Integrating the Healthcare Enterprise (IHE)

 

 

Integrating the Healthcare Enterprise (IHE) International is an organization that enables users and developers of information technology for healthcare to achieve interoperability of systems through the precise definition of healthcare tasks, the specification of standards-based communication between systems required to support those tasks and the testing of systems to determine that they conform to the specifications. The work is managed by IHE committees and sponsored by various national and international bodies.

IHE participants promote interoperability by building systems that conform to an industry-wide framework for implementing standards. More than 100 healthcare vendors worldwide offer ready-to-integrate products to benefit healthcare enterprises of all sizes.

There are four steps to the IHE process:

1. Identify Interoperability Problems. Clinicians and IT experts work to identify common interoperability problems with information access, clinical workflow, administration and the underlying infrastructure.

2. Specify Integration Profiles. Experienced healthcare IT professionals identify relevant standards and define how to apply them to address the problems, documenting them in the form of IHE integration profiles.

3. Test Systems at the "Connectathon.” Vendors implement IHE integration profiles in their products and test their systems for interoperability at the annual IHE Connectathon. This allows them to assess the maturity of their implementation and resolve issues of interoperability in a supervised testing environment.

4. Publish Integration Statements. Vendors publish IHE integration statements to document the IHE integration profiles their products support. Users can reference the IHE integration profiles in requests for proposals, greatly simplifying the systems acquisition process.

Technical Frameworks

Each IHE Technical Framework consists of two parts: Profiles and Transactions. IHE Profiles model the business process problem and the solution to the problem; Transactions to support these profiles are defined in detail, using current, established standards to solve the business problem defined by each IHE Profile.

IHE Profiles

IHE Profiles provide a common language for purchasers and vendors to discuss the integration needs of healthcare sites and the integration capabilities of healthcare IT products. They offer developers a clear implementation path for communication standards supported by industry partners and carefully documented, reviewed and tested. They give purchasers a tool that reduces the complexity, cost and anxiety of implementing interoperable systems.

IHE 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. They provide precise definitions of how standards can be implemented to meet specific clinical needs.

IHE Integration Statements

IHE Integration Statements are documents prepared and published by vendors to describe the intended conformance of their products with the IHE Technical Framework. They identify the specific IHE capabilities a given product is designed to support in terms of the key concepts of IHE: Actors and Integration Profiles.

IHE and the Electronic Health Record (EHR)

IHE has defined a common framework to deliver the basic interoperability needed for local and regional health information networks. It has developed a foundational set of standards-based integration profiles for information exchange with three interrelated efforts:

1. Cross-Enterprise Document Sharing (XDS) support for document content interoperability. This supports a standards-based EHR across clinical encounters and care settings.

2. A security framework for protecting the confidentiality, authenticity and integrity of patient care data.

3. Cross-domain patient identification management to ensure consistent patient information and effective searches for EHRs.

IHE Domains and Annual Work Cycles

IHE is organized across a growing number of clinical and operational domains (e.g. ophthalmology, cardiology, radiology, pathology, laboratory procedures, radiologic oncology…). Each domain produces its own set of Technical Framework documents, in close coordination with other IHE domains. Committees in each domain review and republish these documents annually, often expanding with supplements that define new profiles. Initially each profile is published for public comment. After the comments received are addressed, the revised profile is republished for trial implementation: that is, for use in the IHE implementation testing process. If criteria for successful testing are achieved, the profile is published as final text and incorporated