IHE: Making Interoperability Global Is Becoming Big Business

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 Integrating the Healthcare Enterprise (IHE) has gone from a small-time operation started a decade ago to a major league player in the healthcare interoperability game, and having very positive effects on patient care. Its reach now extends across 19 countries and addresses communication issues within nine different areas of healthcare. Now, the IHE stamp of compliance is what every medical device company wants.

In today's health IT environment, interoperability is the name of the game. If your systems cannot easily communicate with and integrate with other clinical and IT systems within a healthcare facility, you'll be left out in the cold. The Integrating the Healthcare Enterprise organization came on the scene in 1997 and immediately began tackling interoperability challenges between healthcare information systems, starting with radiology. The goal was to use common and established standards such as HL7 and DICOM, among others, to foster better communications among computer systems in healthcare. This was way before health IT was a buzz word. Years later, with the help of primary sponsors such as the Healthcare Information Management and Systems Society (HIMSS), Radiological Society of North America (RSNA), and American College of Cardiology (ACC), IHE has become a heavy hitter in the industry.

IHE's basic argument is that although standards are plentiful, they are often too broad or narrow depending on the situation, and they are commonly redundant. Thus, IHE functions as a means to sort out the standards and to offer ways for them to be implemented in very specific situations to foster interoperability.

Each year, the embodiments of IHE's efforts are the annual Connectathons — a health IT World Series of sorts — that bring together healthcare technology vendors to showcase their compliance with specific IHE Domain profiles. 1999 saw the inaugural Connectathon. Like IHE itself, the Connectathons — which currently take place in the U.S., Europe, and Asia — have grown and become more elaborate. For example, in 2006 the U.S. event was held in the RSNA headquarters basement in Chicago. Other years it was held in a parking garage. They wouldn't even fit in there now.

Health Imaging & IT visited the 2007 Connectathon in Chicago in January and spoke to Didi Davis, director of IHE for HIMSS, about why the events have so much appeal to vendors. Davis believes the collaborative atmosphere at such events is spurred on because vendors don't want to compete on interoperability; they want to compete on feature functionality.

In all, 80 organizations participated in the 2007 Connectathon, testing the interoperability of more than 160 systems and applications.

IHE's growing prominence has been gradually matched by its expansion to a wider variety of healthcare domains. The first IHE domain was radiology which sprouted in 2002, and now includes 18 of what the organization calls "integration profiles" designed to tackle specific workflow situations. Other domains adopted in recent years include: IT Infrastructure for Healthcare, Cardiology, Laboratory, Radiation Oncology, Patient Care Coordination, Patient Care Devices, and, most recently, Quality.

IHE Domain web resources

Eye Care

IT Infrastructure

Patient Care Coordination

Patient Care Devices




IHE begins its integration profile process in each instance by establishing use cases developed out of feedback from experts in specific fields. Put simply, a use case is an area where workflow could be improved by leveraging existing standards for interoperability to tackle a defined problem. Following this, technical experts are brought in who work for months to find solutions leveraging the standards. In some instances, Davis says, you could use 12 to 15 current standards to facilitate workflow. Technical specifications are developed and then tested at Connectathon events and other demonstrations. Vendors then can market their systems as having IHE compliance.

IHE in the spotlight

IHE's Interoperability Showcase at HIMSS in February in New Orleans was a chance for the organization to shine light on its present and future plans. To do this, IHE illustrated how patients and healthcare records move through scenarios that encompass the continuum of care. Multiple