INTEROPERABILITY SHOWCASE - secassociates.com · and wide across the HIMSS Annual Conference...

PLAYBILL

INTEROPERABILITY SHOWCASE

Booth 7511

A HIMSS, IHE, CAQH, CDISC, ELINCS and HITSP presentation

Participants as of 2/1/07 © 2007 Healthcare Information and Management Systems Society

eClinicalWorksSchedule. Prescribe. Chart. Charge.

HxTECHNOLOGIESS E C A S S O C I AT E S , I N C .

Leveraging Standards Across the HIT Continuum

Witness this year’s newly expanded Interoperability Showcasefrom Booth 7511 and live demonstrations across the exhibit floor!

Step into a Secured Health Information Exchange that bridges the HIT continuum…where interoperability standards

partners (IHE, CDISC, HITSP, ELINCS, CAQH) unite for patient-centric clinical workflow…

RHIOs are everyday reality…the EHR is commonplace…the Patient is becoming involved…financial transactions are

part of the puzzle…and Life Sciences, Patient Identity Management,

and Lab Interchange specifications are put into practice!

HIMSS Proudly Presents

A HIMSS, IHE, CAQH, CDISC, ELINCS and HITSP Production

Booth #7511

February 25 – March 1, 2007 Ernest N. Morial Convention Center, New Orleans, LA

Don’t miss this year’s national sensation… the newly expanded Interoperability Showcase!

HIMSS07 Interoperability Showcase

Witness a live performance of Integrating the Healthcare Enterprise: A Framework for Interoperability, taking center stage at the HIMSS07 Conference & Exhibition. The ever-popular, back-by-demand Interoperability Showcase comes to life in the form of a highly interactive HIMSS Regional Health Information Organization (RHIO)-based environment. Be our guest as you are transported through real-world clinical scenarios enabled by the standards-based Integrating the Healthcare Enterprise (IHE) framework. Then travel through distributed demonstrations spanning the exhibit floor. The HIMSS07 Interoperability Showcase is guaranteed to enthrall audiences of all levels.

ThemeIntegrating the Healthcare Enterprise – A Framework for Interoperability

• An initiative that improves patient care by harmonizing healthcare information exchange • Provides a structured framework for implementing standards to seamlessly pass health information among care providers, enabling local, regional and national health information networks• Promotes the coordinated use of established standards- Health Level 7, ASTM, DICOM, CDISC, W3C, IEEE, IETF, etc.—to address specific clinical needs

Directed and Produced for the HIMSS Interoperability Showcase in Cooperation with IHE Sponsors

• American Academy of Ophthalmology (AAO)• American College of Cardiology (ACC)• American College of Physicians (ACP)• American College of Clinical Engineering (ACCE) • American College of Emergency Physicians (ACEP) • American Society for Therapeutic Radiation Oncology (ASTRO)• GMSIH (IT France), JAHIS (IT Japan), SFIL (laboratory)• Radiological Society of North America (RSNA)

StarringMingle with an exclusive ensemble of IHE-enabled care providers committed to applying standards to patient care. Be seen among today’s professionals who partner with industry to coordinate implementation of standards to meet clinical needs, including:

• Care providers who identify the key interoperability problems they face• Providers and industry who work together to develop and make available standards-based solutions• Implementers who follow common guidelines in purchasing and integrating systems that deliver these solutions

PlotTake a journey to uncover the secrets of IHE strategy for implementation…

• Leverage established standards to allow rapid deployment and plan for future Pragmatic, Ease of Evolution• Enable architectural freedom (centralized vs. decentralized, patient vs. provider centric) FlexibilityofRHIOconfiguration• Support breakthrough use cases: variety of care settings, care coordination, EHR as single-source for clinical trials reporting , biosurveillance, public health, PHR, EHR Interoperability for broad constituencies• Reduce business risks: utilizing a framework implemented worldwide at the department, institution, community and national levels• Robust and Reliable

Main AttractionsThis year’s Interoperability Showcase features an expanded performance, enriched with newly added attractions that include:

• Secured Health Information Exchange with broad content• New Directions Focus (Life Sciences (Bio-Pharma), PIX/PDQ v3.0, ELINCS Lab)• HITSP Interoperability Specifications• Health information exchange with patient care devices• Personal health record solutions• Financial and administrative systems for billing and claims attachments (CAQH/CORE)• Expanded distributed demonstration in a RHIO format• HIMSS Multi-RHIO - Technical demonstration

◦ Featuring the IHE framework enabling standards-based health information exchange within and across local, regional, and national networks

• Clinical scenarios◦ Focusing on clinician and patient access and information sharing across the continuum of care◦ Life Sciences bridging to health care ◦ Financial and billing transactions

• Connectivity with: ◦ Participating vendors booths◦ Show-wide attendee access at ‘Surf the Web’ kiosks

• Focused tours – International, VIP, Congressional• Theater – Education sessions

◦ Ongoing educational sessions focused on IHE - RHIOs, success stories, case studies, implementations

Your Backstage PassImplementers can plug into the HIMSS07 Interoperability Showcase and experience the many unique aspects of an IHE framework…

As a Vendor Implementer• Implement IHE Integration Profiles• Test systems through Connectathon process• Publish an IHE Integration Statement

As a User Implementer or Consultant• Use IHE Integration Profiles to develop interoperability strategy• Use Connectathon Results and Integration Statements to evaluate vendors• Demand IHE Integration Profile compliance in RFPs

Audience FavoritesThe highly acclaimed Interoperability Showcase has received rave reviews from previous year’s HIMSS Annual Conference & Exhibition attendees. Now, you can witness how these benefits can be achieved from the front row at HIMSS07:

