Under this cooperative agreement, the Office of the National Coordinator for Health Information Technology (ONC) and Integrating the Health Enterprise (IHE) USA are collaborating to accelerate the creation of new and updated IHE profiles to support the use of the HL7® FHIR® (Fast Healthcare Interoperability Resources) standard.  IHE Profiles provide a common language for purchasers and vendors to define the integration needs of healthcare sites and the integration capabilities of healthcare IT products. They provide healthcare professionals seeking to acquire or upgrade systems a convenient, reliable tool that reduces the complexity, cost and anxiety of implementing interoperable systems by providing a way to specify a level of compliance to standards sufficient to achieve truly efficient interoperability. 

 

The goal of the HL7 FHIR standard is to ease interoperability between legacy healthcare systems, make it easier to access healthcare information on a wide variety of devices, and to allow third-party application developers to design innovative medical applications which can be easily integrated into disparate systems.  This cooperative agreement, launched five years into the United States’ Nationwide Interoperability Roadmap, reflects the ONC’s strategic goal to promote the use of the FHIR standard, as well as advancing standardization through profiling, in support of better interoperability. IHE USA, a national deployment committee of IHE International, engages and supports the health IT community by promoting the adoption and use of IHE and other world-class standards, tools, and services for interoperability. This agreement will also strengthen and streamline cross-organizational collaboration efforts between standards developing organizations (SDO), interoperability test tool developers, FHIR champions and other vital stakeholders. Year 4 of this Cooperative Agreement is focusing on the adoption and implementation of the International Patient Summary (IPS).

International Patient Summary

An International Patient Summary (IPS) document is an electronic health record extract of the essential health information intended for use in unscheduled, cross-border care scenarios. The IPS is also emerging as a potential source document that could be re-used to support use cases beyond the original scope such as vaccine credentialing for COVID19.

IHE USA is supporting the adoption and implementation of IPS by supporting development of the specification, educational programming events, and testing through our Global Health Standards Acceleration efforts.

IHE Deep Dive: How the International Patient Summary Works (25 min - Video)

 

The International Patient Summary, developed collaboratively between ONC, HL7®International, IHE International, and the European Commission is designed to support patient mobility abroad by providing a standardized set of basic personal and medical data at the point of care.  

Presented by IHE International Board Member Michael Nusbaum, BASC, MHSA, FHIMSS and Rob Hausam, MD, HL7 Vocabulary and Orders/Observation workgroup Co-Chair and HL7 FHIR Connectathon track lead, this IHE Deep Dive session will focus on how to integrate the International Patient Summary profile, the IPS projects from across the world and the importance of collaborative interoperability efforts that span the globe.

NEW: The IPS has its own website: https://international-patient-summary.net

Interested stakeholders are welcome to join the cross-SDO joint working groups for the International Patient Summary. More information can be found here: https://confluence.hl7.org/display/PC/Bi-weekly+Cross-SDO+Collaboration+Meeting+-+IPS

 

How are the ONC and IHE USA Driving HL7 FHIR Adoption?

The objectives of the work done by the IHE USA Cooperative Agreement project team are to:  

• Catalog IHE Profiles that utilize the FHIR standard to enable cross community health information exchange
• Identify and prioritize new profiling opportunities to leverage the FHIR standard
• Accelerate the development of robust, real world testing processes and adoption of the updated FHIR-focused IHE profiles and HL7 implementation guides 
• Actively engage with HL7 and IHE International on lessons learned through profiling improvements and real-world testing 
• Strengthen and streamline cross-organizational collaboration efforts between SDOs, interoperability test tool developers, FHIR champions and other vital stakeholders. 

All improvements and extensions created by IHE USA will be complementary to International initiatives and made globally available through IHE publications.

