Integrating the Healthcare Enterprise and the Patient Care Device Domain Emanuel Furst, PhD, CCE Technical Project Coordinator for the PCD [email protected].

Integrating the Healthcare Enterprise and the Patient Care Device Domain

Emanuel Furst, PhD, CCETechnical Project Coordinator for the PCD

[email protected] for the University HealthSystem Consortium

April 6, 2007

© 2007 ACCE, HIMSS, IHE

Outline

Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise• What is the IHE?• What is the PCD?• Why do I care?• What can I do?

More slides than time permits for discussionMore slides than time permits for discussion• Some are provided for reference and will not be

discussed• Some of the material is provided to encourage

CE/IT discussion

What is the IHE?

Integrating the Healthcare EnterpriseIntegrating the Healthcare EnterpriseWhat is the IHE?

Interoperability

The Goal - Interoperability:The Goal - Interoperability:• the ability of two or more systems or

components to exchange and use the information exchanged– Accurately, securely, verifiably– When and where needed

Adapted from HL7, www.hl7.org

IHE: A Framework for Interoperability

Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise

• A common framework for harmonizing and A common framework for harmonizing and implementing multiple standardsimplementing multiple standards

• Enables seamless health information movement Enables seamless health information movement within and between enterprises, regions, nationswithin and between enterprises, regions, nations

• Promotes unbiased selection and coordinated use Promotes unbiased selection and coordinated use of established healthcare of established healthcare andand IT standards to IT standards to address specific clinical needsaddress specific clinical needs

IHE: Connecting Standards to Care

• Healthcare professionals working with industryHealthcare professionals working with industry• Coordinate implementation of standards to meet Coordinate implementation of standards to meet

clinical and administrative needsclinical and administrative needs– Clinicians and HIT professionals identify the key Clinicians and HIT professionals identify the key

interoperability problems they faceinteroperability problems they face– Providers and industry work together to develop and Providers and industry work together to develop and

make available standards-based solutionsmake available standards-based solutions– Implementers are able to follow common guidelines in Implementers are able to follow common guidelines in

purchasing and integrating effective systemspurchasing and integrating effective systems

• IHE is IHE is notnot an SDO, but does provide feedback an SDO, but does provide feedback

IHE: A forum for agreeing on how to implement IHE: A forum for agreeing on how to implement standards and processes for making it happenstandards and processes for making it happen

Why Do I Care About the IHE?

Integrating the Healthcare EnterpriseIntegrating the Healthcare EnterpriseValue PropositionsValue Propositions

• The IHE supports– Patient safety and reduced medical errors– Effective patient care with information when, where needed– Efficient organizations, less tedious and redundant work– Reduced cost, complexity of interface deployment,

management– Best of breed for the organization– National mandate for electronic medical records

• The IHE is changing– Medical records systems – direct data transfers– Patient data systems – various enterprise configurations– Workflow – contributes to revisions– Staffing patterns

IHE Patient Care Devices (PCD)

Value Proposition for Value Proposition for Government and Regulatory StakeholdersGovernment and Regulatory Stakeholders

• Value lies in easing regulators’ tasks by industry adoption and implementation of uniform specifications.• For example one Business Case statement for government

and regulatory stakeholders is: “IHE PCD can simplify the approval process for medical devices and related clinical information systems.”

• IHE-PCD accelerates the fulfillment of key clinical requirements for Efficacy, Efficiency, and Safety in the emerging Electronic Health Record programs that have been mandated by President Bush and Health and Human Services leadership.


Manufacturers also benefit

• Lower development cost

• Shorter time to market

• Better defined requirements

• More competitive position

Value Proposition for companiesValue Proposition for companies

IHE Participants and Relationships

ParticipantsParticipants

• Participants include:Participants include:– Users - Clinicians, Staff, Administrators, CIOs, Governments (e.g. Users - Clinicians, Staff, Administrators, CIOs, Governments (e.g.

