Strategies for Implementing the Digital Healthcare Community Practical conditions for business adoption of standards HL7 UK, London October 26, 2005 Charles Parisot Charles Parisot GE Healthcare Information Technologies GE Healthcare Information Technologies
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Strategies for Implementing the Digital Healthcare Community Practical conditions for business adoption of standards HL7 UK, London October 26, 2005 Charles.
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Strategies for Implementing the Digital Healthcare Community
Practical conditions for business adoption of standards HL7 UK, LondonOctober 26, 2005Charles ParisotCharles ParisotGE Healthcare Information TechnologiesGE Healthcare Information Technologies
HL7 UK 2006 - The future of Integration 2 25-26 October 2006
Topics
• Interoperability and digital communities
• Critical success factors for standards adoption
• Establishing a digital community framework at the international level
• Examples of successful interoperability
• Summary
HL7 UK 2006 - The future of Integration 3 25-26 October 2006
Open, standards-based interoperability critical to building a digital community •Congratulations to
standards development and implementation organizations
•Interoperability creates markets… e.g. $1B+ PACS
•More importantly… Interoperability transforms patient care
HL7 UK 2006 - The future of Integration 4 25-26 October 2006
Standards in the real-world
• One sort of healthcare interoperability standards… Those that are adopted !
• Multiplicity of Standards development organizations in healthcare… necessity given the breadth, complexity and technological evolution, but each one needs to be global by domain.
• Calculated risks to Introduce new standards…. require the first line stakeholders: vendors and providers to gain confidence to implement (focused use cases).
• Interoperability Standards are deployed in incremental steps.
• A Standards Implementation Process needed to orchestrate: Requires an implementation “conductor”.
HL7 UK 2006 - The future of Integration 5 25-26 October 2006
Vendors, Clinicians & CIO’s key to driving interoperability as stakeholders•Clinicians… Quality of care, safety, productivity, affordability
•Vendors… Reliability, ready to implement standards, speed to market
HL7 UK 2006 - The future of Integration 6 25-26 October 2006
Proven Standards Adoption Process: IHE
Document use Document use case case requirementsrequirements
Document use Document use case case requirementsrequirements
Identify available Identify available standards (standards (e.g. HL7, e.g. HL7, DICOM, IETF, OASIS)DICOM, IETF, OASIS)
Identify available Identify available standards (standards (e.g. HL7, e.g. HL7, DICOM, IETF, OASIS)DICOM, IETF, OASIS)
Develop Develop technical technical
specificationsspecifications
Develop Develop technical technical
specificationsspecifications
Testing at Testing at connectathonsconnectathonsTesting at Testing at connectathonsconnectathons
IHE IHE demonstrationsdemonstrationsIHE IHE demonstrationsdemonstrations
Products Products with IHEwith IHEProducts Products with IHEwith IHE
Timely access to Timely access to informationinformationTimely access to Timely access to informationinformation
Easy to integrate Easy to integrate productsproductsEasy to integrate Easy to integrate productsproducts
HL7 UK 2006 - The future of Integration 7 25-26 October 2006
Sharing a Common Framework Internationally ?
•Belief that differences in health systems create insurmountable barriers and requires national customization. Over 10 countries are already rushing down this path.
Many believe that it cannot be done, it is already in progress. Loosing time ? No, results with faster and cheaper deployment
•Once one realizes that challenge is to “connect” the IT systems used in thousands of point of care. This is the primary interface to address with a globally harmonized standards-based framework
•Much energy spent creatinginternationally agreed standards
•Only partially true for clinical information. Languages, some existing codifications, and order in deployment strategies shall be accommodated.
HL7 UK 2006 - The future of Integration 8 25-26 October 2006
US EHR Vendor Association: A roadmap Phase-in of Communication Services
available
6 mos to2yrs
2yrs +
Phase 4: Active Quality Reporting
& Health SurveillancePhase 3: Advanced Clinical Support & Access Control
Phase 2: Share Diagnostic Results &
Therapeutic Information
Phase 1: Share Care Status Information
From: www.himssehrva.org
HL7 UK 2006 - The future of Integration 9 25-26 October 2006
Realizing the complementary roles of document sharing and of message
based transactionsEnd-Point System To End-Point SystemInterchange
End-Point Systems to National Infrastructure Sub-network Communication
From HIMSS EHRVA Response to ONCHIT RFI, January 2005
e.g. EMR e.g. Lab, PACSEMR, etc.
• Thin set of Health Net Services – facilitates information exchange• End-Point System services exist at two distinct levels • Net/Subnet communication level – e.g., IHE/XDS (Cross-enterprise Doc. Sharing)
• Peer-to-Peer level – transparent to infrastructure, e.g., doc content / type
Internet
Document Sharing
Dynamic Information
Mgmt
... ... Med
icat
i ons
PushNotificati
on( eRx,
eReferral )Transaction
Mgmt
Clinical Content Clinical Content
Security &Identity
Historical Documents
DynamicQueries
WorkflowTransaction
Record Locator ServicesRecord Locator Services
Patient &Provider ID Mgmt
AccessControl
CD
A
Lab
resu
lts
PD
F
Rad
iolo
gy
Allerg
ies
Med
icati
on
s
Internet
Document Sharing
Dynamic Information
Mgmt
... ... Med
icat
i ons
PushNotificati
on( eRx,
eReferral )Transaction
Mgmt
Clinical Content Clinical Content
Record Locator ServicesRecord Locator Services
Patient &Provider ID Mgmt
AccessControl
Med
Su
mm
aie
s
Lab
resu
lts
Scan
Docs
Rad
iolo
gy
Allerg
ies
Med
icati
on
s
HL7 UK 2006 - The future of Integration 10 25-26 October 2006
Community orsub-network
Clinical EncounterClinical Encounter
Clinical IT SystemClinical IT System Index of patients records(Document-level)
Aggregate Aggregate Patient InfoPatient Info
4-Patient data 4-Patient data presented to presented to
PhysicianPhysician
Sharing SystemSharing System
Clinic RecordClinic Record Specialist RecordSpecialist Record
Hospital RecordHospital Record
2-Reference2-Referenceto Records to Records for Inquiryfor Inquiry