Expert Views

Behind the scenes of the IHE IT Infrastructure Planning Committee

Charles Parisot was instrumental in the launch of Integrating the Healthcare Enterprise (IHE) in the USA and Europe, and is currently co-chair of the IT Infrastructure Planning Committee. His major focus has been the development of cross-enterprise interoperability for EHRs with regional and national health information networks.  Here, he explains some of the current activities of the IT Infrastructure Domain.

The IT Infrastructure Domain in IHE addresses the common communication capabilities that a hospital, regional or national health information network faces to enable clinical specific information to flow. It includes areas such as patient identification, security, privacy management, provider directories, document repositories and registries. Such a service-orientated architecture is based on general IT standards, but needs “profiling” for compatibility and use within healthcare. 

It has grown to become quite rich, explains Parisot“because IHE has added new components called ‘IHE Integration Profiles’ to form a robust and interoperable IT infrastructure. It may span tens of specialised IT systems in a healthcare enterprise and up to hundreds or thousands of IT systems forming regional or national health information exchange networks.”

IHE reduces implementation costs and time

To enable effective and meaningful exchange of health information, or interoperability, IHE provides detailed technical specifications based on tens of broadly adopted standards, both from the general IT and the healthcare sphere. 

“This avoids the current project-specific, fragmented healthcare IT market which significantly increases costs during the entire project lifecycle. IHE – through its open process and shared expertise – reduces implementation costs and time.”

He continues “as the May issue of HIMSS eMessenger mentioned Austria, which leveraged the IHE IT Infrastructure profiles for patient ID management, audit trail, strong node authentication, and document sharing. Consequently, in the Lower Austria region, 400,000 patient records were shared online in less than two years. 

“there is therefore no surprise that the decision was made to generalise the implementation of these IHE IT Infrastructure Profiles to the entire country in 2008”.

The worldwide recognition of the practical value of IHE, not only for semantically rich clinical content and workflow, but also for IT Infrastructures, has now spread to several countries including Italy, Austria, France, USA, Canada, Japan and China. 

 (ITI) Planning Committee which collects health IT infrastructure interoperability problems, evaluates and prioritizes them. 

“It teams up with the ITI Technical Committee which solves these interoperability challenges by selecting the best set of standards and assembles a detailed and complete implementation guide or an IHE Integration Profile.” 

A process to collate and review input

This work is conducted internationally, openly and transparently. It benefits from the implementation experiences of hundreds of experts through a process which allows for input and reviews at three critical points:

• Identifying the needs to be addressed
• The public comment review of the proposed solution
• Implementation in systems that will be actually tested and connected.

At each control point, anyone may be involved. In between these “feedback” steps, the ITI Planning and Technical Committee members meet face-to-face for three intense 5-day working sessions with bi-weekly telephone conferences in between. 

“This is hard work,” admits Parisot. “But it has resulted in attracting a wide range of stakeholders such as healthcare professionals, vendors, governments, consultants and many organizations from all over the world.”