NIST, VA).NIST, VA).– Vendors - Information Systems and EquipmentVendors - Information Systems and Equipment

• e.g., imaging, cardiology, devicese.g., imaging, cardiology, devices– ConsultantsConsultants

• Relationship with Standards Development Organizations (SDOs):Relationship with Standards Development Organizations (SDOs):– HL7, DICOM, ISO, CDISC, ASTM, W3C, IEEE, IETF, and many HL7, DICOM, ISO, CDISC, ASTM, W3C, IEEE, IETF, and many

othersothers• Approved via ISO/TC 215 allowing for IHE profiles to be published as Approved via ISO/TC 215 allowing for IHE profiles to be published as

ISO deliverablesISO deliverables

Profiles Simplify Implementation

ProfilesProfiles

A profile describes the application of a standard(s) to provide specific requirements to accomplish the communication requirements.– Provides an opportunity for users & vendors to define

requirements• Requirements for development • With Conformance Statements, for purchase

• Single Standard – Constrain optionality, choose terminology, define dynamic interactions– HL7 Conformance

• Multiple Standards – Coordinate workflow, define mappings between standards- HL7/DICOM – IHE Radiology- HL7/IEEE 11073 – Patient Care Devices

Profiles Simplify Implementation

Standards: Necessary…Not Sufficient

• Standards areStandards are– Foundational - to interoperability and communicationsFoundational - to interoperability and communications– Broad - varying interpretations and implementationsBroad - varying interpretations and implementations– Narrow - may not consider relationships between Narrow - may not consider relationships between

standards domainsstandards domains– Plentiful - often redundant or disjointedPlentiful - often redundant or disjointed– Focused - standards implementation guides typically Focused - standards implementation guides typically

focus on a single standardfocus on a single standard

IHE provides a defined process for IHE provides a defined process for implementing standardsimplementing standards

What is the IHE?

The IHEThe IHE• An umbrella organization

– Sponsored by three professional societies: RSNA, ACC, HIMSS

• Non-profit, operating in public view• Voluntary

– Largely manufacturers, users, regulators

• International

Integrating the Healthcare Enterprise

““Achieving Interoperability through Implementation of Standards”Achieving Interoperability through Implementation of Standards”

1997: Founded in Radiology (RSNA) and IT (HIMSS)1997: Founded in Radiology (RSNA) and IT (HIMSS)• Many professional societies (stakeholder representation)Many professional societies (stakeholder representation)

– American Academy of Ophthalmology (AAO)American Academy of Ophthalmology (AAO)– American College of Cardiology (ACC)American College of Cardiology (ACC)– American College of Physicians (ACP)American College of Physicians (ACP)– American College of Clinical Engineering (ACCE) American College of Clinical Engineering (ACCE) – American College of Emergency Physicians (ACEP) American College of Emergency Physicians (ACEP) – American Society for Therapeutic Radiation Oncology (ASTRO)American Society for Therapeutic Radiation Oncology (ASTRO)– GMSIH (IT France), JAHIS (IT Japan), SFIL (laboratory)GMSIH (IT France), JAHIS (IT Japan), SFIL (laboratory)– Healthcare Information Management Systems Society (HIMSS)Healthcare Information Management Systems Society (HIMSS)– Radiological Society of North America (RSNA)Radiological Society of North America (RSNA)– And many more….And many more….

IHE Organizational Structure

ACCACPHIMSSRSNA

JAHISJIRAJRS

METI-MLHWMEDIS-DCJAMI

GMSIHSFRSFILACCE

SIRMBIREuroRec

COCIREAR-ECRDRG

ESC

Professional Societies / Sponsors Contributing &Participating

Vendors

IHE (International) Strategic Development Committee

Global Development

Radiology

Cardiology

ITInfrastructure

Patient CareCoordination

Patient CareDevices

Laboratory

Pathology

Pharmacy /Medication Admin

RadiationOncology

IHE Europe

IHE North America

France

USA

Canada

IHE Asia-Oceania

Japan

Korea Taiwan

Netherlands

Spain Sweden UK

ItalyGermany

Norway

Regional Deployment

China

International Adoption of IHE

FranceUSA

Germany

Italy

JapanUK

Canada

Korea

Taiwan

Norway

Holland

SpainChina

Yea

r 1

(199

9)

Yea

r 2

(200

0)

Yea

r 3

(200

1)

Yea

r 4

(200

2)

Yea

r 5

(200

3)

Yea

r 6

(200

4)

Yea

r 7

(200

5)

Yea

r 8

(200

6)

What is the process?

