Health Information Exchange: The Overarching Role of Integrating the Healthcare Enterprise (IHE)

Abstract

Innovative solutions are needed in Healthcare to deliver interoperable and secure digital services. Big data and Artificial Intelligence (AI), Personalized medicine, are considered as the main priorities by the European Commission for the coming years. As such, topics are placing high demands on medical data to ensure that they are consistent, relevant, and structured. In order to achieve this degree of consistency data that is to be exchanged, needs to be underpinned with protocols and standards which need to be clearly understood by those charged with implementation. To increase data quality, integration guidelines called profiles allow a harmonious combination of standards for answering specific clinical needs and workflows. Alignment and conformity of the IT systems to the requirements is the preferred approach to build trusted healthcare IT ecosystem. The chapter describes a comprehensive process that allows reaching the goal of developing Digital Health Space. Based on two concrete examples, firstly, the Integration Healthcare Enterprise (IHE) is a profiling organization that proposes a use case driven methodology for successfully deploying interoperable systems that are tested during events called Connectathons. Secondly, The Conformity Assessment Scheme for Europe (CASforEU) designed in the European project EURO-CAS completes the process by proposing a rigorous evaluation of the conformity of products and solutions for better confidence of the interoperability implementation. This chapter initially introduces the concept of interoperability and then describes in detail how to implement the process in healthcare setting, It also provides some concrete examples of deployment projects, and introduces the concept and process of the conformity assessment scheme for healthcare IT products and solutions.

Glossary

CDA

Clinical Documentation Architecture

CEN

European Standards Organisation

Conformance

The level of adherance to an agreed rule or standard

Connectathons

Planned events by IHE to test new implementations

DICOM

Digital Imaging and Communications in Medicine

DMP

Dossier Médical Partagé (Electronic Health Record)

EHR

Electronic Health Record

epSOS

European Patients—Smart Open Service

European Interoperability Framework

Four layers of interoperability (Foundational, structural, semantic, and organizational) are the foundation of the framework

FRAND

FAIR, Reasonable and Non-Discriminatory

GSPS

Grayscale Softcopy Presentation State

HIE

Health Information Exchange

HIT

Health Information Technology

HL7

Health Level Seven

HPD

Healthcare provider directory

IAB

Internet Architecture Board

IEEE

IEEE Advancing Technology for Humanity

IETF

Internet engineering Taskforce

IHE

Integrating the Healthcare Enterprise

ISA

Interoperability Standards Advisory

ISO

International Organization for Standardization

ISOC

Internet Society

LOINC

Logical Observation Identifiers Names and Codes

Mandation

A term that groups categories of mandatory, condition, or optional

Metadata

Information that provide facts about one or more aspects of a data element

MPI

Master Patient Index

MRI

Magnetic Resonance Imaging

OASIS

Organization for the Advancement of Structured Information Standards

PACS

Picture Archive and Communication System

PCC

Patient Care Co-ordination

Projectathon

Projectathon, when deploying IHE profiles at the project level, the IHE Gazelle test platform is used at the Projectathon which is a type of Connectathon but dedicated to the specifications-based profiles of the eHealth project. The Projectathon has the same role as the Connectathon: it provides support, training and expertise to vendors that are selected for the project deployment

SDO

Standards Development Organisation

Standard

A rule that enables consistent and repeatable use, performance, and outcomes

Use Case

An integration profile used as a guideline for implementation of a specific process called use case. The use case provides precise definitions of how standards can be implemented to meet specific clinical needs for a specific purpose. For example, integration profiles organize and leverage the integration capabilities that can be achieved by coordinated implementation of communication standards, such as DICOM, HL7, W3C and security standards in Digital Health

VA

United States Department of Veteran Affairs

W3C

World Wide Web Consortium

XCPD

Cross community patient discovery