INTEGRATING THE HEALTHCARE ENTERPISE IHE Orientation Workshop 2 Turk

INTEGRATING THE HEALTHCARE ENTERPISE (IHE) Orientation Workshop(2) Turk. MIA Conference-10 Charles Parisot, IHE-Europe Steering Committee & International Board member, GE healthcare Oct, 2010 1 IHE Orientation-Tur. MIA

Agenda Part 1: THE IHE STANDARDS ADOPTION PROCESS: achieving practical interoperability This Afternoon: Part 2: USERS AND VENDORS WORKING TOGETHER: how can I contribute & benefit from IHE HOW TO USE IHE RESOURCES: hands on experience 2

Understanding the IHE Initiative IHE has a clear focus IHE is a healthcare domain-based initiative IHE creates synergies for interoperability testing across domains IHE addresses the standards adoption process IHE is both regional and multi-national IHE is both user lead and vendor driven 3

Standards Adoption Process Develop technical specifications Testing at Connectathons Identify available standards (e. g. HL 7, IHE Demonstrations Products with IHE DICOM, IETF, OASIS) Timely access to Document Use Case information Requirements Easy to integrate products 4

IHE Organizational Structure IHE International Board Global Development Regional Deployment IHE America Canada IHE Asia-Oceania China USA Japan Radiology IT Infrastructure Laboratory Cardiology Patient Care Coordination Pathology Radiation Oncology Patient Care Devices Eye Care Australia Korea Taiwan IHE Europe & Middle East Austria Italy France Israel Germany Spain Netherlands Turkey UK Swiss Sweden Public Health, Quality and Research Professional Societies / Sponsors ACCE ACEP ACP GMSI HIMSS RSNA SFR SFIL COCIR SIRM ESC EAR-ECR BIR DRG Euro. Rec JAHIS JIRA JRS METI-MLHW MEDIS-DC JAMI Contributing & Participating Vendors 5 5

IHE Sponsors Professional societies Ø Healthcare Information Management Systems Society (HIMSS) Ø Radiological Society of North America (RSNA) Ø British Institute of Radiology (BIR), British Computer Society (BCS Ø German Radiology Society (DRG) Ø GMSIH (IT France), SFIL (laboratory), French National Project (DMP) Ø European Society of Cardiology……Many other European Societies Ø American College of Physicians (ACP), American College of Emergency Physicians (ACEP) …Many other American healthcare societies (ACCE), (AAO), (ASTRO), etc. Ø JAHIS (IT Japan), JIRA, JRS…. Many other Japanese Societies Ø And many more…. Health Authorities Ø NICTIZ (Netherlands), ASIP (F), ELGA (Austria), Infoway (Canada), etc. 6

IHE Participants and Relationships Participants include: Ø Users - Clinicians, Staff, Administrators, CIOs, Governments Ø Vendors of Information Systems and Equipment Ø Consultants Relationship with Standards Development Organizations (SDOs): Ø HL 7, DICOM, ISO, CDISC, IEEE and many others Ø Adoption process approved via ISO/TC 215, IHE profiles to be published as ISO Technical Reports Ø Other Profiling Organizations such as Continua (Consumer Devices) National Adoption of IHE Profiles Ø DMP(France), ELGA(Austria), HITSP (USA), Infoway (Canada), many others worldwide…. . 7

IHE International Governance - Membership: www. ihe. net/governance Ø Members are Organizations–Sign Governance & IP once. Ø Three Organizational Categories: User, Developer, General Interest Ø Member designates a primary/alternate representatives to one of more Committees (Domains, Test& Tools, Mar. Com). Ø Elect Committee co-chairs. One User & one vendor recommended for Planning Committees Ø Regional and National IHE Committee members required to become members of IHE International. Ø Over 300 Member organizations. About half users/half Vendors 8

IHE International Governance – Others Committees IHE Regional or National Deployment Committees are independent entities with their own governance but close collaborative relationship with IHE International Board empowers “Regional and National Committee”. 3 year commitment, renewable. Oversees Testing and Tools Committee Ø Coordinates the various Regional and National Committees. Oversees Marketing & Communication Committee Ø Consistency of communication among Domains within IHE International and various Regional and National Committees. 9