ProcessProcess• Define needs• Set priorities• Develop “profiles” with use cases• Recruit volunteers for each profile to be

developed• Develop the technical solutions• Demonstrate successful implementation

– Connectathons– Showcases

• Publish for public access, comment at various stages

Proven Standards Adoption Process

Document Use Case RequirementsDocument Use Case Requirements

Identify available Identify available standards (standards (e.g. HL7, e.g. HL7, DICOM, IETF, OASIS)DICOM, IETF, OASIS)


Develop technical specifications


Testing at ConnectathonsTesting at Connectathons

IHEDemonstrationsIHEDemonstrations

Products with IHEProducts with IHE

Timely access to informationTimely access to information

Easy to integrate productsEasy to integrate products

Growth in IHE Domains

Radiology (18)

IT Infrastructure for Healthcare (17)

Cardiology (7)

Laboratory (6)

Radiation Oncology (1)

Patient Care Coordination (5)

Patient Care Devices (1)

Quality

Eye Care (3)

VeterinaryEndoscopyPathologyPharmacy

Ye

ar

1

(19

99

)

Ye

ar

2

(20

00

)

Ye

ar

3

(20

01

)

Ye

ar

4

(20

02

)

Ye

ar

5

(20

03

)

Ye

ar

6

(20

04

)

Ye

ar

7

(20

05

)

Ye

ar

8

(20

06

)

Ye

ar

9

(20

07

)

• Over 100 vendors involved world-wideOver 100 vendors involved world-wide• 8 Technical Frameworks8 Technical Frameworks• 48 Integration Profiles48 Integration Profiles

•Testing at “Connectathons” world-wideTesting at “Connectathons” world-wide• Demonstrations at major conferences world-wideDemonstrations at major conferences world-wide

What is the PCD?


• What is IHE?

• What is the PCD?


““Providers and vendors working Providers and vendors working together to deliver interoperable together to deliver interoperable health information systems within and health information systems within and between enterprises and settings”between enterprises and settings”

The PCD, helping to fulfill the general IHE Vision:


Why Patient Care Devices?Why Patient Care Devices?

• There are over 1500 Patient Care Device manufacturers and There are over 1500 Patient Care Device manufacturers and over 3500 Make-Model combinationsover 3500 Make-Model combinations

• The typical 200 bed hospital contains 1,000’s of Patient Care The typical 200 bed hospital contains 1,000’s of Patient Care Devices Devices

• ……that are constantly changing with updated/upgraded that are constantly changing with updated/upgraded technology … and interoperability too?!technology … and interoperability too?!

• For every connected IT Device in the hospital, there are 4 For every connected IT Device in the hospital, there are 4 Patient Care Devices that are Patient Care Devices that are notnot connected connected


Patient Care Devices are unique …Patient Care Devices are unique …• Many devices are used in multiple clinical contexts, with

acquired data having different implications depending upon the clinical setting.

• Many devices provide signals or critical alarms that have direct significance to patient safety and well being in real-time, and should be accorded appropriate priority in the system.

• Many devices are portable, meaning that connectivity must include wireless portions, direct network connections, and Internet links, all with “hacker and virus” risks, too.

• Many devices provide data that should be automatically and accurately incorporated directly into the information stream that feeds the emerging Electronic Health Record (EHR).

The Patient Care Device Domain

The PCDThe PCD

• Established in 2005 when the “charter” was awarded to the ACCE

• Jointly sponsored by ACCE and HIMSS as of July 1, 2006

• Technical Framework 2006-7 developed to communicate patient data (asynchronous)

• Successful demonstration at the 2007 Connectathon and HIMSS 2007 Interoperability Showcase


HIMSS Survey IHE pre-2005 Annual Conference results:HIMSS Survey IHE pre-2005 Annual Conference results:

• Further, Further, 56%56% said they’d pay more for IHE-compliant said they’d pay more for IHE-compliant products!products!

• Survey of all IHE Users

• Over 50% of those surveyed said patient care devices should be the next area developed for IHE *


Key Benefits of PCD InteroperabilityKey Benefits of PCD Interoperability

• Heterogeneity – Multiple manufacturers + multiple device modalities coexisting over a shared infrastructure

• Semantic Interoperability ( comparability) – shared terminology and data models permit users to interpret data based on the clinical context, compare information from different healthcare facilities, and interrogate systems across enterprises and regions.

• Real-Time Availability – ability to provide data in a time frame appropriate to the physiologic function being measured, displayed or affected (controlled).


IHE-PCD CharterIHE-PCD Charter

The Patient Care Devices Domain is The Patient Care Devices Domain is concerned with Use Cases in which at concerned with Use Cases in which at least one actor is a regulated patient care least one actor is a regulated patient care device. The PCD coordinates with other device. The PCD coordinates with other IHE clinical specialty based domains IHE clinical specialty based domains such as medical imaging.such as medical imaging.


