IHE ready for the big time

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The annual IHE (Integrating the Healthcare Enterprise) Connectathon this week lived up to its mission of bringing together vendors to ensure interoperability and connectivity. For sure, the 2007 Connectathon which was substantially larger than previous events, demonstrated that IHE is gaining momentum in the industry. For example, last year they were in the RSNA headquarter basement in Chicago. Other years it was held in a parking garage. They wouldn’t even fit in there now. 1999 saw the inaugural Connectathon.
 
The 2007 Connectathon on Tuesday — again in Chicago — opened its doors to the public for the first time. The event reveals what is actually a surprisingly collaborative part of the health IT industry underbelly that is not often seen. Otherwise fiercely competitive vendors were there working in conjunction towards a common interoperability goal. Showing an increase from previous years, the Connectathon hosted 77 vendors, breaking down into 350 testers and 150 applications.
 
The collaborative atmosphere is spurred on because vendors don’t want to compete on interoperability, said IHE representative Didi Davis, director, informatics, HIMSS. Vendors want to complete on system feature functionality instead.
 
Each vendor must demonstrate successful integration on the Connectathon floor with three peer companies within their area. They have a number of days to accomplish this and results are announced at the end of the 4-day session. If they fail, vendors have the option to wait until next year or to travel to Europe for its own IHE Connectathon event. Although nothing has been formalized, there is a possibility that similar interoperability testing events could soon take place in Canada which would give vendors yet another chance to put their integration to the test, Davis said.
 
IHE is indeed international, currently active in 19 countries. And with sponsors such as RSNA, HIMSS, and ACC, it has come to have a lot of weight in the industry.
 
IHE’s growing prominence has been gradually matched by its expansion to a wide variety of IHE 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 begins its integration profile process in each instance by establishing use cases developed out of feedback from experts in the 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 existing standards. In some instances, Davis said, 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 — something that is gaining in importance in this very competitive field.
 
This year the Connectathon was subdivided into a number of areas, including radiology (internal communication), cross-enterprise, HITSP (HIT Standards Panel), new directions, and eLinks (labs to EHR connection). The new directions area included pharmaceutical companies that are trying to leverage data capture to facilitate drug development.
 
These events represent a great challenge to the engineers from each vendor. They must demonstrate integration between their systems with those from three peer companies. Sometimes the vendors know in advance what systems they will be tested with, and sometimes it is random, said Dr. Steve Moore of the Mallinckrodt Institute of Radiology at Washington University in St Louis, acting as head of the Connectathon floor monitor staff. If vendors cannot meet spec within the week of testing then they do not pass. Failure rate is very low, however, added Moore.
 
The monitors have numerous functions at these events, including acting as mediators in case of vendor disputes. And as the event has grown, so have the tools that facilitate its running smoothly gotten more sophisticated. Moore and his team have developed a custom process management system called Kudu. And to communicate with participating vendors, they have established numerous Wiki pages to send out notices and to disperse essential information about the events and requirements.
 
From the healthcare provider angle, all of this effort towards interoperability is gravy. It’s actually more than many doctors and other practitioners are looking for. According to Tom Kuhn, a senior systems architect with the American College of Physicians (ACP), many of the 120,000 physician members within his organization “would be happy to just be rid of the fax machine.”
 
Kuhn said that ACP members top interoperability priorities is sharing laboratory data, ePrescribing, and electronic referrals.
 
From a consumer standpoint, IHE is making interoperability that is something plug ‘n’ play, said Davis. That idea should appeal to doctors disinterested in learning new processes and systems, and it should also appeal to concerns over the bottom line.
 
The fact is that system integration is expensive, especially when it comes in after disparate systems are already a part of an organization. The average mid-sized hospital has as many as 200 system interfaces which means that “you are talking real money” to establish intergration, said Glen Marshall, standards and regulatory manager at Siemens Medical Solutions. Marshall believes that dealing with such a complex integration situation could cost a facility as much as $30,000 to $50,000 over the period of a few years.
 
Another incentive for companies to participate, Marshall said, is to have an active leadership role in shaping health IT systems within the industry. He reasoned that vendors “don’t like to get told what to do. That’s not good business.” Another benefit of taking an active role in IHE by sitting on committees and taking part in events is the ability to “interject ideas into the marketplace,” he added.
 
Although the results from the 2007 Connectathon will not be announced until week’s end, the opening day event was abuzz with plenty of other activities of interest to the public. A representative from the Office of the National Coordinator of Health IT provided an update regarding its current activities related to interoperability and standards, as did a representative from Certification Commission for Health Information Technology.
 
Look for additional IHE Connectathon 2007 coverage in the Jan. 22 issue of Health Imaging News.