Author: Zhang Jiwu May 2007 published in the "World of Medical Devices" special issue (as cited article, please indicate the source, thank you.)
IHE is a joint initiative of RSNA and HIMSS and is not yet an organization. All of its activities are implemented through RSNA and HIMSS. Although it is not an officially registered organization, it still has its own well-organized structure.
IHE's organizational system shows that it is a technical organization based on engineering applications. It hopes to promote the connection between hospitals and manufacturers, manufacturers and manufacturers through application examples, which embodies the user-oriented service system. thought.
This paper systematically introduces the organization and operation of IHE, including sponsoring units, participating units, committees, organization by region, organization by field, relationship between IHE and HL7. DICOM. EHR.
I. Initiating institutions and participating institutions
1. Initiation: Health Care, Related Societies, Associations
IHE is co-sponsored by different health care professional associations around the world, and welcomes the participation of mainstream medical imaging and information systems vendors. Volunteers from these associations, including radiologists, as well as other medical directors and information technology experts, play a key role in guiding the development of IHE and prioritizing integration needs. They work with vendor representatives to identify barriers to integration and best healthcare services, and to remove these barriers by developing and applying standards-based solutions to share information.
The founding group level was RSNA and HIMSS. Subsequently, many professional societies joined as professional representatives on the one hand as sponsors.
a. Existing sponsors
(1) American Academy of Ophthalmology (AAO):
(2) American College of Cardiology (ACC)
(3) American Medical Association (ACP):
(4) American Society of Clinical Engineering (ACCE);
(5) American Heart Association (AHA):
(6) American Society of Radiation Oncology (ASTRO):
(7) French Medical Information Association (GMSIH);
(8) Japan Insurance Medical Information System Industry Association (JAHIS):
(9) French Laboratory Information Association (SFIL):
(10) American Association of Healthcare Information and Management Systems (HIMSS):
(11) North American Radiological Society (RSNA).
b. Initiatives in various fields
(1) Ophthalmology field: AAO:
(2) Laboratory field: GMSHI. SFIL.HPRIM (Association Harmoniser et Promouvoirles Informati-ques Medicales) and JAHIS;
(3) Nuclear medicine: Nuclear Medicine Society (SNM) and American Society of Nuclear Cardiology (ASNC);
(4) Therapeutic coordination area: ACP:
(5) Patient treatment equipment: ACCE:
(6) Radiation tumor: ASTRO.
At the same time, more institutions are becoming sponsors.
c. Initiatives of regional and national IHEs are listed in Table 1.
2. Participation: mainstream manufacturers in the industry
Mainstream manufacturers in the industry are encouraged to participate in IHE activities. In fact, many mainstream manufacturers have specialized technical personnel to participate in the IHE activities and are elected co-chairs. There were many vendors participating in the HIMSS demonstration conference in 2007, including Agfa Healthcare. Dicta-phone. Eclipsys. GE Heathcare.Kodak et al.
Second, the organizational structure of IHE
1. Three committees
lHE is mainly composed of committees and fulfills its mission. It consists of three committees.
The IHE Program Committee and Technical Committee are composed of representatives of qualified relevant vendors whose products are directly involved in IHE. Any qualified person can join the committee, but a rigorous time commitment is required to attend the meeting and complete the assigned work. The secretarial and logistics services are provided by the sponsoring agencies and are currently RSNA and HIMSS. Every year, the schedules of the various committees are scheduled and published online. You are welcome to attend.
The three committees are:
a, the Strategic Development Committee,
It is composed of representatives of medical and health experts and representatives of various health-related industry organizations. The overall goal is to facilitate the development of IHE processes for the application of standards-based information sharing across healthcare companies. Committee members develop the IHE model by:
(1) Steps to recognize and determine the health care workflow:
(2) Recommend priorities in clinical or business areas:
(3) Identify integration needs and barriers in the cross-cutting area:
(4) Identify key resources and help the IHE Program Committee enter key areas.
b, technical committee
The general idea proposed by the Planning Commission was further developed into a specific IHE technical framework. While completing these documents, the committee members provide liaison between the project technical manager and the participating vendors to guide the vendors on how to participate in the demonstration.
c. Planning Committee
Responsible for establishing broad development directions and scope for demonstration and related integration activities. In addition to the scope of approval and release of the demonstration, the committee is also responsible for planning vendor seminars and other activities.
Generally, there are a number of chairmen and vice-chairmen. Each committee adopts a co-chairman system and is re-elected regularly.
At the earliest, only the Radiological Technical Committee, and later with development, developed several different fields, and established new technical committees and planning committees as needed, such as the Heart Technology Committee, information architecture, and ophthalmology. Its organizational structure expands accordingly, but the basic composition and relationship remain unchanged.
Further, IHE expands to a larger geographic area and more countries. Each region or country has its own IHE organization. Currently. IHE has three large regions: North America, Europe, and Asia. Each region includes the main country of the region. There are the United States and Canada in North America, the United Kingdom, France, Germany, etc. in Europe. At present, there are only South Korea and Japan in Asia, and China is being actively considered by IHE.
2. Relationship between committees, technical frameworks and fields
IHE is divided into multiple areas based on different clinical and operational practices. Users with clinical and operational experience in each area have identified prioritization of integration and information sharing, and relevant vendors have developed consistent standards-based solutions to meet these requirements.
