IHE - ITI Educational Webinar Series. Register Today!

Greetings IHE members,

IHE International is pleased to announce the upcoming ITI Educational Webinars.  Register today!

v  Cross-Enterprise Document Workflow

Presented by Arianna Cocchiglia and Luca Zalunardo

03/06/12  9:00am CT

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"The Cross-Enterprise Document Workflow (XDW) profile enables participants in a multi-organizational environment to manage and track the tasks related to patient-centric workflows as the systems hosting workflow management applications coordinate their activities for the health professionals and patients they support. This profile defines an instrument, called a “Workflow Document”, to manage and track a shared workflow. It is designed to support the complexity of health services delivery with flexibility to adapt as workflows evolve."

v  Patient Identity Management

Presented by Eric Heflin

03/07/12  10:00am CT

Attendee Registration

"IHE has several profiles, actors and transactions designed to enable participants to manage patient identities across different assigning authorities (and/or organizational boundaries).  In this presentation, these profiles will be introduced." 

v  Healthcare Provider Directories

Presented by Eric Heflin

03/14/12  10:00am CT

Attendee Registration

"Several IHE profiles have been created to assist managing providers within, and across, organization boundaries. This presentation will introduce each of these profiles, including the actors, transactions, and options.  Deployment examples will be provided." 

v  Enabling Document Sharing through IHE Profiles

Presented by Karen Witting

03/21/12  10:00am CT

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“The purpose of this webinar is to provide an overview of the collection of IHE profiles which are intended to be used by communities for exchanging health information. The collection of profiles includes support for patient identification, health document location and retrieval, provider directories, and the protection of privacy and security. This white paper will show how various profiles work together to provide a standards based, interoperable approach to community and cross-community health information sharing.”

Thanks to each of our presenters!

Register Today!

IHE IT Infrastructure White Paper on HIE Published

This white paper shows you how the IHE profiles work together to provide a standards-based, interoperable approach to health information exchange.   If you are involved in an HIE, and want to understand the standards and technology that can be used to support information exchange, this is a good document to read.  At 35 pages, it is a short document, but it packs a great deal of information that HIE CTO's and architects should know.

The white paper addresses four key technical challenges:

• Sharing models, including push, pull (Query/Retrieve), and Federation
• Patient Identity Management
• Patient and Sharing Partner Discovery
• Security and Privacy

Because it is focused on the technical infrastructure, the white paper does not address the content profiles that have been developed by a number of IHE domains which can be used with the technical infrastructure. That will likely be the topic of a future white paper from Patient Care Coordination.

  -- Keith

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IHE Community,

 
IHE IT Infrastructure White Paper Published

The IHE IT Infrastructure Technical Committee published the following white paper on January 24, 2012:
 
·         Health Information Exchange: Enabling Document Sharing Using IHE Profiles
 
The document is available for download at  http://bit.ly/IHEDocSharing. Comments can be submitted at http://www.ihe.net/iti/iticomments.cfm.

IHE ITI Technical Framework XDW Supplement for 2nd Public Comment

IHE Community,

IHE IT Infrastructure Technical Framework Supplement Published for Public Comment

The IHE IT Infrastructure Technical Committee has published the following supplement to the IHE IT Infrastructure Technical Framework for Public Comment on July 29, 2011

• Cross-Enterprise Document Workflow - Rev. 2.0 (XDW)

The document is available for download at http://www.ihe.net/Technical_Framework/public_comment.cfm. Comments submitted by August 26, 2011 will be considered by the IT Infrastructure Technical Committee in developing the trial implementation version of the supplement.  Comments should be submitted at http://www.ihe.net/iti/iticomments.cfm 

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For a bit more detail, see John Moehrke's post.

Cross Enterprise Document Workflow

Automating workflows within an enterprise is very different from automating them across enterprises. Within an enterprise one can expect a common platform for workflow automation. Processes can be well-defined, controlled and responsibilities assigned for management and escalation. Think about what you go through to purchase a piece of hardware or software in your own environment. Across enterprises it gets quite a bit more complicated. A common platform is hardly likely. Obtaining agreement on processes is not easy, and can require quite a bit of manual intervention. Think about what it takes to approve a new supplier for goods and services. In most businesses though, dealing with a new supplier still works because there are well defined inputs and outputs at the interfaces between the organizational workflows. You issue a PO, the supplier responds with a well defined package of goods or services and an invoice. When all goods and services are delivered, you pay the bill.

Imagine how complicated cross-enterprise workflows would get in your organization if your IT department required detailed information about the steps used to diagnose and repair a broken laptop that it sent out to someone else to repair, and furthermore wanted to automate the workflow across the two organizations to keep track of status. Some will tell me that they even manage this, and I'm certain they do. Usually with one or two other organizations that they have developed a pretty strong business relationship with. Scale that up to hundreds of other organizations or more, and I can assure you that it isn't done.

But in healthcare, these sorts of workflows happen all of the time. And healthcare providers need to track and route what is happening. Enter Cross Enterprise Document Workflow (XDW). The purpose of XDW is not to "automate" workflows within or even across enterprises. Instead, it's about tracking what happens, or should happen in the next few well-defined steps, and being able to look inside any "sub-workflows" initiated.

Think about a simple referral. Provider detects finding, refers patient to specialist. Specialist examines patient, treats patient and report back to the orginal provider. Getting a bit more complex, the specialist has an additional finding that he/she sends off to someone else (e.g., pathology) to look at. That result is reported back to the specialist. Because of that result, additional treatment (e.g., surgery) is needed. Complications due to surgery require additional treatment (e.g., PT) for recovery. And so on.

Consider that each provider involved in care may have a referral network that includes hundreds of other healthcare providers and organizations. Consider also that the patient may decide to use other healthcare providers that aren't already known to the originating provider.

So we need to think about this differently. The function of workflow automation in healthcare needs to support tracking what is happening to a patient without requiring a "definition" of the workflow to exist up front. XDW allows a healthcare provider to initiate a task, provide inputs in the form of documents, and to track the status of a task, and look at the "outputs" (again, documents). A provider that is working on a task can "claim ownership" of it, generate outputs associated with it (e.g., diagnostic results or consult notes), and initiate new tasks to ensure the completion of the workflow that was initiated by the initial request for consultation.  As the workflow proceeds, it can take new and unanticipated directions without any pre-coordination being required by the initiating provider.

Sounds like cool stuff.

Cross Enterprise Document Workflow (XDW)

IHE IT Infrastructure is defining an integration profile called Cross Enterprise Document Workflow (shortened to XDW).  This is truly infrastructure.  There is no clinical content, and the workflow management component is very thin on management.  Really it provides tracking of the workflow state of various tasks, and provides for a mechanism to update state.  Any associated clinical content that works with this profile would be developed by a clinical domain (e.g., radiology, cardiology, patient care coordination, labs, et cetera).

Each step in the workflow is described by a short set of metadata and the workflow also has a set of metadata.  All of the steps (and their metadata) in the workflow are recorded in a single document.

We (PCC) spent a bit of time in IT Infrastructure today to outline some of the requirements for the step and workflow metadata, and how this could work with the existing XDS infrastructure without change.  One of the key principles of this profile is that applications using it would manage workflows, rather than having them be enforced by a workflow management engine.  It doesn't preclude the use of such an agent once we get into the specific clinical workflows, but it does provide a vastly simpler scope that makes the profile broadly useful.

My next step is to do a little investigation into existing standards for describing workflows and steps, to see if there are any good candidates to include in this profile for representation of the workflow.