Patients• Incorporates patient-controlled Personal Health Record• Fewer forms to fill out• Reduced waits – information from previous care is immediately available• Clear information about what happened during the care process

Clinicians

• Improved workflow• Information when and where needed• Fewer opportunities for errors• Fewer tedious tasks/repeated work• Improved report turn around time

Provider Organizations• Standards-based workflow provides a best-practices model• Standards-based interfaces simplify implementation, reducing time and cost

Vendors

• Align product interoperability with industry consensus• Decrease cost and complexity of interface installation and management• Compete on functionality and service, not information transport

SDOs

• Receive rapid feedback to adjust standards to real-world• Establishment of critical mass and widespread adoption

SetEnter a three-dimensional stage starting at Booth #7511 that envelops you in the awe of this year’s HIMSS Interoperability Showcase. Never before has the expanse of this performance reached so far and wide across the HIMSS Annual Conference exhibit floor! The Interoperability Showcase production crew welcomes audience members to:

• Immerse yourself in a simulated IHE framework for delivering the interoperability needed for local, regional and national health information networks.

• Experience an environment where health information is seamlessly passed among care providers, enabling enter prise, community, regional and national health information exchange.

• Observe information interoperability “up close and personal” by creating and accessing your own personal electronic health record across multiple settings within the RHIO.

• Visit separate theaters and presentation areas within the Showcase featuring educational sessions on IHE and RHIO activities; federal agency interoperability initiatives; and standards development programs.

• Witness the “special effects” – technical demonstrations involving RHIOs, patient care devices and financial and administration systems.

• Travel to a distributed demonstration where the stage sprawls across the exhibit floor to show a Secured Health Information Exchange in motion.

Project:Interoperability Showcase

Show Name:HIMSS 2007

Show Dates:February 25 - March 1, 2007

Show Location:New Orleans, LA

Account Executive:J. Gaudio

Job Number:22-110345

Created By:K. Krayer - Chicago

Creation Date:September 18, 2006

Revised:January 9, 2007

Final:

File Name:himss07-interopshow-case.indd

5040 W. Roosevelt RdChicago, IL 60644-1474

Phone # 773-379-5040Fax # 773-379-5042

All ideas, designs and arrangements represented by this drawing are considered works of authorship and are owned by Freeman, or one of its affiliates, and may not be copied, reproduced, transmitted, displayed, performed distributed, rented, sublicensed, altered or otherwise used in whole or in part in any manner without the prior written consent of Freeman.

ScriptASTM American Society for Testing and Materials Standards ATNA IHE Profile "Audit Trail and Node Authentication" - describes certificate-based node authentication and transmitting

PHI-related audit events to a repository. This helps sites implement confidentiality policies AwOS Analytical Work Order Step: A WOS performed by an Analyzer actorbPPC IHE Profile "Basic Patient Privacy and Consent" - provides a mechanism to record the patient privacy consent(s), a

method to enforce these consents, and supports the creation of an Affinity Domain defined consent vocabulary that identify information sharing policies

CD Compact Disk CAQH Council for Affordable Quality Healthcare - www.CAQH.org CDISC Clinical Data Interchange Standards Consortium COrE Committee on Operating Rules for Information Exchange CT IHE Profile "Consistent Time" - ensures system clocks and time stamps of computers in a network are well

synchronized (median error less than 1 second) DEC IHE Profile "Devise Enterprise Connect" DICOM Digital Imaging and Communications in Medicine DMZ De-Militarized Zone. A computer or small sub-network that sits between a trusted internal network, such as a corporate

private LAN, and an un-trusted external network, such as the public Internet. Typically, the DMZ contains devices accessible to Internet traffic, such as Web (HTTP) servers, FTP servers, SMTP (e-mail) servers and DNS servers.

ECG Electrocardiogram ECG IHE Profile "Retrieve ECG for Display" - specifies a mechanism for Broad Access of ECG documents for review

purposes throughout an enterprise EDIS Emergency Department Information System EDr IHE Document Content Profile "Emergency Department Referral Document" - Allows clinicians to create electronic

referrals to the emergency room. This profile builds on medical summaries by adding structures to pass data specific for ED referrals such as the estimated time of arrival and method of transport.

EHr Electronic Health Record EHr-Cr An HER-CR or Care-delivery Record abstracts the patient information managed by the IT system or set of systems of a

Care Delivery Organization, which may support a broad variety of healthcare facilities: private practice, nursing home, ambulatory clinic, acute care in-patient facility, etc.

EHr-Lr The documents shared by the EHR-CR and tracked by the Registry form a Longitudinal Record for the patients that received care among the EHR-CRs of the Clinical Affinity Domain. This is known as the EHR-LR.

ELINCS EHR-Lab Interoperability and Connectivity Specification eMPI Enterprise Master Patient IndexEMr Electronic Medical Record, an Electronic Health Record system used within an enterprise to deliver care (also called

EHR-CR by IHE-XDS)FSC File-Set Creator FSr File-Set Reader GMT Greenwich Mean Time - See UTC GSPS Grayscale Softcopy Presentation State GUID Globally Unique Identifier HIS Hospital Information System HITSP Healthcare Information Technology Standards Panel HL7 Health Level Seven HTML Hypertext Markup Language ICE Intracardiac Echocardiography IEEE Institute of Electrical and Electronics EngineersIOD Information Object Definitions ISO International Organization for Standardization IT Information Technology ITI IT Infrastructure (IHE domain) IVUS Intravascular Ultrasound KDC Key Distribution Center LIS Laboratory Information System

