Regionale uitwisseling van
medische gegevens (IHE)
Sessie B (10:50-11:50)
Nieuwegein, 20 mei 2014
René Spronk
Trainer / Senior Consultant
Ringholm bv
Haarlem, the Netherlands
Tel.
eMail:
Web:
+31 (0)33 7 630 636
Rene.Spronk@Ringholm.com
http://www.Ringholm.com
HL7/IHE roles:
•Co-chair of the international HL7 AID User Group
•Co-chair of various Committees, HL7 Netherlands
•Contributor to the IHE Laboratory Technical Framework
•HL7 Fellow, 2011
2
Het zes-lagen model
WET &
REGELGEVING
BELEID
Randvoorwaarden
Richtlijnen
ZORGPROCES
Samenwerking
INFORMATIE
Informatie-inhoud
APPLICATIES
Softwarekoppeling
TECHNIEK
Infrastructuur
Informatiestandaarden in de zorg
3
Agenda
•
•
•
•
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Interoperabiliteit
Wat is IHE en wat kun je ermee?
Regionale uitwisseling
XDS
Voorbeelden regionale uitwisseling
Interoperability
Hospital 1
Hospital 2
Policy Alignment
organisations
Policy Alignment
organisations
Use cases, care process
Use cases, care process
Information content and
transactions
Information content and
transactions
Systems, Applications
Systems, Applications
Technique, Infrastructure
Technique, Infrastructure
What is IHE?
Intro IHE
• IHE = Integrating the Healthcare Enterprise
• Based on existing standards such as HL7 and
DICOM
• IHE is not a standard; it is a constraint profile
(a.k.a conformance profile).
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IHE domains
Radiology
since 1998
Pharmacy
Since 2009
Cardiology
since 2004
Pathology
since 2006
Laboratory
since 2004
Eye Care
since 2006
(Healthcare)
IT Infrastructure
since 2003
Quality
Research & Public Health
since 2006
Patient Care Devices
since 2005
Radiation Oncology
since 2004
Patient Care Coordination
since 2004
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Actors and Transactions
• Actor (HL7: Application Role, DICOM:
Service Class)
– Functional grouping of the capability to
exchange a specific set of Transactions in order
to fulfill part of a workflow.
• Transaction
– (Functional) Information exchange
– Abstract concept, could be the equivalent of
multiple message exchanges or service calls.
Affinity Domain; Identity Domain
• Affinity Domain
– A set of implementations of IHE Actors (i.e. applications)
that share common policies when it comes to privacy,
user authentication, auditing, use of code systems, …
Policy Alignment
organisations
WET &
REGELGEVING
BELEID
Document Sharing Affinity Domain
• Set of organizations/systems organized around
a single Registry
• Agreed-upon sharing policies
• Common set of Codes
– Unified terminology
• Single Patient ID Domain
• Involves business and legal agreements
• Security & Access Control model/agreements
XDS profile
Regionale uitwisseling:
Cross-enterprise Document
Sharing
Legacy - heterogeneous,
disconnected silos
Primary Care
Physician
Labs
Community Workflow: Phone, Fax, Mail
Patient Engagement:
Analog, Discrete
Patient Information:
Population
Information:
Scattered
Other HIE
Patient
Unknowable
Independent
Health Facility
Payers
Pharmacy
Government
Specialty
Practice
Academic
Medical Center
Community
Hospital
XDS: Purpose
• Manage the sharing of documents between
healthcare enterprises – healthcare
enterprises within a XDS affinity domain.
• Creation of a longitudinal document-based
patient record within a given XDS affinity
domain.
• Document content neutral.
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XDS Profile
One per affinity domain
Document
Administrator
Update / Delete
Document
Set
Document
Registry
Query
Documents
Register Document Set
Document
Source
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Provide & Register
Document Set
Document
Repository
Document
Consumer
Retrieve Document Set
XDS DocumentEntry meta-data
• Patient: Affinity domain id, demographics (id, name,
birth date…) « as viewed by the source »
• Origin: author, institution, legal authenticator
• Identification: unique id, dates of creation and start
/end of medical act, title, parent document, unique
id of the repository
• Classification: class, type, format, MIME type, type
and specialty of institution and author, medical
codes, confidentiality level, language
– Required, If known, Recommended
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Summary
Health Document Exchange Options - Flexible Infrastructure
XDS
Publish
XDR
Send to
XDM
Write
XDS
INFRASTRUCTURE
M8354673993
L-71614355
A87631
Existing Reliable
Messaging System
Interchange
Media
Send to
Read
Types of XDS implementations in
Netherlands
National screening programs
 MammoXL
 Screening Colon Cancer
Regional projects
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NHN Zorgring
Amsterdam Ezda
Breda area Network
Friesland
Groningen
Leiden Sleutelnet
Rotterdam Rijnmondnet
Terneuzen Zorgsaam
Where in the world is XDS?
Other standards
• HL7 v3, CDA
• SNOMED CT and G-standard could be used for
Content
• XML
• SOAP
Meer details?
• Cursus Regionale uitwisseling : IHE XDS, VNA
en ECM - 21 en 22 mei 2014
– 2 dagen, zie www.iheacademy.nl
• Cursus Regionale uitwisseling : IHE XDS, VNA
en ECM – 5 en 6 november 2014
– 2 dagen, zie www.iheacademy.nl
• www.ihe.net