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Interoperability of Healthcare IT Systems

Interoperability of Healthcare IT Systems

Facing the Challenge: Care to Share

The focus of this issue of eMessenger is Interoperability of healthcare IT systems. Our first contributor is Harm-Jan Wessels, founder and CEO of Forcare B.V., a Dutch software company focusing on healthcare interoperability. He explains that care providers are in the driving seat to point out the critical interoperability gaps in their current way of working.

Harm-Jan Wessels has been closely involved with the development of healthcare IT products and systems for the last two decades. Yet he still finds himself wondering what is hindering the universal, secure access to patient health information. “We can easily receive money from ATMs all over the globe, but we are lost when we end up as a patient in a hospital abroad!”

The challenge is widely recognised; at the European level the need for efficient access to patient-centric, healthcare information is rapidly increasing. The European Commission published its draft Recommendation on eHealth Interoperability this July. The recommendation identifies a current lack of interoperability among systems and services, hindering wider implementation of the European Union’s eHealth applications, including the Electronic Health Record (EHR).

The key to further development of the EHR is thus interoperability. As referenced by the Recommendation, interoperability means “the ability of information and communication technology (ICT) systems and of the business processes they support to exchange data and to enable the sharing of information and knowledge”.

Sharing requires consent and cooperation

How can interoperability be achieved? According to Wessels, it means connecting systems and exchanging data in a meaningful format, ideally supporting semantic interoperability, so that receiving systems actually understand the data.

“Having said that, I believe that the prime inhibitor to progress is in allowing access to information,” says Wessels. “We need to come to the realisation that no progress can be made unless we share the critical elements of healthcare information. Sharing requires consent and cooperation: first-and foremost from the patient, but – equally important – from the healthcare professional.”

To build a strong case for sharing information, Wessels believes the initial focus should be on the healthcare professional. “While quality of care and efficiency in care processes may be admirable goals, in my opinion the key driver for the further implementation of information systems in healthcare is saving time. More specifically, it is saving time for the healthcare professional, who is under ever increasing pressure to treat more patients in less time. To this end, we need to focus on the work process and have the care provider tell us where we can improve the workflow – and thus save time.”

Integrating the Healthcare Enterprise (IHE)

The global Integrating the Healthcare Enterprise (IHE) initiative is doing just this. By using a proven methodology and process cycle, it focuses on global interoperability problems that are recognised by care providers worldwide. The care providers are in the driving seat to point out the critical interoperability gaps in their current way of working, describing them in the form of clinically relevant use cases.

Care providers and industry then develop solution frameworks, known as Integration Profiles, to solve the issues based on proven (healthcare) information standards. The Integration Profiles solutions are refined in a global review process, tested in large-scale connectivity testing events known as Connectathons, and demonstrated at major healthcare IT conferences.

At the 2007 World of Health IT Conference in Vienna, several companies and institutions will be presenting their commitment to IHE in the IHE Interoperability Showcase. In a live demonstration, they will show true interoperability based on IHE’s solution framework for sharing medical information. All this is based on clinical use cases, linking the demonstration to the challenges in daily clinical practice.

“With efforts like IHE’s commitment to interoperability, we can make progress and achieve the goal of the ‘eHealth ATM’”, summarises Wessels. “To get there, remember ‘care to share’ – and save time!”

Harm-Jan Wessels is founder and CEO of Forcare B.V., a Netherlands-based software company focused on developing IHE-based software solutions for healthcare interoperability. In addition, he is vendor-chair for IHE Netherlands. Harm-Jan has been active in healthcare IT since 1990, developing healthcare imaging and information solutions for Applicare Medical Imaging, GE Healthcare, and now Forcare.

Further information:
Forcare
Harm-Jan Wessels

Drawing up a Roadmap: RIDE

Our second contributor, Prof. Dr. Asuman Dogac from the Middle East Technical University, describes a European Commission sponsored project on interoperability. Its aim is to provide a roadmap for interoperability of eHealth systems leading to recommendations for actions and to preparatory actions at the European level.