How can I participate? All Participants: Become a member of relevant domain’s Planning or Technical Committees Become a member of relevant Regional/National Committees Help to shape IHE’s future direction Offer Clinical Use Case Input to Drive IHE Profile Development Respond to Public Comments of Domain Supplements Attend Educational Workshops/Webminars As a Vendor Participant Participate in Connect-a-thons and Demonstrations As a Provider/Consultant Participant Attend Demonstrations and include IHE Integration Profiles in your RFPs and Integration Projects. 10

What can you do? Learn about IHE, www. ihe. net Insist on relevant IHE profiles compliance in your RFPs and contract documents: Ø Select Integration Profiles, and Appropriate Actor(s) Ø Ask vendors for their products “IHE Integration Statements” Need more interoperability ? Ø Contribute to IHE Committees 11

Agenda Part 2: USERS AND VENDORS WORKING TOGETHER: how can I contribute & benefit from IHE HOW TO USE IHE RESOURCES: hands on experience 12

Agenda From IHE Profiles to conformance testing, closing the implementation gap Helping the implementers, testing tools, connectathons How to use other IHE resources: hands on experience Technical Frameworks: navigating, Q&A Test tools: finding, using, configuring Participating in the testing process 13

Connectathon 14

Connectathon Started in 1998 in the USA Europe started in 2001 Japan in 2003 China and Australia have now joined 15

Purpose Test implementation of the IHE integration and content profiles within product/open source Ø Verify that the vendors did a good job Verify that what the committees specified is clear ! Ø Verify that the Technical Frameworks are not ambiguous Ø Verify that the Technical Committee did not miss anything Build a community of computer geeks who loves local brewed beers and have fun working together to connect healthcare 16

From the vendor perspective Unique Opportunity for vendors to test their implementations of the IHE integration profiles Controlled environment Ø Customer is not present ! Ø Not in a clinical production environment Specialists available Ø From SDO Ø From the peer companies Bugs are identified and most of the time fixed !!!! Connectathon Results Ø http: //www. ihe. net/Connectathon/index. cfm 17

From the user perspective Unique Opportunity to engage potential vendors and user own implementation tested for conformance to IHE integration and content profiles Controlled environment Ø User community in IHE designate the Connectathon Monitors ! Ø Not in a clinical production environment Specialists available Ø From SDO Ø From the vendor companies Bugs are identified and most of the time fixed, before the product is installed !!!! Connectathon Results Ø http: //www. ihe. net/Connectathon/index. cfm 18

But… Testing in interoperability is (always) suboptimal Ø Only a part of all the possible tests are performed Ø A system successful at the connectathon is not guaranteed to be error free !!!! Ø But, …. it is the most thorough interoperability conformance widely available 19

From the IHE perspective Feedback from the vendor community Ø Did the profile development committee do a good job ? Ø Did the developed integration or content profile responds to the expectations of the vendors and meets the intended user need ? 20

Maturity of IHE Connectathons We have reached now our cruising speed NA and EU Connectathon are very alike. Japanese Connectathon is now mature. Connectathon also used as an IHE promoting tool Ø Workshop in parallel to the Connectathon Ø VIP visits Ø Visitors are truly impressed !! 21

The IHE testing process Users Testing Results Deployed Systems Testing Tools Sponsors: Project Management Team Develop Testing Tools Vendors/ Implementers Implement Profile Actors Users Demonstrations Approves Test Logs Connectathon In-House Testing Product + Integration Statement Demonstration IHE Technical Framework (Profiles Specification) 22

Unit Testing & Peer Testing Vendor B Vendor A Implementation A Peer Testing Implementation B Unit testing Specifications/Standards 22/05/08 Projet IHE-Dev Inria Rennes 23

Both Unit Testing & Peer Testing Need to have unit testing in the IHE Testing process Important to perform unit testing in advance of the peer testing Peer testing takes place during the testing event (connectathon). Need to perform unit testing as well during the connectathon. 24

Preconnectathon 25

Pre-connectathon Registration Ø Open to all, even non IHE members Ø Choice of what can be tested Actors for a Profile Exchange of configuration parameters Ø IP addresses Ø Assigning authorities, Addresses, AE Title Ø OID Ø Certificates Ø Affinity domain specification (e. g. XDS Meta-data) 26

