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435 pts.
 Integrating Healthcare Enterprise(IHE)
What is IHE.How it is contributing towards Interoperability.How it can be utilized while procuring system for Healthcare Organization.

ASKED: June 13, 2010  5:00 AM
UPDATED: December 27, 2010  7:35 pm

Answer Wiki:
The IHE is an international standards development organization focused pretty much exclusively on sharing health information among systems. The group promotes standardsdeveloped by other organizations (like HL7) and also develops a set of its own standards, many of which are used today in healthcare environments. IHE's relevance in the current health information exchange context is that many of IHE's standards are incorporated in recommended or required standards coming out of HITSP, ONC's federal advisory committees, and technical groups working on initiatives like NHIN Exchange and NHIN Direct. As new areas are evaluated for coverage by standards recommendations stemming from meaningful use, and government health IT initiatives, IHE remains one of several possible sources of standards to be selected. (Generally speaking, ONC and groups like HITSP do not create or define standards; instead they survey the available landscape for existing standards that might be used in support of a given purpose or function, and try to choose the best alternative among those options.) IHE contributes to interoperability by defining and/or promoting common data and service standards that, if implemented by multiple parties wanting to exchange information, facilitate health information exchange by providing common technical ground. Some IHE standards are also designed to abstract out variations in underlying technical standards or approaches adopted by healthcare organizations, to present a common representation that others can use. For example, IHE's cross-enterprise user assertion (XUA) is designed to provide a consistent representation of identification and authentication information about a user, even if the underlying authenication mechanisms or credentials used within different environments are not the same (e.g. one uses Active Directory and Windows Authentication, another uses Oracle Identity Manager, and a third uses Tivoli Access Manager). Similarly, the audit trail and node authentication (ATNA) standard doesn't require that every organziation use the same audit record format, but does specify a common format in which audit records are communicated between organizations. In terms of how to utilize IHE for purchasing a system, you generally don't have to. Many IHE standards are already supported by EHR vendors and other health IT solution providers (even open source ones - the ONC's CONNECT gateway implements quite a few IHE standards, for instance). To the extent that vendors want to take advantage of the incentives provided to eligible providers under meaningful use, those vendors will certainly make sure that their products comply at least with whatever standards are included with the certification requirements issued by ONC (which will be tested by NIST or parties it authorizes). This doesn't mean that a given product will conform to all the IHE standards, but IHE is pretty pervasive in commercial health systems, so if you are looking at established health IT vendors, a lot of IHE is probably already in their product offerings.
Last Wiki Answer Submitted:  June 14, 2010  5:04 pm  by  SteveGonHIT   250 pts.
All Answer Wiki Contributors:  SteveGonHIT   250 pts. , AllinHIT   390 pts.
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IHE – Integrating the Health Enterprise is another body to police the standard implementation by ISVs. Even though there were other bodies, IHE is different in filling the loop holes and making the applications developed by the ISVs interoperable across different practices and ensuring that the cross boundary communication happens as per the guidelines set by the industry representatives.

It adopts standards from HL7, DICOM etc.. IHE will not be another body like HL7, DICOM, LOINC, but something on the lines of processes to be followed while implementing those standards. Right now the industry have standards, but they are not followed exactly the same way for one specific task / transaction. There are differences in implementation for Laboratory result transfer process between vendor A and Vendor B. It will be either same or different for Vendor C. These kinds of practices create chaos in a complex business scenario in large scale deployment.

IHE will be instrumental, when we aim for bigger initiatives of HIE (Health Information Exchange) at national level or for that sake at international level covering USA, Canada and european unions.

 200 pts.


IHE is classified enterprise networking. The standards for such an enterprise (classified) can be found scattered throughout the Internet in “CERT Advisories”. My experience has been that standards required by governing authorities for health care parallels that of government classified nationwide and worldwide enterprise networks. Medical enterprise integration is the culprit which lags behind those standards already utilized by secure enterprises within other diciplines (i.e. intelligence, banking, e-commerce).

The standards for secure communitcations are quite clear between devices with regards to configuration. There are layers of enterprise network communications that must be configured to comply with industry best practices for secure networks.

Procurement today will change next year because of the advances and demands for better performance, scalability, and the sun downing of non-web-based meta server technology (i.e. Citrix). The difference in one example that I will ask if I can devuldge is 1 for every 12 servers by using web-based (e.g. Websphere) techonologies.

The web-based applications still has a long way to go – one year is about four technology years, so in about 1.5 technology years we will begin to see a difference..

 280 pts.

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