RIDE is a Coordination Action supported by the European Commission under Framework Programme 6. It is coordinated by the Software Research & Development Center of the Middle East Technical University. RIDE started in January 2006 and will finalise in December 2007.

“RIDE is a roadmap project for interoperability of eHealth systems leading to recommendations for actions and to preparatory actions at the European level,” says Professor Dogac. “The roadmap will prepare the ground for future actions as envisioned in the action plan of the eHealth Communication COM 356 by coordinating various efforts on eHealth interoperability in member states and the associated states.”

Currently, RIDE progresses successfully with harmonisation of different perspectives by its nine partners spread over Europe. In the RIDE Project, a systematic roadmapping process is being followed and so far many deliverables have been produced. All of these are accessible through the ‘Public Deliverables’ section of the RIDE website.

Analysing the current state of affairs

The first tasks involved collecting data by performing surveys on the current state of standardisation efforts for providing semantic interoperability in the Health domain. In parallel to this, the current states of eHealth interoperability in the EU Member states as well as US and Canada were investigated.

The next step involved investigating the interoperability requirements of applications in the eHealth domain. This was to determine the goals and challenges, where the “State-of-the-Art” and the “Requirement Analysis” provided the necessary input. In order to visualise the goals and to see how the current requirements can be addressed in the future, a set of visionary scenarios are being developed.

Comparing with the desired objective

“Next, the gaps that exist between the ‘as-is’ situation and the desired future description identified in the RIDE vision statement (‘to-be’ situation) are identified,” explains Professor Dogac. “This is supported by a migration strategy for the legacy eHealth applications.”

On the way to achieving the roadmap, the RIDE project is analysing the trends and opportunities in healthcare IT, and documenting the limitations of current policies and strategies. The latest public deliverable by RIDE Consortium presents proposals to eHealth standardisation bodies.

A connected network of networks

Based on all this work, so far two versions of the RIDE Roadmap and one version of the Guidelines to Member States have been delivered. Their final versions will be ready by the end of the project and will embody clear principles for the organisational, political and legal framework, architectural interoperability, monitoring and evaluation that are necessary for a well-established European Health Network. These principles will then be mapped to the technical interoperability framework, providing the minimum set of functionalities for a connected network of networks.

“RIDE Roadmaps consider all the prominent technologies and standards relevant for the Member States in achieving a European eHealth Interoperability Framework based on a Service Oriented Architecture (SOA) by providing use cases, involved services, illustrative scenarios and required security/privacy features,” summarises Professor Dogac.

More information:
Software Research & Development Center
RIDE

Prof. Dr. Asuman Dogac is a full professor in the Department of Computer Engineering at the Middle East Technical University (METU) and the founding director of the Software Research and Development Center (SRDC). Her current research interests include Interoperability, Semantic Web, Internet Computing, eBusiness and eHealth. She is actively working in several European Commission sponsored projects in eHealth and eBusiness. Professor Dogac has published more than 100 articles. In 2004 she received the IBM, USA Faculty award, and is also the recipient of several local awards in Turkey including the Mustafa Parlar Science award in 2000.

Interoperability at WHIT ‘07

The benefits of IT to health services are so overwhelming that investment is certain to increase hugely. But there are still many great concerns. Will systems satisfy all expectations of their various users? Will systems with different core functions and from various suppliers operate together as a ‘connected’ healthcare framework? What is the best solution for a specific case? How can those in the industry work together to deliver a more efficient healthcare system?

These issues will all be addressed at The World of Health IT Conference & Exhibition ’07 (WHIT ’07), at the Austria Center, Vienna, Austria, from 22–25 October 2007.

Now in its second year, the event has been devised as the essential forum for all professions involved in or connected with healthcare IT in the EMEA region: technology users, buyers, vendors, healthcare providers, regulators, clinicians and directors. The inaugural event in Geneva last year attracted 1,700 people from 68 countries.

