All About IHE

Integrating the Healthcare Enterprise

Envision a day when vital information can be passed seamlessly from system to system within and across departments, and then made available at the point of care. IHE is designed to make this vision a reality by improving the state of systems integration and removing some of the barriers to optimal patient care.

What is IHE?

An initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information.
Designed to stimulate the integration of the information systems that support modern healthcare institutions.
To ensure that in the care of patients, information to support medical decisions is both correct and available to healthcare professionals.
Promotes the coordinated use of established standards such as DICOM and HL7 to address specific clinical needs in support of optimal patient care.
Systems developed in accordance with IHE communicate with one another better, are easier to implement, and enable care providers to use information more effectively.

Why is IHE Needed?

Optimal patient care requires efficient access to relevant information. Despite the advanced state of technology healthcare enterprises have not yet begun to realize the full potential of computer systems to help reduce medical errors, improve the efficiency of care providers and enhance the overall quality of clinical care. To do so requires a framework for information sharing that meets the needs of care providers as well as patients and gains acceptance among the companies that build the systems they rely on.

Standards provide the basis for such a framework, but alone do not solve the problem. In any standard there are gaps, options, room for conflicting interpretations. No standard maps perfectly to the complex and ever-changing information domain of a healthcare enterprise. Filling the gap between standards and systems integration has, until now, required expensive, site-specific interface development. To close that gap a process for building a detailed framework for the implementation of standards is needed. IHE provides that process.

How Does IHE Work

IHE involves an intensive, ongoing process of collaboration and communication among key parties, which can be divided into four phases:
Problem Identification: Clinicians and IT experts identify common integration problems in access to information, clinical workflow, administration and underlying infrastructure.
Integration Profile Specification: Stakeholders select standards that address each identified integration need. The technical specifications for implementing these standards are documented in the IHE Technical Framework.
Implementation and Testing: Vendors implement these profiles and test their systems with software tools and at a face-to-face Connect-a-thon, where they test interoperability with other vendors' systems.

Integration Statements and RFPs: Vendors publish IHE Integration Statements to document the integration profiles supported by their products. Users can reference integration profiles in requests for proposals, simplifying the systems acquisition process.

What Can IHE do for me?

Clinicians…
Enabling systems to share information effectively. IHE offers a framework for information sharing designed to optimize clinical workflow. Systems implemented in accordance with IHE can streamline the flow of clinical information, reduce possible errors and improve efficiency. IHE strengthens the information link between different departments-for example, between referring physicians and consulting physicians-to enable the enterprise to function as a single unit in providing optimal clinical care.

Healthcare Administrators…
IHE eases this burden by offering a clear path toward acquiring integrated systems. Referring to IHE Integration Profiles in RFPs and purchasing agreements allows purchasers and vendors to agree on the interoperability of systems being acquired or upgraded, making multi-vendor, best-of-breed solutions more feasible. It enables information technology specialists to concentrate on improving the core functionality of systems, rather than developing and maintaining redundant, point-to-point interfaces. Finally, it makes it possible to implement a streamlined workflow so that care providers can make more efficient use of their time.

IT Professionals…
IHE offers a common framework for vendors, IT departments, clinical users and consultants to understand and address clinical integration needs. The IHE Technical Framework allows flexibility while ensuring that key integration needs are met.

What is the IHE Technical Framework

The IHE Technical Framework is a detailed, rigorously organized document that provides a comprehensive guide to implementing the defined integration capabilities. The Technical Framework delineates standards-based transactions among systems (generically defined as IHE Actors) required to support specific workflow and integration capabilities.

IHE Actors:
Information systems or applications that produce, manage or act on information are represented as functional units called IHE Actors. Each actor supports a specific set of IHE transactions. A given information system may support one or more IHE actors.

Transactions:
Transactions are exchanges of information between actors using messages based on established standards (such as HL7, DICOM and W3C). Each transaction is defined with reference to specific standard and additional detailed information, including use cases. This is done to add greater specificity and ensure a higher level of interoperability between systems.

What are the IHE Integration Profiles

IHE Integration Profiles organize sets of IHE actors and transactions in order to address specific patient care needs. Integration Profiles offer a convenient way for vendors and users to reference the functionality defined in the IHE Technical Framework without having to restate all of the detail regarding IHE actors and transactions. They describe clinical information and workflow needs and specify the actors and transactions required to address them.

What are the 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 integration capabilities a product is designed to support in terms of the key concepts of IHE: Actors and Integration Profiles.

How Do I Use IHE

How you use IHE depends on your specific role and your specific needs. Clinicians and administrators should be aware of the clinical and operational benefits that can be realized through IHE Integration Profiles and encourage their departments to demand those capabilities when acquiring or upgrading systems. Information technology professionals should know how to use IHE Integration Profiles in RFPs and purchasing agreements and should familiarize themselves with sections of the Technical Framework that describe interfaces between systems under their supervision. Developers and systems integrators should have a detailed knowledge of the sections of the Technical Framework relevant to their systems.

If IHE is about achieving a common language for integration, then an analogy can be made to how one uses various resources to understand a foreign language.

Standards such as DICOM and HL7 provide the vocabulary and basic grammar for the language of integration. The Technical Framework organizes these elements somewhat like a language textbook, fitting together the most relevant pieces and eliminating confusion and ambiguity. Integration Profiles are like a phrase book for essential communications. They further organize the language to enable vendors and purchasers to communicate about systems integration-even if DICOM or HL7 is not their native language.

IHE can make systems integration faster, more efficient, less expensive and more successful. Standards-based integration solutions like those defined in IHE are flexible, durable, easier to implement and less expensive to maintain than proprietary methods. Achieving systems integration through IHE is a dramatic step toward providing optimal patient care.

IHE and the RFP

Integration Profiles provide precise shorthand communication between purchasers and vendors of medical equipment. A purchaser can include a requirement for a particular Profile, and IHE provides several hundred pages documenting what the vendor needs to do to claim conformance to that requirement. Referencing an IHE Profile has the advantage of being both brief and precise. When using IHE Integration Profiles to express your requirements, you may want to reference the IHE Radiology TF and include a link to www.ihe.net/Technical_Framework/index.cfm in your RFI/RFP.

The simplification of using IHE leaves the details of the TF for the vendors to implement in their products. You may want to specifically request that vendors provide the IHE Integration Statement for applicable products either before or in response to the RFI/RFP.