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An Overview of IHE IT Infrastructure Profiles and their relationship with other Domains IHE An Overview of IHE IT Infrastructure Profiles and their relationship with other Domains IHE Educational Workshop 2007 June 12 th, 2007

This morning’s program… Overview of IT Infrastructure 9: 00 – 9: 30 am Basic This morning’s program… Overview of IT Infrastructure 9: 00 – 9: 30 am Basic Patient Privacy Consents 9: 30 – 9: 45 am Break 9: 45 – 10: 15 am XDS Content Profiles 10: 15 – 10: 45 am Web Services and HL 7 v 3 10: 45 – 11: 00 am Retrieve Form for Data Capture • 8: 30 – 9: 00 am • • • Breakouts by domain

An Overview of the IHE IT Infrastructure Domain IHE Educational Workshop 2007 IT Infrastructure An Overview of the IHE IT Infrastructure Domain IHE Educational Workshop 2007 IT Infrastructure Domain Michael Nusbaum, FHIMSS Co-Chair, ITI Planning Committee

Agenda • What is IHE IT Infrastructure? • • • ITI’s role as a Agenda • What is IHE IT Infrastructure? • • • ITI’s role as a domain to support the other domains ITI long-range vision ITI work to date, including this year’s activities and roadmap items • Of what value is IHE IT Infrastructure? • How do you get IHE IT Infrastructure? • ITI profiles that we’d like to see featured at the upcoming Connectathon/Showcase cycle • How do you add to IHE IT Infrastructure? • Opportunities to grow ITI, and how to participate • What comes next?

An Infrastructure Component… • Represents a common IT function or service that is used An Infrastructure Component… • Represents a common IT function or service that is used as a building block for a variety of use cases • May be imbedded in an application, but is often deployed as a shared resource within a RHIO or Health Information Exchange • Is a necessary ingredient, but is rarely visible to the end user

What is IHE IT Infrastructure? applliicatiion app cat on • IT that serves multiple What is IHE IT Infrastructure? applliicatiion app cat on • IT that serves multiple applications • Security • Data storage and retrieval • Interfaces applliicatiion app cat on • IT that enables computer applications • Operating platforms • Computer languages • Computing hardware • Networks Infrastructure

Growth in IHE Domains Currently: Veterinary Endoscopy Pathology Pharmacy • Over 100 vendors involved Growth in IHE Domains Currently: Veterinary Endoscopy Pathology Pharmacy • Over 100 vendors involved world-wide • 8 Technical Frameworks • 48 Integration Profiles Quality • Testing at “Connectathons” world-wide • Demonstrations at major conferences world-wide Patient Care Devices (1) Patient Care Coordination (5) Radiation Oncology (1) Eye Care (3) Laboratory (6) Cardiology (7) IT Infrastructure for Healthcare (17) Year 9 (2007) Year 8 (2006) Year 7 (2005) Year 6 (2004) Year 5 (2003) Year 4 (2002) Year 3 (2001) Year 2 (2000) Year 1 (1999) Radiology (18)

What is IHE IT Infrastructure? • IHE IT Infrastructure domain produces. . . • What is IHE IT Infrastructure? • IHE IT Infrastructure domain produces. . . • Profiles that serve the purposes of clinical workflows, regardless of IHE clinical domain Examples: Security, Records Storage, Patient Identifiers • Basic implementation-specification foundations to be extended by other IHE clinical domains Examples: Retrieve Forms for Data Capture; Cross. Enterprise Document Sharing • White Papers for current work items Examples: HIE Security and Privacy; Health Data Re-use Infrastructure; Risk Management

IT Infrastructure Domain Committees Domain Sponsor • • Develops long-term goals Maintain ITI Roadmap IT Infrastructure Domain Committees Domain Sponsor • • Develops long-term goals Maintain ITI Roadmap Identify interoperability problems and priorities Gather and review proposals for new profiles Select and approve proposals for technical review and development Develop educational materials Develop ITI White Papers • Assess feasibility and effort required for selected profile proposals • Builds consensus on appropriate standards-based solutions • Develop integration profiles • Develop ITI White Papers • Maintain ITI Technical Framework

ITI Provides Foundation for Document Exchange Doc Content Profiles Pre Surgery Consent BPPC PPHP ITI Provides Foundation for Document Exchange Doc Content Profiles Pre Surgery Consent BPPC PPHP Emergency EDR Laboratory Imaging Doc Sharing XDS-SD Discharge & Referrals PHR Exchange XDS-MS XD*-Lab XDS-I Scanned Doc XPHR Pt-Pt Doc Interchange Media Interchange XDR XDM Doc Exchange Integration Profiles

IHE IT Infrastructure Composable Integration Profiles Cross-Enterprise User Assertion Patient Demographics Query User Attributes IHE IT Infrastructure Composable Integration Profiles Cross-Enterprise User Assertion Patient Demographics Query User Attributes for Access Cntrl Scanned Doc XDS-SD Document Digital Signature Attesting “true-copy and origin Audit Trail & Node Authentication Doc Sharing XDS * Pt-Pt Doc Interchange Media Interchange XDR XDM Centralized privacy audit trail and node to node authentication to create a secured domain. Doc Exchange Integration Profiles Consistent Time Cross-Community Access Coordinate time across networked systems Querying and Retrieving Documents across multiple communities Personal White Pages (Intra-Enterprise only) Enterprise User Authentication Retrieve Information for Display Adopted by HITSP * Patient Identifier Cross-referencing Map patient identifiers across independent identification domains * Notice of Document Availability * * Know about new information Request Form for Data Capture Remotely Manage Information Capture Patient Administration Management Patient Synchronized Applications

