Integrating Healthcare Enterprise (IHE): History, Technical Frameworks & Benefits

Integrating Healthcare Enterprise (IHE): History, Technical Frameworks & Benefits
The IHE (Integrating the Healthcare Enterprise) operates a process through which the interoperability of IT systems can be improved. It is sponsored by the HIMSS (Healthcare Information and Management Systems Society), RSNA (Radiological Society of North America), and the American College of Cardiology (ACC). The IHE was established in 1998 by a consortium of radiologists and information technology experts. 

IHE profiles share a clinical information need and document how to use the standards to accomplish it. For instance, the DICOM standards specify different formats for image data. The LOINC (Logical Observation Identifiers Names and Codes) codes for use in databases are used in IHE profiles. 

IHE integration statements are published by a vendor to enlist the IHE profiles by the release of the product. IHE technical frameworks are documents that specify the profiles and associated transactions. In 2008, an agreement was announced for cooperation with the Continua Health Alliance. Later, in 2012, a guide was published, sharing the steps on how to access health data from mobile devices. 

IHE involves healthcare professionals and other representatives who work together to enhance the way computer systems work in the healthcare system. It provides a framework for effective solutions to minimize the communication gap between systems and foster their interoperability. 

IHE is a member of the national-level IHE organizations. The Integration statements show the IHE profiles and the leads that ICW solutions can support. The strategy of IHE is integrating radiology workflow within a healthcare setup. It creates a framework for integrating applications and settings across the healthcare enterprise. 

Every year, IHE organizes Connectathon in Europe and North America, which are the industry’s largest interoperability testing events. Connectathon offers an invitation to the community, and thousands of cross-vendor tests are performed using testing tools. IHE profiles and minimizes ambiguities and reduces interface costs. 

Background of IHE

The DICOM was developed and published in 1985 by the American College of Radiology and represented radiologists and the National Electrical Manufacturers Associations (NEMA). It represented manufacturers of diagnostic image equipment like magnetic resonance equipment. It introduced an information model for the management of information in radiology. 

In the late 1980s and 1990s, several DICOM-complaint, digital radiographic systems from different vendors became more commonplace in HCOs. Also, picture archiving and communication systems started to be implemented in radiology to capture and display the diagnostic images. Later, the organizations realized that the interoperability of DICOM was limited to point-to-point interfaces and required coordination between information systems. 

In 1987, the consensus-based HL7 standard was initiated by the HL7 standards development organization. It specified working interfaces for different ranges of administrative structured data messages, allowing healthcare applications to share data. Unfortunately, HL7 lacked an information model for the management of coded data. Despite HL7 compliance, HCOs had no interoperability and cost-effective automation of business processes. 

In 1998, Integrating the Healthcare Enterprise was launched by HIMSS and RSNA. It focuses on the existing DICOM and HL7 standards. It developed the first version of the IHE Radiology and Technical Framework to define how to use HL7 and DICOM to resolve communication tasks that involve multiple information systems in radiology. Furthermore, IHE simplifies transactions and ensures that information has integrity throughout the framework. 

The first demonstration of the IHE Radiology Technical Framework was at the RSNA Annual meeting in 1999 and the annual HIMSS conference and exhibition in 2000. After this, the Radiology Technical Framework has expanded annually and maintained by the IHE technical Committee through the identification and correction of errors. 

Improved Connectivity and Workflow Optimization

Sometimes connecting the systems with different vendors turns out to be a challenging task. It provides a standards-based foundation to minimize the complexity of system integration in multi-vendor environments. DICOM and HL7 are the interoperability building blocks. 

Nowadays, IHE includes SDOs, like, ACR-NEMA and HL7, such as HIMSS, RSNA, and other care providers. These IHE stakeholders agree to participate in the guidelines of the development process and to collaborate to enhance the way healthcare systems work. The IT professionals and vendors embed the frameworks guidelines into their products. 

Today, the IHE has published technical frameworks for laboratory and IT infrastructure. It is expanding into clinical areas and medication management. It is supporting the use of cross-industry standards, which are developed by the IETF (Internet Engineering Task Force). IHE is also planning to support implementations of the American society for testing and materials. 

Integrating the Healthcare Enterprises Around the World

IHE North America includes the US and Canada. International growth of IHE is noticed in Europe, where IHE is organized under the sponsorship of the medical imaging industry. The European initiative was sponsored and demonstrated in France with the French Radiology Society. Today, national committees, along with the United Kingdom and Scandinavia, operate under the IHE Europe. 

IHE Technical Frameworks

IHE consists of vocabularies for humans to discuss how to integrate heterogeneous information systems. They consist of the standards-based vocabularies for systems to use in sharing medical information. Version 5.5 of the IHE Radiology Technical Framework has different integration profiles like basic security, evidence documents, post-processing workflow, patient information reconciliation, and more. 

Version 1.0 has five different profiles, which were demonstrated at the joint of HL7-IHE Interoperability Demonstration at the Annual HIMSS Conference and Exhibition. The different profiles are Consistent Time, Patient Identifier Cross Referencing, Enterprise User Authentication, Retrieve Information Display, and Patient Synchronized Applications. 

IHE technical frameworks identify products and manage information related to the operational process. The frameworks refer to these processes as actors. 

Specific standards are used for every transaction. The IHE details the transaction terms. The Radiology Technical Framework has identified over 50 transitions, such as storage commitment, and more. 

The IHE Benefits

IHE Technical Frameworks help HCOs to determine the need and to upgrade the existing products to implement the standards-based transactions. Furthermore, they also specify the transactions when HCOs consider products for purchase. 

It gives easier access to pertinent clinical information and facilitates systems integration. It offers cost-effective integrated solutions. It gives a seamless exchange of data within hospitals and across the healthcare community. 

IHE Connectathon

IHE Connectathon is a structured test event and culture of interoperability. It opens the way to product conformity assessment. It is a cross-vendor and supervised and structured testing where industry leaders test implementations of IHE profiles to enhance health IT interoperability. 

IHE Connectathon is beneficial in several ways. It collaborates and networks with over 500 of the industry's best professionals at the largest interoperability testing event in the world. 

IHE and Electronic Health Records

Due to the increased adoption of EHR as a primary use, the number of electronic documents stored in systems would boost in the future. To benefit from this development in the healthcare industry: it is important to meet the requirements for the secondary use of EHR data. IHE Technical frameworks provide complete and integrated electronic patient information for care providers and patients. 

Final Words

Systems associated with IHE can communicate better and are easier to implement. It allows providers to share information more effectively. It is a multinational healthcare initiative that publishes domain-based technical frameworks. It consists of vendor-neutral implementations of existing healthcare standards but not including HL7 and digital Imaging and communications. 

Vendors can use the technical frameworks for adopting standards-based system architecture to exchange information in common formats. IHE committees work to address systems and software. They can exchange and share data in clinical domains, including endoscopy, IT infrastructure, patient care coordination, radiology, and laboratory, etc. 
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