IHE IT Infrastructure Cross Enterprise Document Sharing XDS Integration Profile

February 7, 2005

1

IHE IT Infrastructure

Cross Enterprise Document

Sharing – XDS Integration Profile

Charles

Charles

Parisot, GE Healthcare

Parisot

, GE Healthcare

IHE IT Infrastructure co

IHE IT Infrastructure co

-

-

chair

chair

G.

G. Claeys

Claeys, Agfa

, Agfa Healthcare

Healthcare

R&D

R&D

Past Vendor Co

Past Vendor Co

-

-

chair IHE Europe

chair IHE Europe

Amended

Amended

by Nick Brown

by Nick Brown

January

January

2006

2006

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Introduction:

EHR Cross

EHR Cross

-

-

Enterprise Document Sharing

Enterprise Document Sharing

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February 7, 2005

3

Acute Care

(Inpatient)

GPs and Clinics

(Ambulatory)

Long Term Care

Other Specialized Care

(incl. Diagnostics Services)

Continuity of Care

:

Patient Longitudinal Record

Patient Longitudinal Record

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community

Clinical Encounter

Clinical IT System

Records

Records

Sent

Sent

Laboratory Results

_{Specialist Record}

Hospital Record

Finding patient records

Finding patient records

–

–

tedious manual process

tedious manual process

The challenge:

To easily find and obtain

documents from other care

providers in the community

February 7, 2005

5

community

Clinical Encounter

Clinical IT System

_{Index of patients records}

(Document-level)

1-Patient

Authorized

Query

Temporary Aggregate

Patient History

4-Patient data

presented to

Clinician

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Selected

Records

Reference

to records

Laboratory Results

_{Specialist Record}

Hospital Record

2-References

to Records

found

Sharing records that have been published

Acute Care

(Inpatient)

PCPs and Clinics

(Ambulatory)

Long Term Care

Other Specialized Care

or Diagnostics Services

Building and accessing Documents

Building and accessing Documents

EHR

EHR

-

-

CR:

CR:

Care Record

Care Record

systems

systems

supporting

supporting

care delivery

care delivery

Documents Registry

Document

Repository

EHR

EHR

-

-

LR:

LR:

Longitudinal Record

Longitudinal Record

as used

as used

across

across

-

-

encounters

encounters

Submission of Document References

Retrieve of selected Documents

February 7, 2005

7

Actors

Document Consumer Retrieve Document Query Documents Patient Identity Source Patient Identity Feed Document Source Document Registry Document Repository Register

Document Set Document Repository Document Source Provide & Register Document Set

IHE

IHE

-

-

XDS =

XDS =

Flexibility

Flexibility

centralised

centralised

or

or

distributed

distributed

architecture

architecture

Document Source Document Source Document Source Document Consumer Document Consumer Document Consumer Document Source Document Repository Document Source Document Repository Document Source Document Repository

February 7, 2005

9

Standards selection for IHE XDS

Standards selection for IHE XDS

No single standard can address

Cross-enterprise Document Sharing

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Healthcare

Content Standards

HL7 CDA, CEN EHRcom

HL7, ASTM CCR

DICOM, etc.

Internet Standards

HTML, HTTP,

ISO, PDF, JPEG, etc.

Electronic Business

Standards

XDS

XDS

–

–

Value Proposition

Value Proposition

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XDS

XDS

-

-

Value Proposition

Value Proposition

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Queries based on meaningful

attributes ensure deterministic document searches.

How real is XDS ?

How real is XDS ?

Specification work since Nov 2003

Specification work since Nov 2003

Public Comments June

Public Comments June

-

-

July 2004

July 2004

¾

¾

600 constructive comments received.

600 constructive comments received.

¾

¾

Validity of XDS approach confirmed around the world

Validity of XDS approach confirmed around the world

.

.

Stable specification IHE Technical Framework

Stable specification IHE Technical Framework

Published Aug 15

Published Aug 15

th

th

_{, 2004 (TI Supplement)}

_{, 2004 (TI Supplement)}

IHE Connectathon

IHE Connectathon

-

-

January 2005 (USA)

January 2005 (USA)

-

-

17 vendors

17 vendors

HIMSS Feb 2005

HIMSS Feb 2005 -

-

show-

show

-wide demonstration

wide demonstration

IHE Connectathon

IHE Connectathon

-

-

April 2005 (Europe)

April 2005 (Europe)

-

-

22 vendors

22 vendors

February 7, 2005

13

HIMSS 2005 Interoperability Showcase

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 Document Sharing:

¾

Around a central document registry

¾

Distributed document repositories

HIMSS 2005 Interoperability Showcases

HIMSS 2005 Interoperability Showcases

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

HIMSS sponsors the testing and demonstration of IHE

interoperability in two large Showcase Exhibits:

ambulatory

sharing of health information, 13 vendors:

Allscripts

GE Healthcare

MidMark

CapMed/SanDisk

IDX

NextGen

Cerner

Krytiq

WebMD

Eclipsys

MedcomSoft

February 7, 2005

16

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Document Repository and Registry

Document Repository and Registry

Example of Submission Request

Example of Submission Request

Document Repositories

Document Repositories

Document Registry

Document Registry

Submission Request

Submission Request

Document

Entry

Document

Entry

Submission

Set

1

Folder A

February 7, 2005

18

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More about XDS

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

www.bir.org.uk

for details