IT Infrastructure work underway… • Supplements to the Technical Framework • • • Web IT Infrastructure work underway… • Supplements to the Technical Framework • • • Web Services for IHE transactions (Appendix V) [RFD] Retrieve Form for Data Capture [XUA] Cross-Enterprise User Assertion [XDS. b] Cross-Enterprise Document Sharing (WS) [XCA] Cross-Community Access XDS Patient Identity Merge Public Comment • White Papers June 13 – July 13 • XDS Affinity Domain Checklist • Risk Management • SOA and Web Services IHE Roadmap • Health Data Reuse Infrastructure • HIE Security and Privacy

IT Infrastructure Roadmap • 2008 -09 Candidates • 2009 -10 Candidates • Additional candidates IT Infrastructure Roadmap • 2008 -09 Candidates • 2009 -10 Candidates • Additional candidates to be brought forward for consideration this Fall

Of what value is the IHE IT Infrastructure? • Stakeholders • • Healthcare Consumers Of what value is the IHE IT Infrastructure? • Stakeholders • • Healthcare Consumers – People and Employers Healthcare Providers – Institutions and Clinicians Healthcare payers Public health agencies Safety net providers Clinical and health-services researchers Vendors

Of what value is the IHE IT Infrastructure? • Benefits for vendors • • Of what value is the IHE IT Infrastructure? • Benefits for vendors • • • World-Class shared expertise amongst colleagues Reduced development effort Quicker time-to-market Reduced implementation effort and negotiation Greater collaboration amongst all stakeholders Exposure in HIMSS Interoperability Showcase and other venues Simplified RFP responses Better sales results when standards are important Satisfied customers

Of what value is the IHE IT Infrastructure? • Benefits for Purchasers • • Of what value is the IHE IT Infrastructure? • Benefits for Purchasers • • Quicker realization of IT benefits Fewer implementation fumbles Fewer multi-vendor coordination headaches Lower implementation cost • Benefits for Consumers • • • Less user time spent fumbling with infrastructure More time for clinical IT use à Better outcomes Potentially more funding for care-specific IT

Of what value is the IHE IT Infrastructure? • Benefits for Payers • Less Of what value is the IHE IT Infrastructure? • Benefits for Payers • Less overhead in care-provision and interfaces • Benefits for Public Health • Better data collection àbetter population health • Benefits for Safety Net Providers • Easier access to patient data àless expense • Benefits for Researchers • Simpler data collection àless expense

How do you get the IHE IT Infrastructure? • Study: Technical Framework • www. How do you get the IHE IT Infrastructure? • Study: Technical Framework • www. ihe. net/Technical_Framework/index. cfm • Volume 1 – Profiles • Volume 2 – Transactions • www. ihe. net – New profiles and transactions • Practice: Connectathon Testing • www. ihe. net and www. connectathon. net • Buy it: • Healthcare IT vendors are infrastructurespecialists

How do you add to IHE IT Infrastructure? • Implement the profiles • Your How do you add to IHE IT Infrastructure? • Implement the profiles • Your experience adds to the shared knowledge. • Based on experience, you can make Change Proposals to update the framework. • Your participation in the Connectathon adds to the collective IHE experience • Comment on the new profiles • Your knowledge and perceptions adds to the quality of the Technical Framework. • It is better to discover and correct problems in the design phase than in the coding phase. • Your good ideas will be folded-into the final work.

How do you add to IHE IT Infrastructure? • Help author the profiles (Technical How do you add to IHE IT Infrastructure? • Help author the profiles (Technical Committee) • Your technical expertise contributes to – and is honed by – the collaborative experience • Your ideas will be consolidated and improved-upon by working with expert peers. • “Many hands make light work. ” • Help plan the profiles (Planning Committee) • Your market expertise contributes to – and is honed by – the collaborative experience • Your ideas will be consolidated and improved-upon by working with expert peers. • “Many hands make light work. ”

What comes next? Current cycle • Education at this conference • Comments for the What comes next? Current cycle • Education at this conference • Comments for the new IT Infrastructure profiles – due by July 13, 2007 • Publication of the new IT Infrastructure profiles for trial implementation – early August, 2007 • Publication of IHE IT Infrastructure Roadmap update – early August, 2007 • Sign-up for the 2008 Connectathon and HIMSS Interoperability Showcase – September 15 th, 2008 • Implement and test for 2008 Connectathon, per schedule • Connectathon – January 28 – February 1, 2008, Chicago (Hyatt) • HIMSS Interoperability Showcase – February 24 -28, 2008, Orlando

What comes next? 2007 -2008 Development Cycle • Brief proposals submitted to ITI Planning What comes next? 2007 -2008 Development Cycle • Brief proposals submitted to ITI Planning Committee – October 9 -10, 2007 • ITI Planning Committee selects “short list”, hands off to ITI Technical Committee – November, 2007 • ITI Technical Committee selects scopes final profiles, white papers – January, 2008 • Profile development complete, supplements published for public comment – June, 2008

More Information • IHE Web Site - http: //www. ihe. net • • Technical More Information • IHE Web Site - http: //www. ihe. net • • Technical Frameworks Technical Framework Supplements – Trial Implementation Calls for Participation IHE Fact Sheet and FAQ IHE Integration Profiles: Guidelines for Buyers IHE Connectathon Results Vendors’ Product Integration Statements • Sponsors’ IHE sites • • • http: //www. himss. org/IHE http: //www. rsna. org/IHE http: //www. acc. org/quality/ihe. htm

For further info, contact: Michael Nusbaum • • • Co-Chair, IT Infrastructure Planning Committee, For further info, contact: Michael Nusbaum • • • Co-Chair, IT Infrastructure Planning Committee, IHE Strategic Development Committee Interoperability Showcase Planning Committee michael@mhnusbaum. com 250 -384 -0001