Monday, February 1, 2010

Cornucopia of Connectivity

In early January, approximately 500 software engineers gathered in Chicago to test the interoperability of their health IT and diagnostic imaging applications at the 11th annual Integrating the Healthcare Enterprise (IHE) Connectathon. The first Connectathon featured one integration profile that was tested among 47 applications from 23 vendors. The 2010 event saw 104 vendors testing the interoperability of 150 unique systems. Literally tens of thousands of transactions were executed among these software tools.

The Connectathon represents a multi-million dollar investment by industry, given the scope of development required to code to IHE profiles and successfully integrate applications across a healthcare enterprise. Despite the cost, the fruits of their labor will result in significant cost savings to the participants.

In the neutral ground of the Connectathon, the varying interpretations of IHE profiles can be hammered out by software engineers and volunteer monitors, eliminating potential problems before a system or application reaches a user site.

I monitored a group-case test that provides an excellent example of Connectathon achievement. In the scenario, four different sources of patient information were exchanged: A text report; PDF document; a Personal Health Record (PHR); and a document encoded using the HL7 version 3 CDA standard. This scenario required interactions among different vendors to retrieve a global patient identifier, submit the information to a repository, update a registry and then retrieve the information by a data consumer—which was represented by yet another vendor.

The test took us only two hours of walking back and forth among the different vendor's tables where their development staff had setup simulators to run their applications. In a real-world environment, this task would probably have taken days—if not weeks—bringing together vendor staff from locations as disparate as Austria and Taiwan. And, inevitably, many hours would be wasted finger pointing and blame making before a solution could be devised.

Of note was a decided shift among the vendor participants this year. In the early days of the Connectathon, the focus was mainly on PACS interoperability. The start of this decade saw nearly three quarters of the profile testing among implementations of electronic health records (EHRs) and device applications such as EKG and heart monitoring systems.

As a volunteer monitor, I was encouraged by the expertise and enthusiasm among the Connectathon participants. The event effectively demonstrates that there is no reason for the two hospitals in my town of Denton, Texas, to not share lab results, x-rays, and other pertinent information. Once they resolve to do so, along with the rest of healthcare, unnecessary duplicate tests can be avoided and negative interactions between drugs and treatment can be prevented.