Pre-connectathon Unit testing using Gazelle test tools In-house testing for vendors to get ready Vendors return Gazelle tool logs Upon log return, and positive analysis, participation to Connectathon event is accepted by IHE Technical Project Mgr 27

At connectathon 28

Connectathon Testing 3 types of test to be performed Ø “No-peer” tests Ø “Peer to peer” tests Ø “Workflow” tests (multi peers) 29

5 days Configured up and running by Monday morning 11 am Ø Set up time Till Friday noon : Ø Free “peer to peer” and “no peer” testing From Wednesday till Friday noon : Ø Directed “workflow” testing Enough time to test 4 -6 solid profiles and 1 -2 new profiles per participating system 30

Monitors Report to IHE Technical Project Mgr Volunteers, trained and screened Independent from vendors. Selected by IHE Countries users. Standard knowledegeable Verify tests Act as moderator between vendors 31

Results To be successful Ø Pre-connectathon test validated Ø Each peer to peer test needs to be verified with at least 3 peers Ø A vendor may fail for an actor in a profile but pass for the others IHE does not report failure. Vendors have access to their own detailed test results (track issues). Vendors shall publish their products integration statements Market/Contractual sanction 32

Connect-a-thon Results Browser 33

Connectathon Results Browser 34

Connectathon Results Browser 35 35

What does it mean ? The Company was successful at the connectathon for an actor/integration profile combination Results express a company maturity and willingness to collaborate. Does not guaranty product conformity, but enables market/contractual commitments by vendors to their customers Product conformity commitment: This is the role of the « IHE integration statements » 36

IHE Integration Statement Product vendors take the next step 37

Technical Frameworks One per Domain They are the reference, the tools are not ! Written and reviewed by Vendors and Users Freely available on http: //www. ihe. net 38

Organization of the TF Volume 1 Ø Description of the Integration/content profiles and actors Ø Dependencies between actors and profiles Ø Use cases Volume 2 and followings Ø Description of the transactions with reference to used standards 39

TF Life Cycle Every year : Ø New integration profiles Ø Change Proposal Integration Profile proposed as Supplements Ø Public Comment Ø Trial Implementation Ø Final Text Once in Final Text integration into the main document. No concept of profile version (Corrections are applied). Non backward changes result in a new profile. 40

IHE Wiki http: //wiki. ihe. net Ø A lot of information. Used for supporting on-going work by Committees • • Committee planning / minutes /in development documents General membership/Chairs http: //ihewiki. wustl. edu/ Ø Wiki for connectathon organization and management Ø Code exchange Ø XDS implementation page Ø … 41

Gazelle Objectives 42

Objectives Improve the overall quality of testing Ø Conformance and Interoperability Broaden the use of the application. Open Source Licence (Apache). Build a framework for Healthcare interoperability testing Synchronous testing of multiple systems Multilingual Scalable 43

5 Context of Use Connectathon Virtual Connectathon Company Internal Testing tool Healthcare Enterprise Testing tool Governmental/Certification organizations 44

Gazelle Architecture 45

Gazelle Architecture Gazelle Control System External Validation Services Validation Services Gazelle Test Engine Database Configuration Info Control Feedback Gazelle Actor (Simulators) Gazelle Actor (Simulators) System Under Test Tests Scenario Proxy Network 22/05/08 Projet IHE-Dev Inria Rennes 46

System under test More than one system can be tested at the same time Management of System Under Test Ø Web application to provide instructions 47

Participants 3 IHE Regions Ø North America : MIR Ø Europe : INRIA Ø Japan : Shizuoka University DVTK NIST Tiani-Spirit David Clunie Offis Open to more participants 48

Project Management Testing and Tool Committee Ø Overview of IHE testing activities Ø Choice of the license Ø Approve Connectathon Organizers Testing Management Group Ø Project Management Ø Eric and Steve 49

More Resources - www. ihe. net Frequently Asked Questions Integration Profiles in Technical Frameworks: Ø Cardiology Ø IT Infrastructure Ø Laboratory Ø Patient Care Coordination Ø Patient Care Devices Ø Radiation Oncology Ø Radiology Connectathon Results Vendor Products Integration Statements Participation in Committees and Connectathons 50

Oct, 2010 51 IHE Orientation-Tur. MIA