Integrating the Healthcare Enterprise

 
 
 
 
In 1998, the Health Information and Management Systems Society (HIMSS) and Radiological Society of North America (RSNA) began a joint initiative called Integrating the Healthcare Enterprise (IHE) to "bring together healthcare professionals, vendors, and IT executives to develop a framework within existing industry standards, which enables plug-and-play interoperability among systems from different vendors" (Vegoda, 2004)). This allows patient information to be transferred within and between departments seamlessly among systems so that caregivers can access all relevant patient information throughout the health system, and thus provide them with optimal care.

IHE is necessary because providing patients with optimal h4ealthcare requires that physicians have access to all relevant information concerning the patient (IHE, 2003). Currently, patient data is stored in many different systems which do not communicate effectively. Redundant entry of data can lead to errors and mismatches, and case decisions may have to be made without all pertinent data being available. IHE is designed to aid the flow of information between various personnel involved in a patient's care. It does not create new standards, but promotes the adoption of standards to meet specific clinical needs (HIMSS, 2004).

The IHE has "defined a common language within the Human Level-7 (HL-7) and Digital Imaging and Communications in Medicine (DICOM) standards, which removes the ambiguity when discussing t


     
 
 
 
    

 

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nformation coming from different exhibitions and conferences given by the RSNA and the HIMSS (RSNA, 1999). Technical problems also arise because of different standards, for example: DICOM and HL7; different interpretations or implementation of HL7; different ways used to achieve the same results; no agreed system boundaries; no guaranteed application interoperability; and different information models. In the first year, several improvements had been achieved by IHE (RSNA, 1999). In terms of organization, imaging and information systems vendors and users are working together. On the technical front, a common vocabulary and data model are now used, the product boundaries have been addressed; HL7 and DICOM options have been agreed upon; and application interoperability has been achieved. IHE defines the use of established standards for higher levels of integration. Products implemented under the Technical Framework are easier to integrate and give flexibility to address a variety of healthcare enterprise needs; this results in reduced integration costs and increased efficiency. In August of 1993, the IHE set forth the IT Infrastructure Technical Framework (ITI TF) which "defines specific implementations of established standa

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