LUT Look Up Table MPI Master Patient Index MPPS Modality Performed Procedure Step MrN Medical Record Number MwL Modality Worklist OID Object Identifier PACS Picture Archive and Communication System PCC Patient Care Coordination (IHE domain) PCD Patient Care Devices (IHE domain) PDQ IHE Profile "Patient Demographics Query" - lets applications query a central patient information server and retrieve a

patient’s demographic and visit informationPHr Personal Health Record PIr IHE Profile "Patient Information Reconciliation" - coordinates reconciliation of the patient record when images are

acquired for unidentified (e.g. trauma), or misidentified patientsPIX IHE Profile "Patient Identifier Cross Referencing" - cross-references patient identifiers between hospitals, sites,

RHIOs, etc.PKI Public Key Infrastructure POCT Point of care testing POS Point of Service PPS Performed Procedure Step QC Quality Control performed by Analyzer actor on a quality control specimen. rAD Radiology (IHE domain) rFD IHE Profile "Request Form for Data Capture" rIS Radiology Information System SCP Service Class Provider SCU Service Class User SPS Scheduled Procedure Step Sr Structured Report SUID The Study Instance UID from a DICOM SOP instance, or collection of SOP instances SwF IHE Profile "Scheduled Workflow" - integrates ordering, scheduling, imaging acquisition, storage and viewing for

Radiology exams SwOS Specimen Work Order Step - A WOS performed by a Pre/Post Processor actor TEE Transesphogeal Echocardiography TGT Ticket Granting Ticket TTE Transthoracic Echocardiography UID Unique Identifier UrI Unique Resource Identifier UTC Universal Coordinated Time wOS Work Order Step XA X-ray Angiography XD-Lab IHE Profile "Sharing Lab Reports" XDM IHE Profile "Cross Enterprise Document Media Interchange" XDr IHE Profile "Cross Entreprise Document Reliable Interchange" XDS IHE Profile "Cross Enterprise Document Sharing" - registers and shares electronic health record documents between

healthcare enterprises, ranging from physician offices to clinics to acute care in-patient facilities XDS-MS IHE Document Content Profile "Medical Summary" - defines the content and format of Discharge Summaries and

Referral Notes XDS-SD IHE Document Content Profile "Cross Enterprise Sharing of Scanned Documents" XPHr IHE Profile "Exchange of Personal Health Record Content" - describes the content and format of summary information

extracted from a PHR system for import into an EHR system, and visa versa

eClinicalWorksSchedule. Prescribe. Chart. Charge.

HxTECHNOLOGIES

S E C A S S O C I AT E S , I N C .

CastThe HIMSS07 Interoperability Showcase has assembled the nation’s leading troupe of professional performers – the “Who’s Who” among leading manufacturers and healthcare IT organizations. The following talent comprises this year’s event:

Leadership

Implementer

Supporter

Organizational

ActsWitness the following acts from the HIMSS07 Interoperability Showcase, designed to show hospitals, communities and other audiences how IHE can be achieved regionally and around the world.

Orchestra: standards harmonization for the National Health Information Network (NHIN)

Theater A Monday, 2/26 Tuesday, 2/27 Wednesday 2/28

8:00 - 8:15am 8:15 - 8:30 8:30 - 8:45 8:45 - 9:00 9:00 - 9:15 9:15 - 9:30 9:30 - 9:45 9:45 - 10:0010:00 - 10:1510:15 - 10:3010:30 - 10:45 IHE Demo Intro IHE Demo Intro

10:45 - 11:00 Novartis Misys

11:00 - 11:1511:15 - 11:30 IHE Demo Intro IHE Demo Intro11:30 - 11:45 Philips Motion Computing

11:45 - 12:00pm12:00 - 12:15 IHE Demo Intro IHE Demo Intro12:15 - 12:3012:30 - 12:45

12:45 - 1:00 1:00 - 1:15 1:15 - 1:30 1:30 - 1:45 1:45 - 2:00 IHE Demo Intro

2:00 - 2:15 2:15 - 2:30 2:30 - 2:45 IHE Demo Intro

2:45 - 3:00 3:00 - 3:15 IHE Demo Intro IHE Demo Intro

3:15 - 3:30 IHE Demo Intro Blueware McKesson

3:30 - 3:45 NDMA

3:45 - 4:00 IHE Demo Intro IHE Demo Intro

4:00 - 4:15 IHE Demo Intro Pfizer

4:15 - 4:30 4:30 - 4:45 IHE Demo Intro IHE Demo Intro 4:45 - 5:00 IHE Demo Intro IT Infrastructure- IHE Domain

Update 5:00 - 5:15 CAQH 5:15 - 5:30 IHE Demo Intro IHE Demo Intro 5:30 - 5:45 5:45 - 6:00

Cardiology - IHE Domain Update

IHE: Changing the way healthcare connects in COMMUNITIES

IHE: Changing the way healthcare connects in HOSPITALS

IHE and DODIHE: Changing the way healthcare connects in HOSPITALS

IHE in regional and national health information exchange around the WORLD


IHE: Changing the way healthcare connects in COMMUNITIESEHR Vendor Association -

Interoperability Roadmap and IHE

HITSP - Lee Roy Jones

IHE in regional and national health information exchange around the WORLD

KEYToursIHE TutorialsLeadership PresentationsOrganizational PresentationsInvited SpeakerIHE Domains Update

Theater B Monday, 2/26 Tuesday, 2/27 Wednesday 2/28

8:00 - 8:15am 8:15 - 8:30 8:30 - 8:45 8:45 - 9:00 9:00 - 9:15 9:15 - 9:30 French Delegation (40)

9:30 - 9:45 Charles Parisot and Karima 9:45 - 10:00 to lead.10:00 - 10:15 CDISC Executive tour10:15 - 10:3010:30 - 10:4510:45 - 11:00 IHE Demo Intro IHE Demo Intro