The event includes educational sessions, vendor exhibitions, symposia, networking sessions…and an Interoperability Showcase.

An interactive, interoperable environment

Healthcare providers are challenged to provide the best solutions against budgets, which may involve several suppliers. So a particularly valuable element of WHIT ’07 will be the Interoperability Showcase. It will feature cutting-edge technology and standards that create an interactive environment where delegates can experience interoperability of healthcare IT systems. A connected healthcare system will be demonstrated using the standards-based Integrating the Healthcare Enterprise (IHE) framework.

Participants include Agfa HealthCare, Alert Life Sciences, Carestream Health, Draeger Medical Systems, Forcare, IBM, Initiate Systems, InterComponentWare, Philips and Welch Allen.

Registration for the World of Health IT Conference is possible here

A further insight into the Interoperability Showcase at WHIT ’07 is provided on the HIMSS EMEA website in this month’s Expert View.

“What are the potential benefits of interoperability?”

Continuing the theme of interoperability of healthcare IT systems, we look at the advantages that interoperability can bring.

eHealth interoperability will bring benefits to citizens, patients, healthcare professionals, nations and industry. It will lead to more accessible, high-quality, cost-effective, economic, and sustainable health services and systems, especially in the context of cross-border citizen and patient mobility. It may also benefit healthcare professionals and public authorities by lowering the acquisition costs for the components of eHealth infrastructures and services.

“Improving the ability to share information across the enterprise… will lead to faster and more insightful diagnosis, enabling clinicians to make better and quicker treatment decisions.” Jack Harrington, Philips Medical Systems and Technical Co-Chair of the IHE Patient Care Device Domain

Cordula Singer
HIMSS EMEA secretariat

Questions anyone?
Challenge us to help you with your (healthcare ICT related) questions. Send your input to emea@himss.org (subject line: question time) and we will research and publish your questions and our answers in forthcoming issues of the eMessenger.

The HIMSS Mission

The Healthcare Information and Management Systems Society (HIMSS) is the premier professional member organisation exclusively focused on providing leadership for the optimal use of healthcare information technology.

The HIMSS mission is to lead change in the healthcare information and management systems field through knowledge sharing, advocacy, collaboration, innovation and community affiliations. HIMSS EMEA brings this mission to Europe, Middle East and Africa.

HIMSS EMEA

HIMSS in Europe, the Middle East and Africa (EMEA) is dedicated to bringing together all the major players in the Health ICT community to transcend borders and languages and engender a truly regional dialogue. As members of HIMSS EMEA, individual professionals (managers, administrators, clinicians, technology experts and users), vendor companies and IT providers meet, interact and learn from one another.

With the opening of its EMEA office in Brussels, HIMSS is now positioned to provide activities, programmes and education specifically designed for the EMEA Health ICT community. Guided by a Governing Council of members from within the EMEA region, HIMSS EMEA focuses on the needs of individual and corporate members to ensure dedicated services and membership value.

Membership benefits include

• A monthly e-newsletter - HIMSS EMEA eMessenger – delivered to your inbox on the third Thursday of every month.
• A series of educational eSeminars on topics reflecting the challenges of the Healthcare ICT community in the EMEA region. Following April’s successful inaugural eSeminar on Electronic Health Record systems, HIMSS EMEA is planning a challenging programme for the coming months, which covers hot topics like Privacy Protection and Patient Safety. For detailed information, please have a look at the schedule for 2007.
• An interactive website targeted at the main issues and experts within our community. This includes a weekly “Expert View” on the issues that matter to you as well as industry news (RSS feed in partnership with Healthcare IT News Europe).
• Access to the latest industry and policy documents on the HIMSS EMEA online resource centre.
• Significant member discounts on the World of Health IT Conference and Exhibition, the HIMSS Annual Conference & Exhibition, the HIMSS bookstore and HIMSS events.

To learn more about HIMSS EMEA take a look at our website: www.himss.org/emea