There is a corresponding technical committee and planning committee in each area. The primary task of the technical committee is to develop and document those solutions (known as integration profiles). The primary task of the Planning Committee is to develop programs and organize activities (such as testing activities and educational programs). Each domain develops and maintains its own set of technical frame-work documents. Coordination between the fields is the responsibility of the co-chairs of the field. The Co-Chairs Committee is composed of representatives of the Planning Committee and Technical Committees in the field.
Each field has a corresponding technical framework. The IHE Technology Framework is a detailed and intensive document that provides comprehensive guidance on the application of the integrated capabilities defined by IHE. The technical framework describes transactions (Transa-ctions) between standard-based systems (generally defined as lHE Actors) to support specific workflows and integration capabilities.
The IHE technology framework is process-oriented. It defines a set of roles that must interact with each other to successfully complete a particular process. These roles interact by (currently) based on DICOM and HL7 information mechanisms and defining clear transactions. The framework is intended to avoid assigning roles to specific products (such as HIS, RIS, PACS, or imaging equipment), even though some products have traditionally completed some of these transactions. Its purpose is to determine in detail the interaction between functional modules in the health care information system environment. The various information system vendors or users that make up such an environment can decide which role a product can fit in a particular department.
At the beginning, IHE only had a field of radiology (the two sub-areas of Mammography and Nuclear Medicine). Due to its increasing influence, IHE extended to Cardiology, Eye, and Information Architecture. IT Infrastructure). Laboratory, Patient Care Coor-dination, Patient Care Devices and other fields. Each field is composed of a technical committee, corresponding to the establishment of a technical framework. Just in February of this year, IHE announced the addition of a one-price quality field to determine the basic framework for sharing information related to electronic patient care and health care records (Electronic Patient Care and Health Care Records).
The technical framework is composed of many profiles. I won't go into details here.
IHE is not a standard. IHE is a campaign that advocates and introduces multiple information systems integrations. First, IHE creates an open discussion environment among medical information system vendors, users, and other interested parties (such as standards bodies and professional societies) to improve patient services and how to better integrate various information systems. Secondly, IHE provides communication compatibility testing (Connectathon) for manufacturers to test whether the products of the manufacturer can smoothly connect and communicate between systems. For users, the application value of IHE is mainly reflected in the technical framework and integration mode.
IHE follows the HL7 and DICOM standards. If the HL7 and DICOM standards are adhesives that combine different companies' products and different equipment, IHE is more like an architect, describing the framework of the entire healthcare building. Each of its profiles can be seen as a blueprint.
In the technical framework of IHE, HL7 defines the three main types of information for communication in the processing of array transactions: patient, inspection and result information. The operation of these transactions, the requester is between the ADT and the check-in system, and the performer is in the departmental system arrangement and the image management system.
Patient Information - HL7 ADT information is in the communication of demographic and login information in response to more than 60 discrete trigger events, citing 13 trigger events of the HL7 standard, ie causing information generation within the IHE model.
Inspection Information - Within HL7, a general purpose inspection management (ORM) message allows inspection of communication and identity data between inspection submission and inspection scheduling systems. The IHE technical framework details inspection submission management, inspection schedule management, operational scheduling, and operational revision transaction processing, that is, applying HL7's ORM information and inspection response (ORR) to coordinate the transmission of such information.
Results Information - While most IHE processing reports use the DICOM standard, IHE uses HL7 observations to proactively provide information to process ASCII text reporting information between the Report Management and Reporting Manager and Reporting Library.
No radiologist does not know DICOM. Many people think that DICOM is a standard for transmitting radiology images from an workstation to acquire imaging devices or image storage transmission systems (PACS). This is indeed the main purpose of DICOM at the end of the 20th century.
The first aspect of DICOM: DICOM image transmission. The DICOM standard has been accepted by the Radiology Society and is rapidly evolving in areas such as cardiology and hyperthermia. It has been applied in other medical imaging fields, such as microscopy, pathology, and ophthalmology. DICOM will no longer be a discretionary standard for radiology, but will also include special single-dimensional waveforms that can be used in cardiology or electrophysiology.
The second aspect of DICOM: the network connection for producing film and other print media printing devices, called DICOM printing, which is an important tool for connecting film and paper printers and other hardware copy devices to hospital LANs, not only in radiology. Also used in telemedicine.
The third aspect of DICOM: the exchange of images on storage media such as magneto-optical and DICOM.
One of the most notable applications for IHE is the electronic health record (EHR) that supports collaborative work. IHE will facilitate the integration of medical information systems and remove barriers that hinder the optimization of healthcare services processes.
IHE has defined some common frameworks to meet the basic collaborative needs of local or regional medical information networks. It developed a basic set of standards-based integration models for the exchange of information in three related areas:
(1) Cross-Enterprise Document Sharing (XDS), which supports collaborative interaction of file content. This supports a standards-based EHR that spans both clinical and therapeutic.
(2) A security framework for protecting confidentiality, authorizing the use and integration of patient healthcare data.
(3) Cross-disciplinary patient identification management to ensure consistent patient information and efficient retrieval of EHR.