Source: Alan Rector: AIM: A personal view of where I have been and where we might be going. Artificial Intelligence in Medicine (2001) 23:111-127
The healthcare enterprise has been a constant challenge for software developers since IT itself emerged. Healthcare includes a wide range of fields like radiology, laboratory medicine, cardiology. IT systems must serve many different types of users, including care professionals, patients, relatives and administrations. Software developers, system administrators, lawyers and many other professions contribute to IT system development from their specific perspective. Medicine itself continually evolves as science progresses. Medicine increasingly faces challenges to sustain the quality of servise using limited resources under the pressure for example from demographic change and civilisation diseases. IT has a hard time to keep up with the ongoing change of requirements in this environment.
The "Integrating the Healthcare Enterprise" (IHEI initiative has developed a large number of interoperability profiles. These are succesfully used for IT system integration in helathcare by vendors and healthcare providers globally. This page introduces the main domains of healthcare and briefly introduces some examples of available IHE interoperability profiles.
Over time IHE has developed overviews for many domains in healthcare. These domain verviews are available in the Volumes 1 of IHE Technical Frameworks, typically in Sections 2, and then in the initial sections of each profile.
Medicine typically cycles through the phases of "diagnosis" and "treatment", in many variants depending on the individual situation of the patient.
Radiology / medical imaging together with medical laboratories provide a large part of the information used for diagnosis. Imaging and laboratory are often called the "technical professions" of medicine as they use many technical devices. Much of the data is therefore already sematically structured.
Medicine includes many other domains like neurology, internal medicine, orthopaedics, different types of surgery, psychiatry, cardiology, dental medicine. Typically each domain uses it's own set of processes, knowlede and skills. IT systems wil have to consider the specific information requirements.
Medical activities generate and consume high volumes of information. This information comes in many types (free text, structured, coded, ...). It is shared between all those who treat an individual patient, but also for a large number of other processes:
- medical documentation
- care paths, guideline oriented medicine, best practice
- decision making using IT support
- research, public health, clinical trials
- quality control and optimisation of care
IT systems increasingly are used for all these purposes. IHE has provided technical frameworks and integration profiles for IT infrastructure. The IHE technical frameworks provide information about the processes in healthcare, that can be very valuable to learn about the nuts and bolts in a medical domain. This knowledge is valuable for developers who want to implement software for a specific domain.
The Integrating the Healthcare Enterprise (IHE) initiative was founded in the 1990es. At that time the "Digital Imaging and Communication" (DICOM) standards were already widely used to integrate for example medical imaging modalities to reporting workstations and image archives. The Health Level 7 (HL7) V2.x messaging standards were also used widely. The challange then was to integrate IT systems to both provide imaging as wellas other functions.
IHE was founded by users and vendors of medical IT systems to provide specifications for IT system integration. In IHE these are called technical frameworks, including interoperability profiles. The most widely applied profiles cover IT Infrastructure, Radiology and Laboratory medicine. Read the Volume 1 of each Technical Framework for an overview.
IHE not only provides specifications, it also organises testing events called "Connectathons" where vendors test software prototypes for conformity. IHE also provides a conformity assessment scheme (CAS), so that vendors can clearly mark out individual products scording to their conformity to specific IHE profiles.
Read more at the IHE Homepage.