11:00 - 11:15 SAIC IBM

11:15 - 11:3011:30 - 11:45 IHE Demo Intro IHE Demo Intro11:45 - 12:00pm Quovadx Cerner12:00 - 12:15 Press/Media12:15 - 12:30 Tour IHE Demo Intro IHE Demo Intro12:30 - 12:4512:45 - 1:00

1:00 - 1:15 NCSL State public Policy Delegation

1:15 - 1:30 (LA State and Project HITCH legislators)

1:30 - 1:45 IHE Demo Intro

1:45 - 2:00 Initiate Systems

2:00 - 2:15 2:15 - 2:30 IHE Demo Intro Chinese delegation

2:30 - 2:45 VHA - Linda Fishetti IHE Demo Intro

2:45 - 3:00 NIST

3:00 - 3:15 IHE Demo Intro

3:15 - 3:30 GE Healthcare IHE Demo Intro IHE Demo Intro

3:30 - 3:45 Eclipsys Genzyme 3:45 - 4:00 IHE Demo Intro

4:00 - 4:15 IHE Demo Intro IHE Demo Intro

4:15 - 4:30 Eli Lily and Company 4:30 - 4:45 IHE Demo Intro

4:45 - 5:00 IHE Demo Intro IHE Demo Intro 5:00 - 5:15

5:15 - 5:30 HL7 5:30 - 5:45 ISO/TC215 5:45 - 6:00


IHE's contribution to standards harmonization for the NHIN

ACCE

Patient Care Coordination and Laboratory - IHE Domains Update

Patient Care Devices - IHE Domain Update

IHE's contribution to standards harmonization for the NHIN

IHE: Changing the way healthcare connects in COMMUNITIES


KEYToursIHE TutorialsLeadership PresentationsOrganizational PresentationsInvited SpeakerIHE Domains Update

Special PerformancesThe HIMSS07 Interoperability Showcase presents two special performances featuring scenes of a cardiac patient and a trauma patient. Conflicts, suspense and key grips are certain to astound and educate. These scenarios are not for the faint of heart!

THE HIMSS / IHE INTErOPErAbILITy SHOwCASEproudly presents

A Heartfelt PatientStarring

Acuo • Agfa • Alert • Allscripts • Axolotl • Canon • CapMed • CAQH • CGI • CPSI • DraegerEastman Kodak • Eclipsys • Epic • GE Healthcare • HXTI • IBM • Initiate • LiveData • McKesson

MediNotes • MedQuist • Misys • NextGen • NDMA • Philips • QuadraMed • Quovadx • Siemens • Welch Allyn

… and yOU

Home

Cardiologist Office

HOSPITAL

Radiology

ICU

Act 2

Act 3 Act 1

Referral

Vital Signs

Act 4

EKG Cardiology

Ventilator Monitor

OR

Personal Health Record RHIO

Repository

Lab Eligibility

ER Referral

Emergency Room

Order XRay

Value Statement

Pre-Production (before Interoperability) Post-Production (with Interoperability)

• Patient data is scattered, hard to find• Duplicate tests and studies• Incorrect medication lists lead to duplicate therapy, interactions.• Poor decisions based on wrong/incomplete information• Wasted time looking for information• Protected Health Information is passed to any eyes that can see without tracking• Consumers at the mercy of “the system”

• Patient data at the point of care, where ever the point of care is• Unnecessary studies and treatments reduced• Drug/Drug interactions reduced• Improved diagnosis based on correct and timely information• Increased time spent on clinical care• Workflow efficiency for providers and patients (decreased redundant data collection)• Protected health information is encrypted, securely transmitted and logged• Active involvement of consumers

A Heartfelt PatientAct 1

From Home to Hospital

Scene Description Profiles Used1 You are at home and maintain your personal health record (PHR). You notice that you feel winded and fatigue

easily with activities. You prepare an export of your personal health record (PHR), save it to a portable USB drive (or send it to your RHIO). You call your primary care physician, Dr. Paul Primary, for an appointment.

XPHR, XDM, XDS,ATNA, CT, PIX

2(a) In his office, Dr. Primary imports your PHR information into his electronic medical record (EMR). He examines you and decides that a cardiologist, Dr. Henry Hartly, should see you. Dr. Primary prepares a referral note and uploads it to your RHIO.

XPHR, Medical Summary, XDM, XDS, ATNA, PIX, PDQ, CT

2(b) Labs are also sent using a structured lab document. XD-Lab

2(c) Your Health Plan confirms your eligibility to see Dr. Hartly.3 Dr. Hartly sees the referral from Dr. Primary and has the option to import this data into his record. Unfortunately,

as you are seeing Dr. Hartly, you develop more chest pain. Dr. Hartly refers you to the emergency room (ER) for a more urgent evaluation. He prepares the appropriate referral, including ER specific data.