 

IHE International oversees the development and publication of IHE Technical Frameworks worldwide. IHE USA operates as a national deployment committee of IHE International, serving as a voice representing US health IT interests and key partners in national health IT efforts for fostering the national adoption of a consistent set of standards to enable interoperability of health IT systems. The ONC/IHE USA cooperative effort welcomes all stakeholders to collaborate with our project team to make this agreement a success.

 

The complex, wide-randing efforts required to achieve the goals set out in this cooperative agreement could not be completed without the support of dedicated collaborators.  The following organizations support the work of IHE USA in meeting the goals of this agreement.

 

               

 

21st Century Cures Act and its Impact on Interoperability

The 21st Century Cures Act, signed into law in 2016, is designed to enable interoperability through initiatives such as the Trusted Exchange Framework and Common Agreement (TEFCA), US Core Data for Interoperability (USCDI), and the Interoperability, Information Blocking, and the ONC Health IT Certification Program final rule.

The 21^st Century Cures Act requires that developers of certified health IT publish Application Programming Interfaces (APIs), a software intermediary that allows two applications to talk to each other, to be used to enable interoperability “without special effort.” The law’s certification criterion require standardized API access for single patient and population services using the HL7® Fast Healthcare Interoperability Resources (FHIR®) standard. The purpose of HL7 FHIR is to ease interoperability between legacy healthcare systems, making it easier to access health information on a wide variety of devices, and to allow third-party application developers to design innovative medical applications which can be easily be integrated into disparate systems.    

Why is the ONC Partnering with IHE USA to Drive FHIR Adoption?

As part of a multi-year cooperative agreement, the Office of the National Coordinator for Health Information Technology (ONC) and Integrating the Healthcare Enterprise (IHE) USA are working together to accelerate the adoption of FHIR-based IHE integration profiles to drive the adoption of the FHIR standard in compliance with the 21^st Century Cures Act. 

IHE USA is a national deployment committee of the standards development organization (SDO) IHE International.  IHE USA engages the US-based health IT community to adopt and use world-class standards, tools, and services for interoperability to deliver on its vision of improved quality, value, and safety in healthcare by enabling rapid, scalable, and secure access to health information at the point of care.

Which IHE Integration Profiles Are Being Leveraged to Move FHIR Standard Adoption Forward?

IHE Integration Profiles are guides that provide a common language for purchasers and vendors to define the integration needs of healthcare settings and the integration capabilities of health IT products. IHE profiles provide healthcare professionals seeking to acquire or upgrade systems a convenient, reliable tool that reduces the complexity, cost and anxiety of implementing interoperable systems by offering a way to specify a level of compliance to standards sufficient to achieve truly efficient interoperability

The IHE USA Cooperative Agreement project team is engaging stakeholders across the health IT industry to update and drive adoption of the following IHE Integration Profiles.

Profile Name	Description
Mobile Access to Health Documents (MHD)	Defines one standardized interface to health documents (a.k.a. an API) for use by mobile devices so that deployment of mobile applications is more consistent and reusable
Mobile Care Services Discovery (mCSD)	Supports discovery of care services resources using a RESTful interface in interrelated, federated environments
Patient Identifier Cross-Reference for Mobile Integration (PIXm)	Provides a transaction for mobile and lightweight browser-based applications to query a Patient Identifier Cross-Reference Manager for a list of patient identifiers based on the patient identifier in a different domain and retrieve a patient’s cross-domain identifiers information into the application
Paramedicine Care Summary (PCS)	Provides the structures and transactions for sending the patient's paramedicine encounter information to the receiving facility
Quality Outcome Reporting for EMS (QORE)	Uses a query and a SEND transaction to move quality measurement data across several EMR entities that will allow for these data to be used for quality and registry measurement for Hospitals and emergency medical system (EMS) companies.
Referral Interfacility Patient Transport (RIPT)	Provides a methodology for a standard approach to share post-discharge documentation to the EMS transport team that informs them of important patient care information.

 

To learn more about the ONC/IHE USA cooperative agreement, contact Connectathon@ihe.net