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Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth Initiatives Elliot B. Sloane, PhD, CCE, FHIMSS President, Center for Healthcare Information Research and Policy (CHIRP) & Co-Chair, IHE International Joint ITU-WHO Workshop on e-Health Standards and Interoperability (Geneva, Switzerland, 26-27 April 2012)

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Page 1: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Geneva, Switzerland, 26-27 April 2012

Brief Presentation (More information at end, after slide 10)

Integrating the Healthcare Enterprise (IHE) - eHealth Initiatives

Elliot B. Sloane, PhD, CCE, FHIMSSPresident, Center for Healthcare Information Research and Policy

(CHIRP) & Co-Chair, IHE International

Joint ITU-WHO Workshop on e-Health Standards and Interoperability

(Geneva, Switzerland, 26-27 April 2012)

Page 2: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

IHE International - www.IHE.net

Created in 1997 to assure electronic health data interoperability

Triggered by inability of products to reliably exchange DICOM images

Worldwide initiative in > 24 countriesNon-profit, volunteer driven, user-centric

No cost for membership or documentsJoin or download at www.IHE.net

Geneva, Switzerland, 26-27 April 2012 2

Page 3: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Main results to date

Many hundreds of software and hardware products tested around the world using the “IHE Profiles”

See http://connectathon-results.ihe.net/2012 product testing in North America, Asia-Oceania and Europe

Embedded in national/state standards in CanadaGradually emerging in US and China

Some products are “IHE Natives”Successful collaboration with Continua™

Geneva, Switzerland, 26-27 April 2012 3

Page 4: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

4

KoreaKorea

International Growth of IHE

FranceFrance

Local Deployment, National Extensions Promotional & Live Demonstration Events Over 400 Organizational Members (all

stakeholders)

USAUSA

GermanyGermany

ItalyItaly

JapanJapanUKUK

CanadaCanadaTaiwanTaiwan

NetherlandsNetherlandsSpainSpain

AustriaAustria

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

09

Pragmatic global standards harmonization + best practices sharing Pragmatic global standards harmonization + best practices sharing

20

08

AustraliaAustralia

20

10

ChinaChina

TurkeyTurkey

MalaysiaMalaysia

SwitzerlandSwitzerland

Early programs in Brazil, Dubai, Israel, and Saudi Arabia, too

Page 5: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

12 Years of Steady Evolution 1997 – 2010

The IHE Development Domains

PharmacySince 2009

Pathologysince 2006

Radiation Oncologysince 2004

Radiologysince 1998

Cardiologysince 2004

Patient Care Devicessince 2005

Patient Care Coordinationsince 2004

Eye Caresince 2006

QualityResearch & Public Health

since 2006

Laboratorysince 2004

(Healthcare)IT Infrastructure

since 2003

since 2008

IHE has eHealth initiatives in many/most key clinical areas

Page 6: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Future activities

Expanding to more products & nationsExploring “smart phone” tools, appsSee also:

www.CEITCollaboration.orgwww.ACCEnet.orgwww.IHE.net and www.IHE.net/PCDLarge number of device, state, and national examples at http://www.iheusa.org/IHEUSA-Resources-Education-Conference-Archives2012.aspx

See additional slides at end of this set!

Geneva, Switzerland, 26-27 April 2012 6

Page 7: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Challenges, lessons learned

Every new entrant wants to start with a fresh sheet of paper!

Waste of great talent and precious time

Never, ever really “done”Tomorrow’s innovations will require new adaptations

Mobile technologies are coming quickHow to share disciplines like security, standards with that enthusiastic crowd?

Geneva, Switzerland, 26-27 April 2012 7

Page 8: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Conclusions and Recommendations

Make standards, tools and toolsets visible to mHealth developersSponsor Mobile Technology “Connectathons” that demonstrate IHE, IEEE, HL7, Rosetta use

Grand prizes?Chronic disease smart phone apps that use IHE!