Medical Summary, EDR, XDR, XDS, ATNA, PIX, PDQ, CT

4 In the Emergency room, Dr. Eric Rescue, the physician on call, views the emergency referral. Your care is expedited.

EDR, XDS, ATNA, PIX, CT

Seattle Cast:1 Capmed Personal HealthKey™ (A1)2a NextGen EMR (B3)3 Epic Systems EpicCare (D2) **4 Siemens Soarian® (E7)

LA Cast Cast:2a,c MIE WebChart (C4)3 Misys Connect™ (D1) 4 CGI Sovera® (E6)

New york Cast:1 Capmed Personal HealthKey™ (A1)2a NextGen EMR (B3)3 Epic Systems EpicCare (D2) **4 Alert® EDIS (E2)

Toronto Cast:1 Capmed Personal HealthKey™ (A1)2a Allscripts Touchworks EHR (B3)3 Misys Connect™ (D1) 4 CPSI System (E6)

Chicago Cast:2a,b GE Healthcare Centricity EMR (C5)3 Epic Systems EpicCare (D2) **4 Eclipsys (E4)

CAST(& POD location)

Infrastructure (for Acts 1, 2, 3 and 4)

provided by:

• Axolotl Elysium (I3)• IBM ATNA Audit Repository (I1)• IBM EMPI and PIX/PDQ Manager (I2)• IBM XDS Document Registry / XDS Document Repository (J1, J2, J3)• Initiate™ Identity Hub (I4) **

• Eastman Kodak VIParchive (J5)• HXTI iHistory (J4)• National Digital Medical Archive, Inc NDMA (J6)• QuadraMed Smart Identity Exchange (I5)• QUOVADX ISD Cloverleaf® Integration Suite (J7) **

** Using HL7 Version 3 for PIX / PDQ


Interoperability with Radiology Workflow

Scene Description Profiles Used4 Dr. Rescue, the ER physician, orders a chest X-ray. SWF5(a) In the Radiology Department, the radiology technician, Xana Rais, gets the order and schedules the views to be

taken.SWF

5(b) Ms. Rais uses a DR system to capture the images. SWF5(c) The DR system automatically updates and stores the images to the PACS. SWF5(d) Dr. Radmani, the radiologist, reviews the images on a PACS display. SWF5(e) The Images are made available to the RHIO for future reference. XDS-I, PIX,

ATNA, CT6 Later, in his office, Dr. Primary views the X-rays. XDS-I, PDQ,

ATNA, CT


Seattle Cast:4 Siemens Soarian® (E7)5a Agfa RIS (F1)5b Canon Medical Systems CXDI (F4)5c Agfa PACS (F7)5e IBM XDS Image Source (F8)6 McKesson Horizon Medical Imaging™ (C6)

Chicago Cast:4 Siemens Soarian® (E7)5a Kodak Carestream RIS (F2)5b Agfa DR(F3)5c,e GE Centricity PACS (F5)6 McKesson Horizon Medical Imaging™ (C6)


Device Connectivity

Scene Description Profiles Used4 In the ER your vital signs are recorded, and you are noted to be hypotensive. You are admitted to the Intensive

Care Unit (ICU).DEC

6(a) Dr. C. Care, the intensivist in the ICU, examines your vitals taken in the ER on the ICU Clinical Information System before your arrival taken.

DEC

6(b) In the ICU, you are placed on a monitor. The monitor information is sent to the ICU Clinical Information System. DEC6(c) Still hypotensive, you are started on IV fluids and medications to maintain your blood pressure. The infusion

pump uses patient identification provided from the bar code on your wrist band to compare with the bar code on the medication container, in order to confirm that the medication will be delivered to the right patient.

DEC

6(d) Monitored physiological parameters, along with infusion pump parameters, are shown on the ICU Clinical Information System (CIS). The CIS permits visual integration of medication delivery and patient condition.

DEC

7(a) Your condition suddenly worsens and the doctor decides you need immediate surgery. You are rushed to the operating room (OR) where you are placed on both a ventilator and monitor. The ventilator and monitor data are integrated and analyzed in the OR Charting System.

DEC

7(b) The ventilator and physiological monitor values are sent to the OR Dashboard (for the anesthesiologist) and to the OR Information System (for the surgeons and others).

DEC


Seattle Cast:4 Welch Allyn Connex™ Vital Signs System (E8)6a,d Philips Medical Systems CareVue Clinical Information System (G1)6b GE Healthcare Aware Gateway (G2)6c B. Braun DoseTrac™ Infusion Management Software (G4)7a Draeger Medical Systems, Inc. Innovian CC/PC (G5)7b LiveData, Inc. LiveData OR-Dashboard (G7)

Chicago Cast:4 Welch Allyn Connex™ Vital Signs Monitor System (E8)6a,d Philips Medical Systems CareVue Clinical Information System (G1)6b Philips Medical Systems IIC Gateway (G3)6c B. Braun DoseTrac™ Infusion Management Software (G4)7a Draeger Medical Systems, Inc. Innovian CC/PC (G5)7b GE Healthcare Centricity Periop Anesthesia (G6)


Hospital Follow-up

Scene Description Profiles Used8(a) In the hospital, serial EKG’s are obtained, showing an acute myocardial infarction, along with improvement

after your CABG.EKG

8(b) EKG’s are also stored with the RHIO’s data repository. XDS, Scanned Docu-ments, PIX, ATNA, CT

9(a) EKG’s are viewed throughout the hospital. EKG9(b) You are discharged from the hospital. Dr. C.V. Surg, your cardiovascular surgeon, creates a discharge sum-

mary and sends it off to the RIO’s data repository. He recommends routine follow-up with Dr. Hartly (your cardiologist), and home blood pressure monitoring.

