Trend Tracker | IHE: It's Not Just for Imaging Anymore

IT is saving (and spending) money at a record pace in healthcare lately, or haven't you noticed that the doctor now plays games on his PDA while you cool your jets in the waiting room? Hopefully not. But when healthcare IT spending tops $30 billion per year, a few games come pre-installed.

Imaging and IT used to be separate markets - now they have combined forces to generate enough buzz and hype to justify some recent acquisitions and a few new VPs in most major imaging companies, and a new magazine too. I attended HIMSS 2004 (Feb. 22-26, 2004, Orlando, Fla.) to gauge the state of this fast growing segment.

First observation - the people spending IT money are neither doctors nor radiologists. On a sunny day in Orlando, most of these attendees actually came to the meeting, instead of jaunting off to Disneyworld. OK, maybe they like their bits and bytes, but these people are on the front lines when the real emergency call comes in - "THE NETWORK IS DOWN!" Anytime a speaker used this line, everyone in the room flinched in pain - like getting a penicillin shot in the old days - ouch!

My second observation is these professionals are actually running "enterprise" networks in hospitals today. OK, maybe the networks are strapped together, a collection of LANS made into an enterprise level WAN, but networks that serve an entire hospital and multi-hospital systems are the norm. And you know how users are, once they start working on it, they start complaining - it's too slow, the buttons aren't in the right spot, it froze up, why can't I get my ebay bid updated in real time, who took the Post-it Note with the password on it?

My third observation? PACS networks are simple - once you get enough bandwidth. To the IT professional, PACS represents just another clinical application (commodity) network with some physician and technologist preference points. If you are a CIO and need to buy a new PACS, the process is straightforward - put together a committee and make sure enough people are involved that they can't point the finger at IT when the systems don't perform out of the box. Not exactly.

And everyone wants to be your single-source vendor - HIS, RIS, CIS, EMR, CRM, PACS, etc. Big secret No. 1 - nobody buys this line. Big secret No. 2 - the OEMs don't really expect you to, but they can't help themselves when they start writing the marketing plans.


But the real star of HIMSS was IHE, a formerly secret world of planners and programmers, now openly plotting to take over the healthcare IT world. They've already taken over the PACS imaging world (though they are widely unappreciated by radiologists) after a quiet 1998 start. IHE specialists now describe their mission as "Solving complex problematic processes using information technology." This usually keeps innocent onlookers at arms length, so that the planning and technical meetings proceed without interruption.

IHE specialists include a small collection of MDs and a large collection of OEM employees who represent some of the best technical talent in the world. As a group, they represent a technical think tank for solving big-picture problems of interoperability and integration in a multi-vendor networked world.

HIMSS dedicated a substantial area to an IHE-HL7 demo area, which drew well. No sales pitches were given, but plenty of demonstrations showcased how IT products using IHE compliance solves real clinical problems.

IHE is revolutionizing healthcare IT - today. Want to buy single sign-on? Just look at IHE-IT and you'll find Enterprise User Authentication, an integration profile designed for this task.

Will every healthcare IT product, hardware or software have IHE built into it in 5 years? Bet on it and be sure it's in your next RFP and contract.

IHE enables hospitals to buy best of breed and easily replace vendors that have worn out their welcome, without worrying about integration.

Insist on IHE compliance in every medical imaging device and informatics piece of hardware or software that you buy, starting today. IHE is extremely well developed for the radiology world, and is just starting in cardiology and laboratory systems. And it applies outside the U.S. as well, as there are many IHE groups all over the world now.

Now, IHE requires careful research and planning, but you can find most everything you need to know at or to get started.

While IHE is almost impossible to understand in the first run-through, it starts to make sense pretty quickly. I haven't seen anything as powerful that impacts the performance of healthcare networks. If you invest some time to understand IHE (or assign it to someone on your staff), I'm confident that you will start looking for ways to build IHE compliance into every new imaging or IT device that you buy.

Send Trend Tracker questions & comments to Douglas F. Orr at