Education needed on value of “at rest” and “in-motion” data encryption

Free tools available!Personal health data MUST be protected!

Geneva, Switzerland, 26-27 April 2012 8

Page 9: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Questions and enthusiastic ideas are WELCOME!

Please feel free to contact me directly at [email protected] or [email protected]

Elliot B. Sloane, PhD, CCE, FHIMSSSwww.ebsloane.org

Remember: it is all free:www.IHE.net

www.IHE.net/PCD

Page 10: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

<pause>

This slide is intentionally empty

Geneva, Switzerland, 26-27 April 2012 10

Page 11: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Geneva, Switzerland, 26-27 April 2012

Elliot B. Sloane, PhD, CCE, FHIMSSPresident, Center for Healthcare Information Research and Policy

(CHIRP) & Co-Chair, IHE International

Joint ITU-WHO Workshop on e-Health Standards and Interoperability

(Geneva, Switzerland, 26-27 April 2012)

FULL PRESENTATION & DETAILSIntegrating the Healthcare Enterprise

(IHE) - eHealth Initiatives

Page 12: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Some of the current FAQs:

Elliot B. Sloane, PhD, CCE, FHIMSSPresident, Center for Healthcare Information Research and Policy

HIMSS roles:

Board of Directors, Delaware Valley HIMSS HIMSS Annual Conference Education Committee Past Chair, HIMSS Security and Privacy Steering Committee IHE roles:

Co-Chair, IHE International Board of DirectorsCo-Founder IHE Patient Care Device Domain

Board of Directors, IHE-USA

Other professional roles:

Sponsor, IEEE 11073 Medical Informatics Standards Past President, American College of Clinical Engineering Past Board of Directors, IEEE EMBS Past Board of Directors, ANSI/HITSP project

www.ebsloane.org &www.ebsloane.org/HealthSystemsEngineering/

Page 13: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

13

KoreaKorea

International Growth of IHE

FranceFrance

Local Deployment, National Extensions Promotional & Live Demonstration Events Over 400 Organizational Members (all

stakeholders)

USAUSA

GermanyGermany

ItalyItaly

JapanJapanUKUK

CanadaCanadaTaiwanTaiwan

NetherlandsNetherlandsSpainSpain

AustriaAustria

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

09

Pragmatic global standards harmonization + best practices sharing Pragmatic global standards harmonization + best practices sharing

20

08

AustraliaAustralia

20

10

ChinaChina

TurkeyTurkey

MalaysiaMalaysia

SwitzerlandSwitzerland

Early programs and projects in Brazil, Dubai, Israel, Mexico, and Saudi Arabia, too

Page 14: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

12 Years of Steady Evolution 1997 – 2010

The IHE Development Domains

PharmacySince 2009

Pathologysince 2006

Radiation Oncologysince 2004

Radiologysince 1998

Cardiologysince 2004

Patient Care Devicessince 2005

Patient Care Coordinationsince 2004

Eye Caresince 2006

QualityResearch & Public Health

since 2006

Laboratorysince 2004

(Healthcare)IT Infrastructure

since 2003

since 2008

IHE has eHealth initiatives in many/most key clinical areas

Page 15: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

“eHealth”Broad umbrella

Health data needs to be in electronic form so it can be liberated/visible/usable by MANY stakeholders

PatientsCaregivers/family/supporting persons/agenciesPhysicians, nurses, hospitals, clinics, public health

Must be affordable, portable, & durableGIGO: Garbage In = Garbage Out

Health data must be correct, complete, timely, coordinated, AND, of course, secure

Geneva, Switzerland, 26-27 April 2012 15

Page 16: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Technology convergence

Mobile technologies like cell phones, smart phones, tablets, etc offer low cost mobile access to data (text, numbers, and images)

On the one hand “it’s all the same,” in that all computers manage the same binary coded dataMobile devices can do

Geneva, Switzerland, 26-27 April 2012 16

Page 17: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

There is a new breed of crossover products

“smart phone” devices … (many/most w/FDA 510k

clearance) that show what is possible!

