Guest author Uwe Porwollik presents the IHE global initiative Integrating the Healthcare Enterprise, its players, and its strategy in a four-part series – and provides answers to what the IHE is and how IHE aims to achieve the goal of exchanging information across systems and organizations in the health care system. This article focuses on the subject of manufacturer-neutral IT in the healthcare system.
How does IHE guarantee manufacturer neutrality?
In physics, a system is defined as “open” if it is able to exchange energy or matter with its environment. The human body is an obvious example as it inhales oxygen and exhales carbon dioxide. When applied to the healthcare system, the IT systems that we can find there can only be described as “closed.” Healthcare information can neither digitally overcome the boundaries of an institution, nor can it enter them. This not only costs money, but also reduces the quality of care. IHE is a manufacturer-neutral methodology that makes healthcare information available digitally where it is most needed by patients and the people who treat them.
The tumor board review- a practical example!
The “Radiology” domain best illustrates why the exchange of information in the healthcare system must be organized in a manufacturer-neutral way. This area is a central working group within the IHE, which has described most of the profiles/processes since its inception right up until the present day. The need for interdisciplinary treatment strategies in the fight against malignant diseases in combination with increasingly complex therapeutic steps justified the establishment of tumor boards. Doctors from all the fields involved (internists, radiotherapists, radiologists, and nuclear physicians) sit together and coordinate the procedure for tumor treatment in these conferences. In order for this interaction of the different specialties to function smoothly, it is necessary that all patient information and findings are collected and made available to each participant. Diagnoses and findings in the form of text, images, and data tables are generated in highly complex medical devices that generate information in various standards and formats. Each profile within the “Radiology” domain describes a dedicated integration scenario and thus specifies how and in what form the information must be provided. If the decisions made at the tumor conference can have an impact on life and death, the question of which device manufacturer generated the respective information may not play a role in this process. But even if the decisions have less dramatic effects, a manufacturer-neutral flow of information increases the patient’s treatment quality.
A process-related approach!
In IHE logic, manufacturer neutrality means that networking problems are not solved in relation to products and manufacturers but rather in relation to processes. A medical device is no longer integrated into an existing IT landscape using a manufacturer-specific standard. Rather, it describes a medical process that is to be technically mapped from this point on. However, this IHE approach is not guaranteed to be manufacturer-neutral until not only individual manufacturers “fix” the networking scenarios, but users from service providers, industry, and research also collaborate in working groups (domains).
Domains & profile
This procedure requires a great deal of knowledge about medical processes. To meet this requirement, the IHE has so far founded 11 working groups (domains) ranging from radiology to laboratories to IT infrastructure, in which doctors, researchers, and developers, as well as institutions and manufacturers, work together on networking processes. In practice, each domain has a technical committee and a planning committee. The technical committee is responsible for creating integration profiles in which technical solutions and specifications are formulated. The responsible planning committees formulate development goals and accompany the “market launch”, i.e. manufacturer implementation. The results are available at the end of the process in the form of profiles for each manufacturer and, similar to a user manual, assist in product adaptations.
The heart of the IHE and the guarantor for manufacturer independence is the “IT Infrastructure” working group. This domain, abbreviated to “ITI”, formulates the technical prerequisites that allow information from different devices and systems to be brought together and processed together within and outside the institution. The next but one and the last article in this series on Integrating the Healthcare Enterprise (IHE) explains how this works and what technical requirements are necessary.
Find out how the IHE is integrating all healthcare system stakeholders using the interoperability cycle in the upcoming blog.
- Part 1: What is IHE? Standard or Initiative?
- Part 3: The Interoperability Cycle: Quick Access to Relevant Information!
- Part 4: The IHE Cookbook
About the author:
Uwe Porwollik, a partner in eHealth.Business, sales and project success in the health care system.