XDS, Medical Summary Discharge, PIX, ATNA, CT

9(c) Images are also made available to the RHIO’s data repository. XDS-I, PIX, ATNA, CT10 At home, you check your blood pressure. Results are sent to the RHIO. XDS, Scanned Docu-

ments, PIX, ATNA, CT11(a) You follow up with Dr. Hartly. He views your discharge summary, home blood pressure checks and EKG’s. XDS, Scanned Docu-

ments, Medical Sum-mary, PDQ, ATNA, CT

11(b) Dr. Hartly also views your radiological images. XDS-I, PIX, ATNA, CT


New york Cast:8a,b GE Healthcare Centricity Muse (D4)9a McKesson EKG Viewer (E1)9b MedQuist DocQment Enterprise Platform (E3)9c Acuo PACS (F6)10 IBM Innovative Patient Monitoring and Sharing(A3)11a Misys Connect™ (D1)11b HXTI iHistory (D5)

Seattle Cast:8a,b GE Healthcare Centricity Muse (D4)9a McKesson EKG Viewer (E1)9b Eclipsys Sunrise Clinical Manager (E4)9c Acuo PACS (F6)10 IBM Innovative Patient Monitoring and Sharing(A3)11a Epic EpicCare® (D2)11b HXTI iHistory (D5)

Chicago Cast:8a,b GE Healthcare Centricity Muse (D4)9a McKesson EKG Viewer (E1)9b CGI Sovera®(E5)9c Acuo PACS (F6)10 IBM Innovative Patient Monitoring and Sharing(A3)11a MediNotes e™(D3)11b HXTI iHistory (D5)


A Traumatic PatientStarring

Accenture • Agfa • Axolotl • Allscripts • BlueWare • CapMed • CGI • CPSI • Eastman KodakEclipsys • HXTI • IBM • Initiate Systems • MedCommons • MIE • NDMA • NextGen

GE Healthcare • McKesson • Practice Partner • QuadraMed • Siemens

… and yOU

Community Hospital

Primary Care Physician Office

Home

Discharge Summary

PHR

Discharge Summary

Trauma Center

RHIO Repository

RHIO Repository

PHR

Value Statement


• Patient data is scattered, hard to find• Duplicate tests and studies• Incorrect medication lists lead to duplicate therapy, interactions• Poor decisions based on wrong/incomplete information• Wasted time looking for information• Protected Health Information is passed to any eyes that can see without tracking• Consumers at the mercy of “the system”

• Patient data at the point of care, where ever the point of care is• Unnecessary studies and treatments reduced• Drug/Drug interactions reduced• Improved diagnosis based on correct and timely information• Increased time spent on clinical care• Workflow efficiency for providers and patients (decreased redundant data collection)• Protected health information is encrypted, securely transmitted and logged• Active involvement of consumers

A Traumatic PatientAct 1

Scene Description Profiles Used1 You are a vigilant health care consumer. You create a personal health record (PHR) and publish it to

your RHIO’s data repository.XPHR, PDQ, PIX

2(a) Unfortunately, you are involved in an auto accident and are brought to the Emergency Room (ER) of a rural hospital, unconscious. The ER physician, Dr. Eric Rescue, looks up your record and sees your PHR. Your PHR speaks for you when you can’t.

You are found to have fractures requiring the special skills of Dr. Boney, an orthopedic specialist who practices at the Trauma center downtown. Dr. Rescue creates a discharge summary and sends it to the RHIO’s data repository.

XPHR, Medical Summary-Dis-charge, XDS, ATNA, CT, PIX

2(b) Your images are also sent to the RHIO data repository. XDS-I, ATNA, CT, PIX3(a) At another hospital, Dr. Boney sees the discharge summary including history of your accident. Dr.

Boney appreciates that he doesn’t spend hours of time tracking down your records.Medical Summary Discharge, XDS, ATNA, CT, PIX

3(b) Dr. Boney also sees your X-Rays saving repeat examinations. XDS-I, ATNA, CT, PIX3(c) After a successful surgery, you are observed to have developed a severe allergic rash resulting from

the perioperative antibiotics. You are instructed to follow up with your primary care physician, Dr. Paul Primary. Dr. Boney creates a discharge summary and submits it to the RHIO.

Medical Summary Discharge, Scanned Documents,XDS, ATNA, CT PIX

3(d) Your images are also uploaded to the RHIO’s data repository. XDS-I, PIX, ATNA, CT4(a) In his office, Dr. Primary views the documents from your hospitalizations. He notes the new

medications and medical problems added during your hospital stays. In addition, Dr. Primary notes the allergic reaction and updates his EMR. The availability of documentation for Dr. Primary’s follow-up also avoids medical errors such as miscommunication about medication doses.

Medical Summary Discharge, Scanned Documents,XDS, ATNA, CT PIX

4(b) Dr. Primary also sees the images of your fracture and reviews them with you. XDS-I, PIX, ATNA, CT4(c) Dr. Primary creates a document for you to update as part of your PHR. This includes the new

medication instructions, and a note to update your allergy list.XPHR, XDS, PIX, ATNA, CT

5 You update your PHR. XPHR, XDS, PIX, ATNA, CT6 You elect to keep your record with Liberty Alliance.

New york Cast:1, 5 CapMed Personal HealthKey™ (A1)2a GE Healthcare Centricity Enterprise (H1)3a Eclipsys Sunrise Clinical Manager™ (E4)4a,c Allscripts Touchworks EHR (B1)

San Francisco Cast:2a GE Healthcare Centricity Enterprise (H1)2b Agfa PACS (H3)3a,b,c Siemens Soarian® (E7)3d IBM XDS Image Source (F8)4a MIE WebChart (C4)4b McKesson Horizon Medical Imaging™(C6)

Toronto Cast:2a GE Healthcare Centricity Enterprise (H1)2b Eastman Kodak Carestream PACS (H2)3a,c CPSI System (E6)3b,d GE Healthcare Centricity PACS (F5) 4a BlueWare Wellness Connection (C2)4b McKesson Horizon Medical Imaging™(C6)

Chicago Cast:1, 5 MIE No More Clipboard (A2)2a GE Healthcare Centricity Enterprise (H1)3a Eclipsys Sunrise Clinical Manager™ (E4)4a Practice Partner (B2)

