Community Workflow: Phone, Fax, Mail Other HIE Patient Engagement: Analog, Discrete Labs Independent Health Facility Patient Information: Population Information: Scattered Unknowable Patient Payers Pharmacy Government Specialty Practice Academic Medical Center Community Hospital
XDS: Purpose Manage the sharing of documents between healthcare enterprises healthcare enterprises within a XDS affinity domain. Creation of a longitudinal document-based patient record within a given XDS affinity domain. Document content neutral. 14
XDS Profile One per affinity domain Document Administrator Update / Delete Document Set Document Registry Query Documents Document Consumer Register Document Set Retrieve Document Set Document Source Provide & Register Document Set Document Repository 15
XDS DocumentEntry meta-data Patient: Affinity domain id, demographics (id, name, birth date ) «as viewed by the source» Origin: author, institution, legal authenticator Identification: unique id, dates of creation and start /end of medical act, title, parent document, unique id of the repository Classification: class, type, format, MIME type, type and specialty of institution and author, medical codes, confidentiality level, language Required, If known, Recommended 16
Summary Health Document Exchange Options - Flexible Infrastructure XDS Publish XDS INFRASTRUCTURE M8354673993 L-716 14355 A87631 XDR XDM Send to Write Existing Reliable Messaging System Interchange Media Send to Read
Types of XDS implementations in Netherlands National screening programs MammoXL Screening Colon Cancer Regional projects NHN Zorgring Amsterdam Ezda Breda area Network Friesland Groningen Leiden Sleutelnet Rotterdam Rijnmondnet Terneuzen Zorgsaam
Where in the world is XDS?
Other standards HL7 v3, CDA SNOMED CT and G-standard could be used for Content XML SOAP
Meer details? Cursus Regionale uitwisseling : IHE XDS, VNA en ECM - 21 en 22 mei 2014 2 dagen, zie www.iheacademy.nl Cursus Regionale uitwisseling : IHE XDS, VNA en ECM 5 en 6 november 2014 2 dagen, zie www.iheacademy.nl www.ihe.net