Here is a quick tour…

Page 18: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

From: http://www.imedicalapps.com

Page 19: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth
Page 20: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

FREE!

Page 21: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Well, those are “secondary use” devices for

radiologists or other physicians.

How about “real” devices used for diagnosis or

treatment?

Page 22: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth
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Page 27: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Coming soon???

An entire large and growing conference has emerged, called the mHealth Summit, and a community has formed at mHIMSS.org

WHO led sessions there last December

More and more relevant products and services seem to emerge each week.

Some examples follow…

Page 28: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth
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Page 30: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Only the Continua™ WAN devices offer IHE interoperabiity!

Wide spectrum, from “Personal Health Devices” to regulated

Medical Devices

Page 31: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

IHE can handle all of these types of devices: clinical measurements of all sorts!

Geneva, Switzerland, 26-27 April 2012 31

In a real sense, IHE does not care if the device is a smartphone or not! i.e., systolic blood pressure is still the same!

Page 32: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

IHE is vendor and “modality” neutral. e.g., Rosetta Project maps ALL vendor clinical

coding to each other via IEEE 11073

Extensible: IHE’s Rosetta Project harmonizes vendors to ISO/IEEE 11073 to SNOMED to ???

Page 33: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

25% of HIMSS ’11 Interoperability Showcase vendors featured medical devices!

IHE’s Steady Growth!Partners from software, hardware, pharmaceuticals,

telecom, and more

Page 34: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

IHE PCD facilitates -- and is inspiring -- innovation and

competition!

One vendor from China has designed, built, and is selling “IHE-PCD-native” anesthesia and monitoring products to US and global markets already!

Page 35: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

35

Results are public and profile specificResults are public and profile specific

www.ihe.net/Connectathonwww.ihe.net/Connectathon

Page 36: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

(c) 2011, Elliot B. Sloane, All

rights reserved.

The IHE-PCD, Continua-WAN, and IHE EMR interfaces were shown in the

HIMSS Interoperability Showcase for the past couple of years.

Page 37: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Implementation Tools

Open source implementations are available for XDS, XCA, XCPD, PIX, PDQ, ATNA, CT, and more:

Microsoft under codeplex http://ihe.codeplex.com/

NIST under Source Forge http://sourceforge.net/projects/iheos/ HIE-OS under Source Forge http://sourceforge.net/projects/hieos/

FHA CONNECT http://www.connectopensource.org

OHT – IHE Profiles Charter https://iheprofiles.projects.openhealthtools.org

OHT – Open Exchange Forge https://openexchange.projects.openhealthtools.org

OHT – Model Driven Health Tools-Charter https://mdht.projects.openhealthtools.org

37

Page 38: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Barriers to successful eHealth innovation?

13-20,000 new medical apps expected in the coming year

Apple, Droid, Window phones& tablets

NO apparent standardization, even though it would be so, so easy

Frankly, no awareness of a larger picture to share health data with each other and/or various providersFollow/leverage the Continua™ example?

Geneva, Switzerland, 26-27 April 2012 38

Page 39: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Conclusions and Recommendations

Make standards, tools and toolsets visible to mHealth developersSponsor Mobile Technology “Connectathons” that demonstrate IHE, IEEE, HL7, Rosetta use

Grand prizes?Chronic disease smart phone apps that use IHE!

Education needed on value of “at rest” and “in-motion” data encryption

Free tools available!Personal health data MUST be protected!

Geneva, Switzerland, 26-27 April 2012 39

Page 40: Geneva, Switzerland, 26-27 April 2012 Brief Presentation (More information at end, after slide 10) Integrating the Healthcare Enterprise (IHE) - eHealth

Questions and enthusiastic ideas are WELCOME!

Please feel free to contact me directly at [email protected] or [email protected]

Elliot B. Sloane, PhD, CCE, FHIMSSSwww.ebsloane.org

Remember: it is all free:www.IHE.net

www.IHE.net/PCD