Vancouver Cast:2a GE Healthcare Centricity Enterprise (H1)2b Agfa PACS (H3)3a,b,c Siemens Soarian® (E7)3d IBM XDS Image Source (F8)4a GE Healthcare Centricty EMR (C5)4b McKesson Horizon Medical Imaging™(C6)

Philadelphia Cast:2a GE Healthcare Centricity Enterprise (H1)2b Eastman Kodak Carestream PACS (H2)3a,c CPSI System (E6)3b,d GE Healthcare Centricity PACS (F5) 4a Accenture Electronic Health Record Connection Solution (C3)4b McKesson Horizon Medical Imaging™(C6)

LA Cast:1, 5 MIE No More Clipboard (A2)2a GE Healthcare Centricity Enterprise (H1)3a Eclipsys Sunrise Clinical Manager™ (E4)4a NextGen® EMR (B3)

Miami Cast:2a GE Healthcare Centricity Enterprise (H1)2b Eastman Kodak Carestream PACS (H2)3a,c CPSI System (E6)3b,d GE Healthcare Centricity PACS (F5) 4a IBM, Mandriva, Possibility Forge [openEMR/OHF] (C1)4b McKesson Horizon Medical Imaging™(C6)

New Orleans Cast:2a GE Healthcare Centricity Enterprise (H1)3a,c CPSI System (E6)4a MedCommons (C1)6 Liberty Alliance (O1)


• Axolotl Elysium (I3)• IBM ATNA Audit Repository (I1)• IBM EMPI and PIX/PDQ Manager (I2)• IBM XDS Document Registry / XDS Document Repository (J1, J2, J3)• Initiate™ Identity Hub (I4) **

• Eastman Kodak VIParchive (J5)• HXTI iHistory (J4)• National Digital Medical Archive, Inc NDMA (J6)• QuadraMed Smart Identity Exchange (I5)• QUOVADX ISD Cloverleaf® Integration Suite (J7) **

** Using HL7 Version 3 for PIX / PDQ

Infrastructure (for Acts 1, 2, 3 and 4)

provided by:


A Basic Matter of PrivacyStarring

Allscripts • Axolotl • CapMed • GE Healthcare • IBM • MediNotes • Misys • Quovadx

… and yOU

Value Statement


• No way to record a patient’s consent to privacy policy• No way to communicate extra sensitive records• No way to identify when users try to exceed their privileges• No way to allow emergency access to protected documents• Gathering evidence to assist with Disclosure logs uncoordinated

Home

Primary Care Physician Office

Cardiologist Office

Cardiologist Office

Ambulatory Care

Emergency Room

Privacy Officer

Registration Acute Care

XDS, XDR Medical

Summary

XDS, XPHR

XDS EDR

ATNA

BPPC

• Can capture the act of a patient consenting to a policy • Documents can be marked with sensitivity labels that indicate the proper use• Users actions are tracked • Methods defined for emergency mode access to protected documents• Audit log can assist in the creation of disclosure log• User Authentication and Access Controls enforced closest to Patient (safety)

A Basic Measure of PrivacyAct 1

Scene Description Profiles Used1 You are a very important person (VIP)! In fact, today you’re a V.P. who has unfortunately has a “bad

heart.” To capture your VIP status you will be given a copy of the “VIP Patient Privacy Consent” Policy to sign. With this policy your documents will be only made available to care workers with extra-privileges such as senior consultants or department chiefs, or under emergency access. (These senior consultants have shown capability to not hold press releases until you’ve talked to your friends and family first.)

XDS, BPPC, XDS-SD, ATNA, CT

2 You are at home and maintain your personal health record (PHR). You notice that you feel winded and fatigue easily with activities. You prepare an export of your personal health record (PHR), by sending it to the cross enterprise document sharing (XDS) repository for your RHIO, marked with the VIP sensitivity label. You call your primary care physician, Dr. Paul Primary, for an appointment.

XPHR, XDM, XDS,ATNA, CT, PIX, BPPC

3 In his office, Dr. Primary imports your PHR information into his EMR. He examines you and decides that a cardiologist, Dr. Henry Hartly, should see you. Dr. Primary prepares a Referral note and uploads the referral note to the XDS repository.

XPHR, Medical Summary, XDM, XDS, ATNA, PIX, PDQ, CT, BPPC

4 Dr. Hartly sees the referral from Dr. Primary and can optionally import structured data into his record. Unfortunately, as you are seeing Dr. Hartly, you develop more chest pain. Dr. Hartly refers you to the emergency department for a more urgent evaluation. He prepares the referral including ER specific data elements.

Medical Summary, EDR, XDR, XDS, ATNA, PIX, PDQ, CT, BPPC

5 Dr. Bob, your next door neighbor, who works in the same cardiology clinic as Dr. Hartly, notices that you have visited. Curious, he tries to gain access to your records in the RHIO using his account. Because Dr. Bob is not a chief of staff he doesn’t have access to these new documents that are marked with the VIP Privacy Consent Policy.

XDS, BPPC, CT, ATNA

6 In the Emergency room, Dr. Eric Rescue, the physician on call, views the EDR referral. Dr. Eric Rescue is the normal ER doctor and thus doesn’t have the necessary extra-privileges needed. This is a clear emergency case, so Dr. Eric Rescue overrides the Privacy Policy and Your care is expedited.

EDR, XDS, ATNA, PIX, CT, BPPC

7 Chief Privacy Officer, S. E. Cretly, gets an alert from his audit log repository that indicates that there is an unusual event. Reports are run to show all of the uses of the health information including Dr. Bob’s attempt to access the documents inappropriately, and Dr. Eric Rescue’s override for emergency purposes. Reports can also be run to assist with the creation of a Disclosure Log.