IHE-PCD MissionIHE-PCD Mission

The IHE Patient Care Devices Domain will apply the proven, Use Case driven IHE processes to:

• Deliver the technical framework for the IHE-PCD domain profiles;

• Validate IHE-PCD profile implementations via Connectathons; and

• Demonstrate marketable solutions at public trade shows.


IHE-PCD Domain Vision StatementIHE-PCD Domain Vision StatementThe IHE Patient Care Devices Domain (IHE PCD) is the

nexus for vendors and providers to jointly define and demonstrate unambiguous interoperability specifications, called profiles, which are based on industry standards, and which can be brought to market.

IHE-PCD profiles:• improve patient safety and clinical efficacy,• reduce healthcare delivery cost by improving efficiency,

reliability, and operational flexibility for healthcare providers,

• enable innovative patient care capabilities, and• expand the international marketplace for patient care

device vendors.

Proven Standards Adoption Process

Document Use Case RequirementsDocument Use Case Requirements





Testing at ConnectathonsTesting at Connectathons

IHEDemonstrationsIHEDemonstrations

Products with IHEProducts with IHE

Timely access to informationTimely access to information

Easy to integrate productsEasy to integrate products

IHE PCD Connectathon 2007 Systems

LiveDataLiveDataOR MgrOR Mgr

GEGECentricity Centricity Periop CISPeriop CIS

PhilipsPhilipsCareVueCareVue

CISCIS

DOR

DOC

ADTA04 Feed MWB

DraegerDraegerInnovianInnovian

CISCIS

GEGEAwareAware

GWGW

PhilipsPhilipsIICIICGWGW

B. BraunB. BraunDoseTracDoseTrac

GWGW

Welch AllynWelch AllynConnexConnex

CISCIS

Validated VS, Vent, Anesth & Med Export, max

every 3 minutes

Validated Vitals export, Batch

Unvalidated VS, Vent, Anesth. Data export

every 1 minute

Unvalidated VS, Vent, Anesth. Data export

every 1 minute

VS MonPt Mon, Vent,Anesthesia

Pt Mon, Vent,Anesthesia


InfusionDevices

CT (Time)Feed

PhilipsPhilipsCareVueCareVue

CISCIS


Validated VS, Vent, Anesth & Med Export, max every 5 minutes

Unvalidated Med (Infusion System)

exported every 1 minute

PCD HIMSS Showcase Scenario

Welch AllynWelch AllynConnexConnexTMTM

DataDataManagementManagement

SystemSystem

Vital Signs Monitor

GEGE

AwareAwareGatewayGateway

Patient Monitor, Ventilator

PhilipsPhilips

IntellivueIntellivueInformationInformation

CenterCenter

Patient Monitor, Ventilator

Emergency Care Intensive Care

LiveDataLiveData

OR-DashBoardOR-DashBoard

GE GE

CentricityCentricity®®

PeriopPeriopAnesthesiaAnesthesia

DraegerDraeger

InnovianInnovian®®

Solution SuiteSolution Suite

Patient Monitor, Anesthesia Sys

B. BraunB. BraunDoseTracDoseTracTMTM

InfusionInfusionManagementManagement

SoftwareSoftware

InfusionDevices

Perioperative Care

PhilipsPhilips

Intellivue ClinicalIntellivue ClinicalInformationInformation

PortfolioPortfolio

IHE PCD in the HIMSS 2007 Interoperability Showcase

Process for Year 2

Year 2Year 2

• 2006 Survey (to be discussed)

• Call for Short Proposals• “Vetting” by Planning and Technical

Committees• Setting of Priorities• Development of the Technical Framework• Design and testing of new profiles• Demonstration at HIMSS 2008

IHE-PCD Survey Summer-Fall 2006

The SurveyThe Survey

• Survey Managed by HIMSS Analytics• Open Solicitation to HIMSS, ACCE,

AdvaMed, Anesthesia Patient Safety Foundation, ECRI

• 171 Responses, (103 Users, 68 Vendors)

Respondent Demographics 171 Individual Responses

0 10 20 30 40 50 60 70 80

Vendor

Hospital based Clinical Engineer

Other

Other Hospital Based I.T. Professional

User of Medical Devices / Caregiver

Hospital Department Head

Hospital CIO

Regulator - Government or Other

Purchaser / Materials Mgr.