ATNA

broadway Cast1 QUOVADX ISD Cloverleaf® Integration Suite (J7) 2 Capmed Personal HealthKey™ (A1)3 Allscripts TouchWorks EHR™ (B3)4 Misys Healthcare Systems Misys Connect™ (D1)5 MediNotes Corporation MediNotes e™(D3)6 GE Healthcare Muse® Cardiology Information System (D5)7 IBM ATNA Audit Repository (I1)

Additional Infrastructure by

Axolotl Elysium (I3) IBM XDS Document Registry / XDS Document Repository (J2)


HITSP TheaterPod MIn October of 2005, the American Health Information Commu-nity (AHIC) defined three breakthrough areas which framed the use cases that guided the efforts of the Healthcare Information Technology Standards Panel (HITSP) through which specific, near term value to the healthcare consumer could be realized. The Interoperability Showcase includes a demonstration of these use cases: Biosurveillance, Consumer Empowerment, and Electronic Health Record. These use cases are exempli-fied through the stories of an ‘Influenza Outbreak’, a ‘Heartfelt Patient’, and a ‘Traumatic Patient.’ Theses stories will demon-strate the power of consumer participation in their healthcare through an interoperable personal health record; opportunities for early detection, public health monitoring, and improved care management when an outbreak of influenza threatens the health of the American community; and the power of laboratory result sharing and health record document sharing approach, allowing laboratory results to be available at the point of care. The work of the HITSP is conducted through formally chartered Technical Committees. The artifacts of the Technical Committee activities are Interoperability Specifications and related documents. The HITSP Interoperability Specifications to enable implementation of these use cases can be found at http://www.hitsp.org/.

CAQH TheaterPod M CAQH, an alliance of health plans, networks and trade asso-ciations, formed the Committee on Operating Rules for Infor-mation Exchange (CORE) to promote health plan-provider interoperability and improve provider access to administrative information. More than 100 industry stakeholders, covering over 75% of the commercially insured, are collaborating on CORE. Together, they are creating CORE rules by building on existing standards, such as HIPAA, to make electronic transac-tions more predictable and consistent, regardless of the technol-ogy.

CORE’s Phase I rules help the industry move towards interop-erability by supplying the financial data needed by providers and consumers. The Phase I rules were included in the HITSP Consumer Empowerment specifications as one of several imple-mentation architecture variants for populating and maintaining the Insurance Module of the PHR Registration Summary/Medi-cation History Section.

At the HIMSS Interoperability Showcase, CAQH will dem-onstrate the CORE Phase I rules certification testing process, which tests health plans, clearinghouses, vendors and large providers. CORE-authorized Testing Vendors Claredi® and Ed-ifecs, Inc. will show the CORE test scripts, testing scenarios and emulate the health plan’s role during the demonstration on how to integrate the CORE and HITSP rules. In addition, NoMore-Clipboard will demonstrate CORE’s connection to HITSP by showing how their PHR uses the HITSP Consumer Empower-ment Use Case, which incorporates the CORE Phase I rules, to obtain the insurance information and move it into an EHR.

Don’t Miss Other Exciting Attractions at the Following Locations

ELINCS Theater Pod NThe California HealthCare Foundation (CHCF) is an indepen-dent philanthropy committed to improving the way healthcare is delivered and financed. CHCF was asked by Dr. David Brailer to develop an ambulatory lab-EHR standards specifica-tion. CHCF leveraged work done within California (CALINX standards) and published their first ELINCS specification ver-sion 1.0 in July 2005. ELINCS 1.1 was subsequently published in October 2006. The ELINCS 1.1 specification utilizes HL7 v2.4 transactions to deliver real-time lab results messaging from laboratory to ambulatory EHRs. CHCF will be demonstrating ELINCS 1.1 to show lab result interoperability between labo-ratories (Atlas, LabCorp, and Quest) and eMDs and NextGen EHRs.

New Direction – Life Science TheaterPod LThe Clinical Data Interchange Standards Consortium (CDISC) is leading a first-of-its-kind demonstration to prototype the bridging of healthcare data to research and surveillance. Co-sponsored by Integrating the Healthcare Enterprise (IHE), the New Directions- Life Sciences Interoperability demonstra-tions employ the IHE profile--Retrieve Form for Data Capture (RFD)--to enable data integration between systems.

The demonstration depicts five (5) use case scenarios which show how clinical data can be transferred seamlessly between care provider’s EHR systems and systems used for clinical research, patient registries, safety surveillance, and disease outbreak surveillance.

By collecting these data at a single source--the point of care EHr system--physicians and staff need not re-enter data into specialized research and surveillance applications. Avoiding this redundant data entry reduces data errors and saves the care provider’s valuable time while allowing key data to be reported in a timely and accurate manner.

Scenario Sponsor

Secnario Description

ScenarioParticipants

Eli Lilly Clinical Trial: Visit Workflow

Cerner Corporation, IBM, Phase Forward

Genzyme Disease Registry Outcome, Allscripts, Digital Infuzion, SAS, Assero/IPL

Novartis Clinical Trial: Lab and Image Data

Novartis, Siemens, SAS

Pfizer Drug Safety Allscripts, Accenture, Sentrx/Relsys, SAS

SAIC/CDC Biosurveillance IBM, Allscripts, Accenture, University of Washington

Scenario Participant at Large: SEC Associates will be providing regulatory oversight to address considerations relevant to 21CFR Part 11 compliance.

New Directions Industry Scenario Teams:

INTEROPERABILITY SHOWCASE - secassociates.com · and wide across the HIMSS Annual Conference...

Documents

Transcript of INTEROPERABILITY SHOWCASE - secassociates.com · and wide across the HIMSS Annual Conference...