= Hospital Based

Vendor Position on IHE and Interoperability

68 Vendor Responses (Checking all that apply)

0 10 20 30 40 50

We do not currently provide connectivityoptions outside of our own

products/systems

We have proprietary connectivitysolutions

We would use IHE based solutions if theywere available

We are designing IHE compliance intoour products as they emerge

Vendor Demographics: Vendor Products68 Vendor Responses

0 5 10 15 20 25 30

Monitors - Vital Signs

Other

Home Care

Anesthesia

Infusion Devices

POC Lab Devices

Ventillators

Dialysis

0 1 2 3 4 5 6

ECG

Imaging - PACS

Defibrillators

Laboratory

Ultrasound

Bone Density Scanner

Pharmacy

Women's Health

Demographics: User Organization Types

77 Hospital Based Respondents*

*26 of the 103 Non-Vendor Respondents do not work in hospitals

0 5 10 15 20 25 30 35 40

University / Tertiary Care

300+ Bed Non Profit

Smaller Non Profit

Municipal or State Instiution

100-299 Bed Non Profit

For Profit Chain

Other

Relationship of Clinical Engineering and IT at Respondents’ Hospitals

77 Hospital Based Respondents*

*26 of the 103 Non-Vendor Respondents do not work in hospitals

0 10 20 30 40 50

Do not know

CE is Outsourced

Do not cross paths

CE and IT are separate - work closely

CE is Part of IT

Importance of Interoperability to

Hospital Based Respondents

0 10 20 30 40

Not a Priority

Prefer interoperable devicesbut not required

Moving to compliance - willingto pay a premium for

interoperability

IHE compliance is a requirementfor purchase if it is available

Survey Question: With respect to Medical Devices, how important is it for the following devices to

become integrated under the IHE?

= Users= Vendors

0 10 20 30 40 50 60 70 80

Dialysis (acute / chronic)

Intra-Aortic Balloon Pumps

Infusion Pumps

Anesthesia Systems

Ventilators

Physiological Waveform Monitors

Vital Signs Reporting Devices

Percent of respondents that consider it important

Survey Question: Rate the importance to each department below in terms of the benefit from

implementing IHE

= Users= Vendors

0 20 40 60 80 100

Home Health

Oncology

OB/GYN

Infusion Therapy

General Med/Surg

Anesthesia

Pharmacy

ED

Surgery

ICU


Survey Question: Which clinical applications should IHE target?

= Users= Vendors

0 10 20 30 40 50 60 70 80

Wellness Monitoring (Such as non-clinical fitness activities)

Home Health monitoring (Such as remote monitoring of key indicators, smarthealthcare appliances, etc.)

Remote Consultation

Image Guided Surgery

Asset Utilization Management (Such as asset tracking, self-diagnosis / reportingsystems)

Remote viewing of waveforms

Integration of live waveform information into Clinical Systems

Clinical Decision Support

Alarm Notification Management

Remote Viewing of patient information on PDA or Tablet devices

Drug Administration

Medication Management

Real-time medical error detection / mitigation

Communicating physiologic measures to the EHR


Survey Question: Which technological areas are the most important for Patient Care Device integration?

= Users= Vendors

0 10 20 30 40 50 60 70 80 90

Quality of Service Management

RF Wireless

Security

Cross-enterprise information sharing

Common Terminology / Data Structures / Protocols


Examples of emerging IHE-PCD Work flows

Enterprise sharing of Patient Care Data* Patient & Device ID Binding* Point of Care Plug and Play* (multiyear effort) Home Telehealth* (multiyear effort) Real-time data archiving and communication PCD Alarm Management Drug Administration Hospital Bed–Blood Pressure Coordination Mobile, enterprise-wide, reliable vital signs monitoring … many more!Initial device classes – vital sign monitors, bedside monitors,

infusion pumps and ventilators

* Key Objectives for 2006/2007

Why do I care?


• What is IHE?


• Why do I care?

Why Do I Care About the IHE PCD?

SignificanceSignificance

• Clinical implications– Patient safety– Enterprise wide access to the patient’s data– Quality of care– Ability to implement “best of breed” for your

applications– Workflow improvements

Why Do I Care About the IHE PCD?


• My job– CE and IT must collaborate on selection,

specification, support of these systems– New knowledge and skills are required

• Financial implications– Rapid changes in technology increase risk– Interoperability reduces risk– Interoperability improves efficiency

Examples of Purchaser and User “Value Propositions” (i.e, ROI and other motivations)

• Automatic population of all information systems – reducing medical errors - integrity of data

• Automated systems - saves time for clinicians• Defined and easily accessible - audit trails• Eases integration of multiple modalities into a single system;

provides one consistent view of patient data• Facilitates intelligent systems to support clinical reasoning• International standardization of systems so that international

outcomes research can be accomplished• Common and safe user authentication• Access to patient data across devices and systems so

custom communication interfaces can be eliminated. Allows best of breed selection for your application

• Efficiency of care, testing and training - Reduces redundancy

User/Provider/Purchaser Benefit Examples


• Improves agility of enterprises to meet varied patient loads

• Improved life-cycle cost of ownership

– Facilitates heterogeneous brand and model deployment

– May allow use of technologies over longer periods of

time, reducing the “obsolescence effect”

• Vendor-provided IHE-PCD conformance statements will

ease selection decisions and reduce risks

• Automates clinical data capture for EHR

What can I do?

• Integrating the Healthcare EnterpriseIntegrating the Healthcare Enterprise

• What is IHE?


• Why do I care?

• What can I do?

What Can I Do?

To Plan, Evaluate, PurchaseTo Plan, Evaluate, Purchase• In continuing discussions with vendors – at all

levels– Push IHE, Interoperability

• Refer to lower deployment, maintenance costs– Encourage vendors’ active IHE participation

• Lower development, installation, support costs– Refer to profiles

• Leverage public and objective commitments

• In RFPs– Refer to profiles, Conformance Statements– Use Conformance Statements to “nail down” vendor’s

representations– Adopt very specific language

Raise the bar

What Can I Do?

To Define the FutureTo Define the Future• Become a member of a Domain’s Planning or

Technical Committees– Help establish priorities – what the domain will

work on– Help define profiles – clinical, IT requirements– Provide the “business case” to encourage

developments• Provide Public Comments on Technical

Framework Supplements• Attend Demonstrations, Educational Events

and WorkshopsRaise the bar – to join send me an email

PCD Contacts

PCD CoChairs:– Todd Cooper - [email protected] – Jack Harrington - [email protected]– Ray Zambuto - [email protected]

• PCD Technical Project Manager:– Manny Furst - [email protected]

• IHE Strategic Development Committee CoChair– Elliot Sloane - [email protected]

mailto:[email protected]





Sources of Slides

Most slides were copied from the following presentations,and some have been modified for this presentation:• IHE 2007 Theater welcome -V8

– Introductory presentation at HIMSS Interoperability Showcase Theatre

• 20070227-IHE-PCD-Overview -HIMSS-C– Jack Harrington’s presentation at HIMSS

• HIMSS2006-IHEShowcase– Todd Cooper’s presentation at HIMSS

• IHE-PCD2006Survey– ACCE/HIMSS Survey

Used with permission

References

Internet and Other ResourcesInternet and Other Resources

• http://www.ihe.net/About/ihe_faq.cfm• http://www.ihe.net/Resources/ihe_integration_profiles.cfm#acquiring

– Includes useful definitions, links to additional information• http://www.rsna.org, http://www.acc.org, • Parisot, Charles. What IHE Delivers for Vendors, Purchasers, Users and

Patients. IHE Interoperability Workshop Sept. 2004. http://www.ihe.net/Participation/upload/2_What%20IHE%20Delivers_final.ppt#319,1,Integrating the Healthcare Enterprise

• Gauvin, Alain. How to Purchase IHE Functionality. IHE Canada Workshop 2006. http://www.ihe-canada.com/Events/2006/06SepHaramati-Goodhew.pdf

• Haramati, Nogah and Goodhew, Beth. Purchasing IHE Functionality. IHE Canada Workshop 2006. http://www.ihe-canada.com/Events/2006/06SepGauvin2.pdf

• Bak, Peter. Achieving Interoperability Across Canada. IHE Workshop, June 2006. http://www.ihe.net/Events/upload/IHE%20Workshop%20June%202006%20Bak%20Infoway%20v2.ppt#724,1,Slide 1

• Braithwaite, William. IT at the Core of Healthcare Transformation. Proceedings, HIMSS 2007.

Integrating the Healthcare Enterprise and the Patient Care Device Domain Emanuel Furst, PhD, CCE Technical Project Coordinator for the PCD [email protected].

Documents

ihe slide

ihe pcd

ihe profiles

ihe participants

feedback ihe

effective systems ihe

implementation slide

requirements requirements